Frequently Asked Questions (FAQ's)

1. How often should I have my teeth checked an cleaned?

2. What can I expect at my initial examination appointment?

3. What is periodontal disease?

4. How is periodontal disease treated?

5. What are cavities, and what causes them?

6. How do you fix cavities?

7. If my tooth breaks, can I keep the tooth?

8. When is the right time to use either hot or cold in my mouth?

9. What is the difference between a cap and a crown?

10. What is a root canal? When is it necessary?

11.  I've heard that root canals are painful and don't last.  Is that true?

12. I've heard that silver amalgam fillings are bad for you, Is that true?

13. When should my children come in for their first dental visit?

14. Why should we spend money fixing baby teeth, when they're going to be lost anyway?

15. Bad teeth run in my family, why should I fix up my teeth if I'm going to lose them anyway?

16. I am worried about cost.  Can I make payments for the dental services I need?

17. I'm in a wheel chair?  Can I get into your office, receive dental care and access a bathroom if necessary?

Answers:

How often should I have my teeth checked?     Back to the top

Generally speaking, most people should have their teeth cleaned and checked every 6 months.  But the question is similar to asking "How often should I mow my lawn?".  It depends on a lot of things.  The weather, how often you water, whether or not you fertilize and what kind of grass you have all factor in to how often you have to mow your lawn.  Similarly, your genetic makeup, how well you clean your teeth, your nutrition and you're general health all play into how often you should have your teeth checked. 

As mentioned above, 6 months is average for most people.  However, some folks build up tartar more quickly, some don't do as good a job cleaning their teeth, and some have health problems such as Diabetes or Xerostomia (dry mouth) which require more frequent checking and cleaning.  Rarely do we see patients who need to be seen more often than every 3 months.

What can I expect at my initial examination appointment?     Back to the top

The first time you come in for an examination, their will be a few minutes of filling out our "New Patient" forms.  Please bring a "list of medications" if necessary so that you can give us an accurate idea of your health and what medications or important supplements you are taking. 

Dental assistants will then take you to the treatment area where x-rays and photographs of your teeth are taken.  Dr. Clendenon will then come into the room and discuss your examination with you.  He will finally perform a visual examination of your teeth, mouth and surrounding tissues.  Following the gathering of this information and listening to your reasons for coming in, a determination will be made as to whether another appointment is necessary; and if it is,  should it be for treatment, consultation only or cleaning of your teeth.

What is periodontal disease?     Back to the top

"Periodontal" literally means "around the teeth".  Periodontal disease is when the gums, bone and connective tissue around the teeth become diseased.  Periodontal disease can range from very slight and easily controllable to severe and not controllable.  It is usually caused by a combination of several factors:

     1. Insufficient oral hygiene.  Sometimes the patient cannot clean the areas properly, and sometimes they simply aren't.

     2. Poor general health of the body, making it susceptible to disease.  Conditions such as Diabetes,  poor nutritional habits and smoking can weaken your body's resistance to periodontal disease.

     3. Functionality problems with the teeth themselves.  Grinding and clenching of teeth can worsen periodontal disease.  Missing teeth that have never been replaced and become tipped can exacerbate the condition as well.

Periodontal disease frequently can cause the loss of teeth if not treated.  Although you may be aware of some of the more visible signs of this disease such as bleeding gums and teeth that are loose, it is far better to begin treatment before these symptoms become evident.  Consequently, it is highly recommended to have regular cleanings and examinations as mentioned in question #1above.  That way, if you ever develop periodontal disease, it can be detected early; and treatment can be performed more simply and successfully.

How is periodontal disease treated?     Back to the top

Modern treatment of periodontal disease takes a cooperative effort between the patient and the dental practitioner.  Both patient and dental practitioner must be successful in order to control the disease.  The good news is that modalities are available nowadays, through improved treatment techniques, oral hygiene paraphernalia and increased knowledge of the disease that greatly enhance the patient's chances of successful treatment. 

Simply put, periodontal disease is treated by controlling the activity of bacterial plaque and calcified deposits around the teeth, removal of harmful conditions affecting the gums and improving your body's general resistance to disease. Controlling the activity of bacterial plaque and calcified deposits around your teeth consists of making sure the patient has the optimal conditions in their mouth to allow proper oral hygiene techniques, professional cleaning, debridement and scaling of periodontally involved teeth, motivating and training patients to perform proper oral hygiene techniques. Enhancing the body's ability to fight the disease is accomplished through medications, supplements, habit control and restoration of the teeth to their optimal functionality.  Sometimes a patient may be referred to a Periodontal specialist to access treatment or surgical techniques beyond what is available in a General Dental practice.

What are cavities, and what causes them?      Back to the top

Dr. Clendenon's favorite way of explaining cavities probably won't be found in an
American Dental Association's pamphlet.  He feels a little more graphic explanation ensures better understanding. 

Cavities are formed when bacterial "waste products" weaken and break down your tooth's hard surfaces.  In other words, germs go to the bathroom on your teeth, and those acids weaken the tooth structure and soften it.  Softened and  weak tooth structure is called a cavity. 

It is not widely publicized, but at Dr. Clendenon's alma mater, Loma Linda University, a study was conducted by a brilliant scientist, Dr. Ralph Steinman, who found that a tooth kind of "sweats" when it is healthy: that there is a movement of fluid from the inside of a tooth to its outside under healthy conditions.  He also found that high levels of sugar in the blood reduce, stop and even reverse that fluid movement. 

So when bacteria excrete their waste products, they get all over the tooth structure and de-mineralize them.  If a tooth has a healthy outward fluid movement, it has a better chance of diluting the acid waste products of the bacteria and reducing the damage to the tooth.  And if by regular effective brushing and daily use of dental floss the bacteria is not allowed to organize and excrete its acids, the damage is prevented or minimized.

Finally, it has been found that fluoride can harden the tooth structure.

So in summary, let's look at a person who has very few or no cavities and compare them to a person who has a lot of trouble getting cavities. 

The person who does not get many cavities usually has, first of all, a stronger dental genetic makeup.  They usually do not eat and drink excessively of junk food. (pop, Cool-Aid, Lemonade, Gatorade, PowerAde, candy, gum, Twinkies, etc.....).  They usually clean their teeth regularly and use dental floss.

Now look at the person who gets more than their share of cavities.  Usually there is a genetic weakness.  A parent or a grandparent who had similar problems.  Frequently eating, drinking and cleaning habits and attitudes flourish and are handed down from parents.  Cleaning teeth is not a high priority in most cases and using dental floss is frequently sadly lacking.  Sometimes, drug abuse is a causative factor.

That's where dentists fit in.  We stop cavities, tell you how to avoid them, and by regular visits help keep your dental care as minimal as possible.  Waiting until something bothers you is the worst and most expensive route to take.  Prevention is worth it's weight in gold.

How do you fix cavities?      Back to the top

Basically, dentists remove the cavities and restore the tooth back to dental function using whatever materials are at our disposal.  We use fillings, crowns, and veneers to restore teeth.  We will advise using whichever alternative is the best considering "cost vs. longevity". 

A small cavity can be restored for many years with a simple "tooth colored" composite filling.  They are nice looking and the least expensive of the 3 alternatives mentioned above. 

When the space that is left from removing a cavity is too large, a filling will not hold up, given the severe conditions in the mouth.  Fillings that are too large tend to cause the tooth to fracture.  If this happens, sometimes the tooth is not restorable and the tooth is lost.  So, depending on the size and location of the cavity, dentists advise you as to whether a filling, crown or a veneer would be the best value for your tooth.

The "state of dentistry" in the United States considers silver amalgam to be an viable alternative as a filling material.  We don't use them in our office because composite "tooth colored fillings" look much better and have now become just as good if not better than the silver filling material. So we use them exclusively.

If my tooth breaks, can I keep the tooth?     Back to the top 

It depends on how the tooth breaks.  If it doesn't split right down the middle and there is enough tooth left to give us something to work with, generally the tooth can be restored. 

Usually, a tooth will fracture off to the side and only one cusp of the tooth will be missing.  These are usually easy to restore by covering the tooth with a nice looking porcelain crown.

When teeth split right down the middle, they may have to be removed.  But even then, there are frequently good alternatives available for replacing the lost tooth. 

The bottom line here is that it makes sense to have regular checkups.  If  Dr. Clendenon sees a fracture occurring, he will recommend that it have a crown before the fracture has time to complete itself, thus avoiding a split down the middle of the tooth and risking tooth loss.

When is the right time to use either hot or cold in my mouth?   Back to the top  

When Cold is OK. With some toothaches due to large cavities touching the nerve inside the tooth, cold can be the only thing which relieves paid until you can get in and have it looked at.  Cold is also good for holding down the swelling from injuries where there is little chance of infection.

When Heat is OK. Basically, warm rinses or heating pads cause blood vessels to dilate and your body can get more of its infection fighting cells into the area.  Warm can help the body isolate an infection and condense in to a focal point where it might drain by itself or be easily drained by a professional.  Draining will tend to occur eventually in the direction of the applied heat, so intra-oral rinses are better than heating pads. Heating pads could draw the infection out through an external point like your face or neck.  This would be undesirable.  Warm rinses would cause any draining to happen intra-orally, which would be preferred.

When Cold is Not Okay. Cold should never be used when an infection is possible.  Cold might make it feel better, but it cripples the body's ability to rush blood cells in to fight the infection.  The infection could become much worse.  When it does, it is called cellulitis, and it's makes your face look like a football.  Do not use cold in these situations.  Cold would also be contraindicated if it caused pain.

When Heat is Not Okay. Heat causes dilation of the blood vessels.  So heat is okay in most instances, but sometimes it can make teeth hurt more.  If you have a periapically abscessed tooth, from a large cavity touching the nerve inside a tooth, sometimes heat will make it hurt worse and cold will make it feel better.  So if heat makes it hurt worse, don't use it.

What is the difference between a cap and a crown?     Back to the top

No difference.  I think back when porcelain was just coming out in the 70's, Hollywood actors got their front teeth done.  The term "capping" was used then to denote putting porcelain crowns on the front teeth.  But to a Dentist nowadays, a cap and a crown are basically the same thing.  They can be made from Porcelain, gold, stainless steel, and resin.  One time I saw a guy have a piece of whalebone put over his front tooth.  I guess you could say it was a whalebone crown or cap, but I'll bet it didn't last long.  :-)  Today we also make veneers, which do carry a different meaning.  Veneers are conservative restorations that are bonded to the teeth.  They are usually beautiful all-porcelain and involve less preparation of the tooth beforehand.

What is a root canal? When is it necessary?     Back to the top   

A tooth has an inner soft chamber called the pulp chamber.  It contains a nerve and a couple of tiny blood vessels.  It is a sterile compartment.  If bacteria are allowed to touch that chamber, for example by letting a cavity grow too large, that chamber becomes infected.  Infected tissue swells.  Therefore the swollen chamber can be very painful.  Also, if a tooth becomes traumatized by getting bumped, it can kill the living tissue in the tooth, and it will also swell.

In either case, the contents of the chamber must be removed.  Under local anesthesia, the contents of the chamber are cleaned out, the chamber is sterilized and filled with a substance will not allow bacteria to come back and live in that area.  That is a "root canal" or as we call it, endodontics.

I like to use this analogy.  A tooth is like a sink with one or more drains in the bottom of it.  If you can seal off the drains, the sink will hold water.  Likewise, if the small holes at the end of the pulp chamber are sealed off, the tooth will become comfortable.

A myth about root canals is that "If you have a crown, you have to have a root canal."  That is NOT TRUE.  Most teeth with crowns do not have root canals.  But if you have a root canal on a back or side tooth, it is wise to cover it with a crown.  This will help prevent the tooth from breaking apart in the years to come after a root canal has been performed.

I've heard that root canals are painful and don't last.  Is that true?          Back to the top

Usually, root canals are not very painful.  There can be some discomfort after the canal is cleaned and sterilized, but usually this can be held to a minimum with the use of antibiotics.  I will admit that rarely a person will have more discomfort from a root canal.  But usually that is because antibiotics were not used or could not be administered due to allergies or the patient was unable to get the prescription. In our office we prescribe antibiotics starting a couple of days before the appointment if possible.  If it isn't possible, we'll start as soon as it is.  Another thing we do on back teeth is that we will reduce the tooth a little so it's not touching very hard with the opposing teeth.  Since back teeth root canals should be followed by a crown soon anyway, this reduction is not harmful to the overall result.  Reducing the tooth a little and using antibiotics generally results in a fairly comfortable experience. 

People will call and say that their tooth hurts following a root canal treatment they have had done, and I will ask them if they can make it hurt simply by tapping their teeth without any food in their mouth.  If they say yes, I simply bring them in and reduce the tooth so it doesn't occlude with he opposing teeth so much and make sure they are on antibiotics if possible.  They will usually feel better before they get out of the office.

Root canals generally last many years, and many times the full life of the individual.  It is true that root canals are very demanding in that they require exactness.  Probably no other procedure in dentistry tries the metal of a dentist more than root canals.  Probably root canals have a higher incidence of failure than most of the other things we do in dentistry.  But usually they are successful.  And I remember that the generation before mine didn't have the option to keep abscessed teeth.  Many of them have long since lost their teeth and are wearing dentures.  When we consider that most root canals are reasonably comfortable, and that most of them last for many years, they are indeed a wonderful service to offer patients.  Many people enjoy their natural teeth and eat healthfully due to the fact that root canals prevented the loss of some of their teeth.

I've heard that silver amalgam fillings are bad for you, Is that true?          Back to the top

Dentist's themselves argue about this one.  It's becoming a mute issue, because other filling materials are taking over anyway.  But for the record, the standard of dentistry in the United States considers dental amalgam a safe alternative to use for filling material.  A minority of dentists in this country suspect that there might be something to the fears some express about the mercury content in silver amalgam.  Silver amalgam fillings are made from a mixture of roughly 50% silver and 50% mercury.  It exists in your mouth as an alloy.  Not as silver, not as mercury, but as silver/mercury amalgam alloy. Some advocate the removal of old amalgams and replacing them with other things.  While a minority of dentists hold this view, it is not considered harmful by the profession of dentistry as a whole nor by the Food and Drug Administration of the Federal Government.  To promise a patient life-changing results from having their silver fillings removed is considered "quackery" by the powers that be in this country.  Some dentists who have advocated such ideas have  been prosecuted under the law and are practicing in other countries.  I am a little sympathetic with the minority who are against silver/amalgam fillings, but I do not advocate their removal for health reasons.  I take this stand, not because  I even agree with it, but because I practice in the United States and that is the law.

So, when a person asks me to remove their silver/amalgam fillings, I can and will.  But I make no claims or offer no hope of that process curing any maladies they may suffer from.  I think that the white filling look better and are just as good, if not better than the amalgam fillings anyway.  Click here to find out what the American Dental Association says about filling materials, including amalgam.

When should my children come in for their first dental visit?     Back to the top

The American Dental Association says by the time a child is 1 year old, they should have a "well baby" checkup.  Click here to see the article.  We start seeing children in our office at 4 years of age.  If you need to have your child seen before the age of four, contact our office and we can give you the names of  some Pedodontists (Children's specialists) in the area.  Children have no reason to be afraid of dentistry today and getting a good start early makes it nicer for our children in the years to come.

I will use this question and answer to again make this point: never put a baby to sleep with anything in the bottle but water.  Not sweetened water, not milk, not juice, not anything but water.  Rampant baby-bottle decay can give a child a very rough start with their dental visits.

Why should we spend money fixing baby teeth, when they're going to be lost anyway?     Back to the top

Baby teeth (primary teeth) are not only for chewing, but they hold the space open for the permanent teeth to follow.  Most children will lose 8 of the primary front teeth between the ages of 6 to 8.  Their primary back teeth (12 in number) are needed until they are lost naturally in order to hold the spaces open for the permanent teeth that follow.  If a primary molar is lost even a couple of months prior to its time, space will be lost.  Lost space can be difficult to regain, and orthodontic costs will be increased. 

Saving a few dollars by not fixing primary teeth will cost much more down the line.

I frequently see parents holding back on simple treatment of primary teeth only to have the problems worsen and then have to afford even more expensive treatment only months before the tooth is lost.  Keeping baby teeth in good condition is the best and the least expensive way to go.

Bad teeth run in my family, why should I fix them if I'm going to lose them anyway?        Back to the top

As mentioned above, it is true that we all have teeth with inherited traits of our parents and grandparents.  It is true that some people have genetically strong teeth.  They don't brush them and eat poorly, and yet they stay strong for an amazingly long time.

And others try to take care of their teeth and they still get cavities.

But, most of the time that I hear people say they have soft teeth, they are misjudging their teeth.  Usually these people have reasonably strong teeth which simply cannot hold up under the poor dental care and habits which are common in that family.  Frequently the problem is not soft teeth, but rather way too many sugar drinks (pop, beer, Cool-aid, Lemonade, Gatorade, or PowerAde), drugs abuse, candy or absolute failure to clean the teeth with a toothbrush.

Nowadays, people don't have to lose their teeth most of the time.  It is only by sustained neglect that a person can come to a position where teeth cannot be saved.  So don't throw in the towel because your family lost their teeth; be the one who keeps your teeth.  You'll be the marvel of your whole family.

I am worried about cost.  Can I make payments?     Back to the top

We can help you in several ways.  First of all, when Dr. Clendenon decides you treatment, he prioritizes it for you, with the most pressing things first.  If there are options, he will explain them to you.  So, if you are pressed financially, you can frequently take it a bite at a time, so to speak, and do the most pressing things first.  For your convenience we also take Visa, M/C, Discover and American Express cards.  If you need to make payments, we offer "American Dream Financing".  You simply fill out a credit application in our office and we help you submit it for approval.  This can usually be done within a very short time of minutes or hours.  If your credit is approved, you can get "same as cash" money interest-free for 3 months.  This helps many people get larger treatments done "a bite at a time".

I'm in a wheel chair?  Can I get into your office, receive dental care and access a bathroom if necessary?      Back to the top

Yes, we have a ramp in the back.  Our bathroom is capable of accommodating a wheel chair.  To date, we haven't had a situation with a patient in a wheel chair we couldn't handle.  It does help if you let us know and we will be waiting to help you up the ramp in the back.