What is the focus of your child’s beautiful SMILE?
Strong, healthy teeth!

Baby teeth-also called primary teeth-are important in the growth and development of a child. Baby teeth can help your child chew foods and speak. They also hold space in the jaws for adult teeth that are growing under the gums.

Babies are born without teeth. Usually baby teeth start to appear in the mouth when the child is 6 months old. By the third birthday, most children have a full set of 20 baby teeth including incisors, canines and molars.

The chart below tells the names of baby teeth, when they come in (erupt) and when they fall out (are shed). Baby teeth be will replaced by permanent (adult) teeth. However, not all children get the same teeth at the same times. Your child’s teeth may erupt earlier or later than the times shown here.

Surprisingly, tooth decay can occur as soon as your child’s first tooth comes in (erupts). So it is very important to start taking care of those “pearly whites” as soon as you see them peeking through the gums. If your child gets decay, your child can suffer pain and infection. Also, if a child is in pain, he may have trouble eating, sleeping and learning.

The bacteria that cause decay are in everyone’s mouths. Babies get these decay-causing bacteria from their caregivers, mom and dad, just as we all are exposed to germs in our families. These bacteria then stick onto the baby teeth. Brushing the teeth to clean off the bacteria is important to keep teeth healthy. Bacteria on the teeth use the sugar in foods and drinks and turn it into acid. Each time your child eats or drinks, this acid can attack the teeth for 20 minutes or longer after eating or drinking. Over time, enamel gets damaged, tooth decay develops and cavities appear.Children are more likely to get decay if their teeth are in contact with sugar often or for long periods of time. Babies should not be put to bed with a bottle. If your baby falls asleep with the bottle in his or her mouth, the liquid in the bottle pools around the teeth. Liquids such as fruit juice, soda and even milk contain sugar. Plain water in a bottle or sippy cup at the end of the day is a better choice.

Protect your child’s teeth by starting dental checkups early. The American Dental Association and the American Academy of Pediatric Dentistry recommend that the first dental visit should occur when the baby’s first tooth appears, but no later than the child’s first birthday.

Why schedule a visit so early? A dentist can show you how to clean your child’s teeth, talk about feeding, oral habits and recommend dental care products. He or she also can help you make sure your child is getting the right amount of fluoride (FLOOR-ide), a natural mineral that protects teeth. And your dentist can answer questions about your baby’s teeth.

Having a well-baby checkup at this age also connects your child to a dental home. This is a place where you can take your child from year to year. This helps the dentist get to know your child’s and family’s needs, so your child will have the best care.

If your child is a toddler, the dentist will gently examine his or her teeth and gums, looking for decay and other problems. The dentist may also clean the child’s teeth. Your toddler can also be checked for problems related to habits such as thumb or finger sucking.

Fluoride treatments and dental sealants are two important ways your dentist can prevent cavities. Dental sealants are a coating that the dentist puts on the grooves of your child’s back teeth to protect them. Your dentist will let you know if these treatments are right for your child.

Children need strong, healthy teeth to chew their food, speak and smile. Your child’s teeth also help give his or her face its shape and keep space in the jaw for adult teeth.

A baby’s teeth start to come in when the baby is about six months old. Baby teeth will later be lost one by one. This makes space for adult (permanent) teeth. By the time children are teenagers, they usually have all of their adult teeth. The last four teeth that come in are the wisdom teeth.

The charts below tell the names of the baby and adult teeth. The pictures show when each tooth usually comes in and is lost. But not all children get the same teeth at the same times. Your child’s teeth may erupt earlier or later than the ages in these charts.

Adult teeth start to form under the baby teeth. After the baby teeth are lost, the adult teeth will come in through the gums.

Most children go through a stage when they have a mix of primary and permanent teeth. During this time the smile can look uneven, with some big teeth, some small teeth, some crowded teeth or maybe even some missing teeth. Try not to worry. Smiles often even out once all the permanent teeth are in place.

When your child is about age seven, the dentist will do a “bite check” to make sure your child’s adult teeth are coming in properly and that the back teeth are working together the way they should. You dentist may also take an x-ray of the teeth. If your child’s teeth or bite need treatment, it’s best to get an early start.

A bridge is a replacement tooth or teeth that fill the space where one or more teeth are missing. The bridge restores your bite and helps keep the natural shape of your face.

Before you get a bridge, your dentist wants you to know more about the steps involved. He or she can advise which type of bridge is best for you.

A missing tooth is a serious matter. Teeth are made to work together. When you lose a tooth, the nearby teeth may tilt or drift into the empty space. The teeth in the opposite jaw may also shift up or down toward the space. This can affect your bite and place more stress on your teeth and jaw joints, possibly causing pain.

Teeth that have tipped or drifted are also harder to clean. This puts them at a higher risk for tooth decay and gum disease.

When a tooth is missing, the bone may shrink. If that happens, it may change the way the jawbone supports the lips and cheeks. Over time, this can make your face look older.

Placing a bridge usually takes more than one dental visit. On the first visit, your dentist prepares the teeth on both sides of the gap. He or she will later attach the bridge to these teeth.

Your dentist then takes an impression or an image of your teeth and the space and sends it to a dental laboratory. Technicians at the lab make the bridge. Your dentist will place a temporary bridge to protect your prepared teeth while you are waiting for the permanent bridge.

When the permanent bridge is ready, the dentist fits, adjusts and cements the bridge to the prepared teeth. This type of bridge is permanent and cannot be taken out of your mouth without a dentist’s help.

Dental implants may be used to support a bridge when several teeth are missing. Implants are posts that are surgically placed into the jaw. Over time, the bone grows around the implants to hold them in place.

Fluoride treatments and dental sealants are two important ways your dentist can prevent cavities. Dental sealants are a coating that the dentist puts on the grooves of your child’s back teeth to protect them. Your dentist will let you know if these treatments are right for your child.

Bridges are made from metal, ceramics (porcelain) or a combination of the two. Ceramics often are bonded to a metal alloy. Your dentist will talk with you about the materials that are best for you and your mouth.

A bridge can fail if the support teeth or the jawbone is damaged by dental disease. Follow these tips for good oral health:

Your gum disease treatment will depend on several factors, including your personal health history and the stage of your gum disease. This page covers:

In the very early stages – when it is gingivitis – you may just need a professional cleaning from your dental team. They can also give you some great advice and tips on how you can keep your teeth and gums healthy.

If your gum disease is beyond gingivitis, the first step in treating gum disease usually involves a special deep cleaning called scaling (SCAY-ling) and root planing (PLAY-ning). This treatment may be done over more than one visit, depending on your personal needs.

Your dentist or hygienist removes plaque and tartar down to the bottom of each periodontal pocket.

Then, the root surfaces of your teeth are smoothed, or “planed”, to allow the gum tissue to heal and reattach to the teeth.

Your dentist or hygienist may recommend certain medicines to help control infection and discomfort or to aid healing. You may be given pills, a mouthrinse or they may place medication directly into the periodontal pocket after the treatment.

Sometimes, scaling and root planing isn’t enough treatment on its own. If pockets do not heal enough after scaling and root planing, gum surgery may be needed.

Surgery allows your dentist to remove plaque and tartar from hard-to-reach areas. Afterwards, your gums will be stitched into place to tightly hug your teeth.

Surgery can also help to shrink pocket depth and make it easier for you to keep your teeth clean.

If bone has been damaged or lost by gum disease, then you may need surgery to rebuild or reshape the bone in your mouth. This kind of surgery is called a bone graft.

First, your dentist may use splints, bite guards or other types of tools to hold loose teeth in place and help tissues heal. If too much gum or bone tissue has been lost from your gum disease, he or she may need to also do a bone graft.

Your dentist may place a membrane layer at the surgical area to help your gums stay in place while the tooth root reattaches to the supporting bone tissues. This is called guided tissue regeneration.

To help you heal after surgery, your dentist may put a protective dressing over the area and recommend or prescribe a medicated mouthrinse. You may also be given a prescription to treat infection or for pain relief.

Once your gum disease is under control, it is very important for you to get dental care on a consistent basis. The periodic cleanings recommended after these treatments are called periodontal maintenance care. These cleanings are more extensive than the standard cleaning and will help you keep your gums healthy. Your periodontal maintenance involves cleanings that are deeper than a normal cleaning in the dental office. With periodic maintenance, the amount of plaque bacteria is lowered. Then, the inflammation can get better, pockets can shrink and your gums can become healthier.

You will need to see your dentist more often than other people. The pockets and other issues from your gum disease will make it harder for you to clean plaque from your teeth.

Your dentist will talk to you about a treatment plan that works best for you, and he or she will recommend a maintenance care schedule that is based on your personal case. Over time, fewer appointments may be necessary. Once your gums are healthy, your dentist will determine a maintenance schedule based on your clinical evaluations.

Once your gums are healthy, your dentist will determine a maintenance schedule based on your clinical evaluations.

You may also need special medications than can help control the infection and pain or to help your gums heal. The medicine could be a pill, a special mouthrinse, or a medication that your dentist places directly into the pocket right after deep cleaning.

Your teeth and gums may be sensitive after your treatment. This soreness may make you want to avoid cleaning the treated areas. But it’s important to follow your dentist’s instructions on home care! If plaque is not removed, root decay may form. Talk with your dentist or hygienist if a special toothpaste or other treatments can lower your tooth sensitivity.

It is very important that you brush and floss every day – especially if you are healing from gum disease.

Smoking, chewing, vaping and dipping puts you at a higher risk for cancer and other life-threatening diseases. Tobacco use also can make gum disease worse and make it harder to treat it. If you use tobacco, ask your dentist or physician for information about how to quit.

Did you know that tooth decay is the most common long-term childhood disease? Children of any age can get tooth decay, even babies and toddlers. And tooth decay is five times more common than asthma. The good news is that tooth decay can be prevented!

Tooth decay in the primary (baby) teeth of young children is also called early childhood caries. Caries is another word for a cavity. It happens when the child’s teeth come into contact with sugary foods and drinks often and for long periods of time. These drinks include fruit juices, soda and other drinks with sugar.

Parents are often surprised to learn that tooth decay can begin as soon as a baby’s teeth come in, usually by age six months. Decay in baby teeth can cause pain, and the infection can spread. If decay is not treated, it can destroy the baby teeth.

Tooth decay can also have an effect on a child’s general health. If a child has tooth pain, she may have trouble eating. The child may not get enough vitamins and minerals to grow up healthy.

Baby teeth hold space in the jaw for the adult teeth. If a baby tooth is lost too early, the teeth beside it may drift into the empty space. When it’s time for the adult teeth to come in, there may not be enough room for them. This may cause adult teeth to be crowded and crooked. Crooked teeth may be hard to keep clean.

If a child’s baby teeth are healthy, it is more likely his adult teeth will be healthy too. Children who have decay in their baby teeth are more likely to have decay in their adult teeth.

Decayed and crooked teeth also can affect your child’s self-esteem. Tooth decay is not only unhealthy, it also looks bad. If your child has tooth decay he may feel bad about his smile. On the other hand, a nice-looking smile can give your child confidence at school.

Children learn healthy habits from their parents and caregivers. You can start good habits if you clean your child’s teeth every day, feed your child a healthy diet and take her to the dentist regularly.

Insight about your overall health can sometimes be seen in your mouth. In fact, periodontal (perry-oh-DON-tal) – or gum – disease is common in people with chronic diseases like heart disease or diabetes. This page explains the connection between your oral health and your overall health.

When your body reacts to this infection and your gums are inflamed, this condition is called gingivitis (jin-ja-VY-tis), and it can lead to more serious types of gum disease. The good news about gingivitis is that it can be reversed.

If the gum disease is caught early enough (when it is gingivitis), you may simply need a professional cleaning. Your dental team can also give you advice for improving your daily oral hygiene.

If gingivitis is not treated, it can turn into periodontitis (perry-o-don-TIE-tis). Periodontitis is usually not painful, but it can lead to bone loss.

Your body responds to the toxins that the bacteria produce by breaking down the gum tissues and bone around your teeth.

Warning signs of gum disease:

You may notice one or some of these warning signs, or you may not have any signs of gum disease at all. This is why it’s important to see your dentist regularly – treatment of gum disease is most successful when it’s caught early.

Certain chronic diseases are sometimes shown to raise your risk of gum disease. And, sometimes having gum disease is shown to raise your risk and severity of chronic disease. While it may not be clear whether one drives the other, some of the chronic diseases that commonly occur with gum disease are:

Oral cancers can be deadly diseases. Each year in the United States, roughly 45,000 new cases of mouth and throat cancer are diagnosed, and about 13% of people die within the same year they are diagnosed.

Treatment may be more successful with oral cancers that are found early. Your dentist checks for these cancers every time you visit, so this is one more reason to see your dentist regularly.

This brochure will tell you some ways to lower your risk for mouth and throat cancer. And by watching for the signs and symptoms listed here, you are more likely to find the cancer earlier if you do have it.

Anyone can get cancer. There are some factors that you may control – such as smoking cigarettes or chewing tobacco, heavy alcohol consumption, and exposure to the human papillomavirus (HPV) – which increase your risk of developing of developing oral cancer. Below is more information about factors that can affect your chance of developing mouth or throat cancer.

Do you have frequent headaches, earaches, tender jaw muscles or a dull, aching facial pain? Does your jaw lock or stray to one side when you open your mouth? These aches and pains may be related to the jaw joint, called the temporomandibular (tem-PORO-man-DIB-u-lar) joint or “TMJ,” and the muscles that work to move the joint. When the source of these problems is this joint or its muscles, they are often referred to as “TMD” for temporomandibular disorders.

To determine how best to treat your TMD, a complete evaluation is recommended. Your dentist may check the joints and muscles for tenderness, clicking, popping or difficulty moving. Your complete medical history may be reviewed, so it is important to keep your dental office record up-to-date about your health even though you may not think it has anything to do with your teeth. Your dentist may take X-rays of your teeth, jaw or TMJ, and may make a model of your teeth to see how your bite fits together.

The joints and muscles on each side of your jaw work to open and close the mouth. These joints move in many different directions to give you the range of motion needed to chew, talk and swallow.

The two temporomandibular joints are among the most complex joints in the body. They work together in a delicate balance with muscles, ligaments, cartilage and your jaw bones. Pain can result when these parts don’t work together properly.

In some cases, your dentist may recommend fixing an uneven bite by adjusting or reshaping some teeth. Orthodontic treatment may also be recommended.

Mouth sores can be painful, annoying and unsightly.

Some appear inside the mouth – on the gums, tongue, lips, cheeks or palate (roof of the mouth). Others, like cold sores, can appear outside the mouth, such as on and around the lips, under the nose and on the chin.

Although there are many types of mouth sores, the most common are canker sores, cold sores, leukoplakia (a thick white or gray patch) and candidiasis or thrush (a fungal infection).

Some people may experience occasional discolored, painless spots in their mouth. Most are harmless and will disappear or remain unchanged. However, some sores or spots can be serious and need the attention of your dentist or physician. For example, oral cancer may not be painful at first, but it can be deadly. That’s why regular dental checkups are important. Have your dentist examine any mouth sore or spot that fails to heal within two weeks.

Canker sores appear inside the mouth. They usually are small ulcers (minor aphthous ulcers) with a white, yellow or gray center and a flat red border. Rarely, canker sores can be very large (major aphthous ulcers) with a raised border. There may be one or several ulcers and they recur at varying periods of time.A canker sore usually begins as a red spot or bump. It may produce a tingling or burning sensation before other symptoms appear. Canker sores are painful. Fortunately, most canker sores heal spontaneously in 7 to 10 days.

The exact cause of canker sores is not known. Genetics play a role. White cells (lymphocytes) in our immune system may affect the lining of the mouth causing these irritating, but harmless, sores. Fatigue, emotional stress, and certain foods can increase the possibility of a canker sore for some people. Even biting the inside of the cheek or tongue or chewing a sharp piece of food may trigger a canker sore.

Canker sores are not contagious or precancerous. There is no permanent cure for canker sores; therefore, treatment is for discomfort or pain. Over-the-counter topical medications (such as numbing agents or protective ointments) and antimicrobial (germ-fighting) mouth rinses may offer temporary relief. Avoid hot, spicy or acidic foods and beverages that can irritate the sore. Treatment for an attack involves corticosteroids, Prednisone-like medications that control troublesome lymphocytes. The medication may be in a topical form (applied to the skin), or systemic (taken as a tablet or capsule).

Cold sores are groups of painful, fluid-filled blisters (often called fever blisters). These unsightly sores usually erupt on the lips, and sometimes on skin around the lips. Clusters of small blisters may also occur on the gum tissue near the teeth and/or on the bony roof of the mouth.

Cold sores – caused by herpes virus Type 1 or Type 2 – are contagious. The initial infection (primary herpes), which often occurs before adulthood, may be confused with a cold or the flu. The infection can cause painful lesions to erupt throughout the mouth, and some patients can be quite ill for a week. Most people who get infected with herpes do not get sick, however. Once a person is infected with herpes, the virus stays in the body, where it may remain inactive. Unfortunately, in some people, the virus becomes activated periodically, causing the cold sore to appear on the lips or other sites. A variety of irritants (wind, sun, fever, stress) can cause a flare.

Cold sores usually heal in about a week. Once the blister breaks, an unsightly scab forms. Over-the-counter topical anesthetics and protectants, anti-inflammatory agents or topical antiviral agents may provide temporary relief for the discomfort but do little to speed healing. As with the common cold, there is no cure for these viral infections. Topical or systemic antiviral drugs can be prescribed by your dentist, but they are ineffective after 3 to 4 days of blister formation and usually are not recommended in otherwise healthy patients.

Leukoplakia (loo-koh-PLAY-kee-ah) is a white or gray patch that develops anywhere on the inside of the mouth. It is caused by excess cell growth of the lining of the mouth. It is often a response to chronic irritation, such as smoking or smokeless tobacco (snuff, chewing tobacco), certain foods, cheek biting, irregular dental restorations or broken teeth. In some instances, a cause cannot be determined. Leukoplakia patches develop slowly over a period of time. The patch may eventually become rough. It typically is not sensitive or painful.

Leukoplakia generally is harmless, but there is a risk that it can become cancerous. To be certain that a spot or sore is not a threat, your dentist may do a biopsy to determine if any potentially dangerous cells are present. If the leukoplakia is sensitive, cancer must be ruled out by biopsy.

Erythroplakia (e-ryth-ro-PLAY-ki-a) is a red patch that may be found in any part of the mouth but is most common in the floor of the mouth or on the gum tissue behind the back teeth. The cause is unknown but is most likely associated with smoking or other tobacco use and alcoholic beverages. Chronic irritation and poor nutrition may also be contributing factors. Although erythroplakia is less common than leukoplakia, most of these lesions are found to be precancerous or cancerous when biopsied. Red lesions that do not heal in a week or two should be evaluated by your dentist. This applies even if you do not smoke or drink alcohol.

Lichen planus (li-ken PLAY-nus) is a disorder that involves a chronic, itchy, inflammatory rash or lesion on the skin or in the mouth. The lesions may consist of white spots or “lacelike” white changes. Lesions on the sides of the tongue, insides of the cheek and on the gums, may be tender or painful. Its cause is genetic and related to a chronic immune system reaction.

Lichen planus generally occurs during or after middle age. Lichen planus is not contagious and does not pose a high risk for becoming cancer. There is no cure, so treatment is for discomfort or pain. Rinses, ointments, or pills can be prescribed by your dentist, if needed. The diagnosis can be confirmed by biopsy and clinical characteristics.

Candidiasis (can-di-DI-a-sis), also known as oral thrush or moniliasis, is a fungal infection. It produces creamy white and red patches that form on surfaces of the mouth. It can be painful and may cause bad breath and difficulty tasting and/or swallowing.

It occurs when the yeast Candida albicans reproduce in abnormally large numbers. For example, Candida may flourish after antibiotic treatment, when normal bacteria in the mouth have decreased, when the immune system is suppressed or when the mouth is dry (xerostomia). Dry mouth is a common side effect of many prescription or over-the-counter medications.

Candidiasis most often occurs in the very young, the elderly, and those debilitated by disease, such as diabetes and AIDS. It also frequently occurs among people who wear dentures.

Treatment consists of controlling conditions that cause the outbreak. Cleaning dentures to remove Candida is important in preventing denture-induced problems.

Saliva substitutes or prescription medications are also available to treat dry mouth. Antifungal medications may be used when the underlying cause cannot be treated or eliminated. Good oral hygiene is essential.

Oral or mouth cancer may appear on the lips, tongue, cheek lining, gums, palate (roof of the mouth) or floor of the mouth. Cigarettes and other tobacco products, including smokeless tobacco, are associated with 70 percent of oral cancer cases. Drinking alcoholic beverages can also increase your chances of having oral cancer.

Oral cancer may appear as a white or red lesion, lump or ulcer. It is usually small and painless at first, but can grow and spread quickly. Many oral cancers are discovered during routine dental examinations. Control of leukoplakia and erythroplakia may prevent some oral cancers from developing. Some oral cancers can resemble benign (non-dangerous) changes, so may delay early diagnosis. Early diagnosis and treatment increase the chance of a good quality of life.

When your teeth are healthy, your gum tissue tightly hugs each of your teeth. But, when your gums pull away from your teeth, it is called gum recession (re-SESH-un). Gum recession can happen at any age.

Even if you take good care of your teeth, it is possible that gum recession may still happen.

Gum recession can cause problems for your teeth. Your dentist can help you understand what is causing it to happen and suggest a treatment.

Gum recession can leave the tooth root exposed. The root surface does not have a hard, protective layer covering like the top of the tooth, so it may become sensitive to hot and cold. The exposed tooth root is also more at risk for decay.

It is important to treat gum recession so that it doesn’t get worse and cause other problems. The type of treatment for gum recession depends on the cause.

If gum recession is caused by brushing too hard, your dentist or hygienist can show you a better way to clean your teeth. This will not repair the existing damage, but it will prevent new damage to your gums.

If gum recession is caused by periodontal (gum) disease, the first step is usually a deep cleaning treatment called scaling (SKAY-ling) and root planing (PLAY-ning). Your dentist removes plaque and tartar from your tooth and root surfaces. This helps gum tissues heal and reattach to the tooth. For many patients, this plus excellent oral care at home and regular dental visits can help control gum disease and recession.

If gum recession is caused by partial dentures that don’t fit right, your dentist can adjust or remake them for you.

If your recession is advanced, a gum graft may be needed. A thin piece of gum tissue is taken from another place in your mouth and attached where the gum tissue has receded. Once the graft heals, it covers the exposed tooth root.

Grafts may be done around one or more teeth. They protect the tooth root from sensitivity and decay. A graft can also be used to make a smile look better.

If you have a gum graft, your dentist will tell you how to care for your gums. This may include using a special mouthrinse and changing what you eat. A bandage or dressing may be placed over the graft to help it heal.

Gum grafts are a kind of surgery and the area may be tender or sore and may swell. Most people are able to go back to their normal routines the next day. However, you may need to avoid chewing for a week or two where the surgery was done. Your dentist will talk with you about your specific healing time.

To help your gums heal after surgery:

Knowing how to handle a dental emergency can mean the difference between saving and losing your child’s tooth. Here are some tips to help you cope quickly and calmly with a dental emergency.

If something happens to any of a child’s primary (baby) teeth, you should take your child to the dentist as soon as you can. If a tooth is completely out, do not try to put it back into the tooth socket. Although it is normal for children to lose primary teeth, an accident that damages a primary tooth could also harm the permanent (adult) tooth underneath.

Rinse the mouth with warm water to keep the area clean. Put a cold compress (like an ice pack or a washcloth with ice wrapped inside) on the face to reduce swelling. Go to the dentist right away. If you can find the broken tooth piece, bring it with you to the dentist. Wrap it in some wet gauze or a wet towel if possible.

Clean the area gently with a cloth and place a cold compress on the area to keep swelling down. If there is a lot of bleeding or if it doesn’t stop after a short time, take your child to a dentist or an emergency center.

Gently try to remove the object with dental floss. If that does not work, go to the dentist. Do not try to remove the object with a sharp or pointed instrument.

Rinse the mouth with warm water to clean it out. Give your child what you would normally give him or her for pain. Do not put aspirin directly on the aching tooth or gums. Take your child to the dentist as soon as you can. If your child’s face is swollen, take your child to your dentist or physician. Swelling of the face can be a sign of serious infection.

Apply a cold compress to control swelling. Take your child to the dentist or an emergency center right away.

If you answered yes to any of these questions, you may be increasing your chances of developing cavities.

Certain eating patterns and food choices can lead to tooth erosion (ee-ROW-shun) and cavities. A steady supply of sugary foods and drinks, including sports drinks, sodas and energy drinks, can damage your teeth. Even snacking on healthy foods like oranges and dried fruit all day long can increase your risk of erosion and cavities. Here’s why:

Plaque is a sticky film of bacteria that forms on teeth. When you do not remove plaque from your teeth every day, it builds up. The bacteria in plaque create acid from eating the sugars found in what you eat and drink. This acid attacks enamel (e-NAM-uhl), the hard surface of the tooth. The acid stays on the enamel for up to 20 minutes after you are finished eating and drinking. Eventually, the enamel can wear away from these acids and cavities can start to form. Cavities do not go away on their own and must be treated by a dentist.

When you have sugary foods or drinks many times a day or over a long time, it exposes the enamel of your teeth to acid attacks throughout the day. This raises your risk of tooth erosion and getting cavities.

Eating a well-balanced diet may improve your chances of avoiding diseases like heart disease, type II diabetes, and oral diseases, like cavities.

For teeth to be healthy, they need vitamins, protein, calcium, and phosphorous – and you can get them all from a healthy diet.

You cannot and should not remove all sugar from your diet. Many foods and drinks – like apples, carrots, and milk – naturally contain sugars and have key vitamins, minerals, and nutrients that your body needs. Avoiding foods that contain a lot of sugar but few other nutrients will lower your chance of developing cavities and have other health benefits, too!

Periodontal (perry-o-DON-tal) Disease is an infection and inflammation that affects the tissues and bone that support your teeth. It’s also called gum disease.

A surprisingly wide variety of bacteria are normally found in your mouth. When certain types of bacteria outgrow the others, this starts the process of gum disease.

When your gums are healthy, your gum tissues tightly hug each of your teeth. When you have gum disease, your gums pull away from your teeth. As the gum disease gets worse, the tissues and bones that support your teeth become damaged. Over time, your teeth may fall out or need to be removed. Treating periodontal disease in the early stages can help prevent tooth loss.

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

It is important to talk to your dentist if you suffer from any long-term health problem. Together, you can work out an oral care plan for your best oral and overall health.

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

Plaque is a sticky film of bacteria that is always forming on your teeth. Bacteria that live in the plaque can make your gums become red, puffy and swollen. When plaque is left on your teeth and gums, it hardens. Hardened plaque is called tartar (TAR-ter) and can only be removed when your teeth are cleaned in the dental office.

When your gums are red, puffy and swollen, they can start to pull away from your teeth. Spaces called pocketsstart to form between your gums and teeth. These pockets give bacteria a place to collect and grow. The bacteria in your pockets will cause your gum disease to get worse. These bacteria produce toxins, which causes your body to break down the gum tissues and bone around your teeth.

It generally costs much less to keep your teeth and gums healthy than to wait until you have a problem that needs to be treated. These healthy habits can help:

Don’t use tobacco!

If you smoke, chew, or dip tobacco, then it is very important you quit. Using tobacco in any form slows down your healing and raises your chances of getting gum disease again or it getting worse if you already have it. Talk to your dentist or doctor about ways you can quit.

Anyone can get gum disease, but there are things raise your risk of getting it. These include:

Your dentist or hygienist uses an instrument called a periodontal probe to gently measure the depth of the pockets around each tooth. When your teeth are healthy, the pocket depth is 3 millimeters (mm) or less. Usually, the more severe the disease, the deeper the pocket, which give bacteria more room to grow and cause serious damage to your teeth, gums and bone.

Periodontal probe of healthy gums.

Periodontal probe showing a pocket forming between the tooth root and the gums.

Dental x-rays can check on the amount of bone that is supporting your teeth. If low bone levels are spotted, it could be a sign of damage from gum disease.

Healthy gums have bone that supports the teeth.

Gum disease can create bone loss.

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.

Advanced Periodontitis image courtesy of Dr. John C. Hall.

Our teeth are covered with a sticky film of bacteria, called plaque (sounds like PLAK). When we eat or drink anything that contains sugar-such as cookies, candy, soda, juice, or sports drinks-bacteria turn the sugar into acids that can attack tooth enamel. Over time, these attacks may cause tooth decay, or cavities. The good news is that there is a way to protect teeth and prevent decay: dental sealants.

Tooth decay often begins on the chewing surfaces of the back teeth. These surfaces have pits and grooves that trap plaque, bacteria, and bits of food. The pits and grooves are hard to keep clean, because toothbrush bristles cannot reach into them.

That is how decay starts in the pits and grooves and cavities form. To keep decay from starting here, the dentist may recommend dental sealants.

Sealants usually last several years before they need to be replaced. Over time, sealants can become loose or worn. Then they may not protect the teeth as well. Chewing on ice or hard foods can also break down sealants. During regular dental visits, your dentist will check your sealants and reapply them if needed.

Sealants protect only the chewing surfaces of teeth. To prevent cavities, follow these Healthy Smile Tips:

Sealants are most often placed in children and teenagers, since tooth decay can start soon after teeth come in. But adults can sometimes benefit from sealants too, because you never outgrow the risk for developing cavities.

A sealant can be placed on a tooth that does not have a cavity in its pits and grooves. If a tooth is stained or has mild decay, your dentist may suggest you get a sealant, or another option may be necessary. If a tooth has more advanced decay, it will need a filling.

Prevention is always better than treatment. Sealants are very useful in preventing tooth decay on the back teeth and can save patients money over time. Your dentist can make sealants part of your plan for a healthy mouth.

Sealant photos courtesy of Dr. Adam A. Francois.

Periodontal disease (also known as gum disease) is an infection of the gum and bone that support the teeth. If periodontal (perry-oh-DON-tal) disease is not treated, it can get worse and lead to tooth loss. Periodontal disease may not be painful. You may not be aware of a problem until your gums and supporting bone are damaged.

Fortunately, periodontal disease often can be treated with a deep cleaning called “scaling and root planing.”This brochure will tell you why treating periodontal disease is important, and how it can help you keep your teeth.

Periodontal disease is caused by plaque, a sticky film of bacteria that is always forming on your teeth. If teeth are not cleaned well, plaque bacteria can cause your gums to become inflamed.

Inflamed gums can pull away from the teeth, forming spaces called “pockets.” These pockets trap more plaque that cannot be removed with toothbrushing. If the pockets are not treated, the periodontal disease can get worse.

Diseases such as diabetes and AIDS can place a person at higher risk for periodontal disease. Tobacco use also increases your risk of developing periodontal disease, and treatment may be less successful if you continue to smoke or chew.

Healthy gums and bone hold teeth firmly in place. Gums hug the teeth tightly. There is little or no buildup of plaque and tartar (calculus).

Gingivitis (jin-ja-VY-tis) is the early stage of periodontal disease. It develops as plaque irritates the gums. The gums become red, tender, swollen and likely to bleed. Gingivitis can usually be reversed with a professional dental cleaning plus improved oral hygiene. If plaque is not removed, it can harden into tartar.

Periodontitis (perry-oh-don-TIE-tis) is a more serious condition that can develop if gingivitis is not treated. Periodontitis happens over time as plaque inflames the gums. The gums and bone that support teeth are damaged. Unless treated, the affected teeth may become loose and even require removal by a dentist.

If you schedule regular dental exams, your dentist can catch periodontal disease before the gums and the bone supporting your teeth are severely damaged.

Periodontal treatments depend on the type of the disease and how severe it is. If the disease is caught early (when it is gingivitis), and no damage has been done to the supporting structures under the teeth, you may simply need a professional cleaning. The dental team can give you tips for improving your daily oral hygiene.

Even with these measures, some patients develop more severe periodontal disease. The first step in treating the disease usually involves a special deep cleaning called “scaling and root planing.” In this treatment, the dentist removes plaque and tartar down to the bottom of each periodontal pocket. This treatment may be done over several visits, depending on your needs.

The root surfaces of the teeth are then smoothed (or “planed”) to allow the gum tissue to heal and reattach to the teeth. This treatment also may take more than one visit.

Your dentist may recommend medications to help control infection and pain or to aid healing. These can include a pill, a mouthrinse or a medication that the dentist places directly into the periodontal pocket after scaling and root planing.

If you smoke or chew tobacco, it is important to quit. Ask your dentist or physician for information about ways to stop.

Another dental visit will be scheduled within a few weeks or months after your last scaling and root planing treatment. At this visit, your dentist or hygienist will look at your gums to see how they have healed. He or she will measure the periodontal pockets again. If the pockets have gotten deeper and the supporting bone is lost, more treatment may be needed.

Once your periodontal treatment is completed, your dentist may recommend more frequent checkups and cleanings. Regular dental visits and deep cleanings are important to keep periodontal disease under control. In some cases, your appointments may alternate between your general dentist and periodontist.

Good oral hygiene at home also is very important to help keep periodontal disease from becoming more serious or from coming back. Daily home cleaning helps keep plaque under control and reduces tartar buildup.

You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a healthy diet and visit your dentist regularly for a lifetime of healthy smiles.

Your mouth has bacteria that can get into your bloodstream. For most people, these bacteria don’t cause a problem. But there is concern that for some people, bacteria in the bloodstream can cause an infection elsewhere in the body. That’s why your physician or dentist may advise you to take an antibiotic before some dental procedures. The antibiotic can kill infection-causing bacteria.

Not everyone should take antibiotics before dental treatment. This brochure will explain who should take antibiotics in this case and who should not.

Bacteria normally are found on and in some parts of the body, including the skin and mouth. The bacteria in the mouth can enter the bloodstream. This can happen during some dental treatments, like teeth cleanings, or even from daily activities like chewing, toothbrushing, and flossing. For most people, the body’s immune system fights any bacteria, so the risk of infection stays low.

There’s concern that for some people, bacteria in the bloodstream can cause an infection of the heart lining or valves (infective endocarditis) or an infection of an orthopedic implant (such as artificial joints or metal plates or rods).

Because of this concern, some people with certain heart conditions and orthopedic implants are told to take antibiotics before having certain dental treatments. This is done with the belief that antibiotics might help prevent infective endocarditis or an implant infection. Taking antibiotics before dental treatment is called antibiotic prophylaxis (or preventive medicine).

However, there is no scientific evidence to show that bacteria in the bloodstream cause orthopedic implant infections. There is also no scientific evidence that antibiotic prophylaxis defends against infective endocarditis or an implant infection

The American Heart Association recommends antibiotics for patients who would be in the most danger if they developed a heart infection.

The American Dental Association and American Academy of Orthopedic Surgeons also do not recommend antibiotics for all dental patients who have had orthopedic implants. However, some people with orthopedic implants may decide to take antibiotics. For example, people who have weak immune systems are at greater risk for artificial joint infection. Diabetes, rheumatioid arthritis, cancer, chemotherapy, and chronic steroid use can weaken the immune system. All patients should talk to their dentists and/or physicians before deciding whether or not to take antibiotics.

In most cases, taking antibiotics is more likely to cause a problem than defend against one. Antibiotics can cause side effects from mild stomach problems to severe allergic reactions. Taking antibiotics can destroy good germs that protect against infection. Also, improper use of antibiotics can lead to the development of drug-resistant bacteria.

If you’re missing one or more teeth, you may be all too aware of their importance to your looks and dental health. Your teeth are designed to work together to help you chew, speak, and smile. When teeth are missing, it is difficult to do these things. Even the loss of a back tooth may cause your mouth to shift and your face to look older. Fortunately, missing teeth can be replaced.

The following are three options your dentist may suggest, depending on your needs. Replacement teeth should last for years at a time, so it is important to choose a treatment that’s right for you.

Many patients choose implants to replace a single tooth, several teeth, or to support a full set of dentures. Implants are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth. They are made of titanium (a strong, lightweight metal) and other materials that are accepted by the human body.

Most patients find that an implant is secure and stable—a good replacement for their own tooth. However, implants are not an option for everyone. Because implants require surgery, patients should be in good health overall. Patients either must have adequate bone to support the implant, or be able to have surgery to build up the area needing the implant. Patients also should be ready to commit to a daily oral care routine and to regular dental visits.

Chronic illnesses, such as diabetes or leukemia, may slow healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing. Your dentist can help you decide whether implant treatment is a good option for you.

There are many different kinds of implants. Treatment can take only one day, or it can take several months, or somewhere in between. Your dentist can outline a treatment plan that is most likely to be successful for you.

There are three general phases of implant treatment:

1. Placement of the implant: The dentist surgically places the implant into the jawbone. There may be some swelling and/or tenderness after the surgery, so pain medication is usually prescribed to ease the discomfort. Your dentist may recommend a diet of soft foods during the healing process.
2. The healing process: What makes an implant so strong is that the bone actually grows around it and holds it in place. This process takes time. Some patients might need to wait until the implant is completely healed, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.
3. Replacing your missing tooth or teeth (prosthesis): The dentist or a lab will custom-make a crown, bridge or dentures to fit your mouth and your implants. Once completed, the man-made teeth are attached to the implant posts.

The prosthesis usually takes some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture. This can help you eat and speak normally until the permanent replacement is ready.

During one or more follow-up visits, the bridge is fitted, adjusted and cemented in place.

Talk to your dentist. He or she can answer your questions and help you decide which option will work best for you: implants, a fixed bridge or removable partial denture.

Do you sip soft drinks or other sugary drinks all day at your desk? Do you use breath mints or eat candy often? Instead of eating meals, do you snack all day? Do you often grab a sports or energy drink when you are tired?

If you answered yes to any of these questions, you may be increasing your chances of tooth decay. Keep reading to find out why.

Eating habits and food choices can lead to tooth decay, or cavities. A steady supply of sugary foods and drinks, including sports and energy drinks, can damage teeth. But snacking or “grazing” all day long can also lead to tooth decay.

Plaque (sounds like “back”) is a sticky film of bacteria that forms on teeth. When you do not remove plaque from your teeth every day, it builds up. Plaque bacteria use sugar to make acid that attacks enamel, the hard surface of the tooth. The acid can attack tooth enamel for up to 20 minutes after you consume sugary foods or drinks.

When you have sugary foods or drinks many times a day or sip the same sugary drink for a long time, acid attacks the enamel again and again. Repeated acid attacks can cause tooth decay, which must be treated by a dentist.

One way of making smarter food and drink choices is to read their labels to make sure they are low in added sugar.

Eating a healthy diet helps keep you from feeling tired, getting sick, being overweight, and having other health problems, like tooth decay. A healthy diet is one that

Almost all foods have some type of sugar. You cannot and should not remove all sugar from your diet. Many foods and drinks, like apples, carrots, and milk, naturally contain sugars and have vitamins, minerals, and nutrients that your body needs.

For teeth to be healthy, they need vitamins, protein, calcium, and phosphorous.

People generally think of teeth as being white. But tooth enamel can be many different shades. Over time, tooth enamel can change color or become stained.

If your teeth are discolored, tooth whitening may help. “Whitening” is any process that can make teeth look whiter. It may be safely done at home or in a dental office.

Tooth-whitening options range from gentle surface whiteners to stronger ones that can also remove deeper stains. There are many different types of tooth whitening products. They fall into three main types:

Whitening toothpastes help remove stains on the surface of your teeth. They are the gentlest kind of whiteners. Since they work using polishing action rather than chemicals, they usually do not have side effects. However, they do not get teeth as white as chemical products. Whitening toothpastes can lighten teeth a little bit at a time, over days or weeks.

Home-use whiteners come from your dentist or are sold over the counter. They can be applied with trays, strips, a rinse, or a brush. They usually contain a chemical called peroxide, which gets below the surface to lighten tooth enamel. Home-use whiteners are meant to be used over days or weeks. It is best to consult your dentist before whitening your teeth.

Your dentist may make special whitening trays for your upper and lower teeth. You put the whitening gel in the trays and wear them for short times during the day or overnight. Your dentist will tell you how long to wear them. If you wear the trays for too long, the peroxide in the gel can irritate your teeth.

In-office whitening is done in the dental office. In-office whiteners are much stronger than whitening toothpastes and home-use whiteners, since they have more peroxide. They can change the color of your teeth faster than the other methods.

The in-office whitening is usually done in about one hour. To help protect the mouth from the peroxide, the patient’s gum tissues are covered either with a thin sheet of rubber or a protective gel. Sometimes a light or laser is used with the peroxide.

Almost all foods have some type of sugar. You cannot and should not remove all sugar from your diet. Many foods and drinks, like apples, carrots, and milk, naturally contain sugars and have vitamins, minerals, and nutrients that your body needs.

For teeth to be healthy, they need vitamins, protein, calcium, and phosphorous.

For a few days after treatment, your teeth may be sensitive to very hot or cold temperatures. Whitening may also irritate the gums for a short time. If the side effects do not go away after a few days, see your dentist.

To avoid harming your teeth and gums, always follow the product directions and any instructions from your dentist. If your teeth become very sensitive or you get sores in your mouth, stop using in-home products and call your dentist.

There is such a thing as too much whitening. Do not use whitening products for longer than advised in the product directions or by your dentist. Overwhitening can cause severe discomfort to your teeth and gums. Too much whitening can even harm your tooth enamel.

Tooth whitening is not a good choice for all people. If your gums have pulled away from the teeth in some places, whitening may irritate these areas. If you have tooth decay or gum disease, your dentist may recommend that these be treated before whitening. Also, the color of fillings, crowns, and some stains cannot be changed by tooth whitening.

So talk to your dentist about tooth whitening before you begin. He or she will do an oral exam to find out if tooth whitening is right for you.

Having dental coverage can make it easier to get the dental care you need. But, it’s important to understand that most dental benefit plans do not cover all dental procedures. When deciding on your treatment, dental benefits should not be the only thing you consider.

You should know what your dental plan covers and what it doesn’t. This information can help you understand why your dental benefit plan may not pay for all or even a portion of your recommended treatment. Ultimately, your treatment should be determined by you and your dentist – not by your level of dental coverage.

Your dentist’s primary goal is to help you maintain good dental health, but not every procedure your dentist recommends will be covered. To avoid surprises on your bill, it’s important to understand what and how much your plan will pay. Your employer and the plan provider agree on the amount your plan pays and what procedures are covered. Your dentist is not involved in deciding your level of coverage.

Your dental coverage is not based on what you need or what your dentist recommends. It’s based on how much your employer pays into the plan. Sometimes, you may have a dental care need that is not covered by your plan. Employers generally choose to cover some, but not all, of employees’ dental costs.

Almost all foods have some type of sugar. You cannot and should not remove all sugar from your diet. Many foods and drinks, like apples, carrots, and milk, naturally contain sugars and have vitamins, minerals, and nutrients that your body needs.

For teeth to be healthy, they need vitamins, protein, calcium, and phosphorous.

There are certain cost-control measures that dental benefit plans use to determine how they share treatment costs with you. Here are some key terms that are used to describe these measures:

A deductible is the amount of money that you must pay before your benefit plan will pay for any service. It can take more than one service or visit to meet your deductible. Most plans don’t require a deductible for preventive services like cleanings and exams or for diagnostic services.

If the annual maximum of your plan is too low to meet your specific needs, you may want to ask your employer to consider a higher annual maximum. If your plan also covers braces, there is usually a separate lifetime maximum limit.

Bruxism is a habit of grinding or clenching the teeth. Clenching means you tightly hold your top and bottom teeth together. Grinding is when you slide your teeth back and forth over each other. Bruxism can happen in children and adults of any age.

Many people with bruxism wake themselves up during the night with a loud clenching or grinding sound. Sometimes the sound is so loud that other people can hear it. For other people, bruxism may be silent.

The causes of bruxism are not known for certain. Stress, sleep disorders and an abnormal bite are some things that may play a role.

Your dentist can diagnose bruxism by checking for unusual wear spots on your teeth and looking at any related symptoms. Regular dental checkups are important to find damage in the early stages. Your dentist can help you manage bruxism and the related symptoms, as well as repair your teeth if necessary and help prevent further damage.

Almost all foods have some type of sugar. You cannot and should not remove all sugar from your diet. Many foods and drinks, like apples, carrots, and milk, naturally contain sugars and have vitamins, minerals, and nutrients that your body needs.

For teeth to be healthy, they need vitamins, protein, calcium, and phosphorous.

Treatment depends on each person’s situation. Your dentist may recommend one or more treatments, such as the following:

Your dentist may recommend that you wear a nightguard during sleep. Nightguards are custom-made by your dentist from plastic or acrylic. The nightguard slips over the upper or lower teeth and prevents them from touching. It protects teeth and helps keep them from wearing down.

Since bruxism has many causes, you may need to try a few different treatments to find out what works for you. You can help manage bruxism by paying attention to the symptoms, having regular dental visits and talking with your dentist.

A crown is a cover or “cap” your dentist can put on a tooth. The crown restores the tooth to its normal shape, size and function. The purpose of a crown is to make the tooth stronger or improve the way it looks.

You may need a crown if you:

Crowns are made from several types of materials. Metal alloys, ceramics, porcelain, composite resin, or combinations of these materials may be used. In the process of making a crown, the material often is colored to blend in with your natural teeth.

Several steps are involved, and two dental visits are generally needed to complete the treatment.

To prevent damage to a crown, there are a few things you can do:

Produced in cooperation with the American College of Prosthodontists “Crown Used to Replace a Filling” – photos courtesy of John R. Nosti, DMD, FAGD, FACE, www.cosmeticdentistryofsj.com.

Look in the mirror.

If your answers show that you might want a change in your smile, talk to your dentist about Improving Your Smile.

A great smile can be the most attractive feature of your face. A smile helps you express health, success, youth and sincerity. It is a great asset in your personal, business and social contacts. So it’s important that you are happy with how your smile looks. But if you are like many people, you may not be.

Your dentist has many different techniques to shape, sculpt, and make your smile more beautiful. With a few simple steps, you can have a smile you feel great about. And treatment may be more affordable than you think.

Your dentist can use natural-colored materials to restore teeth that have cavities. Options include composite materials, such as resin, as well as lab-made porcelain inlays, inlays and crowns.

Teeth become stained for many reasons – drinking coffee, tea or wine; smoking; and even aging can discolor teeth. Tooth whitening is a process that makes discolored teeth whiter. The bleach used for in-office (chair side) whitening is stronger than the bleach found in at-home whitening kits. Keep in mind that not everyone’s teeth can become movie-star white. Your dentist can recommend the whitening treatment that is right for you.

Veneers are thin, tooth-colored shells that are bonded, or cemented, to the front of your teeth. They are custom-made of ceramic or composite resin, and look like natural teeth. Veneers can be used to fill spaces between teeth and to cover teeth that are stained, poorly shaped, or a bit crooked.

Braces can help correct crowded or crooked teeth or an uneven bite. Braces have become much smaller and less noticeable over the years. Brackets, the part of the braces that attach to each tooth, can sometimes be attached to the back of the tooth to make them less noticeable. Some brackets are clear or tooth coloured-which help braces blend in.

In some cases, treatment may be done without using braces at all. A series of clear, removable aligners are used to move your teeth over time. These aligners are more discreet than traditional braces.

Your dentist can “reshape” your teeth by contouring tooth enamel, the outer layer of the tooth. When teeth are a little crowded or uneven, or when teeth appear too long, your dentist can use enamel shaping to improve how the teeth look.

If a tooth needs more a dramatic change than veneers or enamel shaping can provide, crowns are an option. The outer part of the tooth is removed and a crown is placed over it. The crown can be made to fit in with your other teeth. It’s like a fresh start for your tooth.

Once you decide to improve your smile, the first step is to visit your dentist. At this visit, you will talk about the best plan for you. If you have any signs of dental disease, your dentist may recommend treatment for this. It’s important to have a healthy mouth before starting cosmetic treatment.

These treatments and others can help you have more natural-looking and attractive teeth. What are you waiting for? Talk to your dentist today about how to make your smile the best it can be.

Before-and-after photos courtesy of Dr. John R. Nosti, SmileDesignNYC.com.

Sometimes, teeth need to be removed due to decay, disease or trauma. Having a tooth “pulled” is called a tooth extraction.

When you have an extraction, it’s natural that changes will occur in your mouth. Your dentist may give you instructions to follow after the extraction, and it’s important to talk to your dentist if you have any questions or problems. Here are some general guidelines to help promote healing, prevent complications, and make you more comfortable.

Before the extraction, you will be given an anesthetic to reduce your discomfort. Your mouth will remain numb for a few hours after the extraction. While your mouth is numb, you’ll want to be careful not to bite your cheek, lip or tongue. Do not eat any foods that require chewing while your mouth is numb. The numbness should go away within several hours. If it doesn’t, contact your dentist.

Your dentist may place a gauze pack on the extraction site to limit bleeding. This will also help a blood clot to form, which is necessary for normal healing. This gauze pack should be left in place for 30 to 45 minutes after you leave the dentist’s office.

Do not chew on the pack. There may be some bleeding or oozing after the pack is removed. If so, here’s what to do:

The blood clot that forms in the tooth socket is an important part of the normal healing process. You should avoid doing things that might disturb the clot. Here’s how to protect it:

Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth well and begin cleaning the teeth next to the healing tooth socket the next day. You can also brush your tongue. This will help get rid of the bad breath and unpleasant taste that are common after an extraction.

The day after the extraction, gently rinse your mouth with warm salt water (half a teaspoon salt in an 8 oz. glass of warm water) after meals to keep food particles out of the extraction site. Try not to rinse your mouth vigorously, as this may loosen the blood clot. If you have hypertension, discuss with your dentist whether you should rinse with salt water. Avoid using a mouthwash during this early healing period unless your dentist advises you to do so.

If your dentist has prescribed medicine to control pain and inflammation, or to prevent infection, use it only as directed. If the pain medication prescribed does not seem to work for you, do not take more pills or take them more often than directed-call your dentist.

After a tooth is removed, you may have some discomfort and notice some swelling. This is normal. To help reduce swelling and pain, try applying an ice bag or cold, moist cloth to your face. Your dentist may give you specific instructions on how long and how often to use a cold compress.

If you have any of the following issues, call your dentist immediately. If you cannot reach your dentist, go to a hospital emergency room.

After the extraction, drink lots of liquids and eat soft, nutritious foods. Avoid hot liquids and alcoholic beverages. Do not use a straw. Begin eating solid foods the next day or as soon as you can chew comfortably. For the first few days, try to chew food on the side opposite the extraction site. When it feels comfortable, you should resume chewing on both sides of your mouth.

Your teeth are meant to last a lifetime. Years ago, diseased or injured teeth were usually pulled. But today, a tooth can often be saved through root canal (endodontic) treatment.

Endodontics (en-do-DON-tics) is the branch of dentistry that deals with treating diseases or injuries to the dental pulp. An endodontist is a dentist who specializes in root canal and other endodontic treatments.

The pulp is soft tissue inside the tooth that contains blood vessels and nerves. When the pulp becomes inflamed or infected, treatment is needed. The most common causes of pulp inflammation or infection are a cracked or chipped tooth, a deep cavity or filling, or other serious injury to the tooth. All of these can allow bacteria to enter the pulp.

If damaged or infected pulp is not removed, the tissues around the root of the tooth can become infected. Pain and swelling often result. Even if there is no pain, bacteria can damage the bone that holds the tooth in the jaw. Without treatment, the tooth may have to be removed.

When a tooth is removed and not replaced, the teeth around it may shift. This can make biting and chewing difficult and may make it harder to clean your teeth. Areas that are not cleaned well are more likely to get gum disease.

Root canal treatment can prevent these problems by saving your natural tooth. Also, root canal treatment usually is less expensive than a replacement tooth

Root canal treatment may involve one or more dental visits. Your dentist or endodontist will perform the necessary steps to save your tooth:

Look in the mirror.

If your answers show that you might want a change in your smile, talk to your dentist about Improving Your Smile.

A great smile can be the most attractive feature of your face. A smile helps you express health, success, youth and sincerity. It is a great asset in your personal, business and social contacts. So it’s important that you are happy with how your smile looks. But if you are like many people, you may not be.

Your dentist has many different techniques to shape, sculpt, and make your smile more beautiful. With a few simple steps, you can have a smile you feel great about. And treatment may be more affordable than you think.

Your dentist can use natural-colored materials to restore teeth that have cavities. Options include composite materials, such as resin, as well as lab-made porcelain inlays, inlays and crowns.

Teeth become stained for many reasons – drinking coffee, tea or wine; smoking; and even aging can discolor teeth. Tooth whitening is a process that makes discolored teeth whiter. The bleach used for in-office (chair side) whitening is stronger than the bleach found in at-home whitening kits. Keep in mind that not everyone’s teeth can become movie-star white. Your dentist can recommend the whitening treatment that is right for you.

Veneers are thin, tooth-colored shells that are bonded, or cemented, to the front of your teeth. They are custom-made of ceramic or composite resin, and look like natural teeth. Veneers can be used to fill spaces between teeth and to cover teeth that are stained, poorly shaped, or a bit crooked.