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FAQ

• What can I do about bad breath?

  • Do you constantly worry about bad breath? Bad breath (halitosis) is one of the most common oral health concerns, and it can be an embarrassing and distracting condition. Deducing the most likely cause of your bad breath will help determine what you can do to prevent it.
    
    Greatly reduced saliva flow during sleep (the cause of morning breath), certain foods (such as garlic, onions, and peppers), poor oral hygiene, gum disease, dry mouth, tobacco, dieting, dehydration, and some medical conditions (including sinus infections and diabetes) can all cause bad breath. Brushing your teeth at least twice a day is the first thing to start doing, if you are not already in the habit. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of your teeth. Additionally, clean between your teeth daily with floss or an interdental cleaner, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every couple months.
    
    When bad breath is a symptom of a larger bacterial problem in your mouth, Dr. Nuosce can help. If he finds that your mouth is healthy, he may refer you to your physician for further consultation and more comprehensive treatment.
    

• I don't have a toothache, and I brush and floss regularly. Do I really need a check-up?

  • Biannual teeth cleanings performed by a skilled dental hygienist are central to keeping teeth and gums looking, feeling, and functioning well. If you have gum disease, more frequent visits to the dentist will probably be recommended for your oral and overall health.
    
    During cleanings, plaque and calculus (more commonly known as tartar) are removed from teeth. Plaque is a sticky deposit on teeth in which bacteria grow, and tartar is basically calcified or hardened plaque, which is more difficult to remove. Tartar that has accumulated under the gumline often requires more extensive treatment than a standard cleaning. Hygienists also polish teeth, floss (partly to test the condition of gums, to see if they bleed), and document any bleeding, stains, or areas of concern.
    
    Exams with a dentist enable problems to be diagnosed and treated before they grow to be more serious and painful (not to mention more expensive to treat). A typical dentist exam includes a visual assessment of teeth and occlusion (bite), along with an appraisal of current restorations. When x-rays have been taken, your dentist will carefully review them to identify areas of decay and possible cysts, tumors and other abnormalities. Digital panoramic x-rays are especially beneficial to this process. Your dentist will also perform a general screening for early detection of gum disease and oral cancer.

• If my filling is still in place and my tooth does not hurt, why does my dentist want to replace the filling?

  • Constant pressure from chewing, grinding, and/or clenching can cause dental fillings to wear away, chip, and even crack. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth. Again, regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.
    
    If your restorations are large or the decay beneath them is extensive, there might not be enough remaining tooth structure to support a replacement filling. In these cases, we will probably need to replace the filling with a natural looking porcelain crown.

• What is "comprehensive dentistry"?

  • Our aim is to have all concerns and issues known and resolved before an emergency occurs. After all, it’s never a good time for a toothache or a broken tooth! We see patients for many reasons with many different needs, from routine preventive care and dental emergencies to life changing restorative and cosmetic treatments.
    
    A large part of comprehensive dentistry is the development and fulfillment of ongoing maintenance plans, which helps minimize the chance of original problems reoccurring. After your exam and consultation, we will work with you to customize a treatment plan that fits your individual needs and budget. Good oral hygiene at home is also important, but man cannot live by toothbrush alone. In-office exams are critical to keeping your smile healthy, because your dental team has the ability to remove plaque your toothbrush can’t.
    
    In a way, comprehensive care really refers to our commitment to the present and the future of your smile. Not only do we want to keep it healthy, we want to make it beautiful, and make it last.

• My dentist told me I'm going to need root canal therapy. What should I know before my appointment?

  • Beneath the top layer of your tooth (the enamel) and the second layer (the dentin), there is a pulp, or nerve, which delivers sensations such as heat, cold, and pain to the brain. Whether from excessive decay or physical trauma, this nerve can become damaged, causing an abscess to form at the root of the tooth. Your dentist has recommended root canal therapy, a procedure in which the diseased pulp is removed from an infected tooth, to prevent further damage and tooth loss, and most importantly, to relieve your pain.
    
    Symptoms of an infected root include severe toothaches, sensitivity, discoloration, and upraised lesions on your gums. X-rays and a thorough dental examination determines whether a root canal your best option. Though root canal therapy has a reputation for being painful, the toothaches associated with an infected root are most likely causing you more pain than the treatment will. In addition, there are a number of ways to relieve pain and discomfort, including nitrous oxide and oral sedation.
    
    The nerve is not a vital part of day-to-day function, so removing it will not affect your tooth—unless you count saving the tooth from total loss! In fact, allowing it to decay further can lead to more pain and bone loss. Usually, an over the counter pain medication takes care of immediate post-operative discomfort, and most patients return to normal activities the very next day. Root canal therapy is highly successful, and a tooth receiving the treatment can last you a lifetime. Especially when used in conjunction with a restoration (a crown or composite filling), no one will even notice a difference in your smile.

• Is smoking really that bad for my teeth?

  • Smoking isn’t just bad for your teeth—it affects the health of your entire mouth, especially your gums. Lighting up stains your teeth, causes bad breath, and promotes the buildup of plaque and tartar. Cigarette smoking is also one of the leading causes of tooth loss. Worst of all, smoking has been linked to the development of periodontal disease and may lead to the loss of taste and smell. Smokers also tend to require more dental treatment, due to the damage done by smoking. Certain procedures, such as dental implants and oral surgeries, tend to be less successful in smokers due to damaged gum tissue. This results in a higher cost of dental healthcare and often more frequent (and complicated) treatment.
    
    Pipes and cigars aren't any safer, causing similar rates of tooth and bone loss even if the smoke is not inhaled. Smokeless tobacco products like snuff and chewing tobacco also pose great health risks to your gums, increasing your risk for both oral cancer and cancers of the throat, esophagus, and lips. Additionally, they contain a significant amount of sugar, which when pressed against your teeth for long periods of time can lead to tooth decay.
    
    So what’s the verdict on tobacco? Seek help on how to quit using, or just don’t start.

• I experience severe anxiety during dental visits, and I've been hearing a lot about oral conscious sedation lately. Is it safe, and could it be right for me?

  • Oral conscious sedation medications are measured and evaluated by pharmacists and physicians on a safety scale called the therapeutic index, where the higher the number on the scale, the better the safety rating of the drug. The sedation medications commonly used by dentists have high numbers on this index, and you will probably recognize some of the names of the drugs (including Valium® and Halcion®). When Dr. Nuosce is determining which primary sedation agent is right for you – there are several – he takes into consideration factors such as your age, weight, level of dental anxiety, alcohol consumption, medical history and current prescriptions. Prior to your visit, Dr. Nuosce will review the proper preparation steps, from diet adjustments and possibly taking a sleep agent the night before, to having a companion drive you to your appointment and what to expect after treatment.
    
    Most patients experience little to no discomfort or remaining effects from a sedation dentistry visit. Immediately after treatment, you might feel a little wobbly while the medication wears off, but Dr. Nuosce will give you simple, helpful instructions for the rest of your day.

• What dental insurance does your office accept?

  • Our office policy regarding dental insurance is that we participate with most of the major insurance companies. For the ones we do not participate with, if we have received all of your insurance information by the day of the appointment, we will be happy to file your claim for you as an out of network provider. You must be familiar with your insurance benefits, as we will collect from you the estimated amount that your insurance does not cover. By law your insurance company is required to pay each claim within 30 days of receipt. We file all insurance so your insurance company will receive each claim within three days of the treatment. You are responsible for any balance on your account after 30 days, whether your insurance company has paid or not. If the balance has not been paid within 60 days, accounts are turned over to collections. We will be glad to send a refund to you once insurance has paid us.
    
    Please understand that we file dental insurance as a courtesy to our patients. For some insurances, we do not have a contract with your insurance company; only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We cannot guarantee what your insurance company will or will not cover for each claim. Once again, we file claims as a courtesy to you. This does not mean that we take these insurances as payment in full, as this is completely up to the contract you have with you and your employer.

• What should I do in case of a dental emergency?

  • Accidents happen, and especially when it comes to our teeth and mouths, they can be pretty frightening. It's important to know when home care will suffice and when a trip to the dentist is necessary, so here are some guidelines to help you through common situations:

    Toothache/Sore Gums

    Rinse with warm water to remove any food or debris. If you notice anything lodged between teeth, floss to remove it. Take an over the counter pain medication (but never apply the medication directly to tooth or gums), and see your dentist if the pain persists.

    Chipped Tooth

    Save the pieces, if you can, and rinse them thoroughly. Apply an ice pack or a cold compress to the swollen lip or gum tissue near the chipped tooth to prevent swelling. If the area is bleeding, apply gauze for ten minutes, or until the bleeding has stopped. See your dentist as soon as possible.

    Broken Tooth

    With recent advancements in restorative and cosmetic dentistry, you might not lose your tooth. If there is enough remaining healthy tooth structure, your dentist might be able to create a crown that will “grab onto” what’s left, eliminating the need for root removal. While the success of this process, known as crown lengthening, depends on the severity of the break, it’s worth asking about options other than complete removal.

    Knocked Out Tooth

    Depending on the situation, find the tooth and, holding it by the crown only, rinse it briefly with warm water. Gently reinsert the tooth into the socket and bite down on gauze or cloth to keep it in place. If the injury is to a child never attempt to re-insert the baby tooth, as it is possible to damage the permanent tooth growing below the surface of the bone. Place it in a container of milk or a mild salt water solution, then see your dentist as soon as possible – if treated within two hours, the tooth may be salvaged.

    Soft Tissue Injuries

    Our gums, cheeks, lips, and tongue tend to bleed heavily because the tissue contains a high concentration of blood vessels. To control the bleeding, first rinse with a warm, mild salt water solution. Apply pressure with gauze or a moistened towel for 15 to 20 minutes. Afterwards, to reduce swelling and help stop residual bleeding, apply a cold compress to the outside of your mouth. In the event of a serious soft tissue injury with visible trauma or excessive bleeding, it's best to stay calm, keep applying pressure, and head to the emergency room.

• Hot or cold, my teeth hate both! Why are they so sensitive, and how can I stop the pain?

  • If you’ve been avoiding that ice cream cone or cup of coffee because of sensitive teeth, you don't have to! Sensitivity is a common complaint that can be the result of a number of factors. Involuntary grinding, jaw clenching, gum recession, and enamel loss can all cause teeth to become extra sensitive, because the usually-protected layer of dentin--the nerve-packed surface beneath the enamel--is exposed to external stimuli. Surface irritants such as braces and whitening products can also cause temporary sensitivity.
    
    Occasionally, sensitive gum tissue is an indication of a more serious problem, so it’s important to ask your dentist which treatment is best for you. A softer toothbrush is usually the first step, and special toothpastes can reduce sensitivity over time. There are also over-the-counter fluoride rinses to protect your enamel against further damage, and your dentist can even provide an in-office procedure to coat your teeth with a protective agent.

• Am I candidate for dental implant restorations?

  • Dr. Nuosce and our team work hard to stay on the leading-edge of restorative dentistry. If you or someone you love struggles with ill-fitting, uncomfortable dentures or a retainer with false teeth, dental implants could give your smile a second chance! Implants are useful in denture stabilization and can also be used in conjunction with crowns, bridges, and in single-tooth replacements.
    
    Permanent dental implants are not only more durable and long-lasting than traditional tooth replacements, they also look and feel more like natural teeth. Most importantly, they function like natural teeth, so you can chew, talk, and smile with confidence again. Because the implant procedure allows for more of your healthy tooth structure to be saved, fixed implants can even prevent further bone loss after tooth loss.
    
    Many patients suffering from advanced tooth decay, root canal failure, trauma to the mouth, or just extreme natural wear and tear on teeth are benefiting from this revolutionary option in restorative dentistry. However, there are still some things to consider before you decide on dental implants. For example, implants are best performed after adolescence, when the teeth and jaw bone are fully developed. Additionally, the implant procedure can be more complicated for individuals with gum disease, active diabetes, immune deficiencies, and for patients who smoke. To ensure that you get the treatment that’s right for you, keep Dr. Nuosce and his team informed and up-to-date about your entire medical history and dental habits.

• I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What's the problem?

  • You could be suffering from temporomandibular disorder, or TMD, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.

    TMD has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause extreme fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of TMD. TMD can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.

    Professional treatment of TMD ranges from minor fixes to surgical options. If your dentist determines that the main cause of your TMD is an irregular bite, he or she may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet. If it's a structural issue occurring in your jaw bone (especially if your TMD is a result of injury), you may benefit from surgery. When it comes to TMD treatment, it's important to choose the most conservative plan for your individual needs.

• Is professional teeth whitening safe?

  • We offer several Ultradent products so we may tailor your whitening experience to your exact need. Opalescence® take-home whitening kits that include comfortable, custom-made trays and professional-strength whitening gel are perfect for patients with severe discoloration. We also offer Tres White, which is also professional-strength whitening gel but comes pre-loaded in a semi-custom tray. There is no need for messy impressions or wait time to have customs trays fabricated. We even have Tres White that are designed to fit over conventional orthodontics. These kits give you the dramatic results you want in less time than the strips and gels you’ll find at drugstores.

    The most common side effect of any whitening method is sensitivity. It’s usually temporary and should subside soon after you've stopped using the product. Whitening is not recommended for children under 16, as their teeth are still developing, and is also not recommended for women who are pregnant.

    You will notice that ZOOM!® is not listed above. We do not offer this treatment because Dr. Nuosce feels it is too likely to cause extreme sensitivity as the Zoom process dehydrates teeth beyond a healthy level. All of the Ultradent products are designed to hydrate teeth as they whiten, and our staff and patients have both commented on the dramatic reduction in sensitivity.

• What causes tooth discoloration?

  • The two main types of tooth discoloration are extrinsic (external or surface stains) and intrinsic (internal stains). External stains affect the outside of the tooth, while internal stains discolor a tooth from within. External stains can be attributed to anything that comes into contact with the surface of the teeth, such as red wine, coffee, tea, or tobacco products. Internal discoloration reflects the condition of the tooth, often occurring as a result of treatment procedures, exposure to excessive amounts of fluoride (Fluorosis), and certain antibiotics.
    
    Some types and degrees of discoloration respond well to whitening methods, while others require veneers, bonding, or other restorative procedures. Dr. Nuosce can determine which type of stains you have and which whitening method will work best for you.

• Why is fluoride good for my teeth?

  • Each day, foods and acids feed bacteria in your mouth, which can accumulate on your teeth to form plaque. Plaque wears away at a tooth's enamel in a process known as demineralization. Fluoride is a naturally-occurring mineral that can promote the remineralization of enamel, replacing important minerals that strengthen your teeth and can protect them from decay. Fluoride can also help reverse early stages of decay.
    
    Children with newly-erupted permanent teeth benefit a great deal from fluoride exposure, but adults should make sure their teeth come into contact with it, too. The safe and easy way to ensure your teeth are getting enough fluoride is to use fluoride toothpaste, available at drugstores in a variety of types and flavors. If your dentist recommends more intense fluoride treatments, there are a number of gels, rinses, or even in-office procedures that can do the trick. Though the most fluoride is absorbed from direct contact with the teeth, many public drinking water systems contain small, safe amounts of fluoride that can have positive health effects.

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