Manhattan Dental is committed to providing the knowledge that patients need to make the best decisions for their smiles. There are some questions we are continually asked by our valued patients.
We have prepared a FAQs list to clarify some common concerns. If you have any questions that are left unanswered, please feel free to contact our office on Central Park West in New York today. Call 212-873-5400 to speak with our friendly staff.
What should I do if I have bad breath?
Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.
There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially on the back of the tongue. Some studies have shown that simply brushing the tongue can reduce bad breath by as much as 70 percent.
What may cause bad breath?
- Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
- Certain foods – Garlic, onions, and other foods that contain odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
- Poor oral hygiene habits – Food particles that remain in the mouth promote bacterial growth.
- Periodontal (gum) disease – Colonies of bacteria and food debris may reside under inflamed gums.
- Oral health issues – Dental cavities and improperly fitted dental appliances may also contribute to bad breath.
- Dry mouth (Xerostomia) – This condition may be caused by certain medications, salivary gland problems, or continuous mouth breathing.
- Tobacco products – These dry the mouth, and cause bad breath.
- Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
- Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
- Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.
Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with your dentist.
What can I do to prevent bad breath?
- Practice good oral hygiene – Brush at least twice a day with an ADA-approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every two to three months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
- See us regularly – Get a checkup and cleaning at least twice a year. If you have or have had periodontal disease, we may recommend more frequent visits.
- Stop smoking/chewing tobacco – Ask Dr. Burger what he recommends to help break the habit.
- Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
- Use mouthwash/rinses – Some over-the-counter products provide only a temporary solution to mask unpleasant mouth odor. Ask us about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.
In most cases, we can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, Dr. Burger may refer you to your primary care physician to determine the cause of the odor and an appropriate treatment plan.
How often should I brush and floss?
Brushing and flossing help control the plaque and bacteria that cause dental disease. Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay.
Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, and cause periodontal (gum) disease.
Plaque formation and growth are continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.
Tooth brushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA-approved, soft-bristle brush and toothpaste.
- Brush at a 45-degree angle to the gums, gently using a small, circular motion, and make sure you always feel the bristles on the gums.
- Brush the outer, inner, and biting surfaces of each tooth.
- Use the tip of the brush head to clean the inside front teeth.
- Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, and prevents damage to the gums, teeth, and bone.
- Take 12 to 16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about two inches (5cm) of floss between the hands.
- Using your thumbs and forefingers to guide the floss, gently insert it between teeth using a sawing motion.
- Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down to clean the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Rinsing – It is worthwhile to rinse your mouth with water after brushing, and after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with Dr. Burger or a dental hygienist on its appropriateness for you.
Are amalgam (silver) fillings safe?
Over the years, there has been some concern about the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin, and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years.
The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.
According to the American Dental Association, up to 76% of dentists use silver that contains mercury to fill teeth. The ADA also states that silver fillings are safe and studies have failed to find any link between silver containing mercury and any medical disorder.
The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Centers for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective. The U.S. Public Health Service says the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling.
The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, which is out of countless millions of silver fillings over the decades.
Although studies indicate no measurable health risks to patients who have silver fillings, we know that mercury is a toxic material when we are exposed at high, unsafe levels. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.
There are numerous options to silver fillings, including composite (tooth-colored), porcelain, and gold fillings. We encourage you to discuss these options with us so you can determine which is the best option for you.
How often should I have a dental exam and cleaning?
You should have your teeth checked and cleaned at least twice a year, though we may recommend more frequent visits.
Regular dental exams and cleaning visits are essential for preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities.
Many other things are checked and monitored to help detect, prevent, and maintain your dental health. These include:
- Medical history review – Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and your dental health.
- Examination of diagnostic X-rays (radiographs) – Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Oral cancer screening – Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation – Check the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay – All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations – Check current fillings, crowns, etc.
- Removal of calculus (tartar) – Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
- Removal of plaque – Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing – Removes stain and plaque that is not otherwise removed during tooth brushing and scaling.
- Oral hygiene recommendations – Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
- Review dietary habits – Your eating habits play a very important role in your dental health.
As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so will require regular checkups and cleanings.
How can I tell if I have gingivitis or periodontitis (gum disease)?
Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Undergoing regular dental checkups and periodontal examinations is vital and will help detect whether periodontal problems exist.
Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, several other factors may increase the risk of developing periodontal disease:
- Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
- Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
- Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side effects that reduce saliva, and make the mouth dry and plaque easier to adhere to the teeth and gums.
- Pregnancy, oral contraceptives, and puberty – These can effect changes in hormone levels, and cause gum tissue to become more sensitive to bacteria toxins.
- Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
- Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.
For the signs and symptoms, see our page on periodontal disease. Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Why is it important to use dental floss?
Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.
Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, and thus prevents damage to the gums, teeth, and bone. Plaque is a sticky, almost invisible film that forms on the teeth. It consists of a growing colony of living bacteria, food debris, and saliva.
The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and steadily destroy the bone.
This is the beginning of periodontal disease. Floss holders are recommended if you have difficulty using conventional floss.
Daily flossing will help you keep a healthy, beautiful smile for life!
How can cosmetic dentistry help improve the appearance of my smile?
If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.
Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health.
This includes dental prevention and having a healthier, whiter, more radiant smile. There are many cosmetic dental procedures available to improve your teeth and enhance your smile.
Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth makeover. Ask Dr. Burger how you can improve the health and beauty of your smile with cosmetic dentistry.
What are porcelain veneers and how can they improve my smile?
Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth. They are very durable and will not stain, which makes them a very popular solution for those who seek to restore or enhance the beauty of their smile.
Veneers may be used to restore or correct the following dental conditions:
- Severely discolored or stained teeth
- Unwanted or uneven spaces
- Worn or chipped teeth
- Slight tooth crowding
- Misshapen teeth
- Teeth that are too small or large
Getting veneers usually requires two visits. Veneers are created from an impression (mold) of your teeth that is sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.
With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers. The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements, and occasionally a specialized light may be used to harden and set the bond.
Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.
What can I do about stained or discolored teeth?
Since teeth whitening has now become the number-one aesthetic concern of many patients, many products and methods are available to achieve a brighter smile.
Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association.
As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade. The color of our teeth also comes from the inside of the tooth, which may become darker over time. Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull.
Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.
It’s worthwhile to have your teeth evaluated by your dentist to determine whether you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis stains are difficult to bleach, and Dr. Burger may offer other options, such as veneers or crowns to cover up such stains.
Since teeth whitening only works on natural tooth enamel, it is also essential to evaluate replacement of any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, we can match the new restorations to the shade of the newly whitened teeth.
Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.
The most widely used professional teeth whitening systems include:
At-home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), and created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep. It usually takes several weeks to achieve the desired results, depending on the degree of staining and the desired level of whitening.
In-office teeth whitening: This treatment is done in the dental office and you will see results immediately. It may require more than one visit, with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened.
Some patients may experience tooth sensitivity after having their teeth whitened. This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.
Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!