Frequently Asked Questions

What should I expect at my first visit to the office?
What kind of bleaching do you offer?
What should I expect after a root canal?
What should I expect after an extraction?
What should I know about Crowns or Bridges (fixed partial dentures)?
What types of fillings are there?
What should I know about complete dentures?
What should I know about removable partial dentures?
What should I do if my crown comes out?
What if I have a tooth ache?
What is the difference between Gingivitis and Periodontitis?

 


 

What should I expect at my first visit to the office?
You first appointment will be scheduled with the hygienist. She will record all your existing restorations in your chart, as well as periodontal probing of your gum tissues. She will take any necessary x-rays and with clean your teeth. A doctor will come in and do an oral exam and an oral cancer screening. The doctor will discuss any findings and you will make an appointment for any work deemed necessary. This New Patient Exam generally lasts an hour. Please do not hesitate to ask any questions to any of our staff. ^


What kind of bleaching do you offer?
We offer many different bleaching methods in our office. The doctor and you can make the decision that will work for you. We offer traditional take-home bleaching, take-home TresWhite strips as well as in-office Zoom!. ^

 


 

What should I expect after a root canal?
There is no such thing as a simple root canal. Endodontic or root canal therapy is the removal of the nerve tissue from the tooth. the procedure may take 1-4 visits depending on the complexity of the therapy. Each patient responds differently, but the most common complications include:

  1. Swelling
  2. Sensitivity when biting
  3. Bad taste
  4. Pain

Medication to relieve these symptoms may be prescribe and should be used and finished as directed. If you feel ill after taking them, call the office immediately. After the root canal is completed, the doctor will then inform the patient of the restorative treatment necessary to complete treatment.

Should you have any further questions--please feel free to contact us at 516-735-3550. ^

 


 

What should I expect after an extraction?
Bleeding: After an extraction, a wet gauze pack is placed over the extraction site to prevent excessive bleeding and to promote the healing blood clot. Keep pressure on it for 30-45 minutes and replace if bleeding continues. Slight bleeding may occur for up to 2 days. Avoid activities that could apply a suction action to the blood clot such as smoking or sucking through a straw.

Rinsing: Do not rinse your mouth today. Tomorrow you can rinse your mouth gently with a glass of warm water mixed with 1/2 teaspoon of salt. You can do this every 3-4 hours a day especially after meals. You should rinse your mouth for the next 4 or 5 days.

Swelling: Following an extraction, some swelling and skin bruising may occur. A cold moist cloth or an ice bag applied to the cheek will keep it to a minimum. Place on affected area for about 15-20 minutes of every hour for the next 6 hours. Peak swelling can take place anytime from 24-48 hours after the surgery.

Medications: Some slight discomfort is expected. To alleviate this discomfort, take 2 or 3 tablets of Tylenol or Advil, starting one hour after the extraction. This will help maintain minimal discomfort. You may want to repeat this every 4 hours for the next day or two depending upon how uncomfortable you are. If non-aspirin pain medication does not relieve the discomfort you may experience, a stronger medication can be prescribed. Be sure to use all medications as directed.

Food: Do not eat or drink for the first 4 hours after oral surgery. A light diet with plenty of fluids is recommended for the first day. Avoid carbonated or hot beverages. Chewing should be done away from the extraction site. Never Use a Straw.

Oral Hygiene: Continue brushing and flossing being extra gentle near the extraction site.

Chips: During healing you may notice small bony fragments working their way through the gums. We can easily remove them if they are too annoying.

Smoking: Smoking should be avoided the first 24 hours following oral surgery.

Call our office, if any unusual symptoms occur. ^

 


 

What should I know about Crowns or Bridges (fixed partial dentures)?
An artificial crown is a metal and/or porcelain restoration that covers most of the tooth. A bridge is an appliance that replaces one or more teeth and is fixed to the adjacent teeth by crowns.

POTENTIAL FOR ROOT CANAL TREATMENT
When crowns or bridges are made, tooth substance is prepared or drilled away so that metal and/or porcelain can take its place. This procedure may cause inflammation in the pulp (nerve). Most teeth survive this process, but others do not. It may be necessary immediately or at some future date to do a root canal. This may then involve placing a post in the tooth. If a root canal is required after the crown or bridge had been placed, remaking the crown or bridge may be necessary. You would be responsible for the cost of root canal treatment, the post and the new bridge or crown.

POSTS
Posts are placed in endontically treated teeth to replace missing tooth structure. This is done so that a crown or bridge will have proper support to stay in place.
After a root canal filling is done, the remaining tooth structure in the root can be very thin next to the bone. On rare occasions this thin layer of root is perforated when a post preparation is made. IF perforation occurs, the tooth will have to be removed. IF a bridge is then necessary you be responsible for that additional fee.
A post can also fail because there is too much force during function. It may come out or break. IF the root breaks or the post comes loose, the replacement fee for a new restoration will also be your responsibility.

GUM RETRACTION
An impression must be made of the prepared tooth to make a crown. The gums are retracted away by thin strings or cords, or a gel-like material. Some of these materials contain epinepherine (adrenaline) and, rarely, can cause rapid heartbeat and light-headedness. The gum tissue will feel uncomfortable for a few days.

TEMPORARY CROWNS AND BRIDGES
Temporary crowns and bridges are made of plastic to cover the prepared tooth. The color and shape of the temporary bridge will be approximate, but will not be as esthetic as the final crown or bridge.

ESTHETICS
Crowns and bridges most commonly have a metal framework to provide strength. Porcelain can be used to cover the metal, but in some areas metal may show. Every effort will be made to reduce the metal showing.

PORCELAIN
In the back of the mouth, metal crowns and bridges are the best. The reason for this is that metal stands up to chewing forces better than porcelain. Porcelain is a close cousin to glass. If you have porcelain on the chewing surfaces on the back teeth, you must understand that it can fracture; if fracture occurs, payment for the resulting new crown or bridge will be your responsibility. All porcelain crowns in the front of the mouth require a certain thickness for esthetics; thus thin or small teeth may need root canal treatment and posts to provide space for the porcelain.

RESIN RETAINED BRIDGES
A procedure to replace one missing tooth without entirely reducing the teeth on either side of the space is called a resin retained or "Maryland Bridge." It is cemented in place using techniques similar to those used to bond tooth colored fillings to teeth. These bonding agents work very well but can fail. Bridges in the back of the mouth have a poorer success rate than bridges in the front part of the mouth. WE cannot predict for individuals how long any one of these may last. If the bond between the bridge and the tooth fails it occasionally can be re-cemented with success, but most often the bridge would be your responsibility.

There is a dark, silver colored metal that covers the inside surface of the teeth and parts of the top of the back teeth. Also there may be fine metal line between the teeth and the replacement tooth. Often this line can be covered with tooth colored bonding agents, but these may add bulk and so the separations between the teeth may be compromised.

LENGTH OF SERVICES OF crown OR BRIDGE
About five to seven years is the average for crowns with porcelain and about five to ten years for all metal crowns. The length of service for an individual crown or bridge cannot be predicted however. Therefore, even if failure occurs before the average life span, you will be financially responsible for any re-treatment. You must keep the crown/bridge clean (free of bacterial plaque) to increase longevity.

ALTERNATIVES TO CROWNS OR BRIDGES:

  1. No treatment
  2. Implants and crowns or bridges if indicated
  3. Removable partial dentures
  4. Resin retained bridge if indicated ^

 


 

What types of fillings are there?
TOOTH COLORED FILLINGS (COMPOSITE RESTORATIONS)
Tooth colored fillings are used to fill teeth that have decayed, or to cover parts of teeth for esthetic reasons. They are held to the teeth with bonding agents. The materials do not stand up to biting forces as well as metallic (silver or gold) fillings, and so are of limited value in the back of the mouth. The shades may match closely but may not match perfectly. Although it is not possible to predict success for individuals, the average life span for a tooth colored filling is 4 years, but failure may occur sooner. A strong bite, large fillings or decay can shorten the longevity. Smoking and tea or coffee drinking will stain the fillings. Decay will occur around the filling if good plaque control is absent. If failure occurs you will be financially responsible for re-treatment.

ALTERNATIVES TO COMPOSITE RESTORATIONS

  1. Silver fillings
  2. Gold inlay or onlay
  3. Crown

SILVER FILLINGS (AMALGAM RESTORATION)
Silver amalgam fillings are a combination of silver, tin, copper and mercury. They have been used for over a hundred years to fill teeth. They are metallic and so can withstand the strong biting forces in the back of the mouth. The color is initially a soft gray but will soon turn darker with age. the average life span of a silver amalgam filling is 7 years and although it is not possible to predict for individuals, certain situations can contribute to failure. They can fail sooner if there is a strong bite, if the filling is very large, or it the tooth around the filling decays. Decay will occur if plaque control is inadequate. If failure occurs, you will be financially responsible for re-treatment.

ALTERNATIVES TO AMALGAM RESTORATIONS

  1. Tooth colored filling
  2. Gold inlay or onlay
  3. Crown
GOLD INLAYS AND GOLD ONLAYS
A gold inlay sits inside the tooth to fill the space decay has created. A gold onlay fills the inside of the tooth and covers the top of the teeth when a great amount of tooth has been lost due to extensive decay or large fillings. Gold fillings are stronger than tooth colored or silver amalgam fillings. They are used in the back to the mouth where such strength is required. Gold fillings wear at about the same rate as tooth structure. In some situations they are an alternative to silver amalgam fillings, and even tooth colored fillings. The gold color remains the same over the years. The average life span of a gold filling is about 8 years, but success for individuals is not possible to predict. The strength of bite the size of the filling and plaque control can reduce long-term success, and if failure occurs you will be responsible financially for re-treatment.

ALTERNATIVES TO GOLD INLAYS OR GOLD ONLAYS

  1. Silver filling
  2. Tooth colored filling
  3. Crown

PORCELAIN VENEERS
A porcelain veneer is a thin layer of porcelain bonded to the front of a tooth. They are used in some situations to change the color and shape of the tooth. They are used in some situations to change the color and shape of the tooth. They cannot be used to cover large fillings, unaesthetic fillings or when a large amount of tooth has been lost. They require minimal tooth preparation and are bonded to the tooth using conventional tooth colored filling materials. They have an average life span of about 5 years. Heavy smoking or coffee and tea drinking can stain the margins of the veneers; heavy biting forces can cause them to fracture, poor plaque control can result in decay. Prediction for success or failure cannot be made for individuals, and failure before the 5 year period can occur. If this happens you will be responsible financially for re-treatment.

ALTERNATIVES TO PORCELAIN VENEERS

  1. Crowns
  2. Tooth colored composite veneers

RISKS
Certain risks are associated with all filling procedures. Rarely to they occur, but they include:

  1. Allergies--Possible allergy to latex, chemicals in impression materials and/or chemicals in filling materials.
  2. Damage to pulp or weakening of tooth structure leading to endodontic treatment.
  3. Damage and weakening of hard tooth structure leading to crown placement.
  4. Electolytic action between dissimilar metals--gold and silver amalgams--causing sensitivity.
  5. Deterioration and loss of cementing materials leading to secondary cavities (caries) and/or loss of restoration. ^

 


 

What should I know about complete dentures?
A complete denture is a denture that replaces all the missing teeth in one jaw. The amount and shape of your jawbone may determine how tight the denture is, how it feels, chews and looks. The best effort will be made to give you the best possible retention, comfort and appearance for your mouth and ridges but you may not have ridges that will allow you to have a "tight" denture.

There will be one or more try-ins to assure that you like the way the teeth look before they are completed. Once the dentures are completed, the position, shape and color can be changed but this will incur and additional cost to you.

After a denture is placed, there is a period of adjustment when you may have sore spots that the doctor will adjust. Your taste may be altered. Most dentures will need to be relined at some time and probably remade after 5 to 10 years.

IMMEDIATE DENTURES
An immediate denture is a denture that is inserted immediately upon extraction your remaining teeth. The fit, appearance and comfort of such dentures are very difficult to predict. There is no way that teeth can be fitted in advance to show you what the denture will look like, what the bite will be like and how they will fit. Every effort will be made to duplicate or improve upon the position of you natural teeth, but if the immediate denture is not quite what you expected you may have to have a second denture made. The cost of these procedures must be covered by you.

Immediate dentures often require tissue conditioning or temporary liners during the healing phase as the natural process of gum and bone shrinking takes place. You are responsible for the cost of these liners after the first two.

OVERDENTURES
Overdentures are dentures that are made over the roots of remaining teeth. Overdentures tend to be more bulky but have the advantages of better stability, natural feeling and better chewing and speaking than complete dentures.

Overdentures require root canal fillings in the remaining teeth. In addition, these teeth may sometimes have attachments that could improve the retention of your Overdentures.

Overdentures can break and need to be relined more frequently than complete dentures. The costs of the denture repair and relines or attachment replacement is your responsibility.

Another risk of Overdentures is decay to the roots of the remaining teeth. You must place fluoride gel in the denture every day in the area where the roots are.

You will be recalled every three to six months so that the Overdentures supporting teeth may be cleaned and so that you may have fluoride supply replenished.

ALTERNATIVES TO COMPLETE DENTURES

  1. No treatment.
  2. Implants if indicated and then construction of a bridge.
  3. Interim or transition all acrylic partial denture. ^

 


 

What should I know about partial dentures?
Removable partial dentures are plastic and/or metal appliances made to replace one or more teeth, or gum or bone tissue. They are an alternative to a fixed partial denture (bridge).

Removable partial dentures are designed to rest on your teeth and gums. Teeth must be slightly prepared with grooves to receive the partial denture. Old fillings should be replaced or new crowns made to support the partial denture. To stay in place, the partial dentures must be attached with metal or flexible acrylic clasps to teeth on both sides of the mouth. You should understand that these clasps will be visible. A thin metal plate may connect one side of the jaw to the other. The plate may interfere with speech and may be noticeable to the tongue during eating.

After a partial denture is placed, there is a period of adjustment when you may have sore spots that the doctor will adjust.
A partial denture can hold bacterial against the teeth and gums so it is also very important to clean the teeth and denture thoroughly, and to remove the denture at night. If the teeth are not kept clean, they will decay and/or gum disease will occur.

LENGTH OF SERVICE OF A PARTIAL DENTURE
Most partial dentures will need the plastic bases refitted to the gums, after 1 to 5 years as the gums naturally recede. The fee for the reline will be your responsibility. Most partial dentures will need to be remade with 5 to 10 years. Failure can occur sooner as a result of decay or gum disease related to poor plaque control. Fracture of the clasps, teeth or fillings can result from heavy or hard biting or dropping the denture. If failure occurs you will be financially responsible for re-treatment.

ALTERNATIVES TO PARTIAL DENTURES

  1. No treatment
  2. A fixed bridge
  3. Remove the teeth and have a complete denture
  4. Resin retained bridge if indicated
  5. Implants and crown(s) or bridge(s) as indicated ^

 


 

What should I do if my crown comes out?
If your crown or bridge, whether it is a permanent or temporary, can usually be recemented.  If the office is closed, you can usually put the crown or bridge back in yourself, using a denture adhesive or temporary cement sold in most drug stores.  DO NOT USE CRAZY GLUE.  We ask that you call the office when it opens, and we will try to get you in as soon as possible to see you.  DO NOT THROW AWAY A CROWN OR BRIDGE; WE CAN USUALLY RECEMENT THEM. ^



What if I have a tooth ache?
If you have a toothache, swelling or any other emergency we ask that you call the office as soon as you can. ^

 


 

What is the difference between Gingivitis and Periodontitis?
GINGIVITIS is an inflammation of the gum tissue, characterized by changes in the color, shape, firmness, surface appearance, and presence of bleeding and/or exudates (pus). Gingivitis is the only reversible state of gum disease where permanent bone loss has not yet occurred. Lack of early treatment and/or good home care can lead gingivitis to advance to permanent bone loss (periodontal disease) and eventual tooth loss.

PERIODONTITIS is the progression of gingival inflammation into the deeper periodontal tissues and bone crest, with slight loss of bone. Probing depths are generally between 3-6mm. Symptoms can be bad breath, bad taste, tender gums and bleeding. A conservative, non-surgical treatment to remove plaque bacteria, calculus (tartar), and infection has been recommended to halt progression of this disease. Periodontitis has many different states, early, acute, chronic, etc. The only way we can tell you what type it is, is with a thorough exam.

Our office is very fastidious in treating your gum tissues as well as your teeth. When you come in for your routine re-care appointments, we will alert you if we see a change in your gum tissue and inform of a treatment plan we feel is best for you. ^

 


 

 

 

 

 

 

 

 

 

 

   
   
4250 Hempstead Tpke. Suite 7, Bethpage, NY 11714
Phone: 516-735-3550 • Fax: 516-735-8067