I am afraid of going to the dentist ... What can I do?

It’s common for patients to feel dental anxiety or uneasiness before or during their dental appointments. Here are some tips to help you overcome your fear of the dentist:

• Talk with Dr. Krempel and/or his dental hygienist about your dental anxiety so they can explain what the procedure really entails and you know what to expect. They’re there to make your experience as comfortable and stress-free as possible.
• Patients often say that their fears were worse than the actual procedure and that if they’d only known what to expect they would have been less anxious.
• Wear headphones during your appointment to help block out sounds. Be sure to discuss this with your Dr. Krempel or your dental hygienist prior to your appointment.
• Request a numbing agent. Your dental hygienist and Dr. Krempel can often apply a numbing gel or use a local anesthesia to minimize pain.
• Everyone’s pain threshold is different. Don’t be afraid to ask for a numbing agent if you weren’t offered one or if you’re in pain—Dr. Krempel will not want to proceed unless you’re comfortable.
• Ask about anti-anxiety medication. We offer patients anti-anxiety medication to help reduce dental anxiety during the appointment. Please ask Dr. Krempel before the day of your visit about anti-anxiety medications.
• Use the chair-side TVs to watch a favorite show during your procedure. Dr. Krempel can also use the monitor to show you your x-rays and to help you to better understand your procedure. TVs are available in most exam rooms.
• Bring someone you trust to your appointment to help provide comfort and reduce dental anxiety.
• Arrive early to your appointment. Stress management can start just by reading a magazine in the waiting room.

What causes cavities?

Most people have a cavity or two. The good news is that there are several things you can do to prevent cavities. Here you can learn about cavities, what they are, and how you can avoid getting them.

Symptoms of tooth decay can include spots on the teeth, bad breath and loose fillings. Tell your dentist if your teeth are sensitive to heat or cold or if you have any tooth pain. Dr. Krempel will examine your teeth and take X-rays if needed.

Some people think only children get tooth decay, but all of us are at risk our entire lives. The good news is that tooth decay can be prevented. By following a healthy oral care routine and making smart food choices, you can lower your risk for tooth decay.

What is tooth decay?

Tooth decay is a disease that damages and breaks down teeth. A tooth has a hard outer layer (enamel), a middle layer (dentin) and a center (pulp). The more layers affected by decay, the worse the damage.

What causes tooth decay?

Your teeth are covered by a sticky film of bacteria called plaque (sounds like PLAK). After a meal or snack, the bacteria turn the sugars in foods and drinks into acid. The acid attacks the tooth enamel.

When you have sugary foods or drinks many times a day, or if you sip on the same sugary drink for long periods of time, the acid attacks your tooth enamel again and again. The acid eats away at the tooth and can cause decay. A hole can form, called a cavity .

Who gets tooth decay?

People of all ages can get tooth decay. Your risk may increase if you:

  • often snack and sip on sugary foods and drinks
  • have a dry mouth from medicines or for other reasons
  • have weak enamel due to genetics or a childhood illness
  • don’t brush twice daily with a fluoride toothpaste

Can tooth decay be passed from person to person?

No, but the bacteria that cause tooth decay can be shared. Bacteria can be passed from one mouth to another by kissing, sharing a cup or spoon, or anything else that carries a drop of saliva.

Can tooth decay be prevented?

Yes. Here’s how:

  • Brush your teeth twice a day with a fluoride toothpaste.
  • Avoid frequent sipping and snacking on sugary drinks and foods.
  • Drink water that has fluoride.
  • Visit your dentist regularly for an exam and a professional teeth cleaning.
  • Ask your dentist if dental sealants are right for you or your children.

Your saliva helps prevent tooth decay, too. It reduces acid damage to a tooth by washing away sticky, sugary foods. Saliva also makes the acid weaker. Chewing sugarless gum after eating can increase saliva flow and help rinse away sugars. The minerals in saliva also can help repair the tooth.

When choosing dental care products, look for those that show the American Dental Association’s Seal of Acceptance. The Seal of Acceptance tells you that, when used as directed, the product meets the ADA’s standards for safety and effectiveness.

Tooth decay can damage any tooth. It often occurs between the teeth and in the grooves of the back teeth, where bits of food collect. Back teeth are harder to keep clean because they are not as easy to reach. Also, toothbrush bristles cannot get into the grooves. Decay also can form at the tooth root and go below the gumline.

How is decay treated?

Treatment depends on how early the decay is caught. Before cavities form, fluoride treatments may solve the problem. If you have a cavity, you’ll need a filling. A large cavity may need a crown to replace the decayed part of the tooth. If the center (pulp) of your tooth is involved, root canal treatment may be your last chance to save the tooth. Finally, a badly damaged tooth might have to be pulled and replaced. Your dentist will discuss options and plan the best way to get your mouth healthy again.

Are baby teeth really that important to my child?

Yes, But…. Primary, or “baby,” teeth are important and serve many purposes. Primary teeth help children speak clearly, chew, and smile. Most importantly, they also act as a “spaceholder” for the developing permanent teeth. Some of the baby molars save the place for a permanent tooth until 12 years old or longer.

Pain, infection of the gums and jaws, impairment of general health, decreased nutrient intake, missed school days, and premature loss of teeth with future orthodontic issues are just a few of the problems that can happen when baby teeth are neglected. Proper care of baby teeth is instrumental in enhancing the health of your child.

Are dental X-rays safe?

Yes. According to the Radiological Society of North America the amount of radiation you are exposed to during a chest x-ray, which effects a dosage 10x more than a dental x-ray, is equivalent to the same dosage you receive from simply being alive for 10 days.

That’s right, we are exposed to very small doses of naturally occurring radiation every day such as cosmic radiation from outer space. X-rays are a necessary part of the diagnostic process. They are used to detect cavities, evaluate bone health, monitor developing dentition, evaluate traumatic injuries, and plan for orthodontic treatment.

With proper shielding and use of digital sensors, the amount of radiation received in a dental X-ray examination is extremely small. It is important to realize that dental radiographs represent a far smaller risk than undetected and untreated dental problems.

What is gum disease?

More than 75% of Americans suffer from some form of gum disease —yet many don’t even know it. If Dr. Krempel has diagnosed you with gum disease, don’t worry—he will develop a gum disease treatment plan for you that will help stop the progression of the disease.

Periodontal (gum) disease is an infection. It affects the tissues and bone that support the teeth.

Healthy gum tissue fits like a cuff around each tooth. When someone has periodontal disease, the gum tissue pulls away from the tooth. As the disease gets worse, the tissue and bone that support the tooth are damaged. Over time, teeth may fall out or need to be removed. Treating periodontal disease in the early stages can help prevent tooth loss.

Periodontal disease has been linked to some other diseases. People with diabetes or heart disease are more likely to get periodontal disease. Strokes and high stress also may be related to periodontal disease. Researchers are still studying these links.

Warning Signs of Gum Disease

If you notice any of the signs below, see Dr. Krempel. However, you can have periodontal disease and not notice any of these warning signs. That is why regular dental checkups are very important.

  • gums that bleed when you brush or floss
  • red, swollen or tender gums
  • gums that have pulled away from your teeth
  • bad breath that doesn’t go away
  • pus between your teeth and gums
  • a change in the way your teeth fit together when you bite
  • a change in the fit of partial dentures

What Causes Periodontal Disease?

Periodontal disease is caused by plaque, a sticky film that is always forming on your teeth. Plaque contains bacteria that can irritate and inflame the gums.

Inflamed gums can pull away from the teeth and form spaces called “pockets.” These pockets collect more bacteria. If the infected pockets are not treated, the gum disease can get worse.

How Can I Prevent Periodontal Disease?

  • Brush your teeth twice a day with fluoride toothpaste.
  • Floss or use another between-the-teeth cleaner daily to remove plaque and food from areas your toothbrush can’t reach.
  • Dr. Krempel or your hygienist may recommend using a germ-fighting mouth rinse or other products.
  • Eat a healthy diet and limit snacks. Find out more at the website choosemyplate.gov.
  • Visit your dentist regularly. If plaque stays on your teeth, it hardens into tartar (also called “calculus”). Professional cleanings are the only way to remove tartar, which traps bacteria along the gumline.

Are You at Risk?

Anyone can get periodontal disease. These things can increase the risk:

  • Poor oral hygiene
  • Tobacco. People who smoke or chew tobacco are more likely to have periodontal disease.
  • Diseases that affect the whole body—such as diabetes and AIDS—lower resistance to infection. If you have one of these diseases, you are at higher risk for periodontal disease.
  • Many medications, such as steroids and blood pressure drugs, can affect your gums. Some have side effects that reduce saliva, which can affect soft tissues and make tooth decay more likely. Tell your dentist about all the medications you take and any changes in your health.
  • Teens, pregnant women and those taking birth control pills face changes in hormone levels. These changes can cause gums to become more sensitive to plaque bacteria.
  • Genes may play a role. If your parents wear dentures or you have a family history of tooth loss, be extra alert for changes to your gums.
  • The bacteria that cause periodontal disease may be passed from parents to children and between partners through saliva.

You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a healthy diet and schedule regular dental visits for a lifetime of healthy smiles.

How often should I go to my dentist for a check-up?

The American Dental Association recommends a check-up at least once every six months. Medical research continues to show that poor oral health negatively impacts your entire system.

Regular checkups can ensure your dental well being, and help us catch problems early. Then we can affordably and quickly treat your issues.

Will a root canal help my toothache?

In many cases, toothaches are the result of root canal infections. Teeth that have been comprised by decay and damage are often vulnerable to bacterial infections.

Bacteria will get inside the tooth and infect the root canals, which causes pain and irritation. Most of the time, a root canal will alleviate the discomfort and cause instant relief.

Why is my tooth sensitive following a recent filling I had placed?

Tooth sensitivity after having a new filling placed, especially composite or tooth colored fillings, is a common thing. Sometimes the sensitivity is the result of the new filling being a little bit “too high” which can be fixed with a quick 5 minute adjustment.

Some sensitivity is normal after any tooth has been worked on, especially if there has been tooth decay. Decay irritates the tooth, and working on that tooth irritates it further, to where it can develop into a painful sensitivity. Generally the bigger the cavity, the bigger the filling, and consequently the greater the likelihood that you will have some sensitivity.

The decay could have been close to the pulp of the tooth. In this situation, some bacteria will always be present in the thin porous dentin between the filling and the tooth. With the tooth being irritated from being worked on, it creates a situation in which the tooth can easily become infected. If the sensitivity persists, it indicates that the tooth is not recovering from this tooth infection and will need a root canal. This is fairly uncommon however, but still important to be aware of.

Most of the time the tooth will gradually get better, usually within a couple of days, but it can last for several months. As long as the tooth gradually improves, there should be no cause for concern.

Are over the counter bleaching products the same as the kind you get from the dentist?

There are a few differences between OTC and professional tooth whitening products. The key to successful tooth whitening is having a strong enough product being in contact with the tooth surface for a sufficient amount of time to get a result. The active ingredient in both OTC and professional products is some form of peroxide, whether that be hydrogen peroxide or carbamide peroxide. The professional products have a significantly higher concentration of this ingredient in them. The other benefit of professional whitening is that the product is staying in contact with the tooth surface for a longer amount of time, due to the delivery system of either a custom tray which fits intimately over your teeth, or the direct application while you are in the dentist’s chair. The drawback of the OTC product in this aspect is that with strips, paste, or paint on products, it is more quickly rinsed off the tooth by your own saliva.

Finally, many professional products have additional ingredients which minimize side effects such as sensitivity or discomfort. These ingredients include potassium nitrate, fluoride, and water, to keep the tooth hydrated (dehydration can be a cause of post-treatment sensitivity).

OTC products are not harmful, and are worth a try if you have never whitened your teeth before. If you do not get the result you desire, seek out the advice of Dr. Kremel. Most people can benefit from tooth whitening; depending on how committed they are to the process. You should remember that keeping your teeth white is something that needs to be maintained throughout your life.

One more thing…don’t be fooled by miracle bleaching products you may hear about on the internet, radio or TV. THESE DO NOT WORK. Reviews on these products can be found on Amazon.com.

We are dedicated to giving each of our patients the healthy smile they deserve!