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FREQUENTLY ASKED QUESTIONS
How do I make an appointment?
For non-emergency patients, please call the office at (401)-738-2500. One of our front desk people can schedule an appointment for you. If you are calling after office hours, please leave your name, phone number, and a brief message and the front desk will call you back on the next day that we are open.
If you are having a dental emergency during office hours, please call the office at (401)-738-2500. We keep time open during the day for emergency visits. Please call early in the morning, so that you can be seen promptly the same day.
For our patients of record who are having an emergency after hours, Dr. Small can be reached by pager at: (401)-581-7901. After dialing the number for the pager, you will hear a tone, please enter the number that you want Dr. Small to return your call on. Please also call the office number and leave your name, telephone number, and a brief message about the nature of the emergency. Dr. Small will check the office answering machine when he is paged to get an idea for what the problem is.
If you are not a patient of record and are having an emergency after hours, please contact your local walk in clinic or emergency department for emergency treatment. We will be happy to see you during our regularly scheduled hours.
What is an amalgam (silver filling)?
An amalgam filling is made of silver, mercury, tin, copper, and zinc. It is normally used in the back teeth. Because an amalgam is made of metal, it is a strong filling material and it will work well for many years.
Many people are concerned about the mercury used in amalgam. Amalgam has been used as a filling material for over 100 years and it has never been proven to cause harm, except for the rare person who is allergic to it. The ADA, FDA, and many others have done numerous studies of amalgam and they have found it to be a safe, cost effective, long lasting filling material.
What is a composite (tooth colored filling)?
A composite filling is a mixture of resin and filler particles. Traditionally composite fillings are placed on the front teeth. More people like the appearance of the tooth colored material and are having it placed in the back teeth. While composites are not as strong or long lasting as amalgams, they are a good choice for those areas of the mouth where esthetics are important.
What is a cavity?
A cavity occurs when the normally hard tooth structure becomes soft. The bacteria that occur naturally in the mouth take the starches and sugars that we eat, use them as food, and excrete an acidic waste. The acid, over time, dissolves the minerals in the tooth and cause the cavity.
It is possible to get a cavity under a crown, bridge, or filling. The place where the filling or crown meets the tooth is susceptible to the acids that are released from the bacteria.
What is a crown (cap)?
A crown is a covering that is placed over a tooth that has a large filling, is cracked or fracturing, or is badly discolored. The dentist shapes the tooth, makes a mold of the tooth, and places a temporary crown. The mold is sent to a dental lab and a short while later the permanent crown is cemented in place.
There are three types of crowns. The first type is a gold crown. Gold is an excellent material to use on the back teeth where esthetics are not a concern. The second type is a porcelain fused to gold crown. This combines the strength of gold with the beauty of porcelain. The crown looks like a natural tooth and is used where appearance is important. The third type of crown is the all porcelain crown. The natural translucency of the porcelain mimics the appearance of the tooth. Since porcelain is not as strong as metal, this type of crown is normally used on the front teeth.
What is a bridge?
A bridge is used to replace a missing tooth or teeth that are between other teeth. The dentist shapes the teeth on either side of the missing tooth, a mold is taken, and a temporary bridge is placed. The mold is sent to a dental lab and soon afterwards the permanent is cemented in place. Bridges normally have a metal frame for strength with porcelain placed over it for esthetics. It is also possible to have an all ceramic bridge made.
What is an implant?
An implant is an artificial root that is placed into the jaw to either replace a missing tooth or to anchor a denture into place. The implant is made of a titanium alloy and titanium is well tolerated by the body. A periodontist, oral surgeon, or general dentist places the implant in the bone. It is allowed to heal and an impression is taken of the implant. The dental lab makes the crown or denture attachment, and it is connected to the implant.
Dental implants have been used for over 30 years and they have an excellent success record. Age is not a limiting factor with implants. They were first developed to help older people with loose lower dentures eat better. Implants are a great way to replace a single missing tooth. In the past, a single missing tooth would be replaced with a fixed bridge. The teeth on either side of the missing tooth would be reshaped to hold the bridge. With dental implants, the adjacent teeth are left untouched!
What is periodontal disease (gum disease, pyorrhea)?
Periodontal disease is caused by an infection in the gums and bone around the teeth. If left untreated it can lead to the loosening and loss of the teeth. There is also evidence that periodontal disease can contribute to heart attacks, strokes, and low birth weight babies. You may have periodontal disease if your gums are red, swollen, bleed easily, or if you have exposed roots, loose teeth, or a change in tooth position. The dentist will measure the depth of the gum tissue and take x-rays to see if bone has been lost around the tooth.
There are several treatments for periodontal disease. The first step is a procedure called “Scaling and Root Planing.” It is also referred to as a deep cleaning. During the scaling and root planing, the part of the mouth being treated is numbed and the hygienist removes tartar and plaque from underneath the gums. If the disease has progressed far enough, a periodontist may perform minor surgery to clean out the infected gums and bone.
What is a sealant?
A sealant is a plastic film that is put over the grooves, pits, and crevices of the teeth to help prevent decay. The grooves are often very fine and food traps in them easily. The sealant fills in the grooves and prevents food from sticking there. Since there is no decay in teeth that need to be sealed, there is no need to get the teeth numb or use the drill.
What is tooth whitening (bleaching)?
Over time the teeth absorb stains from the foods that we eat. Coffee, tea, red wine, and cigarette smoking are the biggest sources of stain. Tooth whitening uses hydrogen peroxide to remove these stains. We are currently using two different bleaching systems. For our patients that have teeth that are slightly yellowed, we recommend Tres White. This is preformed tray that uses a low concentration of hydrogen peroxide. The patient places that trays in his mouth, gently squeezes it, and leaves it in place for 30 – 60 minutes. For our patients that have darker stains, we recommend Nite White. A customized impression tray is made and the patient is given kit with a more concentrated bleaching gel in it. This tray is worn for about an hour a day.
What is a root canal?
When the nerve of a tooth is dead the dentist opens the tooth up and removes the dead tissue. After the inside of the tooth has been cleaned and shaped, a rubber filling material is put inside the tooth to prevent bacteria from getting in and causing an infection. Once the root canal is finished the tooth then has either a crown or a filling put into it.
What is fluoride?
Fluoride is a mineral that is often found naturally in drinking water. In the mouth fluoride combines with the calcium and phosphorus in the enamel and dentin and makes them more resistant to tooth decay. In many cities fluoride is added to the drinking water so that people young and old can get the benefits of fluoride’s cavity prevention. For those who don’t have fluoridated water, there are fluoride pills, drops, and of course fluoridated toothpaste. The dentist will put fluoride varnish on children’s teeth to help them not get cavities. The dentist can even give fluoride rinses or prescription strength toothpaste to cavity prone adults.
What is an oral cancer screening?
As a part of the regular exam, Dr. Small checks the soft tissues of adults for signs of oral cancer. Normally the lips, cheeks, gums, tongue, and floor of the mouth are a uniform pale pink. Areas that are white, red, mixed red and white, or swollen might be cancerous. The oral cancer screening looks for these signs.
Why do I need x-rays?
Many of the things that a dentist is looking at are hard and show up well on dental x-rays. The x-rays look in between the teeth and under the gums at the bone where the dentist can’t see or feel. Cavities in between the teeth can’t be felt or seen until they are large. Periodontal disease will cause the bone to move away from the teeth and cause them to get loose and eventually lost. Dental x-rays use a very low dose of radiation, much lower than a chest x-ray looking for pneumonia or an x-ray of a broken arm or leg.
What causes teeth to be sensitive?
Many things can cause the teeth to be sensitive. One of the things that causes sensitivity is over aggressive tooth brushing. Brushing too hard causes that gums to get brushed away and expose the roots of the teeth. The roots of the teeth have pores in them which lead to the nerve and cause sensitivity.
Acidic foods or plaque on the teeth can cause the teeth to be sensitive. The bacteria in the plaque make an acid that not only causes tooth decay, but can also open the pores on the roots.
Grinding or clenching your teeth can cause the teeth to be sensitive. When you grind your teeth, they flex slightly and open pores on the root surface.
Sensitive toothpaste or prescription strength toothpaste can help seal the pores and reduce the sensitivity. For people who grind or clench, a night guard can protect the teeth from the effects of grinding and clenching.
What causes a dry mouth?
The most common cause of a dry mouth is prescription medication. Radiation treatment and aging are also causes of dry mouth. Many medicines will cause a dry mouth as a side affect. Sometimes your physician can change the medicine to one that does not dry the mouth out as much. If you can not switch medication, you should have small frequent sips of water during the day. There are artificial saliva substitutes and over the counter soothing mouth washes and toothpastes.
People with dry mouth are much more likely to get severe tooth decay. The saliva performs many functions. One of them is to protect the teeth from tooth decay. Avoid sucking on hard candy and be meticulous about brushing and flossing.
What is TMJ?
TMJ stands for temporal mandibular joint. Some times the joint gets out of alignment and causes pain, popping and clicking, or jaw locking. There are many different treatments for TMJ problems. Pain medicine, muscle relaxants, ice packs, moist heat, and night guards are used to treat TMJ symptoms. Often the TMJ pain is caused by clenching and grinding so a night guard is used to lessen this. It the joint is painful, you should eat a soft diet, avoid gum chewing, and keep your teeth apart when you are under stress.
What is a mouth guard?
There are two types of mouth guards. The one most people think of are those worn by boxers, football players, and other athletes. These are made of a soft rubbery material and are designed to protect the teeth and jaw from injury while playing sports. You can use the premade “boil and bite” mouth guards that are available at sporting good stores, but custom made athletic mouth guards will fit better.
The other type of mouth guard is used by people who clench or grind their teeth at night. The teeth are not made strong enough to withstand extreme biting forces. Clenching or grinding can cause the teeth to wear down, chip, or break. Clenching and grinding the teeth can also cause the jaw joint to become misaligned. This can cause pain, clicking or popping sounds, muscle soreness, or jaw locking. This type is made of a hard plastic to withstand the biting forces caused by the clenching and grinding. While there are over the counter products that can be used, they do not work as well as those that are custom made by the dentist.
What are dentures?
Dentures are removable appliances that are use to replace missing teeth. Partial dentures are used when the patient has some teeth remaining and are held in place by clipping onto those teeth. Full dentures replace all of the missing teeth in an arch and are held in place by either suction or dental implants.
POST OPERATIVE INSTRUCTIONS
Extractions
When you leave the office, you will be biting on a gauze pad. Continue to bite on it for 30 minutes. It is normal for your saliva to have a reddish tint afterwards, but if bleeding recurs, take the extra gauze that you were given and bite on that for 30 minutes. If this does not stop the bleeding, take a tea bag, moisten it and bite on it for 30 minutes.
Do not eat or drink for 1 hour after your extraction. Afterwards you can eat a light, soft meal as tolerated. Do not smoke, rinse your mouth, use a straw, drink hot liquids or eat spicy foods after the extraction. These can dislodge the clot that forms in the socket. After 24 hours you can rinse your mouth with warm salted water 2 or 3 times a day. Put teaspoon of table salt into an 8 ounce glass and gently swish in the affected area.
If you have any swelling, place an ice pack on the affected area for 20 minutes on and then leave off for 20 minutes, and repeat as necessary. Sometimes after extractions, pieces of the bone will work themselves through the gums. They normally work themselves out, but they can be removed at the office.
It is normal to have mild to moderate pain following an extraction. Over the counter pain medicines when taken as directed are normally sufficient for managing this pain.
If you are having any usual problems such as severe pain, swelling, or uncontrolled bleeding then call the office at (401)-738-2500.
Fillings
The area near the filling will be numb for several hours after the visit. Do not play with or chew on the soft tissue that is numb. If you had a silver filling, do not eat for one hour and avoid chewing on that side for the rest of the day. The white filling material is completely set before you leave the office, so you can eat on it right away. It is normal for the teeth to be sensitive especially to cold after they have been filled. This usually improves over the following two weeks.
Root Canal
You may experience some mild discomfort in the tooth following root canal treatment. Over the counter pain medicine, when taken as directed on the package, often do a good job of managing this pain. There may also be some swelling. An ice pack 20 minutes on and 20 minutes off can help with the swelling. The tooth will have a temporary filling in it. This must be replaced with either a filling or a post and core and a crown.
Scaling and Root Planing (Deep Cleaning)
After scaling and root planing, the gums may have mild discomfort. Over the counter pain medicine, when taken as directed on the package, often do a good job of managing this pain. Warm salted water rinses taken 2 or 3 times a day can soothe the gums. Put teaspoon of table salt into an 8 ounce glass and gently swish in the affected area. The teeth might be sensitive to hot, cold, and sweets. This is normal and will usually improve over several days or weeks. Sensitive toothpaste can help reduce the post operative sensitivity.
Temporary Crowns and Bridges
When you are having crowns or bridges made, you will have a temporary while the dental lab makes the permanent crown or bridge. You can eat most foods, but you can not have anything that is sticky or chewy. This includes gum. These foods will cause the temporary to come off. If it does come off, it usually will stay on well by itself. Place it back on the tooth or teeth. It only fits on one way. If it does not go down easily, turn it around until it does seat fully. It is important to keep the temporary on. If the teeth have not had root canal treatment, they will be sensitive when they are uncovered. The temporaries also keep the teeth from shifting while the permanent crown or bridge is being made at the lab. If it keeps coming off or if it breaks, then call the office at (401)-738-2500 so that we can recement or remake the temporary. You should floss around the temporary. You can push the floss towards the gums and move it back and forth, but do not pull it away from the gums. Unravel the floss from one of your fingers and slide it out to the side.
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