FAQs

What is a Dental Emergency?

Patients often ask what to do in case of a dental emergency – when they should call Dr. Fomich after office hours and when a problem can wait for regular office hours. This list covers most typical dental issues and can help guide you. If you are not certain, if you are in pain and want advice, call Dr. Fomich. He will always answer your questions and, when necessary, make arrangements to treat the problem as an emergency.

Toothaches
Thoroughly rinse your mouth with warm water and use dental floss to remove any lodged food. If your mouth is swollen, apply a cold compress to the outside of your mouth or cheek. Take aspirin, Tylenol or your regular over-the-counter pain reliever. DO NOT put aspirin or painkiller against the gums or on a tooth. Call our office to schedule an appointment as soon as possible.

Chipped or Broken Teeth
If you can, save all pieces of tooth that broke off. Rinse the mouth using warm water; rinse the broken pieces. If there is bleeding, apply a piece of gauze to the area for 10 minutes or until bleeding stops. Apply a cold compress to the outside of the mouth, cheek or lip near the chipped or broken tooth. Take aspirin, Tylenol or your regular over-the-counter pain reliever. DO NOT put aspirin or painkiller against the gums or on a tooth. Call our office to schedule an appointment as soon as possible.

Knocked-Out Tooth
Time is important here so we want you to move quickly and efficiently. The chances of saving a knocked-out tooth improve dramatically when you see the dentist within an hour. Call our office immediately! Then…If you can, retrieve the tooth and holding by the crown, never the root, rinse off the tooth root with warm water to remove any dirt. DO NOT scrub it or remove any bits of tissue that may be attached to the tooth. If you can, place the tooth back in the socket. If that isn’t possible, place the tooth in a small container of milk or, if that isn’t possible, in a cup of water with a pinch of salt.

Partially Dislodged Tooth
Again, time is important. Call our office immediately! Apply a cold compress to the outside of the mouth or cheek. Take aspirin, Tylenol or your regular over-the-counter pain reliever. DO NOT put aspirin or painkiller against the gums or on a tooth.

Lost Filling
As a temporary solution, stick a piece of sugarless gum into the cavity. DO NOT use sugar-filled gum, it will cause pain. There are also over-the-counter dental fillers that may help. Take aspirin, Tylenol or your regular over-the-counter pain reliever. DO NOT put aspirin or painkiller against the gums or on a tooth. Call our office to schedule an appointment as soon as possible.

Lost Crown
If possible, retrieve the crown and place it over the tooth. You can use over-the-counter dental cement, toothpaste or denture adhesive to temporarily hold the crown in place. Take aspirin, Tylenol or your regular over-the-counter pain reliever. DO NOT put aspirin or painkiller against the gums or on a tooth. Call our office to schedule an appointment as soon as possible.

Soft-Tissue Injury
Injuries to the soft tissue – tongue, cheeks, gums and lips – can result in significant bleeding. Try to control the bleeding by first rinsing your mouth with a mild salt-water solution. Then apply a moistened piece of gauze or a wet tea bag to the bleeding site and hold in place for 15 – 20 minutes. Apply a cold compress the the outside of the mouth or cheek.If bleeding does not stop, call our office or go to a hospital emergency room. Continue applying pressure to the bleeding site until you are treated by a professional.

You can certainly minimize the number of cavities you get. Always spend two to three minutes brushing your teeth. It takes that long to get rid of the bacteria which destroy tooth enamel. Do not brush too hard. It takes very little pressure to remove bacteria and plaque. Floss at least once a day. It is the only way to get bacteria from between your teeth.

Watch the sugar you eat. There is sugar in candy, fruits, crackers and chips. These are the foods that the bacteria in your mouth like best. Be mindful of foods like raisins and peanut butter that stick to your teeth. They can provide a constant supply for the bacteria eating into your teeth. Try to minimize the times during the day when sweet items are eaten and clean your teeth afterwards.

If you cannot brush after a meal, rinse your mouth with water—which can help to remove food from your teeth. Chewing sugarless gum after a meal can also help. Chewing stimulates the flow of saliva which acts as a natural plaque-fighting substance.

Do not forget your regular dental visits. Good dental habits will go a long way toward a no-cavity visit.

The American Dental Association points out sealants are an effective weapon in the arsenal against tooth decay. Sealants are a thin coating painted on chewing surfaces of molars and premolars. Dental sealants act as a barrier, protecting the teeth against decay-causing bacteria.

Sealants have proven effective with both adults and children, but are most commonly used with children. Despite the fact that sealants are about half the cost of fillings, only a small percentage of school-aged children have sealants on their permanent teeth.

Ask your dentist whether sealants are a good choice for you or your children.

Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth. An X-ray examination may reveal:

• Small areas of decay between the teeth or below existing restorations (fillings)
• Infections in the bone
• Periodontal (gum) disease
• Abscesses or cysts
• Developmental abnormalities
• Some types of tumors

Finding and treating dental problems at an early stage can save time, money and often unnecessary discomfort. Dental radiographs can detect damage to oral structures not visible during a regular exam. If you have a hidden tumor, radiographs may even help save your life. Your dentist will evaluate your need for radiographs based on the conditions present in your mouth. The schedule for radiographs can vary with age, risk for disease or for evaluation of growth and development. There are many benefits to having dental radiographs taken. Any additional questions or concerns should be discussed with your dentist.

We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital x-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.

Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.

How often should dental x-rays be taken?

The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.

A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

Fluoride is a mineral that occurs naturally in many foods and in water. Some natural sources of fluoride are brewed tea, canned fish, cooked kale and spinach, apples, and skim milk. Some city water contains fluoride, so by drinking tap water you will acquire fluoride. If your drinking water does not have fluoride, supplements are available.

The lack of exposure to fluoride places individuals of any age at risk for dental decay. Fluoride is important to dental health because it helps prevent tooth decay by making the enamel outer portion of the tooth more resistant to acid attacks from plaque bacteria in the mouth.

Studies have shown that children who consumed fluoridated water from birth had less dental decay. Fluoride can reverse early decay and help prevent osteoporosis, a disease that causes degenerative bone loss.

Talk to your dentist or dental hygienist about whether you’re getting the daily amount of fluoride you need.

Oral injuries are often painful, and should be treated by a dentist as soon as possible.

• Attempt to find the tooth
• Rinse, do not scrub, the tooth to remove dirt or debris.
• Place the clean tooth in your mouth between your cheek and gum or under your tongue
• Do not attempt to replace the tooth into the socket as this could cause further damage.
• Get to the dentist. Successful re-implantation is possible only when treatment is performed promptly

If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse it in milk.

When you are asleep, saliva production in your mouth decreases. Since saliva is the mouth’s natural mouthwash, most people experience morning breath. Bacteria found on teeth, in the crevices and on the taste buds of the tongue, break down the food particles, which produce sulfur compounds. It is actually these sulfur compounds which give our breath a bad odor. During waking hours, saliva helps to wash away bacteria and food particles. Saliva also helps to dissolve the foul smelling sulfur compounds.

Chronic, long-term mouth odor can be a sign of more serious illness. See your dentist if this is a concern.

Periodontal disease is inflammation and infection of the gums and supporting bone structure, which if left untreated, can cause permanent jaw bone destruction and possible tooth loss. Untreated periodontal disease has been linked to increased risk for conditions such as heart disease, stroke, low birth weight babies and pre-term delivery, respiratory disease, and prostate cancer. An advanced stage of periodontal disease exhibits inflamed gums pulling away from your bone and teeth. Other signs of periodontal disease include:

• Bad breath
• Red or swollen gums
• Loose teeth or teeth that have moved
• Sensitive teeth
• Pus coming from around the teeth
• Pain on chewing
• Tender gums
• Bleeding gums

Treatment of early periodontal disease can be performed in-office. However, advanced stages may require surgery. Periodontal disease can be prevented and treated successfully by seeing your dentist and dental hygienist regularly and following recommended care plans.

Like other investments, if you whiten your teeth, the length of time you can expect it to last will vary. If you smoke, drink red wine or coffee, or consume other acid-containing foods, your bright smile may begin to yellow more quickly than you expect. In general, a teeth whitening procedure can last up to a few years. And even though the results can fade, occasional touch-ups can be done to regain luster.

Ask the experienced staff at Fomich Family Dentistry about the long-term benefits of teeth whitening.

Commercial whitening toothpastes vary greatly in their ability to whiten teeth. They work by removing surface stains from the teeth with the use of mild abrasives. However, unlike professional whitening, some whitening toothpastes do not alter the intrinsic color of the teeth. Toothpastes that are effective in removing stains can also destroy tooth enamel in the process. These toothpastes use harsh abrasives. With repeated use, harsh abrasives begin to damage tooth enamel and can contribute to increased tooth sensitivity. If you would like to try a whitening toothpaste, consult with your dentist first.

The exact cause of canker sores is not known. Some factors may include genetics, allergies, stress, and vitamin and mineral deficiencies. Trauma to the inside of the mouth can result in the development of canker sores. Ill-fitting dentures or braces, toothbrush trauma from brushing too hard, or biting your cheek, may produce canker sores.

Certain foods may also be a factor. Citrus or acidic fruits and vegetables can trigger a canker sore or make the problem worse. Foods like chips, pretzels and hard candies have sharp edges that can nick and injure the soft tissue of the mouth.

To treat a canker sore, rinse your mouth with antimicrobial mouthwash or warm water and salt. Over the counter treatments are also available.

If the canker sore is present longer than two weeks, see your dentist.

Smokeless tobacco may be smokeless, but it isn’t harmless. These are some of the potential hazards:

• Tooth abrasion from grit and sand in tobacco can scratch teeth and wear away the enamel
• The constant irritation caused by chewing tobacco can result in gum recession and other permanent damage to periodontal tissue
• Increased tooth decay can result from sugar that is added to smokeless tobacco
• Tooth discoloration and bad breath are common with long term use
• Nicotine blood levels are similar to those found in cigarettes
• A diminished sense of taste and smell caused by tobacco use can lead to unhealthy eating habits
• Cancer can be caused by all forms of smokeless tobacco

Watch out for some of these danger signs:

• A sore that does not heal
• A lump or white patch
• A prolonged sore throat
• Difficulty in chewing
• Restricted movement of the tongue or jaw
• A feeling of something in the throat

Pain is rarely an early symptom. All tobacco users need to see their dentist regularly.

People often respond to bleeding gums with the wrong method of treatment. Usually, gums that bleed are a symptom of the onset of periodontal disease or gingivitis. But often, people stop brushing frequently and effectively because it may be painful or it may cause the gums to bleed again. Instead, when gums are inflamed, brushing often and effectively is imperative. More importantly, you should see your dentist to have a periodontal screening and recording performed in order to determine the level of disease present and the best treatment course to pursue.

It is also worth noting that chronic dental pain and discomfort are obvious signs of a problem. Over-the-counter drugs may provide some temporary relief. These medications usually only mask the existence of a problem and should be taken on a temporary basis.

It is important to see your dentist as soon as possible if your gums begin to bleed.

Many factors work to destroy the naturally white smile we are born with. Tobacco, certain foods we eat, and certain drinks actually stain teeth. These substances continually work on our teeth causing our white smile to gradually fade. Hot coffee and tea are especially hazardous to your smile because they change the temperature of your teeth. This temperature change—hot and cold cycling—causes the teeth to expand and contract allowing stains to penetrate the teeth. Cutting down on coffee and tea can go a long way to creating a great smile.

Foods that are slightly acidic are also dangerous to your white smile. These foods open up the pores of the tooth enamel allowing stains to move more easily into the tooth.

Your dentist can help you with more tips on keeping a white smile.

Research today suggests a link between gum disease and diabetes. Research has established that people with diabetes are more prone to gum disease. If blood glucose levels are poorly controlled you may be more likely to develop gum disease and could potentially lose teeth. Like all infections, gum disease can be a factor in causing blood sugar levels to rise and make diabetes harder to control. Be sure to see your Dentist regularly for check-ups and follow home care recommendations. If you notice other conditions such as dry mouth or bleeding gums be sure to talk with your dentist, and don’t forget to mention any changes in medications. Foods that are slightly acidic are also dangerous to your white smile. These foods open up the pores of the tooth enamel allowing stains to move more easily into the tooth.

Your dentist can help you with more tips on keeping a white smile.

About half of women who are pregnant experience a condition called pregnancy gingivitis. This condition can be uncomfortable and cause swelling, bleeding, redness or tenderness in the gum tissue. A more advanced oral health condition called periodontal disease (a serious gum infection that destroys attachment fibers and supporting bone that hold teeth in the mouth) may affect the health of your baby. Studies have shown a relationship between periodontal disease and preterm, low birth-weight babies. In fact, pregnant women with periodontal disease may be seven times more likely to have a baby that’s born too early and too small. The likely culprit is a labor-inducing chemical found in oral bacteria called prostaglandin. Very high levels of prostaglandin are found in women with severe cases of periodontal disease.

Chemotherapy and Radiation can cause a number of problems in the mouth, some of which might include: mouth sores, infections, dry mouth, bleeding of the gums and lining of the mouth and general soreness and pain of the mouth. It can be harder to control these things while undergoing treatment as the immune system is generally compromised as a result of the treatment. There are some special mouth rinses that can be prescribed to help with discomfort during treatment. It is very important to see your Dentist before treatment begins and then to continue with recommended follow-up care. These treatments can cause dry mouth, and recommendations might be made for additional care both in-office and at home.

Make it fun! If you are enthusiastic about brushing your teeth, your children will also be enthusiastic. Children want to do the things their parents do. If your children see you brushing your teeth and displaying good dental habits, they will follow.

Begin to take your children to the dentist at an early age. All children should be seen by their 1st birthday or 6 months after the eruption of the first tooth. Ask your dentist or dental hygienist for other creative ways to get children to brush their teeth.

Sensitivity toothpaste, which contains strontium chloride or potassium nitrate are very effective in treating sensitive teeth. After a few weeks of use you may notice a decrease in sensitivity. Highly acidic foods such as oranges, grapefruits and lemons, as well as tea and soda can increase tooth sensitivity, and work against any sensitivity toothpaste. If you do not get relief by brushing gently and using a desensitizing toothpaste, see your dentist. There are special compounds that can be applied in office to the roots of your tooth to reduce—if not eliminate—the sensitivity. High-fluoride containing home care products can also be recommended to help reduce tooth sensitivity.

Visits to the Dentist include more than just “checking teeth”. While those patients who wear dentures no longer have to worry about dental decay, they may have concerns with ill fitting appliances or mouth sores to name a few. Annual visits to the Dentist (or sooner if soreness is present) is recommended. During these visits an oral cancer screening and head and neck exam will be performed as well as an evaluation of the fit or need for replacement of the existing appliances. Regular visits can help you to avoid more complicated problems down the road even with a denture.