1My teeth are very sensitive – why is that?
Generally sensitivity is due to exposed root structure or grinding/clenching. Roots are more sensitive as roots are not as hard or dense as enamel. Roots are made out of cementum – not enamel. Cementum is 50% less dense. As a result, sweets and cold materials generally create more sensitivity in those areas. The solution is using an over the counter sensitive toothpaste which contains Potassium Nitrate. Sometimes a prescription toothpaste is necessary which has both Sodium Fluoride and Potassium Nitrate in it. Grinding and clenching will also make teeth sensitive as well as create many other negative dental issues. The solution is simple though. Simply wear a nightguard or bruxism appliance while you sleep. This appliance can be made in-office by simply taking some impressions. Decreasing all those forces on your teeth does decrease the sensitivity over time. Some people clench or grind for 3 to 5 hours a night while they sleep. During the day, most people will not do it as long or often. But the guard can also be worn during the day if necessary.
2Will my insurance cover this?
Our office can do what is called a "preauthorization.” It is no guarantee of what insurance will cover but it generally gives the patient a good idea of what will be covered. However, insurance should not dictate dentistry. We are trying to provide the best dentistry for our patients. Most insurance companies want to minimize claims with no regard to the patient’s health. An insurance person has never looked in a patient’s mouth.
3Why do my gums bleed?
Gums bleed when they are inflamed and unhealthy. It is called gingivitis. Healthy gums do not bleed. Unfortunately, often times patients get frightened when their gums bleed, and as a result brush and floss less. If a patient has bleeding gums, you need to brush and floss the area more frequently until the gums stop bleeding. Gums do heal quickly. Sometimes, the patient may need a prescription rinse of Perio Rx that contains Chlorhexidene Gluconate to decrease bleeding.
4I bleached my teeth recently. Why are my teeth still yellow at the gumline?
Only enamel bleaches. Roots do not bleach as roots or gumline areas of teeth are not made out of enamel – rather cementum. Cementum does not bleach and nor do any restorative materials in your mouth. Patients should be told ahead of time before bleaching that if they have a lot of exposed root surfaces, that these areas will not bleach. Those areas can be bonded later with restorative material after bleaching to match the new lighter color of the enamel.
5Why am I getting food stuck between my teeth? And why does it hurt?
Sometimes it can strictly be an orthodontic problem. Due to the position of your teeth, there can be huge spaces between your teeth where food can lodge and get stuck. However, generally it is due to the aging process. As we get older, our gums recede a little over the years and the teeth become longer. Hence, the expression, “Long in the Tooth.” It means that as we get older the teeth become longer which creates a much larger area for food to impact around our teeth.. Hence, more food getting stuck between and around your teeth. The gums hurt because all that food impaction causes gum inflammation or gingivitis. Therefore, the gums begin to bleed more and hurt. Patients just have to brush and floss those areas more frequently for the rest of your lives.
6Why is my friend’s breath so bad?
Bad breath is called halitosis or fetor oris. Bad breathis caused by bacteria in your mouth. The human mouth has more bacteria in it than any other area in your body. So your dental hygiene is critical. Increased bacteria in your mouth can be the result of infection. Some patients simply have more bacteria in their oral cavity. Your friend should have a thorough dental exam with radiographs to rule out gingivitis, periodontitis, or an abscess. Sometimes decreased salivary flow in the oral cavity will cause halitosis. Medications or even vitamins can cause a decrease in salivary flow. There are many rinses and products on the market to help with salivary flow such as Biotene and MI Paste. However, the most important thing to do is to increase your oral hygiene – simply brush and floss more frequently.
7Will this hurt?
We try to minimize any discomfort as much as possible. The vast majority of the prodedures that are done in the office are pain free. With adhesive bonded dentistry, we frequently do not even have to anesthetize the patient. Our local anesthetic that we use is Septocaine which achieves more profound anesthesia than any other on the market today. Nitrous Oxide is available to calm patients down safely while their dentistry is being done. Nitrous Oxide is simply breathing in a gas which is safely regulated and it decreases a patient’s apprehension. Medications can also be taken prior to your dental appointment to decrease patient apprehension. However, the vast majority of the time, patients are very comfortable simply with routine dentistry because the entire staff is wonderful. The office is very calming and patients can also watch television during their dental visit.
8Why is there a black line at the gumline around my crown?
That is because your crown has metal in it. Many crowns are porcelain fused to metal. At the base of your crown you are seeing the metal collar around what is called the margin of your crown. If porcelain fused to metal crown’s margins are placed below the gumline, you will not see that black line. So either your crown was not placed below the gumline to begin with, or your gums have receded over time exposing the metal collar at the base of your crown. All of our crowns are made entirely of porcelain. Hence, there is no metal in them. You will never see a black line on a CEREC Crown.
9What is a dental implant?
It is generally a Titanium Post placed into your bone. Once the titanium post integrates in with your bone, you can place a crown on it or attach it to a denture. Implants are very successful and can last a lifetime. Dr. Balber places implants using “A Guided Surgery” implant system which is the most precise and least invasive way to place a dental implant. Dr. Balber is able to use this system due to the amazing technology in his office. The Guided Surgery Implant System combines the Cerec and CT Scan Technology.
10Why does my tooth hurt if it has had a root canal?
Because you still have an infection. If the root canal was done years ago, you may have a reabscess in which you may lose the tooth or the tooth may need to be retreated for another root canal or surgical procedure. If the root canal was just done, it takes time for the abscess or infection to heal. The abscess has to fill in with healthy bone which can take 6 to 12 months depending on the size of the infection. Abscesses are much like a broken arm. The minute a cast is placed on your arm, the bone is not healed. It takes weeks for the bone to fill in and mend the break. The minute a root canal is done, the abscess is not gone. It takes months for new bone to fill in. Teeth take longer than arms, as the abscess is generally much larger than a hairline crack, and your are still biting on the tooth. Your arm is immobilized in a cast. The clinical pain from the abscess generally goes away in days after root canal treatment.
11Are electric toothbrushes better than manual toothbrushes?
Our practice is results based. So if you are doing a good job with either a manual or electric toothbrush, we will not try to make you change. However, if you are not doing a good job with a manual toothbrush, we have seen great results in moving patients to electric toothbrushes. That is because electric toothbrushes have you brush longer as they time you. In addition, they create the correct brushing motion and pressure as you brush. Oral-B electric toothbrushes are available for purchase from the office.
12Do I really need X-Rays? I fear I am getting too much radiation.
X-Rays are absolutely necessary in dentistry. We cannot see in between your teeth or below the gum line without x-rays. Pain is never a good indication of dental health. Meaning, just because you are not in pain, does not mean your teeth, gums, and bone are in good condition. You can have a huge cavity in a tooth or major bone loss without any pain. And often the cavity cannot be seen visually. Frequently, only an x-ray can reveal decay or periodontal issues. Our x-rays are all digital which reduce radiation exposure over 90%. Radiation is cumulative however. So if someone has had a lot of medical radiation procedures, they should consult their physician.
13Why is my tooth still sensitive after a filling?
Fresh or newly exposed tooth structure is always more likely to be sensitive. Teeth are made out of dentinal tubules. Dentinal tubules are like straws with a lumen or hole inside of it. The lumen is bigger in new or fresh dentinal tubules. Hence, it conducts more feeling such as cold, sweets, and pressure. Therefore, we always place a desensitizer over the exposed dentinal tubules before placing the final restoration. This eliminates 99% of the sensitivity issues.
14Where did Dr. Balber go to school?
Dr. Balber went to dental school at UCLA School of Dentistry. He graduated in 1980.
Child Specific Questions
1When should my child see the dentist?
The ADA recommends that children should first visit the dentist by age 1. This is done so the child can get used to the dentist and does not develop dental phobia. It is an easy first appointment. We generally count their teeth and clean them. They leave with a wonderful first impression of the dentist. We have a toy chest filled with toys for them. If the child is unmanageable – we might try again in 6 months or refer them to a children’s dentist (pedodontist). All baby (primary/deciduous) teeth are usually in the mouth by age 2.5 to 3 years.
2How should a parent care for their children’s teeth?
Parents should begin introducing children to a toothbrush as young as possible. They may not be able to really brush – but it is good to establish healthy habits. Children usually begin to develop teeth at 6 months which is when brushing should begin. Parents need to assist their children with brushing to insure that it is done well until age 7. Flossing should begin at 2 years of age when the back deciduous molars develop. Children generally have spaces or diastemas between their front or anterior teeth but not in the back or posterior teeth. So the posterior teeth need to be flossed to prevent interproximal decay. Parents will definitely need to assist with flossing.