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Frequently Asked Questions

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We are happy to answer questions about our services and procedures. These are a selection of some common questions that patients have. If your question isn't answered here, please contact our office. It's important to us that our patients understand their dental care.

Crowns and Bridges

When and why do I need a crown? What is a

A crown (or “cap”) is usually needed when there is no longer sufficient healthy tooth structure left to retain a simple filling. Teeth that have had root canals need crowns to strengthen them. After root canals teeth become more susceptible to fracture if not protected with a crown. A growing trend in dentistry is to replace missing teeth with an implant. The implant is like a screw that goes into your bone (sort of like the root of your tooth did before) and is the foundation for which a crown will be placed. The crown is the portion of tooth above your gums and the implant or root is the portion of the tooth below your gums that anchors into the bone.

A “post” is most commonly needed for front teeth for which there has been a break in the tooth that is level with, or nearly level to, the gums. As you can imagine, this makes it very difficult to anchor enough restorative material above the gums to make a crown around. With these teeth, we will typically let an Endodontist prepare the root canal space for a root canal and post. After your treatment with the Endodontist, you will be referred back to our office and they will give you the post to bring back to us. And Endodontist is a specialist that has additional training in specifically doing root canal procedures.

At your crown preparation appointment, we will begin by cementing this post into the root canal space. This will give us something that sticks up to hold our restorative material onto. After this we have enough substance to anchor our “buildup” onto. The buildup is the foundation to which a crown can be anchored to when there is not enough natural tooth left. Most of the time, on back teeth, we can just do a buildup if there is a significant amount of tooth structure missing, unless the break encompasses the entire tooth at or near the gumline. This has a lot to do with the direction of force being put onto the back teeth versus the front teeth. Front teeth have more of a shearing force (back to front) force being put on them than do back teeth. Back teeth are more under a compressive type force (straight down towards the root of the tooth when biting).

Emergency Services

My tooth is in severe pain, what should I do? What are the different options for treating my tooth?

Give our office a call as soon as possible. We will try our best to fit you in, Dr. Jackson has even stayed late some afternoons to squeeze people in to give them at least a little more comfort until they can be properly treated. We have diagnostic protocol (x-rays, tests) we will go through to see exactly what could be the cause of your pain. In the rare instance that we cannot pinpoint what is going on, we will refer you to an Endodontist (tooth pain specialist). Often a tooth infection is the cause of pain. If this is the case, a simple prescription of antibiotics can give a major relief until permanent treatment can be provided. As is with everything else, if you let us know of this issue ASAP, we can most likely save your tooth.

General Dentistry

I have not had a cleaning in many years. What is the process for getting back to a normal 6 month routine?

When you come into our office for a comprehensive exam, we will spend a significant amount of time during your visit assessing the periodontal health of your teeth and gums. The reason we rarely do same day cleanings with comprehensive exams (patients who haven’t been in a while) is because we do not know the extent of cleaning you need before we take x-rays and measurements to assess your periodontal tissue health. It is impossible for us to know how much time and resources to allocate to your cleaning procedure if we haven’t yet looked inside your mouth to see what’s going on. Some patients can be sufficiently cleaned with just a normal prophylaxis cleaning (above the gums) and some patients will need to be numbed up to get the calculus below your gums. Don’t worry, this will not be painful because you will be numb for this procedure (a deep cleaning). If you need this type of deep cleaning (“gum infection therapy”), it is very important to get it done because your teeth are losing their supporting bone and will fall out if not taken care of. We always use the analogy of a post (tooth) being anchored into cement (bone around the tooth). If all of the bone is lost, the tooth can no longer withstand the forces of your bite and will come out.

Lots of professional research has been done, and by and large dental professionals agree that it is essential to have a professional cleaning done every 6 months. Using a toothbrush and floss removes much of the buildup (plaque) from your teeth, but it’s very difficult to remove all the plaque every time you clean. This plaque that is left behind, after about 10 days, begins to turn in “tartar” or “calculus” which is a hardened version of the buildup that you cannot remove with home care (toothbrush, floss). Your body sees this calculus as an invader somewhat like an autoimmune disease and starts to try to remove it by becoming inflamed and increasing blood flow to the area(s). This is called gingivitis, which literally means “inflammation of the gums.” If left untreated, gingivitis can further progress to a disease known as periodontitis. This is where the inflammation of the gums now leads to bone loss of the bone supporting your teeth. There has been a lot of recent research that suggests oral hygiene health (periodontal) and cardiovascular health to be very related to one another.

Other reasons for six month interval professional cleanings and exams include us being able to find fillings that may have fractured and are easily restorable if found quick enough. Over time fillings breakdown and need to be replaced due to actual damage to the filling or due to decay being found between the filling and the tooth. If caught early enough, most times we can just replace the filling (or whatever restoration is on the tooth already) which saves you money. As more tooth structure is lost to a growing amount of decay when left untreated, treatment becomes more expensive and leads to root canals and crowns, etc.

It is unrealistic to promise that you will not feel anything whatsoever, but we do go above and beyond to make sure that your visit with us is as comfortable as possible. This is another reason to keep your regular visits so that we can catch anything going wrong upfront before it worsens. Our office has done everything within our power to ensure our patients are comfortable, we have learned techniques when we have to give anesthetic to numb patients. We use a very effective topical anesthetic before administering local anesthetic. We are not stingy with our local anesthetic, Dr. Jackson believes in not feeling a thing while being treated. He will ask you over and over during your procedure “are you ok?” If you are very anxious about being treated, please let Dr. Jackson and his staff know. We do have some moderate sedation options if you need them. The key to managing discomfort is clear communication, if you let us know if you are uncomfortable in the least little bit, we can fix it. Our patients are very comfortable and report not even being able to feel anything on a daily basis.

Tooth-Colored Fillings

Do you do tooth-colored (composite resin) fillings? Why are they better/worse than silver-colored fillings?

We are an amalgam-free practice, meaning that we only place tooth-colored composite resin fillings. The technology of tooth-colored filling material has came so far in the past few years, that we are basically able to pickup all of the desirable qualities of amalgam (silver) fillings and add to them with the composite resin tooth-colored fillings. Amalgam fillings have a tendency to fracture after many years of wear and are not very esthetic. Amalgam is an alloy of lots of different metals including silver, tin, zinc, copper, and mercury. Although there has been no research (as of yet) to support that the mercury content in amalgam fillings is detrimental to one’s health, we choose to avoid it altogether. Dr. Jackson always says he is more concerned with the tendency of amalgam to fracture over time than the concern with mercury toxicity. So there is no reason to go and remove amalgam fillings unless there has been a breakdown of the material or there is decay under the amalgam filling.

FAQs

What is an implant and how does it work? How long does it last?

An implant is essentially a titanium screw that anchors into the bone that replaces a root. It is important to note that the “implant” only replaces the root, it doesn’t have any function without a crown or an implant-supported denture that connects to the titanium screw/implant. If only replacing one tooth, an implant is usually placed and left to heal for about 4-5 months, depending on bone quality, medical considerations that may impact healing time, etc.

If the broken tooth is causing pain, assuming no allergies, take 1 Tylenol (acetaminophen) Max Strength (500mg) and 600mg of Motrin (ibuprofen) every 6-8 hours until the office reopens and we can assess the broken tooth to find out if it can be restored. We will also need to assess what type of restoration is needed (compsite resin filling/crown, etc.).

Our teeth are supported by bone. Over time, if the plaque (which turns to calculus if not removed) will cause a condition called gingivitis. Gingivitis is inflammation of your gum tissue. This can occur rather quickly (48 hours, sometimes less) if improper brushing technique is used, if you do not brush at least 2x per day, and if you do not floss your teeth after each meal. Once the plaque hardens, it becomes impossible to remove with just brushing alone. We have professionally sharpened instruments that remove the calculus from your teeth and that prevents the gingivitis from becoming worse, leading to a condition called periodontitis. When periodontitis is reached, gingival attachment loss begins to occur as well as the loss of the supporting bone around your teeth.

You may absolutely have your teeth cleaned more frequently than 6 months, which is the bare minimum someone should have their teeth cleaned. Insurance companies (most) will only cover 2 cleanings per year, however. We do have lots of patients that get their teeth cleaned every 3 or 4 months.

Imagine driving a car blindfolded. If a dentist doesn’t have x-rays, he/she cannot assess your oral health. Most oral pathology is initiated between teeth and it’s impossible for a dentist or dental hygienist to see between teeth without x-rays. Also, many conditions such as oral cancer and sinus infections cannot be seen without x-rays.

Recently, there has been a lot of controversy surrounding amalgam (“silver”) fillings. Research has shown that the levels of mercury released by these types of fillings are well below the levels that can cause harm. Risks can exist, however, for certain types of patients (young kids, pregnant women, and patients with kidney disease or some neurological diseases). More commonly, amalgam fillings over time go through a process called “creep.” They expand and cause lots of stress on teeth that can lead to fracture of entire cusps. This most often indicated the need for full coverage restorations (crowns). When removing old amalgam fillings, Dr. Jackson will place a “rubber dam” on any patients with high-risk to ensure no mercury vapors are breathed.

This is also a controversial topic. Research shows that fluoride is perfectly safe and effective tool for preventing tooth decay when used in recommended amounts. Anything in excess is bad for you. If you need proper guidance on a safe amount of fluoride, please reach out to us. Some families with well water do not have enough naturally occurring fluoride and may need supplementation. If you test your well water, 0.7 mg/L is considered an effective amount to prevent tooth decay. It is also very important to not overdose fluoride, it can cause a condition called dental (2.0mg/L) or skeletal (4.0+ mg/L) fluorosis over time.

  1. Dental Implant + Crown (implant-supported denture if multiple teeth)
  2. Dental Bridge
  3. Removable Denture – if teeth remain, a partial denture. If all teeth need to be removed, a complete denture.

It is absolutely, even more important, to get your teeth cleaned after getting them restored. No matter how perfect of a job be do, you must do your job in home care and also coming for your preventative appointments to ensure decay or disease doesn’t reoccur around the work that has been done.

 

While you are sleeping, many people have no idea they are grinding their teeth. Most people that don’t know they grind come in with significant wear on their teeth that is very challenging to restore. It lessens the vertical height of how your teeth come together and getting your bite back to the proper vertical dimension is extremely challenging and expensive. Symptoms typically include bad headaches in the morning, facial pain/tightness around the muscles you use to chew, fractured teeth during the night, sensitivity and many others. It is very common in today’s world for people to grind their teeth. We have multiple treatment options for this and would be happy to assess your severity at your exam.

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