Are you open Fridays?

Most Fridays, there are no appointments scheduled. My office manager is usually manning the phone and sometimes I am there taking care of duties I can not attend to when seeing patients.

Friday is also used as an overflow day- If we are unable to accommodate all the patients who need to be seen during the week or if a patient needs a lengthy appointment that requires lots of attention, I will open a Friday for patient care.

Why is my tooth sensitve after having a filling?

This is a very common problem that patients have. The most common reason is a high bite. If a patient comes to my office with a recently filled tooth and the tooth is hurting, the first thing I do is check the bite with articulating paper. If the patient has any discomfort when biting in any excursion, I relieve the bite. Often this is all that is necessary to make the tooth comfortable.

Sometimes relieving the bite is not all that is needed. The bite can be comfortable, but a tooth can ache, or be sensitive to hot or cold. If I place a filling adjust the bite and it remains sensitive for over a month . I would consider removing the filling and examining the tooth for possible causes(Cracks, voids, or a tiny pulpal exposure. Afterwards I place a sedative filling in the tooth and see how it responds.

If the filling was a large one, where the tooth structure was overly compromised, I recommend crowning tooth. If on the other hand the filling was small and the tooth returns to normal after having the sedative filling placed I may refill the tooth with a new filling.

Some sensitive teeth do end up requiring root canal treatments to become comfortable, but I usually try making the tooth comfortable in these other ways, before suggesting root canal therapy.

If you have recently had a filling place and it is still sensitive, it is good idea to contact your dentist and make him aware of your situation. He(or She) is in the best position to help with your problem.

After an extraction is it always necessary to have an implant or a bridge done to keep the adjacent teeth from shifting?

Sometimes if the inclines of the opposing arch fit tightly against the inclines of opposing teeth that are adjacent to an extraction site, they can discourage any shifting. A visit to a dentist can determine if this is the case.

Many times the occlusion is not tight enough to discourage the shifting and some method should be used to keep the teeth adjacent to an extraction site in their proper place.

Replacing the missing tooth with an implant restoration, three unit bridge or a partial denture, will keep adjacent teeth from moving. Another even simpler option is to have removable orthodontic retainers made and wear them for several nights every week. The retainers will not allow permanent shifting of teeth adjacent to an extraction site.

What are the black lines I see at the base of my crowns?

Porcelain fused metal crowns are often finished at the margins in a silver colored metal. Covering the margins with porcelain can create a bulky margin and also make the porcelain more succeptable to fracture, when the crown is seated in the patients mouth.

The skinny metal line created by the metal margin is intended to be invisible and under the gum when a crown is cemented, but sometimes because the gums receed, it becomes visible.

Patients who do not want to ever see 'grey lines' at the gums should consider having their dentist use another type of crown. Some other options for posterior teeth that will never show grey margins are Pocelain fused to yellow gold, Captek crowns, Empress crowns, Procera crowns, and my personal favorite of the moment Lava crowns.

For anterior teeth bonded porcelain restorations usually have the most natural appearance, but they are not suitable for all teeth and in cases where bonded porcelain restoration may not work, I use Lava crowns because they are strong and look quite good.

Should I save a loose tooth?

There is not one definative answer to this question. Often dentists and patients have more than one option when treating a loose tooth. The dentist should evaluate the degree of looseness, the remaining supporting bone and periodontal health of the supporting tissues, when making a treatment decision.

If the looseness is possibly the result of a poor periodontal condition of the gums supporting the tooth and sufficient supporting bone remains, then root planning and treatment for periodontal disease should be performed, before making a final decision about the tooth.

If the looseness is secondary to an abcess of endodontic origin, usually root canal therapy will help improve the situation. Endodontic abcesses can cause bone loss around the apex of a tooth and this area of bone loss can gradually fill back in with new bone if the root canal is succesful.

In some cases, when a tooth is made healthy, but still is displaying too much mobility, a dentist can connect it to an adjacent tooth or teeth(with connected crowns or a maryland splint), so that it is splinted and will experience less or no mobility.

Sometimes the looseness stems from not enough supporting bone being present and no amount of dental treatment will improve the situation. In this case having the tooth out is usually the best option. If the patient has sufficient remaining bone or can have bone grafting, then an implant can be a good option.

Do you accept any DMO dental insurance plans?

No, my office does not participate in any DMO dental insurance plans. If you look at your dental insurance card and it has the words DMO next to the name of the plan, you must use a participating dentist to get reimbursement. We are not currently signed up with any DMO dental plans. If your dental insurance card says PPO , than you can usually use your insurance at my office. Patients are only responsible for the difference between our fee and what their dental insurance covers.