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Articles reviewed by Dr. Samuel Bacon, DDS for patients of Indy Smile Group in Carmel, Fishers, and North Indianapolis. General education only.
Emergencies
What is a dental abscess and is it an emergency?
A dental abscess is a pocket of pus caused by a bacterial infection in or around a tooth, usually from deep decay, gum disease or a cracked tooth. It needs prompt dental care, because it won't go away on its own. Swelling in your jaw or face, fever, or trouble breathing or swallowing is an emergency.
What is a dental emergency?
A dental emergency is a problem that needs prompt care to relieve severe pain, stop an infection or bleeding, or save a tooth. Examples include a knocked-out adult tooth, a badly cracked tooth, severe toothache, or swelling from a possible abscess. For trouble breathing or swallowing, or swelling spreading toward your eye or neck, call 911 or go to the ER. Otherwise, call your nearest office during office hours.
What should I do if I crack a tooth?
Rinse your mouth with warm water, put a cold compress on your face if there's swelling, and see your dentist as soon as possible. A crack won't heal on its own. The AAE says the sooner a cracked tooth is treated, the better the outcome. Severe pain, facial swelling or fever needs prompt care.
Symptoms
How do I stop grinding my teeth at night?
Start with your dentist. A custom night guard can protect your teeth while you sleep. Talking with your dentist or doctor about stress, habits and sleep can help find the cause. Many people don't know they grind until a dentist spots worn or chipped teeth, or they wake with a sore jaw or headache.
What are the risks of not treating a cavity?
A cavity doesn't heal once there's a hole. MedlinePlus says untreated decay can destroy the inside of the tooth (the pulp), which means more extensive treatment or losing the tooth. It also lists abscess, a fractured tooth, bone infection and tooth loss as complications. Facial swelling or fever needs care right away.
What are the signs of an infected tooth?
Signs can include a severe, constant toothache, pain when biting, swelling of the gum (sometimes a pimple-like bump), and swelling in the jaw or face. A tooth infection won't go away on its own. For trouble breathing or swallowing, call 911 or go to the ER. Facial swelling or fever: call your nearest office during office hours.
What causes jaw pain?
Common dental causes include problems with the jaw joint and chewing muscles (TMD), grinding or clenching, and a tooth infection or abscess. Many jaw problems are short-lived and improve with simple care. Jaw pain with chest pressure, shortness of breath, sweating or arm pain can be a heart attack. Call 911 right away.
What causes teeth grinding (bruxism)?
There's no single cause. The ADA and MedlinePlus say stress is a common trigger, and grinding can also be linked to sleep disorders, an abnormal bite, and missing or crooked teeth. The ADA notes that tobacco, alcohol and coffee have been linked to grinding too. Many people grind without knowing it, especially during sleep.
What causes tooth sensitivity?
Sensitivity usually happens when the layer under your enamel, called dentin, is exposed. Hot, cold, sweet or acidic things can then reach the nerve. The ADA lists causes including cavities, cracked teeth, worn fillings, gum disease, worn enamel and exposed roots. Because the cause varies, a dentist should check sensitivity that doesn't go away.
What is the best way to treat sensitive teeth?
The right treatment depends on the cause, so start with a dental exam. The ADA says options include desensitizing toothpaste, an in-office fluoride gel, a crown, inlay or bonding to fix a flaw or decay, a gum graft for exposed roots, or a root canal if sensitivity is severe and nothing else helps. Good daily brushing and flossing also help prevent it.
Common conditions
Gum health
What are the signs of gum disease?
Common signs include gums that bleed easily, red, swollen or tender gums, gums pulling away from the teeth, lasting bad breath or taste, and loose teeth. Gum disease is often painless, so you may not notice it. Caught early as gingivitis, it can usually be reversed with a professional cleaning and good home care.
What is gum disease / gingivitis?
Gum disease is an infection of the tissues that hold your teeth in place, usually caused by plaque buildup. Gingivitis is the early stage: red, swollen gums that may bleed easily. The ADA says gingivitis can usually be reversed with a professional cleaning and good daily brushing and flossing. Untreated, it can progress to periodontitis, which damages gums and bone.
Why do gums recede?
Gums can recede, or pull back to expose the tooth root, for several reasons. These include gum disease, brushing too hard, teeth that are out of position, injury to the gums, and naturally thin gum tissue. Recession can make teeth sensitive and roots easier to decay. Treatment depends on the cause.
Treatments
Are dental implants worth it?
For many people missing a tooth, an implant is worth considering. It's anchored in the jawbone, it doesn't rely on neighboring teeth, and it can restore chewing and speaking. It also takes surgery, healing time and good daily care. Whether it's worth it for you depends on your health, your bone and your goals.
Do wisdom teeth always need to be removed?
Not always. The ADA says wisdom teeth that come in correctly and are healthy can help you chew. Removal may be needed for pain, infection, cysts, tumors, damage to nearby teeth, gum disease, or decay that can't be repaired. Wisdom teeth you keep still need monitoring. Your dentist will examine your mouth and take X-rays before recommending anything.
How long do dental implants last?
An implant is designed to be a long-term tooth replacement, but there's no set lifespan. How long it lasts depends on your health, your bone, whether you smoke, and how well you clean around it. The crown on top can wear and may need repair or replacement at some point. Regular checkups help catch problems early.
How long does a root canal take?
Usually one or two office visits. The ADA and the American Association of Endodontists both say root canal treatment typically takes one or two appointments, depending on the tooth and its condition. Afterward, the tooth needs a filling or crown to protect it. The AAE says you'll likely stay numb for two to four hours after treatment.
Is a bridge or an implant better for a missing tooth?
Neither is better for everyone. A bridge attaches artificial teeth to the teeth next to the gap, which usually means reshaping those teeth. An implant is anchored in the jawbone and doesn't rely on neighboring teeth, but it takes surgery and healing time. The right choice depends on your health, your bone and the teeth around the gap.
Cosmetic
Are there natural ways to whiten teeth?
There's no proven natural way to bleach teeth. Brushing twice a day, cleaning between your teeth, limiting staining drinks and tobacco, and getting professional cleanings help remove surface stains. The ADA warns that DIY methods such as scrubbing with acidic fruit, vinegar or charcoal can wear away enamel, which can make teeth look more yellow.
How long do veneers last?
Veneers are a long-term treatment, but they don't last forever, and there's no set lifespan. The ADA says a veneer may chip, crack, wear down or loosen over time and need to be re-bonded, repaired or replaced. The ADA describes porcelain veneers as strong and long-lasting, and composite veneers as easier to fix but less stain- and wear-resistant. Your habits and daily care also matter.
Is it okay to use whitening toothpaste every day?
For most people, whitening toothpaste with the ADA Seal is meant for daily brushing. Whitening toothpastes remove surface stains with polishing agents or mild abrasives, and some contain low levels of peroxide. They don't change the natural shade of your teeth. If your teeth become sensitive, switch products and talk with your dentist.
Is teeth whitening safe?
For most adults with healthy teeth and gums, whitening done as directed is considered safe. The most common side effects are temporary tooth sensitivity and gum irritation. Overusing whiteners can harm enamel or gums, so it's best to have a dental exam first and follow directions.
What causes yellow teeth?
Common causes include stains from coffee, tea, red wine and tobacco, and aging. The ADA explains that enamel thins over time, letting more of the yellowish layer underneath show through. Some medicines, injury and genetics can also change tooth color. Surface stains often respond to whitening, but some discoloration doesn't. A dentist can help tell which kind you have.
What's the best way to whiten teeth?
The right whitening method depends on what caused the stains and how much change you want. Options include stain-removing toothpaste, store-bought bleaching strips, custom take-home trays from a dentist, and in-office whitening. A dental exam first shows whether bleaching will work on your stains and dental work.
Invisalign
Invisalign / Whitening
Prevention
Are electric toothbrushes better?
Both can clean well. The ADA says manual and powered brushes can both clean teeth effectively and thoroughly if you brush twice a day for two minutes with fluoride toothpaste. A 2014 Cochrane review found powered brushes reduced plaque and gum inflammation somewhat more than manual brushes, though the long-term importance is unclear. Pick the one you'll use well.
Can I use hydrogen peroxide as a mouthwash?
Hydrogen peroxide is an active ingredient in some whitening mouthrinses, which the ADA says may contain 1.5 to 2 percent. The ADA's guidance covers rinses sold for use in the mouth, not household peroxide. Peroxide whitening can cause temporary tooth sensitivity and gum irritation. Ask your dentist before you start, and choose a product with the ADA Seal.
How do I brush correctly?
The ADA recommends brushing twice a day for two minutes with a soft-bristled brush and fluoride toothpaste. Hold the brush at a 45-degree angle to your gums and use gentle, short, tooth-wide strokes on the outer, inner and chewing surfaces. Don't scrub hard. Replace your brush every three to four months, or sooner if the bristles fray.
Is flossing really necessary?
Yes, cleaning between your teeth matters. The ADA recommends doing it once a day with floss or another interdental cleaner, because a toothbrush can't fully reach those spaces. Plaque left there can harden into tartar, which only a dental professional can remove. Floss, floss picks, tiny interdental brushes and water flossers are all options.
Is mouthwash necessary?
It's not a must. The ADA says mouthwash isn't a replacement for brushing and flossing, but it may be a helpful addition for some people. Therapeutic rinses can help reduce plaque, gingivitis, cavities or bad breath. Cosmetic rinses only freshen breath for a while. Ask your dentist whether a rinse would help you, and look for the ADA Seal.
Is oil pulling effective?
There's no reliable evidence that it is. The ADA says no reliable scientific studies show that oil pulling reduces cavities, whitens teeth or improves oral health, and it doesn't recommend oil pulling as a dental hygiene practice. Instead, the ADA recommends brushing twice a day with fluoride toothpaste and cleaning between your teeth once a day.
What are dental sealants and who needs them?
Sealants are thin protective coatings painted onto the chewing surfaces of back teeth, where grooves can trap food and bacteria. NIDCR says children should get sealants on their permanent molars as soon as those teeth come in. The ADA says first molars usually appear around age 6 and second molars around 12, and that adults can benefit too.
What is the best toothpaste for sensitive teeth?
There isn't one best brand for everyone. The ADA suggests a desensitizing toothpaste, which contains compounds that help reduce sensitivity, and recommends always choosing a fluoride toothpaste with the ADA Seal of Acceptance. It usually takes several applications to notice a difference. If sensitivity doesn't improve, see your dentist to find the cause.
What is the best toothpaste?
There's no single best brand. The ADA recommends a fluoride toothpaste, and says every toothpaste with a cavity-protection claim that earns the ADA Seal of Acceptance contains fluoride. Beyond that, choose for your needs: desensitizing for sensitive teeth, formulas for tartar or gingivitis, or whitening for surface stains. Your dentist or hygienist can help you choose.
What is the difference between plaque and tartar?
Plaque is the sticky film of bacteria that's constantly forming on your teeth. You can remove it by brushing and cleaning between your teeth. Tartar, also called calculus, is plaque that has hardened. The ADA says once tartar forms, only your dentist can remove it. Both can lead to gum disease and cavities.