Steven A. Carr

How long does it take?
Results are usually seen after the first application, however success is individual depending on the reason and nature of the discoloration. Some stains are harder to lighten that others. Maximum results for most generally occur in 10 - 14 days.

Are there any side effects?
Some people experience temporary increased tooth sensitivity to cold during the treatment. These symptoms disappear within 1-3 days after interruption or completion of the treatment. If you get tooth sensitivity with bleaching, bleach every other day or every 2 days.

How long do the results last?
The teeth will always be lighter than they once were. However, most patients need to do maintenance bleaching one day a month to maintain the color that you have achieved. It is also best to have your teeth professionally cleaned prior to using a bleaching system. Plaque and tarter or calculus prevent the bleach from penetrating the enamel.

Orthodontics

When is the right time to start orthodontics (braces) for my child?
The two factors most important are (1) your child’s dental development and (2) the type of problem your child has. Some problems are best treated earlier, but most cases are best begun after most of the primary teeth have been lost.

Is there an upper age limit to orthodontics?
No! We have successfully treated patients in their 60’s

Restoring a Tooth

What are my options in filling a tooth?
Teeth are generally filled with either silver or composite resin. Patients generally prefer composite resin due to its life like appearance. Often these fillings are “invisible”. The teeth look like perfect untouched teeth. These fillings bond to the teeth and effectively seal the tooth against further bacterial invasion as long as the bond is secure. However occasionally there are situations when silver is a more long lasting restoration.

What are my options when a tooth needs a crown?
The three most commonly used crowns are metal, ceramic and metal and all ceramic.
All metal crowns often made of gold are the strongest and are often used on far back teeth where they resist the greatest chewing pressures and are not usually visible.
Ceramic- metal crowns look quite good in most cases and provide both strength and beauty.
All ceramic crowns are the most life like restorations and are most commonly used in the front of the mouth.

Why did my dentist recommend a crown rather than a filling?
Fillings repair a tooth but add no strength. Crowns repair the structure lost to decay and strengthen the tooth at the same time. When a large portion of the tooth is lost due to decay and previous fillings, a crown protects the tooth from further decay, fracture and filling loss. Sometimes it also can prevent the need for a root canal procedure later on.

What is root canal treatment?
When the “nerve” in a tooth becomes infected, inflamed or has died, the soft tissue in the canal(s) inside the root is removed, the canal is shaped and smoothed and finally filled with an inert bio-compatible material.
Modern root canal or endodontic treatment is usually completed in one appointment and is not uncomfortable for the patient.

Dentures and Impalnts

My dentures are loose, and I have been told that I have very little bone. Is there something I can do to help this situation?
There is a fairly new procedure called mini implants that can stabilize a denture. This can truly be a life changing procedure for those who have been troubled by loose dentures, allowing them to eat many things easily that they could not.

A wonderful thing with this approach is that it is usually accomplished in one appointment using the patient’s existing dentures.

What is MDI Technology?
It is an implant system. That consists of a miniature titanium implant that acts like the root of your tooth and a retaining fixture that is incorporated into the base of your denture. The head of the implant is shaped like a ball, and the retaining fixture acts like a socket that contains a rubber O-ring. The O-ring snaps over the ball when the denture is seated and holds the denture at a predetermined level of force. When seated, the denture gently rests on the gum tissue. The implant fixtures allow withstanding natural lifting forces.

How are MDI implants placed?
Placement of the implants is accomplished quickly and easily in a process performed in the dentist’s office, with local anesthesia or light sedation to help make you more comfortable. Using a precise, controlled, minimally invasive surgical technique, MDI Implants are placed into the jawbone. The heads of the implants protrude from the gum tissue and provide a strong, solid foundation for securing your dentures. It is a one-step procedure that involves minimally invasive surgery, no sutures nor the typical months of healing.

What Will My First Day be Like?
Leave the denture in place until bedtime. You should not experience any excessive bleeding. There will be some mild discomfort, but this should be minimal and controlled by the medication indicated by your dental professional. The denture should feel secure. You may eat as soon as you wish to, but avoid excessively hard or sticky foods for a week. Upon removing the denture, rinse your mouth with an antiseptic mouthwash and clean around each implant fixture with a cotton swab and toothpaste. Use a cotton swab for three days. After that you can use a regular toothbrush.

Your Child’s Teeth

When will my child begin loosing his primary (Baby) teeth?
The first teeth to be shed are usually the lower central incisors. These are the two center teeth in the lower jaw. This occurs usually between 6 and 7 years. There is considerable variation and these teeth may loosen as early as 5 years. Below is a table with average ages the primary teeth are shed.

Need I be concerned if a permanent tooth begins showing before the primary tooth is lost?
Yes this is often caused by incomplete resorption of the primary tooth root. It is important to see the dentist for evaluation. Often it is necessary to remove the primary tooth to allow the permanent one to erupt in the proper position.

What causes cavities in my child’s teeth?
For decay to occur three things must be present. Plaque, sugars, and of course a tooth. When foods containing sugars or starches are eaten the bacteria in the plaque produce acids that eat into the tooth. The sticky plaque holds these acids onto the teeth. After many such attacks the enamel breaks down causing a cavity.

How can I prevent cavities from forming?
A two-fold approach seems to work best. The first thing to do is to completely remove the plaque from the teeth regularly. This requires brushing and flossing at least two times a day. The second part of this strategy is to limit the sugars as much as possible, limiting sweets to meal times and eliminating soda. Many factors determine how sugary foods affect teeth. The amount of sugar in the food is one factor. But there are others such as the frequency of eating these foods. Drinking a soda quickly would not be as bad as sipping on the soda all afternoon. It is very important that young children do not go to bed with a bottle that contains juice, milk or any other sweet liquid. If a bottle is taken to bed it should only contain water.
Fluoride and sealants are very helpful in preventing cavities

How can I tell if I have removed all the plaque?
Since it is white plaque is difficult to see on teeth. It is a good idea to use a plaque disclosing solution or tablet occasionally to check that the plaque is being removed. When no color remains on the teeth you know that all the plaque has been removed.

What about Fluoride?
Fluoride is one of the most effective elements in preventing cavities. Fluoride makes the teeth stronger and therefore less susceptible to decay. Your child can get the benefits of fluoride in a number of ways. The most effective way is to drink fluoridated water as the teeth are developing. This allows the fluoride to be incorporated into the teeth as they are developing. If your water supply is not fluoridated, we often recommend fluoridated vitamins for children in the tooth forming years.
Fluoride toothpastes and fluoride treatments at the dental office after a professional cleaning are also very helpful in preventing cavities.

What about Sealants?
Sealants are clear or white plastic materials that are painted on to the cavity prone grooves and pits present on the chewing surface of teeth. The sealants literally seal these cavity prone areas, keeping plaque and sugars out of the grooves, thereby reducing the risk of cavities forming.

What happens when a primary tooth is lost early due to a cavity?
Primary teeth are just as important as permanent teeth for chewing, speaking and appearance. In addition primary teeth hold the space for permanent teeth If primary teeth are lost too early, the teeth next to the empty space can move, and tip and there often is not enough room for the permanent teeth to erupt in the proper position. This is one cause of crooked teeth and the necessity of orthodontic treatment.
If a tooth must be lost we usually recommend that a spacer be placed until the permanent tooth erupts into the vacant space.

What should be done if a tooth is knocked out?
If your child’s tooth is knocked out, gently rinse it out in cool water. Wrap the tooth in a moist cloth or place in a cup of milk. Take your child and the tooth to the dentist immediately. Time is important. Teeth that are re-implanted within 60 minutes have a good prognosis (outlook) for functional recovery. The sooner the better but we have had positive results with teeth that have been out of the mouth for many hours.

What are the causes of chronic Bad Breath?
Out side of lots of garlic, the biggest cause of bad breath or halitosis is gum disease ands cavities. These causes can be addresses and remedied. The gum disease can be treated and the cavities can be restored.