Frequently Asked Questions

• What can I do about bad breath?

  If you feel constantly worried about bad breath, you’re not alone. Bad breath (halitosis) is an all too common problem, not to mention embarrassing and distracting for you and others around you. Deducing what is most likely causing your bad breath will help determine what you can do to prevent it.

  Greatly reduced saliva flow during sleep (the cause of morning breath), certain foods (such as garlic, onions, and peppers), poor oral hygiene, periodontal (gum) disease, dry mouth, tobacco, dieting, dehydration, and some medical conditions (including sinus infections and diabetes) can all cause bad breath. Brushing your teeth at least twice a day (in the morning and at night) is the first thing to start doing, if you are not already in the habit. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of your teeth. Additionally, clean between your teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every couple months.

  Biannual dental cleanings and checkups at our office will not only keep your teeth and gums in good shape, but seeing you regularly will also allow us to better detect any problems, such as gum disease, dry mouth (Xerostomia), or other dental conditions (like decay), that may be the cause of persistent bad breath. If you have gum disease, more frequent visits to our office might be recommended for your oral and overall health.

  Breaking a tobacco habit (smoking or chewing tobacco) can significantly improve your oral health and the way your breath smells. Ask us about ways we suggest to help break a tobacco habit. Drinking plenty of water and eating healthy also keeps your mouth moist and more free of bad bacteria. Mouth rinses can help, too, but ask us which rinses actually kill the germs that cause bad breath, because some only mask odor as a temporary solution.

  When bad breath is a symptom of a larger bacterial problem in your mouth, Dr. Sievert can help. If he finds that your mouth is healthy, we may refer you to your physician for further consultation and more comprehensive treatment.

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• I don't have a toothache, and I brush and floss regularly. Do I really need a check-up?

  Biannual teeth cleanings performed by a skilled dental hygienist are central to keeping teeth and gums looking, feeling, and functioning well. If you have gum disease, more frequent visits to the dentist will probably be recommended for your oral and overall health.

  During cleanings, plaque and calculus (more commonly known as tartar) are removed from teeth. Plaque is a sticky deposit on teeth in which bacteria grow, and tartar is basically calcified or hardened plaque, so it is more difficult to remove. When tartar builds up under the gumline, causing gum disease, more extensive treatment than a standard cleaning is needed to remove it and help ensure healthier gums. Hygienists also polish teeth, floss (partly to test the condition of gums, to see if they bleed), and they document any bleeding along with stains they noted during the cleaning in a patient's file.

  Dental exams with a dentist make it so problems can be diagnosed and treated before they grow to be big, often painful and expensive. A typical exam includes a visual assessment of teeth and occlusion (bite), along with an appraisal of current restorations. When x-rays have been taken, the dentist will carefully review them to identify areas of decay and other possible areas of concern for cysts, tumors, and other disorders of the mouth. Panoramic x-rays are especially revealing and beneficial to this process. The dentist will perform a general screening for early detection of gum disease and oral cancer, as well.

  In between cleanings and exams at a dental office, brushing teeth at least twice a day (in the morning and at night) is the most important thing you can do to take care of your teeth. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of teeth. Additionally, clean between teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells, and how clean it actually is. Restorations, such as bridges and partial dentures, should be cleaned thoroughly, too, just like natural teeth. Toothbrushes should be replaced every two to three months.

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• Are silver fillings safe?

  Amalgam fillings are commonly called silver fillings. Dental amalgam is a stable alloy of mercury with other metallic elements, including silver, copper, and tin. While some concern has been raised about dental amalgam’s mercury content, the combination with other metals renders it stable and safe for use in filling teeth. The major U.S. Scientific and health bodies have been satisfied that dental amalgam is a safe restorative material, and current studies indicate no measurable direct health risks to patients. The extensive use of mercury in fillings, however, might have a long-term environmental impact.

  Amalgam fillings are durable and can withstand high chewing loads, so they are especially useful for restoring back molars where the mouth’s chewing load is the greatest. They are also practical for deep fillings in areas below the gum line, where it is difficult to keep dry during preparation and filling. Because amalgam fillings do not bond (stick) to teeth, preparation is “undercut,” creating a space that is narrower at the surface of the tooth and wider enough inside to keep the filling from falling out.

  One of the biggest disadvantages of amalgam fillings is that the preparatory undercutting requires the removal of more healthy tooth structure than is generally necessary with other types of dental fillings. This can weaken the natural tooth, and when amalgam fillings eventually need to be replaced it means the removal of even more healthy tooth structure. The most noticeable disadvantage of amalgam fillings is that they are not as natural looking as tooth-colored fillings, particularly when the restoration is near the front of the mouth. Composite (tooth-colored) dental fillings or, in more extensive cases of decay, inlays, onlays, and crowns, are good alternatives to silver fillings.

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• If my filling is still in place and my tooth does not hurt, why does my dentist want to replace the filling?

  Constant pressure from chewing, grinding and/or clenching can cause dental fillings to wear away, chip, and even crack. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth. Again, regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.

  When restorations are large, or if recurrent decay is extensive, there might not be enough remaining tooth structure to support a replacement filling. In these cases, we may need to replace the filling with a natural looking porcelain crown.

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• How can I tell if I'm at risk for gum disease?

  According to the American Academy of Periodontology, gum disease is the number one cause of tooth loss in adults over age 35. Gum disease ranges from gingivitis to the various forms and stages of periodontitis, and the prevalence of gum disease increases with age because teeth wear down and become more sensitive as time passes, gums naturally recede and medications can affect oral health. The prevalence of gum disease increases with age, because as we age, our teeth wear down, our gums naturally recede, teeth can become more sensitive, and medications can affect some oral changes. If your gums feel tender or sore, or if they look red and swollen, you may be at risk for gum disease. Other signs include bleeding and/or receding gums, pain or sensitivity in your teeth (and even loose teeth, caused by weakening gum fibers and/or bone loss), and persistent bad breath. If left untreated, gum disease can lead to tooth loss as well as various other health problems. More and more life-threatening illnesses are being linked to the presence of dental diseases.

  The first thing to do is get a thorough dental evaluation. If you have any degree of periodontal disease, Dr. Sievert can help. He strongly believes in and focuses on the importance of healthy gums for a healthy mouth and body. Gum disease used to require surgery more often than not. While surgery is still an option and sometimes needed, many cases are now treated with less invasive techniques first, such as deep cleanings, local antibiotics, and special rinses. Please come in and let Dr. Sievert help you achieve and maintain healthier gums for a healthier you.

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• Is there anything to calm my nerves during my exam?

  Nitrous oxide is one of the safest anesthetics used in dentistry. Nitrous oxide is a colorless blend of oxygen and nitrous oxide gases with a pleasant, sweet smell and taste. It is also known as "laughing gas." Inhaling nitrous oxide creates a sense of well-being and relaxation, and it is used effectively to help individuals who experience anxiety or fear about dental treatment feel more comfortable and at ease. Nitrous oxide increases a patient's pain threshold and, when necessary, makes the administration of anesthetic injections more comfortable. Combined with a caring dental staff, nitrous oxide has proven to be especially beneficial for children and adolescents who experience dental anxiety. It has also been found helpful if a patient has a strong gag reflex which interferes with dental treatment. Nitrous oxide can help make visits to the dental office less difficult for individuals with mental or physical disabilities, as well. The dentist has special equipment which is regularly checked and calibrated, to monitor the proportion of nitrous oxide released and adjust the flow rate to the individual patient. The gas is administered by specifically trained members of the dental staff.

  Nitrous oxide has few side effects and/or risks. It is non-addictive, and patients remain fully conscious during treatment. Nitrous oxide is administered comfortably with a mask over the mouth and nose, and a pleasant feeling of calm and sedation are felt almost immediately. Normal breathing of pure oxygen for several minutes after dental treatment is finished completely reverses the effects of the nitrous oxide, so adults can usually leave the dental office of their own accord.

  Some individuals may experience slight nausea if nitrous oxide is administered on a full stomach. For this reason, it is advisable to limit food intake for several hours before treatment, although fasting is not typically necessary. Nitrous oxide is not effective if a patient suffers from claustrophobia (because of the mask used to administer the gas), or has extreme dental anxieties. Because nitrous oxide is inhaled, it is also not effective if the patient has blocked nasal passages. For unknown reasons, it does not affect about 10% of individuals.

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• How can cosmetic dentistry treatments improve my life?

  A more beautiful smile can make life more beautiful. Studies have shown that a healthy and attractive smile can raise self-esteem, increase confidence, improve your personal as well as your professional life, and help you make better first impressions on others. Sometimes it doesn’t take much treatment for you to feel better about your smile, and there are a variety of subtle, yet noticeable ways that smiles can be enhanced. There are also more significant and dramatic treatment procedures (and combinations of procedures), often called “smile makeovers,” that can totally change teeth and smile appearance, to give you the smile of your dreams.

  While there is no true “specialist” association with cosmetic dentistry, there are a number of organizations with advanced training and awards associated with cosmetic dentistry. Some dentists place greater emphasis on cosmetic dentistry treatments, especially when they have an exceptionally artistic eye and/or particular enjoyment for cosmetic procedures.

  Advancements in dental technology have made it possible for dentists to address a wide variety of issues affecting smile appearance. Some common cosmetic dentistry treatments include teeth whitening, cosmetic bonding and enamel shaping, porcelain veneers, bridges, and orthodontic solutions (including braces and aligner therapy). Replacing old, amalgam (silver) fillings with tooth-colored fillings can also be considered cosmetic in nature, as it is done to improve both the health and structure, and the appearance of teeth. Really, all dental treatment aimed to improve the appearance of your teeth, gum shape, and smile can be considered cosmetic in nature.