Q: Which type of toothbrush should I use?
A: The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums, and a small head allows you to get around each tooth more completely and is less likely to injure your gums. It's unnecessary to "scrub" the teeth as long as you are brushing at least twice a day and visiting your dentist at least twice a year for cleanings. Electric brushes, even the less expensive battery brushes, are effective and have a place. The critical point is how to direct the brush action. Hand held do best with "Up like a Rocket, Down like the Rain, and Back and Forth like a Choo Choo Train", while electic are best held in a location for 5 to 7 counts, then moved to the next adjacent area.
Q: Is one toothpaste better than others?
A: Generally, no. However, it's advisable to use a fluoride containing toothpaste to decrease the incidence of dental decay. We recommend our patients use what tastes good to them as long as it contains fluoride. Specialty toothpastes exist for sensitive teeth, dry mouth, and other conditions. Baking Soda and Salt in a paste with Hydrogen Perioxide makes a fine homemade product as well. Since the bristles actually remove the placque, "dry" brushing works, too!
Q: How often should I floss?
A: Flossing of the teeth once per day helps to prevent cavities from forming between the teeth where your toothbrush can't reach. Flossing also helps to keep your gums healthy. However, improper flossing (a sawing motion between the teeth, for example) can cut the gum and even bone, contributing to unnecessary pain which is self inflicted. The key is to floss teeth: be sure the floss is held tight to the tooth, pulling or pushing it against the tooth to be cleaned, then lifting gently up and down or softly back and forth. Tooth picks, interproximal brushes, and other devices also can have a place in cleaning areas, especially if a space exists next to a tooth.
Q: What's the difference between a "crown" and a "cap"?
A: These are restorations to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. The restoration material is made of gold, porcelain, composites, or even stainless steel. Dentists refer to all of these restorations as "crowns". However, patients often refer to the tooth-colored ones as "caps" and the gold or stainless steel ones as "crowns".
Q: What's the difference between a "bridge" and a "partial denture"?
A: Both bridges and partial dentures replace missing teeth. A bridge is permanently attached to abutment teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures. Partials may be metal free, and sometimes flexible to a degree. Partials often cost less, but food may collect around or under them as they rest on gum tissue, and have a larger "foot print" than a bridge.
Q: What about "silver" fillings versus "white" fillings?
A: Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting "white" or tooth-colored composite fillings. In about 1983 or so I switched to composite bonded fillings. I still own the necessay insturments to place an amalgam, and would under the right circumstances, but advances in materials with tooth-colored fillings allow they "bond" to the tooth structure and therefore help strengthen a tooth weakened by decay. White fillings are also usually less sensitive to temperature, and they also look better. However, "white" fillings cannot be used in every situation, and if a tooth is very badly broken-down, a crown or bonded ceramic inlay or onlay will usually be necessary and provide better overall satisfaction for the patient.
Q: Do I need to have a root canal just because I have to have a crown?
A: No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal.
Q: Would I be better served doing an extraction and an inlay than a Root Canal and a Crown?
A: This is a really good question. I would have to say we should discuss this, as I am having mixed feelings about the answer. Root Canals may fail, as may implants. I would say sometimes an up front expense for a younger person may avoid the loss in a lifetime of the tooth and its eventual replacement with an implant and crown later.