Frequently Asked Questions

I was a smoker who gave up smoking recently but my teeth are quite yellow. Will whitening toothpastes help?

Teeth generally stain over a period of time and appear darker as we age. The outer layer of the teeth gets stained by smoking or by drinking coffee, wine or other drinks or foods that stain.

Whitening toothpastes can remove only minor stains from the external surface of the teeth and do not change the color of the teeth. These toothpastes contain some abrasive particles that helps in physically scrubbing away the stains from your teeth. They are not very effective if your stain is moderate to severe. If you are using a whitening toothpaste, it is recommended that you do not use them regularly for long periods as overuse can lead to the removal of outer surface of the teeth causing the teeth to appear dull and not glossy. So it is better if you use it occasionally alternating with a regular toothpaste.

The best way to remove stains from your teeth is to visit a dentist or a hygienist for a professional cleaning and polishing. Using ultrasonic scalers and polishing paste they can remove all the stains from your teeth safely and effectively, restoring your teeth to the original color. However, if you want to whiten your teeth from its existing color, then you would have to do a teeth whitening procedure. This involves application of whitening gels containing chemicals such as Carbamide Peroxide or Hydrogen Peroxide that can whiten your teeth by 3-8 shades lighter. Whitening procedures can be done in the dental clinic assisted with a whitening lamp to give you faster results or you could use a program at home where the dentist would take impressions of your teeth to give you custom made bleaching trays and whitening gels to use at home. The whitening gels dispensed by the dentists are approved by the American Dental Association and are certified to be safe to use.

There are many over the counter whitening gels and trays that are sold, but you need to be careful, as in many instances they can cause more harm than good. These trays are not custom made for you and the whitening gels may sometimes leak onto your gums causing chemical burns.

Two of my front teeth are quite bigger than others. Can they be reshaped to look smaller and less obvious?

Generally, the front two middle teeth is slightly larger and longer that the adjacent teeth, but from your description, it appears that they are quite prominent. These teeth may be inherently bigger or the adjacent two teeth could be smaller in size than normal, giving the illusion that the front two teeth are larger. It is difficult to give you an exact treatment unless your teeth are examined.

Depending on the above, your dentist would decide on the correct line of treatment. Cosmetic dentistry can now fix your problem and give you the perfect smile. The treatment can range from minor reshaping of your large teeth, to building up of the adjacent small teeth using composites or having porcelain veneers done to achieve a beautiful smile.

It is best that you consult with a dentist who is experienced in cosmetic procedures and he should be able to advise you the correct treatment.

Are electric toothbrushes better than manual toothbrushes?

Both manual and electric toothbrushes will work the same, depending on how you use them. It is like comparing an automatic car with a manual one. Both cars will have the same performance depending on how good the driver is. If you are quite adept at using a manual toothbrush with a correct technique and use it for minimum of two minutes then you need not use an electric toothbrush. The electric toothbrush is useful for someone who is not skillful in proper brushing techniques or tend to complete the brushing very fast. Children also find the electric toothbrushes more user friendly. By just placing the brush over the tooth using its pulsations and movements, it cleans your teeth without you having to do any brushing strokes. Many of the electric toothbrushes also come with timers that can be set to two minutes so that there is no guess work on how long you have brushed.

There are some studies showing that the electric toothbrushes are more efficient in removing plaque from teeth as compared to a manual brushes. But ultimately it depends on the person and how comfortable he is with the toothbrush and its use.

Should one keep changing toothpaste brands regularly?

All toothpastes basically contain the same ingredients. It is just a marketing ploy used by large companies claiming that their toothpaste contains a special ingredient that can solve all your dental problems. You need not change your toothpaste, unless you are using a whitening toothpaste, as prolonged use of this can damage your teeth. If you are using any medicated toothpaste for a long time it would be good to consult with a dentist to treat the underlined cause rather than just continuing using these toothpastes which would only control the symptom but not cure the problem.

It is important to understand that it is not the toothpaste that is most important but it is your brushing that is critical to maintain good oral hygiene. Only use a pea sized amount of tooth paste and brush your teeth at least twice a day.

I don’t have any major problem with my oral health. Should I still meet a dentist?

One of the most common misconceptions is that as long as there is no pain you don’t need to see a dentist, as most people consider the dentist a pain!

Unfortunately, many serious dental problems such as gum disease or dental decay may not cause any pain until the disease has reached an advanced stage, where extensive treatment may be required which could be also much more expensive to treat.

It is very important that you should visit a dentist at least once in 6 months for a regular dental checkup. Your dentist would be able to detect any potential problems in your mouth in an early stage such as cavities which could be treated with a simple restoration. Ignoring this could lead to an infection of the tooth leading to a root canal treatment and a crown. Similarly, gum disease if detected early, can be stopped by professional cleaning and oral hygiene measures. But if it is ignored, it can cause extensive destruction of the supporting bone leading to loss of teeth. As the saying goes it is always better to prevent than to cure and the only way you can do that is by regular dental checkups.

Why should children have their first orthodontic screening by age seven?

The American Association of Orthodontists recommends age seven, as the optimal time for a child to have his or her first orthodontics screening by a specialist.

By age seven, the permanent first molars and incisors have usually come in, and enough jaw growth has occurred that the orthodontist will be able to identify any current problems, anticipate future problems, and alleviate parents’ concerns.

Some signs or habits that may indicate the need for an early orthodontic examination include:

  • Early or late loss of baby teeth
  • Crowding
  • Injury-prone upper incisors (front teeth) that protrude (stick out) excessively
  • Thumb or finger sucking
  • Missing, misplaced, or blocked out teeth
  • Cross bites
  • Difficulty in chewing or biting
  • Mouth breathing
  • Jaws that shift or make sounds
  • Biting the cheek or roof of the mouth
  • Teeth that bite abnormally or not at all
  • Jaws and teeth that appear out proportion to the rest of the face

If your child has not seen an orthodontist by age seven, don’t worry. Dr Joy will still be able to detect and evaluate any existing problems, determine what type of treatment, if any, is recommended, and advice you of the best time to start treatment regardless of age.

What is the optimal time for orthodontic treatment?

Orthodontic treatment is appropriate when patients have primary (baby) teeth as well as permanent teeth. The orthodontist will determine the appropriate timing of orthodontic treatment based on your specific needs.

Phase I, also known as “interceptive treatment” or early treatment, may begin while primary (baby teeth) are still present. This treatment corrects potentially harmful conditions or makes dental adjustments that are best accomplished while the patient is still growing. Phase I treatment usually does not eliminate the need for the later treatment of your permanent teeth with full braces, but may mean future treatment goes more quickly.

Phase II, also referred to as “definite treatment”, is the period of treatment when full braces are used to adjust the position of permanent teeth to develop a proper bite and achieve the best aesthetic result. This phase can start before or after the loss of all primary (baby) teeth, and is usually necessary after Phase I interceptive treatment.

My teeth have been crooked for many years. Why should I consider orthodontic treatment now?

Orthodontic treatment, when indicated, is a positive step, especially for adults who have endured a long- standing problem. Orthodontic treatment can restore optimal tooth and jaw function. Teeth that work better usually look better, and a healthy, beautiful smile can improve self-esteem, no matter what age.

Can orthodontic treatment do for adults what it does for children?

You may be amazed to learn that one in five of the orthodontic patients is an adult. In fact, the American Association of Orthodontists estimates that nearly 1,000,000 adults in the United States and Canada are currently receiving orthodontic treatment from a specialist.

Healthy teeth can be moved at almost any age. Many orthodontic problems can be corrected as easily and as well for adults as children. Orthodontic forces move the teeth in the same way for both a 55-year-old adult and a 12-year-old child. Complicating factors, such as lack of jaw growth and periodontal (bone and gum) disease may create special treatment planning needs for the adult.

How does adult treatment differ from that of children and adolescents?

Despite the fact that teeth can be moved at almost any time in your life, some complicating factors, such as periodontal (gum and bone) disease, missing, worn, and damaged teeth become more common as you get older.

Dr Joy will ensure close communication among your general (family) dentist, periodontist, endodontist, and oral surgeon to assure that adult orthodontic treatment and any special problems are well-managed. Below are the most common characteristics that can cause adult treatment to differ from treatment for children.

Gum or bone loss (periodontal breakdown): Adults are more likely to have experienced periodontal (gum and bone) disease than children. Special treatment by the patient’s general (family) dentist or a periodontist may be necessary before, during and/or after orthodontic treatment. Bone and gum loss may limit the amount and direction of tooth movement that is advisable.

Missing, worn or damaged teeth: Missing, worn, or damaged teeth are perfect reasons to consider orthodontic treatment. Missing teeth that are not replaced often allow adjacent teeth to tip and drift. This is likely to worsen the bite and may increase the likelihood of developing periodontal problems.

No jaw growth: Jaw problems can usually be managed well in a growing child with an orthopedic growth modification appliance. Unfortunately, the adult patient no longer has growth potential. On occasion, it may be recommended for an individual to pursue both orthodontic treatment and jaw surgery to modify the size, shape and position of his or her jaw. If surgery is a necessary component of your chosen orthodontic treatment plan, Dr. Joy will discuss all aspects of your orthodontic treatment with you and an oral surgeon prior to initiating any treatment. As with all procedures, you will be able to discuss all of your concerns thoroughly with Dr. Joy and an oral surgeon so that you are comfortable with your treatment decision.

Why do teeth sometimes need to be removed?

On occasion, selective removal of primary (baby) teeth may alleviate future crowding by allowing permanent teeth to erupt in a more desirable location and in the correct order. Sometimes, particularly in cases of severe crowding, permanent teeth may need to be removed as part of your orthodontic treatment. Tooth removal will be recommended only if it is absolutely necessary and would improve your prospects for successful orthodontic treatment.

Why does orthodontic treatment sometimes take longer than anticipated?

Each patient is an unique individual and only an estimate of treatment time can be made depending on the patient’s growth maturity. Permanent teeth respond at different rates to orthodontic treatment. Rest assured, the orthodontist has specific treatment goals and objectives in mind and is dedicated to continue treatment until they are achieved. The estimated time of treatment is usually very close to the actual treatment time.

The length of treatment largely depends on the severity of the initial problem, the patient’s growth pattern, and the level of patient cooperation. Patient cooperation is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands or other needed appliances as directed, while taking care not to damage braces will most often have on-time and excellent treatment result. However, treatment can be lengthened if growth occurs differently than expected or if the patient’s cooperation is less than ideal. Inability to keep appointments, excessive tardiness, poor appliance wear, and excessive breakage can all extend treatment time.

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