General Questions

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Some common dental questions are included below with basic answers. If you have questions specific to the office or would like more in-depth information about a procedure, please follow this link to contact us!

 Common Dental Questions

• What is an Implant?
• What is a Root Canal?
• What is a sealant?
• What is a white filling?
• What are veneers?
• What is a crown?
• What is a bridge?
• What is a partial?
• How do I whiten my teeth?
• What is a night guard?
• Why are my teeth sensitive?
• What is cosmetic dentistry?
• Why would I have a toothache?

  What are Implants

What IS an implant exactly?

Essentially at its most basic level - an implant is a screw that is put in your bone to hold a tooth (or teeth).  The couple pictures at right are showing examples of how an implant would restore a gap.

A person missing one tooth would have an implant placed to become the new "root" for a fake tooth. A crown would be made to connect to the screw and that would be your fake tooth. Implants are very reliable and are currently the best option to replace missing teeth in many situations.

So then, why would I want/need need an implant?

Implants can be used when a tooth (or teeth) is missing.  It is an alternative to a bridge or a partial that is most appealing because (a) it is a fixed (permanent) solution, and (b) it does not involve shaving down any other teeth to fix a gap. 

Here is a great series of pictures that shows (1) the gap, (2) the implant is inside the bone under the gums and this picture shows the attachement that sticks above the gums, and (3) the final picture shows the finished crown that has been placed on top of the attachment (abutment).

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  What is a Root Canal?

A good visual of what a root canal looks like is shown in the following picture:

This picture shows a healthy tooth on the left with a live nerve. The nerve (or pulp) has both nerve endings and blood vessels for the tooth. The dentin is the inner layer of the tooth just outside of the nerve. The enamel is the tooth's insulation.

The second picture shows the tooth after a root canal. The nerve has been cleaned out and replaced with a rubber material called Gutta Percha.

Why would I need a root canal?

Root canals are needed when you have a toothache from an inflamed nerve or from a dead infected tooth. It is a procedure that gets rid of pain and allows you to keep a tooth that may otherwise have to be removed.

What is a root canal?

A root canal is a procedure where the dentist numbs your mouth, and then cleans out the nerve of your tooth. At the end of the root canal procedure, a rubber material (Gutta Percha - the pink material seen in the picture to the right filling the nerve space) is placed inside your nerve to seal the 'canal' of your tooth root. Many times after a root canal, a crown is then made to protect the top part of the tooth.

Root canals have gotten negative publicity in the media. Essentially - the root canal procedure is similar to having a filling done (from the patient perspective) except the appointment is normally a bit longer. The reason root canals have gotten a bad wrap is because of the association with pain. Root canals are normally needed when a person is experiencing a toothache. Because of this, there is a negative association with the procedure and what was happening with the tooth at the time the procedure was done.

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 What is a sealant?

A sealant is a great preventive measure taken in young individuals to prevent cavities. A sealant is a bit of resin that is bonded to the tops of back teeth that have deep grooves. This resin seals grooves that are more prone to cavities. By having a sealant in place, a person will be less apt to develop a cavity on a back tooth groove where unbrushed food and sugars can accumulate.

This is one of the huge measures that can be taken to keep young mouths free of dental disease.

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  What is a white filling?

A white filling is also called a composite filling. It is made of an acrylic resin that is bonded to your tooth and repairs a void left behind by a cavity.

The pictures at right show a case of with several cavities on front teeth.  The cavities have really damaged the front teeth.  The second picture is after the cavities have been cleaned out and filled in with white fillings. 

White fillings can also be used to fix fractured (chipped) front teeth and work well for fillings on back teeth too.  Some people are electing to remove old silver fillings and replace them with white fillings.  This is another common use of white fillings.

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  What are veneers?

Veneers are small pieces of porcelain that are made to alter the appearance of front teeth. Changes to shape and color of front teeth can be accomplished with veneers.

Veneers are made by a laboratory after a dentist takes a mold of the teeth. In many cases, veneers can only be made to look natural by shaving a small bit of tooth structure on the front of teeth to be changed.

In cases where teeth will be enlarged - there can be instances when no shaving is required but this is a special circumstance that you would discuss with your dentist to see if it is applicable to your case.

All of the examples included here show that some change in shape, position, color, or combination of all three was needed to give the patient the desired result.

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 What is a crown?

A crown is a hat or cap for your tooth. There are many reasons why a tooth may need a crown. Some of the common reasons are:

• a large filling broke
• part of the tooth broke off
• a very large cavity exists
• a tooth has a very large filling and a new cavity
• a cracked tooth is causing biting pain
• a tooth just received a root canal

Your dentist will help you decide when a crown is needed.

How does it work when the dentist says I need a crown?

The tooth is shaped to be a smaller version of itself in all directions (front, back, both sides, and top). A mold is made of this smaller tooth and this mold is sent to a lab so a fitting can be made to cover the tooth. This fitting is the 'crown' or 'cap' and it will cover the tooth in all directions making the tooth whole again and back to normal size.

Essentially the final product will look just like a regular tooth but the outer portion is fake and the inside is the tooth.

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  What is a bridge?

A bridge is used when you have a one or two tooth gap that you want to fill in. A bridge uses the teeth on either side of the gap as anchors to hold a fake tooth (or teeth) that rest on the gums. In the most basic example here (at right), this person is missing one tooth.

 The front tooth and back tooth next to the space are going to anchor the bridge. These teeth are shaped to be smaller version of themselves so that crowns can be make to cover these teeth. A third crown is made for the gap. All three crowns are connected together and then the anchor crowns are cemented to the anchor teeth. The result is a gap is filled with a fixed solution that will not move and behaves reasonably like another tooth.

Bridges can replace more than one tooth.  Sometimes the bridge replaces two or even maybe four teeth depending on the situation.  Your dentist can tell you if the anchor teeth are strong enough to support a bridge that spans a longer distance.  This second example is a situation where the front two teeth were replaced with a bridge and so the resulting solution involves the teeth on either side of the gap to make a four tooth bridge.

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  What is a partial?

A partial is a mouthpiece-type of device that is used to fill spaces in the mouth where there are missing teeth. Depending on where teeth are missing, different designs can be made of partials so that the partial will clip into place and brace off the remaining teeth in the mouth. This is an economical way to fill in many gaps with one appliance. It is a removable appliance that is taken in and out.

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  How do I whiten my teeth?

What is tooth whitening?

Whitening is a process of bleaching the external layer of tooth structure and eliminating extrinsic stains. Teeth have inherent shades that exist to them so it is only possible to achieve a certain level of whitening before no more change is seen.

How does the whitening process work?

In our office, we will make you custom whitening trays that you use at home. The first step is to have impressions of your teeth (molds). We use the molds to fabricate clear flexible plastic trays that fit over your teeth. A small amount of whitening gel is added to the tray on each tooth that you would like to whiten. (Normally I suggest only whitening the teeth visible in your smile line if you smile really big).

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What is a night guard?

A night guard is also called an "occlusal guard". It can be made of hard or soft plastic. In general, these guards are recommended if you have a grinding habit or have a lot of crowns or veneers on your front teeth (for protection of the dental restorations). The night guard is made by making impressions (molds) of your teeth and a laboratory fabricates the night guard so that it is a custom fit unique to your mouth.

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Why are my teeth sensitive?

Sensitive teeth can result from any number of reasons.  But there is one fundamental reason behind all sensitive teeth - a lack of insulating enamel in the area of sensitivity.

Enamel can be lost for a variety of reasons

• Cavities

• Tooth wear of the biting surface

• Toothbrush abrasion

• Gum recession resulting in exposed root surfaces

Regardless of the reason for the lost enamel, the outcome is the same ... sensitive teeth.  Enamel's benefit to the tooth is its protection.  It is the most mineralized part of the tooth (much higher mineral content then the inner tooth or root surface, and much higher mineral content than our bones).

It is the protective nature of enamel that allows us to chew and deal with temperature swings in the mouth without exciting the nerves within our teeth ... because the insulating properties of enamel do not let environmental changes reach the nerves of our teeth.

But in areas where the tooth does not have enamel (root surface or exposed dentin on a thinned out part of the tooth because of tooth wear) - the mineral content is lower, and there exists tiny microscopic pathways to the nerve of the tooth that can allow things like air or temperature changes to reach the nerve of the tooth.  The nerve of the tooth only knows one sensation ... pain (only type of nerve ending in the tooth), so when the enamel is stripped in an area, cold water or air or whatever the stimulus can cause the 'nervy' feeling you may have experienced before.

Certain toothpastes can block the microscopic pathways that exist in areas without enamel.  The goal is to eliminate passageways that will stimulate the nerve of the tooth.  The end result is a less sensitive tooth and less occurrences of the 'nervy' feeling from air or cold beverages.

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 What is cosmetic dentistry?

Cosmetic Dentistry is a name tied to the part of dentistry focused on improving smiles.  The example above shows how a combination of crowns, veneers, and whitening can have a dramatic effect.

Many procedures are used to improve the smile.  It really depends on the problem being addressed.

Often, the reasons people seek out cosmetic dentistry are for:

• tooth color changes (example at right)

• tooth shape changes (again at right)

• fixing broken teeth

• fixing gaps (second example at right)

• crooked teeth

• missing teeth

 

Common cosmetic dental procedures include:

• teeth whitening
• veneers (example below at left)
• white fillings
• crowns (example below at right)
• orthodontics
• implants
• "Snap on Smile" or similar temporary smile transition (example at right)
• Clear Retainers

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Why would I have a toothache?  And what should I do?

What may be the cause of your dental pain?

There are many reasons why people experience dental pain.

Some of the more common causes of dental pain are listed here:

• Inflamed Nerve of Tooth
• Infected or Abcessed Tooth (picture at right)
• Decayed tooth or "cavity"
• Exposed root surface
• Broken Tooth
• Broken filling
• Cracked tooth
• TMJ related pain
• Sinus problems can also mimic toothaches

What can we do to ease your dental pain?

Dr. Worthington will help determine the cause of your dental pain and discuss solutions appropriate for you.

Step 1:  Phone our office for a same day or next day Emergency Dental Appointment (503) 281 - 0866.

- Our current dental emergency special for non-insured patients is for $52 (limited exam and x-ray).

- If you are really nervous, perhaps ask to speak with the doctor for a phone consult before you visit.  Dr. Worthington is happy to listen to your dental concerns.

Step 2:  Visit our office 15 minutes prior to your appointment to fill out paperwork.

Step 3:  Tell our Dental Assistant your dental concern.  She will take one x-ray of the area of concern.  (Additional x-rays will be an additional charge if you have several areas of concern.)

Step 4:  Tell Dr. Worthington your dental concern.  Dr. Worthington will review your x-ray and examine your tooth.  He will let you know what treatment is required.

Step 5:  Our staff will inform you of the cost for the treatment of that area.  If time permits, we will try to do any treatment at this time.  Otherwise, the doctor may sometimes provide prescriptions and we will re-appoint you for the next day (or earliest opening).

Step 6:  If finances for your treatment is a concern, we offer care-credit third party financing.  We will help you apply for this payment option in office if you are interested.  In general, if you can get approved for a credit card, you will have no trouble getting approved for care credit.  The nice thing about care credit is there are no-interest payment options in certain scenarios.

What procedures are done to alleviate pain?

With dental pain, there may be multiple solutions to alleviate your pain. Common procedures used are:

• Sedative Fillings
• Desensitizing Agents
• Fluoride Varnishes
• Root Canals (picture of a root canal at the right ... remove the nerve and place filling material inside where nerve was)
• Tooth Extractions
• Crowns / Fillings

If you want more information about what any of these procedures are and why you may do these procedures, follow the links.

We look forward to helping you get rid of your dental pain.  Call us today:  503-281-0866.

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