FAQs

Athletic Mouth Guards

Athletic mouth guards help protect your teeth while playing contact sports such as baseball, basketball, field hockey, football, gymnastics, lacrosse, soccer, softball, track and field, and volleyball. The American Dental Association (ADA), the American Academy of Endodontists (AAE), and the American Academy of Pediatric Dentists (AAPD) are all strong proponents of mouth guard use. John S. Olmstead, D.D.S., M.S., President of the AAE was quoted in a press release as stating, “Just as helmets help protect an athlete’s head from trauma, mouth guards are essential to protect teeth from serious injury.” The three categories of athletic mouth guards can be custom fitted in the dental office, or bought over-the-counter in most sporting goods stores.
Links:

American Dental Association
American Academy of Endodontists
American Academy of Pediatric Dentists

Abscessed Tooth

An abscessed tooth has a dental infection. This kind of infection is caused by bacteria that break through the hardest substance in the human body – the outer layer of the tooth called enamel. When bacteria eat through the enamel, we call it tooth decay, or a “cavity.” If left untreated, the decay can spread into the second layer of tooth called the dentin. When the bacteria or decay enter the dentin, you still may not experience any pain. However, when the bacteria travel through the dentin to the inside of the tooth where the nerves of the tooth are, the tooth can become extremely painful. The infection can cause your face to swell up and your tooth to throb so much that it will wake you up from your sleep. As the bacteria continue to multiply inside the tooth, they get trapped inside the nerve canal. Because the tooth in encased in bone the pressure will continue to build. Sometimes the bacteria find an escape route through the bone and into the gum tissue. If this happens, you may notice a pimple on your gums which, when pressed, oozes pus (the infection). You also might complain of a bad taste or odor in your mouth which is due to the pus seeping out from the inside of your tooth.
FAQs:
Can you see an abscess on a dental x-ray?
An abscess usually shows up as a dark spot at the end of the root.

How do I get rid of this abscess?
One of the ways the dentist treats this infection is to do a “root canal” procedure. This treatment involves removing all of the infection inside the tooth, cleaning out the infected canals, and filling those canals with a medicated filling. Once all of the infected nerves and blood supply have been removed the tooth is now technically “dead” and becomes very brittle. (You can think of a root canal tooth like a dead tree branch that snaps easily when bent.) The canals are then filled and the tooth is sealed off to prevent bacteria from entering the canals. To protect and strengthen a root canal treated tooth, the dentist will rebuild the tooth, and cover it completely with a “cap” or a crown.

Amalgam “Silver” Fillings

Dental amalgam or “silver” fillings have been used for over 200 years. Amalgam fillings are composed of a mixture of metals such as tin, silver, and copper bound together with mercury.

While there has been much controversary about the possible negative health effects of these amalgam fillings, the American Dental Association, the Centers for Disease Control and Prevention, The U.S. Public Health Service, National Institues of Health, and the World Health Organization are all confident that dental amalgam fillings are safe.

In fact, the Food and Drug Administration (FDA) issued its final regulation on dental amalgam in a press release dated July 27, 2009. After considering around 200 scientific studies, the FDA has classifyied dental amalgam and “its component parts – elemental mercury and a powder alloy” from Class I to a Class II “moderate risk” medical device. The new classification will allow the FDA to “impose special controls to provide reasonalble assurance of the safety and effectiveness” of dental amalgam fillings.

The American Dental Association (ADA) issued a press release in response to the recent Food and Drug Administration’s announcement stating that they concurred with the FDA’s decision “not to place any restriction on the use of dental amalgam, a commonly used cavity filling material.” The ADA believes that dental amalgam fillings are “valuable, viable, and safe choice for dental patients.”
FAQs:
Why don’t many dentists use amalgam filling anymore?
Thanks to continuing research, we now have more choices when it comes to filling materials. For example, we can now use composite, or “tooth-colored” fillings in the back of the mouth where chewing forces are the greatest. Composite fillings come in all shades and are quite natural looking. In addition, the dentist does not have to remove as much natural tooth structure to place a composite fillings as compared to placing the century-old old amalgam ones.

How can I get a cavity in a tooth that already has a filling?
No matter what type of filling material you have, everytime you come in for a check-up, your dentist will carefully examine and evaluate your fillings to make sure they are flush with the tooth. As fillings get older they start to shrink and break down creating a gap between the filling and the tooth. When that happens, bacteria can get underneath the filling creating a new cavity (decay) under the old filling.

Why does my dentist want to replace my old filling with a crown?
When a filling needs to be replaced your dentist will check your tooth and your x-rays to see how big the existing filling is, and will decide if there will be enough tooth structure left to hold another filling. Most of the time that decision is pretty strightforward, however, because an x-ray is only a two-dimensional view of a three-dimensional object, sometimes your dentist won’t be able to predict what kind of restoration is needed until the old filling and decay is removed. At that time, if there is enough tooth structure left to hold another filling, your dentist will place another filling. If there is not enough tooth structure left, a crown will be needed to keep the tooth strong and healthy for years to come.

Links:

American Dental Association
Food and Drug Administration

Antibiotic Premedication

The American Heart Association (AHA) has updated its guidelines for preventing infective endocarditis (I.E.) with antibiotics (premedication). The AHA indicates that only people who have had infective endocarditis, have artificial heart valves, serious heart conditions from birth that have or have not been repaired, or heart valve problems stemming from a heart transplant need to take antibiotics before invasive dental treatment. As of April 2009, The American Academy of Orthopaedic Surgeons also states that patients with any kind of joint replacements need to take antibiotics before having any dental treatment.
FAQs:
What is Infective Endocarditis (I.E.)?
Infective Endocarditis is an infection around the heart valves caused by bacteria from the mouth that gets into the blood stream and accumulates around the inner lining of the heart. Based on new research, many people who previously had to take an antibiotic before going to the dentist do not have to do so anymore. Evidence based research shows that the risks of taking the antibiotics outweigh the benefits. Risks of taking antibiotics include the possibility of your body becoming resistant to the antibiotic, or having an allergic reaction to the medication.

I have a heart murmur and I have always been told I needed to premedicate before dental appointments. Why don’t I have to anymore?
Evidence based research concludes that the risks of taking the antibiotic outweighs the benefits.
Even though I don’t have to premedicate before a dental appointment, I’ve done so for so long I would just feel better doing so. Why can’t I just do it?
If you overuse antibiotics you risk your body becoming resistant to the antibiotic when you really need it to fight off an infection. You can also have an allergic reaction to the medication which can result in life threatening anaphylactic shock.

Links:

American Academy of Orthopaedic Surgeons
American Dental Association
American Heart Association

DentalSmiles16 50Anxiety

Many people put off going to the dentist because they have had an unpleasant experience in the past. Thanks to modern dentistry, you can be confident that your dental visit can be as painless as possible. At Dental Smiles at Purcellville Gateway you can stretch out and relax in our all-leather chairs while you watch your favorite TV show snuggled up in our soft, comfortable blankets! We use a numbing gel on your gums and give nearly painless injections. We also have nitrous oxide, or “laughing gas” available to relax you while you get your dental work completed. We can even use “conscious sedation” where you take one pill the night before to give you a sound sleep, and then one more pill an hour before your dental appointment to relax you even more. We are committed to making your dental visit as comfortable as possible!
FAQs:
Does someone have to drive me to and from my dental appointment if I use the Nitrous Oxide or “pill?”
You will only need a driver if you choose to take the conscious sedation pill. Nitrous Oxide is breathed and out through your nose and you will be completely back to normal when you get out of the chair.

Links:

Dental Organization for Conscious Sedation

Avulsed Tooth

When a permanent tooth gets knocked out it is referred to as an avulsed tooth. Avulsed teeth can often be successfully re-implanted into the jaw. However, there are a few things you need to do. First, the tooth can be rinsed under running water, but not scrubbed. Teeth have fibers on them that connect the teeth to the jawbone. Re-implantation success is greatest when these fibers remain intact. Second, get to your dentist or the emergency room between 30 minutes to two hours after the tooth is knocked out. Finally, transport the tooth in either milk, a saline solution, or in saliva from your mouth. All these transport medias will keep the tooth at the correct pH and greatly improve the chances of saving the tooth.
Links:

American Academy of Endodontists
American Dental Association
American Academy of Pediatric Dentists

Baby Bottle Caries

Baby bottle caries is caused by allowing your baby to fall asleep while nursing or by putting your baby to bed with a bottle of milk or juice. Milk and juice break down into sugar and can cause lots of cavities on your child’s newly developing teeth. The best way to avoid baby bottle caries is to back sure you don’t let your baby fall asleep with a bottle or at the breast. See your dentist when your child gets their first tooth – no later than one years old. Your dentist will talk to you about caring for your child’s teeth right from the start!
FAQs:
Will they clean my child’s teeth at that age?
No. This will just be a “happy visit.” The dentist will discuss good home care techniques, nutritious diet, and fluoride intake with the parent or primary caregiver. In addition, the dentist will examine your child’s mouth to see that everything is developing normally.

Links:

American Dental Association
American Academy of Pediatric Dentists

Baby Teeth

There are twenty “baby” or deciduous teeth. These teeth start to erupt when the child is between 6 months and one year old. The American Dental Association (ADA), and the American Academy of Pediatric Dentists (AAPD) recommend that your child should see the dentist as soon as their first tooth appears, or by their first birthday. It is important for the parent or caregiver to clean these teeth as soon as they come in. A small-sized soft toothbrush, a clean piece of gauze, or a clean washcloth can all be used to clean the child’s teeth.
Links:

American Academy of Pediatric Dentists

Bad Breath

Bad breath, or halitosis, can be caused by many things including the foods you eat such as garlic or onions. Bad breath can come from untreated medical issues such as diabetes, or chronic bronchitis or sinusitis among others. Smoking can also cause bad breath. Finally, bad breath may be coming from bacteria or food particles in your mouth or on your tongue that haven’t been removed through brushing and flossing.
FAQs:
What can I do to get rid of bad breath?
One of the simplest things you can do is make sure your mouth is clean and healthy. Brushing for two minutes in the morning and evening and flossing once a day is a great start! Remember to brush your tongue to remove bacteria and food. Have a dental cleaning to remove any bacteria that have hardened on your teeth (called calculus or tartar). If that doesn’t help, a visit to your physician to eliminate undiagnosed medical issues may be in order.

Bitten Lip/Tongue/Cheek

When you are numb, you must be careful not to chew your lip, cheek or tongue. You won’t feel it when you do it, but you will be sore after the numbness wears off! That’s why it’s important for parents to watch their children carefully until the numbness goes away.
FAQs:
What do I do if my child bites their lip, tongue or cheek?
If the area is bleeding, put a piece of ice inside a clean washcloth and apply it to the bleeding area with mild pressure. This should stop the bleeding and reduce the swelling. If the area is just sore, use a warm salt water rinse (dissolve 1/2 teaspoon of salt in one cup of warm water) to aid in healing. If the bleeding doesn’t stop, please call the office. Our doctors are on-call 24-7.

Bleaching

A brighter, whiter, beautiful smile helps you look and feel your best! Impressions are made of your teeth so we can custom fit you for your whitening trays. Wear your trays for an hour a day to get the dazzling smile you want and deserve!
FAQs:
What do you think about the in-office whitening?
They are fine ways to jump start the whitening process. However, most in-office whitening programs also have the traditional take home bleaching kits. The advantage of the in-home whitening is that you can touch up whenever you want to!

Braces

The American Academy of Orthodontics (AAO) recommends that children should visit the orthodontist by age seven for a simple (and generally free) consultation. The orthodontist will examine the growth and development of the child’s teeth and may recommend treatment, or just a follow up visit. Today’s technology is exciting! The jaws can be expanded through functional appliances. Sometimes all it takes is creating more space for the teeth to come in. If the teeth need to be moved, there are now a number of options: through traditional braces with silver, gold, or ceramic brackets on the fronts of the teeth, with i-braces where the brackets are placed on the insides of the teeth; or through InvisalignR, a series of rigid aligners that are changed every couple of week. You and your orthodontist will choose the right treatment for you!
FAQs:
As an adult, is it too late to have my teeth straightened?
It is never too late to have a healthy, beautiful smile! According to the AAO, one in five orthodontic patients is an adult. With Invisalign technology, i-braces (that are placed behind your teeth), and tooth colored brackets, getting that fabulous smile you’ve always wanted is just a phone call away!

Do I have to go to the specialists office?
If your dentist is certified in Invisalign technology, they will evaluate your teeth to see if you are a candidate for Invisalign (the invisible aligners). If not, your dentist will recommend a local orthodontist.

Links:

Braces.org
Invisalign
iBraces

Bridges

There are several ways to replace missing teeth: a bridge, an implant, or a partial. A bridge is placed on the teeth on either side of the missing tooth. It usually takes two visits to place a bridge. On the first visit, the teeth on either side missing tooth are trimmed down and an impression is made. In two to three weeks the bridge is fitted and permanently cemented in place. You still must brush and floss around the bridge. Having professionally applied fluoride treatments after your dental cleaning, as well as using a fluoride rinse at home, is also helpful to protecting your bridge from decay.
FAQs:
What is an implant?
Another way to replace a missing tooth is with an implant. An implant is a titanium root that is restored with a crown or “cap.” It generally takes a few visits over several months to replace a tooth with an imlant. The implant is placed on the first visit. After a few months of healing, an impression is made for a crown. In about three weeks, the crown is cemented in place. You must still brush and floss around the implant crown.

What is a partial?
A partial can also replace missing teeth. A partial has clasps that hold it in place. It takes several visits to replace missing teeth with a partial. Impressions are made on the first visit. A couple of weeks later, the partial is tried in; about two weeks later the permanent partial is inserted. It should be removed at night and cleaned.

Brushing

DentalSmiles16 55

Tooth brushing removes the plaque from the front and back of the teeth. It takes about two minutes of brushing to remove all the plaque. You should brush your teeth in the morning and after you’ve eaten the last meal of the day. Remember that plaque also coats your tongue – be sure to clean your tongue as well.
FAQs:
How often should I replace my toothbrush?
You should replace your toothbrush four times a year. If your toothbrush bristles are frayed and bent, you need to replace your brush sooner. Worn toothbrushes are ineffective in cleaning teeth.

Are electric toothbrushes good to use?
Yes! Especially if you have a tendency to brush too hard, or if you have any type of dexterity problems.

Do I have to floss?
If your teeth touch, you need to clean in-between your teeth with something. You can use dental floss, small interdental brushes, wooden stimulators, or water irrigation devices.

What kind of rinse should I use?
That depends on your oral problems. If you get a lot of cavities, a fluoride rinse can really help. You can buy fluoride rinses over-the-counter or your dentist can prescribe a stronger, prescription strength fluoride. If gingivitis is a problem, using an antibacterial rinse can help. Some antibacterial rinses can be purchased over-the-counter and others are prescription strength.

Bruxism

Many people clench or grind their teeth. Some clench or grind throughout the day, while others do it while they are sleeping. There are many signs and symptoms of clenching and grinding. One of the most common symptoms is waking up with a headache in the temple area. Other symptoms can include a sore or tired jaw, neck pain, itching or ringing in the ears, chipped, broken or sensitive teeth. Your dentist or dental hygienist may notice the following signs of clenching or grinding: worn down teeth, notches in the enamel at the gumline, dimples on your molars, scalloped edges on your tongue, and overdeveloped chewing muscles.
FAQs:
What can I do to stop clenching or grinding?
The first thing you can do is become aware of the habit. Say to yourself, “Lips together, teeth apart.” Your teeth should only touch when speaking or chewing. When you find yourself clenching, relax.

How can I stop clenching or grinding when I’m sleeping?
You can’t! The best thing to do is to have an occlusal guard or nightguard made. This simple device doesn’t stop your habit, but it does prevent your teeth from coming together and your muscles from engaging. Therefore, wearing an occlusal guard prevents any further damage to your teeth, and gives your muscles some rest.

Cancer, Oral

An oral examination includes an oral cancer screening. During an oral cancer screening, the doctor or hygienist will check your lymph nodes, and all of the structures in your mouth. They are looking for any lumps or bumps that shouldn’t be there. Smoking and alcohol use increase your risk for oral cancer. Remember, if you notice a lump, bump, or a sore in your mouth that has been there for more than two weeks, see your dentist right away.
Links:

American Cancer Society
National Cancer Institute

Cancer Treatment and Your Oral Health

If you are about to have radiation treatment to your head and neck area, there are a few things you need to know about your oral health. Sometimes you can experience a decrease in salivary flow. Saliva is important to keep your mouth moist and to clear away food from your teeth. Without adequate saliva, you can be at a higher risk for cavities. Your dentist could recommend salivary substitutes and daily home fluoride treatments to protect your teeth. It is also important to have a comprehensive examination of your mouth and have necessary dental treatment completed before you start your radiation therapy.
Links:

American Cancer Society
National Cancer Institute

Canker Sores

Canker sores occur inside your mouth. They are very painful but usually go away in a week or two. It is unclear as to what causes these sores but a weakened immune system may be one of them. Stress and fatigue seem to be a couple of the triggers that bring them on. Some people are sensitive to a common ingredient used in toothpaste, sodium laurel sulfate (SLS). There are a couple of toothpastes that are SLS free. Anesthetic creams can help reduce the symptoms. While the canker sore is healing, it is best or avoid spicy or acidic foods.
FAQs:
Are canker sores the same thing as cold sores or fever blisters?
No. Cold sores, also known as fever blisters are caused by a herpes virus and occur on the outside of the lips and face. Painful and unsightly, cold sores generally go away in about a week. Oral prescription medication and over-the-counter creams seem to help clear up the infection sooner.

Caps

A “cap” or a crown can be made out of gold, porcelain fused to metal, or all porcelain. A crown covers the entire tooth. There are several reasons why a tooth might need a crown. One reason can be when an old filling and the decay underneath it is removed there is not enough tooth structure left to hold another filling. Another reason is after a root canal procedure is completed, the tooth becomes brittle and like a dead branch and can easily crack and break unless it is fully covered. Having professionally applied fluoride treatments after your dental cleaning, as well as using a fluoride rinse at home, is also helpful to protecting your crown from decay.

Caries

Caries is another word for cavities or tooth decay. To get a cavity, you need three things: a tooth, bacteria, and sugar or carbohydrates. Everyone has bacteria in their mouth. When bacteria mix with sugar or carbohydrates, acid forms. The acid attacks the tooth and the enamel begins to weaken in a process known as demineralization. If the cavity has just started and is in the outermost layer of the enamel, it can be reversed in a process known as remineralization. Remineralization can occur through the application of fluoride. That is why a professionally applied fluoride treatment is so beneficial in the prevention of decay.
FAQs:
How can I prevent caries?
Simple! Brushing twice a day with an ADA approved fluoridated toothpaste, flossing twice a day, rinsing with a fluoride rinse daily, reduce the number of incidents of carbohydrate intake, and regular visits to your dentists.

Cavities

Caries is another word for cavities or tooth decay. To get a cavity, you need three things: a tooth, bacteria, and sugar or carbohydrates. Everyone has bacteria in their mouth. When bacteria mix with sugar or carbohydrates, acid forms. The acid attacks the tooth and the enamel begins to weaken in a process known as demineralization. If the cavity has just started and is in the outermost layer of the enamel, it can be reversed in a process known as remineralization. Remineralization can occur through the application of fluoride. That is why a professionally applied fluoride treatment is so beneficial in the prevention of decay.

Chewing “Spit” Tobacco

Chewing tobacco, also known as “snuff,” is ground tobacco that is placed between the gum and cheek. Smokeless tobacco contains more nicotine than cigarettes and contains 28 cancer causing agents. During an oral cancer screening, the doctor or hygienist will check your lymph nodes, and all of the structures in your mouth. They are looking for any lumps or bumps that shouldn’t be there. Smoking and alcohol use increase your risk for oral cancer. Remember, if you notice a lump, bump, or a sore in your mouth that has been there for more than two weeks, see your dentist right away.
Links:

American Cancer Society
National Cancer Institute

Child’s First Visit to the Dentist

The American Academy of Pediatric dentists recommends that the child’s first visit to the dentist occur when their first tooth erupts, or no later than their first birthday. At that visit, the dentist or hygienist will discuss with the parent or caregiver homecare instructions, fluoride use, and nutrition.
Links:

The American Academy of Pediatric Dentists

Clenching

Many people clench or grind their teeth. Some clench or grind throughout the day, while others do it while they are sleeping. There are many signs and symptoms of clenching and grinding. One of the most common symptoms is waking up with a headache in the temple area. Other symptoms can include a sore or tired jaw, neck pain, itching or ringing in the ears, chipped, broken or sensitive teeth. Your dentist or dental hygienist may notice the following signs of clenching or grinding: worn down teeth, notches in the enamel at the gumline, dimples on your molars, scalloped edges on your tongue, and overdeveloped chewing muscles.
FAQs:
What can I do to stop clenching or grinding?
The first thing you can do is become aware of the habit. Say to yourself, “Lips together, teeth apart.” Your teeth should only touch when speaking or chewing. When you find yourself clenching, relax.

How can I stop clenching or grinding when I’m sleeping?
You can’t! The best thing to do is to have an occlusal guard or nightguard made. This simple device doesn’t stop your habit, but it does prevent your teeth from coming together and your muscles from engaging. Therefore, wearing an occlusal guard prevents any further damage to your teeth, and gives your muscles some rest.

Cold Sores

Cold sores, also known as fever blisters are caused by a herpes virus and occur on the outside of the lips and face. Painful and unsightly, cold sores generally go away in about a week. Oral prescription medication and over-the-counter creams seem to help clear up the infection sooner.
FAQs:
Are cold sores or fever blisters the same thing as canker sores?
No. Canker sores occur inside your mouth. They are very painful but usually go away in a week or two. It is unclear as to what causes these sores but a weakened immune system may be one of them. Stress and fatigue seem to be a couple of the triggers that bring them on. Some people are sensitive to a common ingredient used in toothpaste, sodium laurel sulfate (SLS). There are a couple of toothpastes that are SLS free. Anesthetic creams can help reduce the symptoms. While the canker sore is healing, it is best or avoid spicy or acidic foods.

Composite or “Tooth-Colored” Fillings

With today’s advances in dental materials, we can now use bonded resin fillings on back teeth. Strong, and durable, these fillings are a favorite because they match the color of your tooth.

Cosmetic Dentistry

Cosmetic dentistry can create the dazzling smile you’ve always wanted! We can change the shape, color and size of your teeth with tooth whitening and a combination of crowns, bridges, or veneers. Tooth whitening can be completed in as little as two weeks. A crown or a “cap” covers the entire tooth. A bridge replaces missing teeth. Veneers cover the front of the tooth.

Core Build Up

When a tooth has had an old filling and the decay is removed sometimes there is not enough tooth structure left to hold another filling. In that case, the tooth needs to be rebuilt with a very stong material called a core build up.

Crown

A “cap” or a crown can be made out of gold, porcelain fused to metal, or all porcelain. A crown covers the entire tooth. There are several reasons why a tooth might need a crown. One reason can be when an old filling and the decay underneath it is removed there is not enough tooth structure left to hold another filling. Another reason is after a root canal procedure is completed, the tooth becomes brittle and like a dead branch and can easily crack and break unless it is fully covered. Having professionally applied fluoride treatments after your dental cleaning, as well as using a fluoride rinse at home, is also helpful to protecting your crown from decay.

Decay

Caries is another word for cavities or tooth decay. To get a cavity, you need three things: a tooth, bacteria, and sugar or carbohydrates. Everyone has bacteria in their mouth. When bacteria mix with sugar or carbohydrates, acid forms. The acid attacks the tooth and the enamel begins to weaken in a process known as demineralization. If the cavity has just started and is in the outermost layer of the enamel, it can be reversed in a process known as remineralization. Remineralization can occur through the application of fluoride. That is why a professionally applied fluoride treatment is so beneficial in the prevention of decay.
FAQs:
How can I prevent caries?
Simple! Brushing twice a day with an ADA approved fluoridated toothpaste, flossing twice a day, rinsing with a fluoride rinse daily, reduce the number of incidents of carbohydrate intake, and regular visits to your dentists.

Dental Amalgam Fillings

Dental amalgam or “silver” fillings have been used for over 200 years. Amalgam fillings are composed of a mixture of metals such as tin, silver, and copper bound together with mercury.

While there has been much controversy about the possible negative health effects of these amalgam fillings, the American Dental Association, the Centers for Disease Control and Prevention, The U.S. Public Health Service, National Institues of Health, and the World Health Organization are all confident that dental amalgam fillings are safe.

In fact, the Food and Drug Administration (FDA) issued its final regulation on dental amalgam in a press release dated July 27, 2009. After considering around 200 scientific studies, the FDA has classifyied dental amalgam and “its component parts – elemental mercury and a powder alloy” from Class I to a Class II “moderate risk” medical device. The new classification will allow the FDA to “impose special controls to provide reasonable assurance of the safety and effectiveness” of dental amalgam fillings.

The American Dental Association (ADA) issued a press release in response to the recent Food and Drug Administration’s announcement stating that they concurred with the FDA’s decision “not to place any restriction on the use of dental amalgam, a commonly used cavity filling material.” The ADA believes that dental amalgam fillings are “valuable, viable, and safe choice for dental patients.”
FAQs:
Why don’t many dentists use amalgam filling anymore?
Thanks to continuing research, we now have more choices when it comes to filling materials. For example, we can now use composite, or “tooth-colored” fillings in the back of the mouth where chewing forces are the greatest. Composite fillings come in all shades and are quite natural looking. In addition, the dentist does not have to remove as much natural tooth structure to place a composite fillings as compared to placing the century-old old amalgam ones.
How can I get a cavity in a tooth that already has a filling?
No matter what type of filling material you have, everytime you come in for a check-up, your dentist will carefully examine and evaluate your fillings to make sure they are flush with the tooth. As fillings get older they start to shrink and break down creating a gap between the filling and the tooth. When that happens, bacteria can get underneath the filling creating a new cavity (decay) under the old filling.
Why does my dentist want to replace my old filling with a crown?
When a filling needs to be replaced your dentist will check your tooth and your x-rays to see how big the existing filling is, and will decide if there will be enough tooth structure left to hold another filling. Most of the time that decision is pretty strightforward, however, because an x-ray is only a two-dimensional view of a three-dimensional object, sometimes your dentist won’t be able to predict what kind of restoration is needed until the old filling and decay is removed. At that time, if there is enough tooth structure left to hold another filling, your dentist will place another filling. If there is not enough tooth structure left, a crown will be needed to keep the tooth strong and healthy for years to come.
Links:

American Dental Association
Food and Drug Administration

Dental Anxiety

Many people put off going to the dentist because they have had an unpleasant experience in the past. Thanks to modern dentistry, you can be confident that your dental visit can be as painless as possible. At Dental Smiles at Purcellville Gateway you can stretch out and relax in our all-leather chairs while you watch your favorite TV show snuggled up in our soft, comfortable blankets! We use a numbing gel on your gums and give nearly painless injections. We also have nitrous oxide, or “laughing gas” available to relax you while you get your dental work completed. We can even use “conscious sedation” where you take one pill the night before to give you a sound sleep, and then one more pill an hour before your dental appointment to relax you even more. We are committed to making your dental visit as comfortable as possible!
FAQs:
Does someone have to drive me to and from my dental appointment if I use the Nitrous Oxide or “pill?”
You will only need a driver if you choose to take the conscious sedation pill. Nitrous Oxide is breathed and out through your nose and you will be completyl back to normal when you get out of the chair.
Links:

Dental Organization for Conscious Sedation

Dental Insurance Benefits

Dental insurance benefits are generally purchased by the employer for the employee as a part of the employee’s benefits package. Just as consumers shop for the most affordable car or homeowners insurance, employers shop for the best dental plans within their company’s budget. Like car insurance, dental insurance plans vary in the amount of the deductible as well as the maximum benefits paid per year. Where dental insurance benefits become a little harder to understand is how the benefits are applied and what is excluded.

You have probably heard about something called the “UCR.” Insurance companies UCR stands for the usual, customary, and reasonable. Insurance companies come up with a figure of what they deem to be a customary fee for a procedure. Then the insurance company will pay a percentage of the UCR.
FAQs:
When I get a treatment estimate, why isn’t it always accurate?
When insurance benefits are verified, the insurance company gives the dental office general information, but doesn’t guarantee that it is correct. It is only until the claim is filed can you know for sure what the actual reimbursement will be. Many insurance companies have exclusions that they don’t reveal until the claim is filed.

Dentures

Dentures are removable prosthetic devices that replace missing teeth and restore your smile. Dentures can be “full” replacing a whole arch of teeth, or “partial” replacing just a few teeth. Whether full or partial, no matter how well your dentures are made, you must realize that they are never going to function as well as your natural teeth. Replacing teeth is the same as replacing any other body part; a wooden leg is good, but never as good as your original leg. When you are getting acclimated to your new full or partial denture, eat soft foods or foods that have been cut into pieces. Practice reading out loud until you can speak comfortably. Practice taking your full or partial denture in and out in front of a mirror; never force them or bite down to try to get them in place. If your full or partial denture is loose, causes soreness, or is bent or broken in any way, please call our office for an appointment.

Dry Mouth/Xerostomia

Xerostomia, or dry mouth, can be caused by many medications, certain systemic disorders, or radiation treatment to the head and neck. Sipping water and using dry mouth products such as sugar free candy and chewing gum can help to stimulate salivary flow. Meticulous home care is critical, as well as using a daily fluoride product.

Dry Socket

After a dental extraction you must allow the tooth socket time to heal. You should not drink through a straw or smoke during the healing phase as these habits can dislodge the clot. Rinsing with warm salt water can help the healing process. An ice pack can help reduce any swelling. The area should feel a little better every day. Sometimes, however, the clot may not form or may become dislodged. If this happens, the tooth socket will become very painful. At that point, you must return to the office and have a special dressing placed to help heal the “dry” socket.

Emergencies, Dental

If you have severe dental pain, swelling, or bleeding, call the office right away. We will see you at one of our convenient offices the same day. Our caring doctors are on call 24 hours a day, seven days a week.
FAQs:
What can I do if my temporary crown comes out?
Temporary crowns are made to last for about 3 weeks. If you floss or eat sticky foods your crown may come off. Temporary crowns can be re-cemented at home with Fixodent. You can also call the office and have your crown re-cemented the same day.

Extractions, Dental

After a dental extraction you must allow the tooth socket time to heal. You should not drink through a straw or smoke during the healing phase as these habits can dislodge the clot. Rinsing with warm salt water can help the healing process. An ice pack can help reduce any swelling. The area should feel a little better every day. Sometimes, however, the clot may not form or may become dislodged. If this happens, the tooth socket will become very painful. At that point, you must return to the office and have a special dressing placed to help heal the “dry” socket.
Facial Pain

Fever Blisters

Fever blisters, also known as cold sores, are caused by a herpes virus and occur on the outside of the lips and face. Painful and unsightly, cold sores generally go away in about a week. Oral prescription medication and over-the-counter creams seem to help clear up the infection sooner.
FAQs:
Are fever blisters or cold sores the same thing as canker sores?
No. Canker sores occur inside your mouth. They are very painful but usually go away in a week or two. It is unclear as to what causes these sores but a weakened immune system may be one of them. Stress and fatigue seem to be a couple of the triggers that bring them on. Some people are sensitive to a common ingredient used in toothpaste, sodium laurel sulfate (SLS). There are a couple of toothpastes that are SLS free. Anesthetic creams can help reduce the symptoms. While the canker sore is healing, it is best or avoid spicy or acidic foods.

Fillings

There are two main types of dental fillings: amalgam and composite. Dental amalgam or “silver” fillings have been used for over 200 years. Amalgam fillings are composed of a mixture of metals such as tin, silver, and copper bound together with mercury.

While there has been much controversary about the possible negative health effects of these amalgam fillings, the American Dental Association, the Centers for Disease Control and Prevention, The U.S. Public Health Service, National Institues of Health, and the World Health Organization are all confident that dental amalgam fillings are safe.

In fact, the Food and Drug Administration (FDA) issued its final regulation on dental amalgam in a press release dated July 27, 2009. After considering around 200 scientific studies, the FDA has classified dental amalgam and “its component parts – elemental mercury and a powder alloy” from Class I to a Class II “moderate risk” medical device. The new classification will allow the FDA to “impose special controls to provide reasonable assurance of the safety and effectiveness” of dental amalgam fillings.

The American Dental Association (ADA) issued a press release in response to the recent Food and Drug Administration’s announcement stating that they concurred with the FDA’s decision “not to place any restriction on the use of dental amalgam, a commonly used cavity filling material.” The ADA believes that dental amalgam fillings are “valuable, viable, and safe choice for dental patients.”

With today’s advances in dental materials, we can now use bonded resin fillings on back teeth. Strong, and durable, these fillings are a favorite because they match the color of your tooth.
FAQs:
Why don’t many dentists use amalgam filling anymore?
Thanks to continuing research, we now have more choices when it comes to filling materials. For example, we can now use composite, or “tooth-colored” fillings in the back of the mouth where chewing forces are the greatest. Composite fillings come in all shades and are quite natural looking. In addition, the dentist does not have to remove as much natural tooth structure to place a composite fillings as compared to placing the century-old old amalgam ones.
How can I get a cavity in a tooth that already has a filling?
No matter what type of filling material you have, everytime you come in for a check-up, your dentist will carefully examine and evaluate your fillings to make sure they are flush with the tooth. As fillings get older they start to shrink and break down creating a gap between the filling and the tooth. When that happens, bacteria can get underneath the filling creating a new cavity (decay) under the old filling.
Why does my dentist want to replace my old filling with a crown?
When a filling needs to be replaced your dentist will check your tooth and your x-rays to see how big the existing filling is, and will decide if there will be enough tooth structure left to hold another filling. Most of the time that decision is pretty strightforward, however, because an x-ray is only a two-dimensional view of a three-dimensional object, sometimes your dentist won’t be able to predict what kind of restoration is needed until the old filling and decay is removed. At that time, if there is enough tooth structure left to hold another filling, your dentist will place another filling. If there is not enough tooth structure left, a crown will be needed to keep the tooth strong and healthy for years to come.
Links:

American Dental Association
Food and Drug Administration

Flossing

If your teeth touch, you need to clean in-between your teeth with something. You can you dental floss, small interdental brushes, wooden stimulators, or water irrigation devices.
FAQs:
How often should I brush?
Tooth brushing removes the plaque from the front and back of the teeth. It takes about two minutes of brushing to remove all the plaque. You should brush your teeth in the morning and after you’ve eaten the last meal of the day. Remember that plaque also coats your tongue – so be sure to clean your tongue as well.
How often should I replace my toothbrush?
You should replace your toothbrush four times a year. If your toothbrush bristles are frayed and bent, you need to replace your brush sooner. Worn toothbrushes are ineffective in cleaning teeth.
Are electric toothbrushes good to use?
Yes! Especially if you have a tendency to brush too hard, or if you have any type of dexterity problems.
What kind of rinse should I use?
That depends on your oral problems. If you get a lot of cavities, a fluoride rinse can really help. You can buy fluoride rinses over-the-counter or your dentist can prescribe a stronger, prescription strength fluoride. If gingivitis is a problem, using an antibacterial rinse can help. Some antibacterial rinses can be purchased over-the-counter and others are prescription strength.

Gingivitis

Plaque is a sticky white film of bacteria that accumulates on your teeth about every 24 hours. If thorough plaque removal isn’t achieved, carbohydrates and sugary foods mix with the plaque to form acid. This acid begins to destroy the outer layer of the tooth for 20 minutes or so starting a cavity. The acid also starts to destroy the gum tissue causing bleeding gums. This is the first stage of periodontal disease, called gingivitis. If plaque is allowed to accumulate on the teeth, it eventually hardens into tarter or calculus. If left untreated, the bacteria starts to destroy the bone underneath the gums. This is called periodontal disease. If the bacteria and calculus aren’t professionally removed, periodontal disease can progress to the point where teeth loosen and fall out.

Grinding

Many people clench or grind their teeth. Some clench or grind throughout the day, while others do it while they are sleeping. There are many signs and symptoms of clenching and grinding. One of the most common symptoms is waking up with a headache in the temple area. Other symptoms can include a sore or tired jaw, neck pain, itching or ringing in the ears, chipped, broken or sensitive teeth. Your dentist or dental hygienist may notice the following signs of clenching or grinding: worn down teeth, notches in the enamel at the gumline, dimples on your molars, scalloped edges on your tongue, and overdeveloped chewing muscles.
FAQs:
What can I do to stop clenching or grinding?
The first thing you can do is become aware of the habit. Say to yourself, “Lips together, teeth apart.” Your teeth should only touch when speaking or chewing. When you find yourself clenching, relax.
How can I stop clenching or grinding when I’m sleeping?
You can’t! The best thing to do is to have an occlusal guard or nightguard made. This simple device doesn’t stop your habit, but it does prevent your teeth from coming together and your muscles from engaging. Therefore, wearing an occlusal guard prevents any further damage to your teeth, and gives your muscles some rest.

Gum Disease

See “Gingivitis”

Halitosis

Bad breath, or halitosis, can be caused by many things including the foods you eat such as garlic or onions. Bad breath can come from untreated medical issues such as diabetes, or chronic bronchitis or sinusitis among others. Smoking can also cause bad breath. Finally, bad breath may be coming from bacteria or food particles in your mouth or on your tongue that haven’t been removed through brushing and flossing.
FAQs:
What can I do to get rid of bad breath?
One of the simplest things you can do is make sure your mouth is clean and healthy. Brushing for two minutes in the morning and evening and flossing once a day is a great start! Remember to brush your tongue to remove bacteria and food. Have a dental cleaning to remove any bacteria that have hardened on your teeth (called calculus or tartar). If that doesn’t help, a visit to your physician to eliminate undiagnosed medical issues may be in order.

Implants

There are several ways to replace missing teeth: a bridge, an implant, or a partial. An implant is a titanium root that is restored with a crown or “cap.” It generally takes a few visits over several months to replace a tooth with an imlant. The implant is placed on the first visit. After a few months of healing, an impression is made for a crown. In about three weeks, the crown is cemented in place. You must still brush and floss around the implant crown.
FAQs:
What is a bridge?
A bridge is placed on the teeth on either side of the missing tooth. It usually takes two visits to place a bridge. On the first visit, the teeth on either side missing tooth are trimmed down and an impression is made. In two to three weeks the bridge is fitted and permanently cemented in place. You still must brush and floss around the bridge. Having professionally applied fluoride treatments after your dental cleaning, as well as using a fluoride rinse at home, is also helpful to protecting your bridge from decay.
What is a partial?
A partial can also replace missing teeth. A partial has clasps that hold it in place. It takes several visits to replace missing teeth with a partial. Impressions are made on the first visit. A couple of weeks later, the partial is tried and a couple of weeks later the permanent partial is inserted. It should be removed at night and cleaned.

Infection Control

We take precautions for you! Our providers wear gloves, masks, eyewear, and we use the state-of-the-art sterilization techniques.

Insurance, Dental

Dental insurance benefits are generally purchased by the employer for the employee as a part of the employee’s benefits package. Just as consumers shop for the most affordable car or homeowners insurance, employers shop for the best dental plans within their company’s budget. Like car insurance, dental insurance plans vary in the amount of the deductible as well as the maximum benefits paid per year. Where dental insurance benefits become a little harder to understand is how the benefits are applied and what is excluded.

You have probably heard about something called the “UCR.” Insurance companies UCR stands for the usual, customary, and reasonable. Insurance companies come up with a figure of what they deem to be a customary fee for a procedure. Then the insurance company will pay a percentage of the UCR.

FAQs:
When I get a treatment estimate, why isn’t it always accurate?
When insurance benefits are verified, the insurance company gives the dental office general information, but doesn’t guarantee that it is correct. It is only until the claim is filed can you know for sure what the actual reimbursement will be. Many insurance companies have exclusions that they don’t reveal until the claim is filed.

Invisalign

The American Academy of Orthodontics (AAO) recommends that children should visit the orthodontist by age seven for a simple (and generally free) consultation. The orthodontist will examine the growth and development of the child’s teeth and may recommend treatment or just a follow up visit. Today’s technology is exciting! The jaws can be expanded through functional appliances. Sometimes all it takes is creating more space for the teeth to come in. If the teeth need to be moved, there are now a number of options: through traditional braces with silver, gold, or ceramic brackets on the fronts of the teeth, with i-braces where the brackets are placed on the insides of the teeth; or through Invisalign, a series of rigid aligners that are changed every couple of week. You and your orthodontist will choose the right treatment for you!
FAQs:
As an adult, is it too late to have my teeth straightened?
It is never too late to have a healthy, beautiful smile! According to the AAO, one in five orthodontic patients is an adult. With Invisalign technology, i-braces (that are placed behind your teeth), and tooth colored brackets, getting that fabulous smile you’ve always wanted is just a phone call away!
Do I have to go to the specialists office?
If your dentist is certified in Invisalign technology, they will evaluate your teeth to see if you are a candidate for Invisalign (the invisible aligners). If not, your dentist will recommend a local orthodontist.
Links:

Braces.org
Invisalign
iBraces

Jaw Pain

Many people clench or grind their teeth. Some clench or grind throughout the day, while others do it while they are sleeping. There are many signs and symptoms of clenching and grinding. One of the most common symptoms is waking up with a headache in the temple area. Other symptoms can include a sore or tired jaw, neck pain, itching or ringing in the ears, chipped, broken or sensitive teeth. Your dentist or dental hygienist may notice the following signs of clenching or grinding: worn down teeth, notches in the enamel at the gumline, dimples on your molars, scalloped edges on your tongue, and overdeveloped chewing muscles.
FAQs:
What can I do to stop clenching or grinding?
The first thing you can do is become aware of the habit. Say to yourself, “Lips together, teeth apart.” Your teeth should only touch when speaking or chewing. When you find yourself clenching, relax.
How can I stop clenching or grinding when I’m sleeping?
You can’t! The best thing to do is to have an occlusal guard or nightguard made. This simple device doesn’t stop your habit, but it does prevent your teeth from coming together and your muscles from engaging. Therefore, wearing an occlusal guard prevents any further damage to your teeth, and gives your muscles some rest.

Knocked Out Tooth

See “Avulsed Tooth”

Medications and Your Oral Health

Bisphosphonate Medication (Fosamax, Actonel, Boniva, Aredia, Bonefos, Didronel or Zometa) (see Osteonecrosis of the Jaw)

Oral Cancer

An oral examination includes an oral cancer screening. During an oral cancer screening, the doctor or hygienist will check your lymph nodes, and all of the structures in your mouth. They are looking for any lumps or bumps that shouldn’t be there. Smoking and alcohol use increase your risk for oral cancer. Remember, if you notice a lump, bump, or a sore in your mouth that has been there for more than two weeks, see your dentist right away.
Links:

American Cancer Society
National Cancer Institute

Oral Hygiene

Tooth brushing removes the plaque from the front and back of the teeth. It takes about two minutes of brushing to remove all the plaque. You should brush your teeth in the morning and after you’ve eaten the last meal of the day. Remember that plaque also coats your tongue – be sure to clean your tongue as well. If your teeth touch, you need to clean in-between your teeth with something. You can you dental floss, small interdental brushes, wooden stimulators, or water irrigation devices.
FAQs:
How often should I replace my toothbrush?
You should replace your toothbrush four times a year. If your toothbrush bristles are frayed and bent, you need to replace your brush sooner. Worn toothbrushes are ineffective in cleaning teeth.
Are electric toothbrushes good to use?
Yes! Especially if you have a tendency to brush too hard, or if you have any type of dexterity problems.
What kind of rinse should I use?
That depends on your oral problems. If you get a lot of cavities, a fluoride rinse can really help. You can buy fluoride rinses over-the-counter or your dentist can prescribe a stronger, prescription strength fluoride. If gingivitis is a problem, using an antibacterial rinse can help. Some antibacterial rinses can be purchased over-the-counter and others are prescription strength.

Orthodontics

The American Academy of Orthodontics (AAO) recommends that children should visit the orthodontist by age seven for a simple (and generally free) consultation. The orthodontist will examine the growth and development of the child’s teeth and may recommend treatment or just a follow up visit. Today’s technology is exciting! The jaws can be expanded through functional appliances. Sometimes all it takes is creating more space for the teeth to come in. If the teeth need to be moved, there are now a number of options: through traditional braces with silver, gold, or ceramic brackets on the fronts of the teeth, with i-braces where the brackets are placed on the insides of the teeth; or through InvisalignR, a series of rigid aligners that are changed every couple of week. You and your orthodontist will choose the right treatment for you!
FAQs:
As an adult, is it too late to have my teeth straightened?
It is never too late to have a healthy, beautiful smile! According to the AAO, one in five orthodontic patients is an adult. With Invisalign technology, i-braces (that are placed behind your teeth), and tooth colored brackets, getting that fabulous smile you’ve always wanted is just a phone call away!
Do I have to go to the specialists office?
If your dentist is certified in Invisalign technology, they will evaluate your teeth to see if you are a candidate for Invisalign (the invisible aligners). If not, your dentist will recommend a local orthodontist.
Links:

Braces.org
Invisalign
iBraces

Partials

There are several ways to replace missing teeth: a bridge, an implant, or a partial. A partial has clasps that hold it in place. It takes several visits to replace missing teeth with a partial. Impressions are made on the first visit. A couple of weeks later, the partial is tried I; a couple of weeks later the permanent partial is inserted. It should be removed at night and cleaned.
FAQs:
What is a bridge?
A bridge is placed on the teeth on either side of the missing tooth. It usually takes two visits to place a bridge. On the first visit, the teeth on either side missing tooth are trimmed down and an impression is made. In two to three weeks the bridge is fitted and permanently cemented in place. You still must brush and floss around the bridge. Having professionally applied fluoride treatments after your dental cleaning, as well as using a fluoride rinse at home, is also helpful to protecting your bridge from decay.
What is an implant?
An implant is a titanium root that is restored with a crown or “cap.” It generally takes a few visits over several months to replace a tooth with an implant. The implant is placed on the first visit. After a few months of healing, an impression is made for a crown. In about three weeks, the crown is cemented in place. You must still brush and floss around the implant crown.

Payment Options

We offer several options so that you can obtain the dental care you need and deserve. In addition to cash, check, Visa, Mastercard, Discover and American Express, we are pleased to offer no-interest payment plans through Chase and Care Credit.

Plaque

Plaque is a sticky white film of bacteria that accumulates on your teeth about every 24 hours. If thorough plaque removal isn’t achieved, carbohydrates and sugary foods mix with the plaque to form acid. This acid begins to destroy the outer layer of the tooth for 20 minutes or so starting a cavity. If plaque is allowed to accumulate on the teeth, it eventually hardens into tarter or calculus. Once calculus forms, it must be professionally removed.

Pregnancy and Your Oral Health

Pregnancy is a wonderful time of life! Mom’s need to make sure they get the necessary vitamins such as A, C, D, calcium, protein and nutrients necessary for the good development of baby’s teeth which form around the second trimester. Meticulous home care is very important during this time as one of the common side effects of increased progesterone levels can be gingivitis. Gingivitis is characterized by red, puffy, bleeding gums.

Premedication/Antibiotic Premedication

The American Heart Association (AHA) has updated its guidelines for preventing infective endocarditis (I.E.) with antibiotics (premedication). The AHA indicates that only people who have had infective endocarditis, have artificial heart valves, serious heart conditions from birth that have or have not been repaired, or heart valve problems stemming from a heart transplant need to take antibiotics before invasive dental treatment. As of April 2009, The American Academy of Orthopaedic Surgeons also states that patients with any kind of joint replacements need to take antibiotics before having any dental treatment.
FAQs:
What is Infective Endocarditis (I.E.)?
Infective Endocarditis is an infection around the heart valves caused by bacteria from the mouth that gets into the blood stream and accumulates around the inner lining of the heart. Based on new research, many people who previously had to take an antibiotic before going to the dentist do not have to do so anymore. Evidence based research shows that the risks of taking the antibiotics outweigh the benefits. Risks of taking antibiotics include the possibility of your body becoming resistant to the antibiotic, or having an allergic reaction to the medication.
I have a heart murmur and I have always been told I needed to premedicate before dental appointments. Why don’t I have to anymore?
Evidence based research concludes that the risks of taking the antibiotic outweighs the benefits.
Even though I don’t have to premedicate before a dental appointment, I’ve done so for so long I would just feel better doing so. Why can’t I just do it?
If you overuse antibiotics you risk your body becoming resistant to the antibiotic when you really need it to fight off an infection. You can also have an allergic reaction to the medication which can result in life threatening anaphylactic shock.
Links:

American Academy of Orthopaedic Surgeons
American Dental Association
American Heart Association

Radiographs

At Dental Smiles at Purcellville Gateway we use computerized digital radiographs (x-rays). Using this technology reduces radiation to our patients by 60-80%. Digital radiography also saves our patients time because the images go instantly from the mouth to the computer.

Root Canal Treatment

When decay reaches the nerve of a tooth, the nerve becomes infected. We call this infection an abscess. One of the ways the dentist treats this infection is to do a “root canal” procedure. This treatment involves removing all of the infection inside the tooth, cleaning out the infected canals, and filling those canals with a medicated filling. Once all of the infected nerves and blood supply have been removed the tooth is now technically “dead” and becomes very brittle. (You can think of a root canal tooth like a dead tree branch that snaps easily when bent.) The canals are then filled and the tooth is sealed off to prevent bacteria from entering the canals. To protect and strengthen a root canal treated tooth, the dentist will rebuild the tooth, and cover it completely with a “cap” or a crown.

DentalSmiles16 58Sealants

Dental sealants are great prevention! Sealants are placed on the biting surfaces of back teeth to fill in the grooves where the toothbrush can’t reach. Sealing the six and twelve year molars can really help reduce the incidence of caries for children and teens.

Second Opinion

If you are confused about your dental diagnosis, we invite you to come in for a free second opinion appointment! Our doctors will review your treatment plan and answer all of your questions and concerns. Call today to schedule your free, no obligation appointment! You’ll love our experienced doctors!

Sedation Dentistry

Many people put off going to the dentist because they have had an unpleasant experience in the past. Thanks to modern dentistry, you can be confident that your dental visit can be as painless as possible. At Dental Smiles at Purcellville Gateway you can stretch out and relax in our all-leather chairs while you watch your favorite TV show snuggled up in our soft, comfortable blankets! We use a numbing gel on your gums and give nearly painless injections. We also have nitrous oxide, or “laughing gas” available to relax you while you get your dental work completed. We can even use “conscious sedation” where you take one pill the night before to give you a sound sleep, and then one more pill an hour before your dental appointment to relax you even more. We are committed to making your dental visit as comfortable as possible!
FAQs:
Does someone have to drive me to and from my dental appointment if I use the Nitrous Oxide or “pill?”
You will only need a driver if you choose to take the conscious sedation pill. Nitrous Oxide is breathed and out through your nose and you will be completely back to normal when you get out of the chair.
Links:

Dental Organization for Conscious Sedation

Sensitive Teeth

Teeth can become sensitive to hot, cold, sweets, or biting pressure. Often the cause of the sensitivity can be treated with a simple bite adjustment or a topically applied desensitizing or fluoride product. On the other hand, sensitivity could be a sign of a cracked tooth, or a serious infection. If you have sensitive teeth, it is best to have your teeth examined by one of our experienced doctors.

Smokeless Tobacco

Smokeless tobacco, also known as “snuff,” is ground tobacco that is placed between the gum and cheek. Smokeless tobacco contains more nicotine than cigarettes and contains 28 cancer causing agents. During an oral cancer screening, the doctor or hygienist will check your lymph nodes, and all of the structures in your mouth. They are looking for any lumps or bumps that shouldn’t be there. Smoking and alcohol use increase your risk for oral cancer. Remember, if you notice a lump, bump, or a sore in your mouth that has been there for more than two weeks, see your dentist right away.
Links:

The American Cancer Society
National Cancer Institute

Smoking

Smoking has a negative impact on your oral health. Smoking constricts the blood vessels in your mouth. Blood cells carry healing cells. Limiting blood flow limits healing to body – including the oral cavity. Certain dental procedures such as gum surgery, extractions, and implants, count on good wound healing for a positive outcome. Smoking also increases your risk for cancer – especially oral cancer.
Links:

The American Cancer Society
National Cancer Institute

Smoking Cessation

Mark Twain said, “Quitting smoking is easy. I’ve done it a thousand times.” The reason it is so hard to quit smoking is that the nicotine found in tobacco products is extremely addictive. Experts agree that nicotine is addictive as cocaine or heroin. However, if you want to quit tobacco use, there are plenty of resources available.

The National Cancer Institute has a Smoking Quitline (1-877-44U-QUIT) that is open Monday through Friday 9:00 AM to 4:30 PM. The American Cancer Society also has a Quitline: 1-800-ACS-2345 (1-800-227-2345).
Links:

The American Cancer Society
National Cancer Institute

Sores

Two types of mouth sores are fairly common: cold sores and canker sores. Cold sores, also known as fever blisters are caused by a herpes virus and occur on the outside of the lips and face. Painful and unsightly, cold sores generally go away in about a week. Oral prescription medication and over-the-counter creams seem to help clear up the infection sooner.

Canker sores occur inside your mouth. They are very painful but usually go away in a week or two. It is unclear as to what causes these sores but a weakened immune system may be one of them. Stress and fatigue seem to be a couple of the triggers that bring them on. Some people are sensitive to a common ingredient used in toothpaste, sodium laurel sulfate (SLS). There are a couple of toothpastes that are SLS free. Anesthetic creams can help reduce the symptoms. While the canker sore is healing, it is best or avoid spicy or acidic foods.

Space Maintainers

When a baby tooth is lost too soon, a space maintainer is usually made to hold the space so that the permanent tooth has the room to erupt.

TMJ/TMD/Temporomandibular Joint Disorders

Your jaws open and close on a hinge. The Temporomandibular joints are attached to the skull and lower jaw with muscles and ligaments. The skull and jaw bone are separated by a cartilage disc. Sometimes the disc slips and bone rubs against bone causing pain.

Many people clench or grind their teeth. Some clench or grind throughout the day, while others do it while they are sleeping. There are many signs and symptoms of clenching and grinding. One of the most common symptoms is waking up with a headache in the temple area. Other symptoms can include a sore or tired jaw, neck pain, itching or ringing in the ears, chipped, broken or sensitive teeth. Your dentist or dental hygienist may notice the following signs of clenching or grinding: worn down teeth, notches in the enamel at the gumline, dimples on your molars, scalloped edges on your tongue, and overdeveloped chewing muscles.
FAQs:
What can I do to stop clenching or grinding?
The first thing you can do is become aware of the habit. Say to yourself, “Lips together, teeth apart.” Your teeth should only touch when speaking or chewing. When you find yourself clenching, relax.
How can I stop clenching or grinding when I’m sleeping?
You can’t! The best thing to do is to have an occlusal guard or nightguard made. This simple device doesn’t stop your habit, but it does prevent your teeth from coming together and your muscles from engaging. Therefore, wearing an occlusal guard prevents any further damage to your teeth, and gives your muscles some rest.

Tobacco Use

Smoking and smokeless tobacco has a negative impact on your oral health. Smoking constricts the blood vessels in your mouth. Blood cells carry healing cells. Limiting blood flow limits healing to body – including the oral cavity. Certain dental procedures such as gum surgery, extractions, and implants, count on good wound healing for a positive outcome. Smoking also increases your risk for cancer – especially oral cancer.

Smokeless tobacco, also known as “snuff,” is ground tobacco that is placed between the gum and cheek. Smokeless tobacco contains more nicotine than cigarettes and contains 28 cancer causing agents.

During an oral cancer screening, the doctor or hygienist will check your lymph nodes, and all of the structures in your mouth. They are looking for any lumps or bumps that shouldn’t be there. Smoking and alcohol use increase your risk for oral cancer. Remember, if you notice a lump, bump, or a sore in your mouth that has been there for more than two weeks, see your dentist right away.
Links:

The American Cancer Society
National Cancer Institute

Tooth-Colored Fillings

With today’s advances in dental materials, we can now use bonded resin fillings on back teeth. Strong, and durable, these fillings are a favorite because they match the color of your tooth.

Tooth Brushing

Tooth brushing removes the plaque from the front and back of the teeth. It takes about two minutes of brushing to remove all the plaque. You should brush your teeth in the morning and after you’ve eaten the last meal of the day. Remember that plaque also coats your tongue – be sure to clean your tongue as well.
FAQs:
How often should I replace my toothbrush?
You should replace your toothbrush four times a year. If your toothbrush bristles are frayed and bent, you need to replace your brush sooner. Worn toothbrushes are ineffective in cleaning teeth.
Are electric toothbrushes good to use?
Yes! Especially if you have a tendency to brush too hard, or if you have any type of dexterity problems.
Are electric toothbrushes good to use?
If your teeth touch, you need to clean in-between your teeth with something. You can you dental floss, small interdental brushes, wooden stimulators, or water irrigation devices.
What kind of rinse should I use?
That depends on your oral problems. If you get a lot of cavities, a fluoride rinse can really help. You can buy fluoride rinses over-the-counter or your dentist can prescribe a stronger, prescription strength fluoride. If gingivitis is a problem, using an antibacterial rinse can help. Some antibacterial rinses can be purchased over-the-counter and others are prescription strength.

Tooth Decay

Caries is another word for cavities or tooth decay. To get a cavity, you need three things: a tooth, bacteria, and sugar or carbohydrates. Everyone has bacteria in their mouth. When bacteria mix with sugar or carbohydrates, acid forms. The acid attacks the tooth and the enamel begins to weaken in a process known as demineralization. If the cavity has just started and is in the outermost layer of the enamel, it can be reversed in a process known as remineralization. Remineralization can occur through the application of fluoride. That is why a professionally applied fluoride treatment is so beneficial in the prevention of decay.
FAQs:
How can I prevent caries?
Simple! Brushing twice a day with an ADA approved fluoridated toothpaste, flossing twice a day, rinsing with a fluoride rinse daily, reduce the number of incidents of carbohydrate intake, and regular visits to your dentists.

Tooth Whitening

A brighter, whiter, beautiful smile helps you look and feel your best! Impressions are made of your teeth so we can custom fit you for your whitening trays. Wear your trays for an hour a day to get the dazzling smile you want and deserve!
FAQs:
What do you think about the in-office whitening?
They are fine ways to jump start the whitening process. However, most in-office whitening programs also have the traditional take home bleaching kits. The advantage of the in-home whitening is that you can touch up whenever you want to!

Veneers

Veneers can quickly change the shape, color or size of your teeth in two short visits! Veneers are made out of porcelain and are cemented on the fronts of your teeth. They can make you look great in just a couple of visits!

Wisdom Teeth

Did you know that not everyone gets wisdom teeth? Wisdom teeth, also known as your third molars, usually erupt during the late teens, early twenties. If the wisdom teeth are impacted (lying sideways) your dentist may recommend that they be taken out. Some people do just fine getting numb and having them removed. Other people prefer to go to sleep to take them out.

Xerostomia

Xerostomia, or dry mouth, can be caused by many medications, certain systemic disorders, or radiation treatment to the head and neck. Sipping water and using dry mouth products such as sugar free candy and chewing gum can help to stimulate salivary flow. Meticulous home care is critical, as well as using a daily fluoride product.

X-rays

At Dental Smiles at Purcellville Gateway we use computerized digital radiographs (x-rays). Using this technology reduces radiation to our patients by 60-80%. Digital radiography also saves our patients time because the images go instantly from the mouth to the computer.