1. Are dentist-prescribed whitening systems different than the ones I see in the drugstore?
The key differences are the fit of the tray and the quality of the whitening product. Mouths are not "one-size-fits-all." If the tray doesn't fit well, the whitening gel will not be in perfect contact with your teeth and you could get spotty results or burn your gum tissue. The professional gels contain desensitizers that make the process more comfortable and they have faster, more consistent results than any gels available over the counter.

2. Why do I need a crown now if my tooth was filled long ago?
Unfortunately, fillings don't last forever. In fact if left for too long, they can actually weaken what is left of your tooth. Luckily, we can usually detect decay under the filling or see crack lines in the tooth. These cracks around your filling mean that your tooth will inevitably break apart.

While I would never suggest it, you can wait for the tooth to break on its own. You might get lucky and it will break in such a way that a crown can still be done. But sometimes the tooth will break up into the root system. If this happens, it will mean an extraction and an implant or a bridge. These will be far more expensive and involved than a simple crown. I don't want you to lose a tooth, so I always try to communicate the importance of doing a crown or an onlay in a timely fashion.

3. Why doesn't my abscess hurt?
It might sound hard to believe, but not all abscesses are painful. If the nerve in a tooth has a quick death, it can be very painful. But if the nerve dies slowly, sometimes you'll feel no discomfort at all. I call these a "quiet abscess."

It's important to remember that just because you can't feel it, this doesn't mean it's not a problem. An abscess is actually a pus sac, and you can only get rid of it by doing a root canal on the tooth and cleaning out that dead nerve.

4. How long will this new crown last?
It's difficult to answer that question with any accuracy. Let's imagine that your new crown is a car. Are you going to drive around like a crazy teenager without ever checking under the hood? Or will you only take the car out for leisurely Sunday drives and always check the oil before you go?

Your dental work is just like anything else in your life - the better care you give it, the longer it will last.

5. If you put a crown on a tooth, do I have to get a root canal?
These are two different treatments. The crown is put on your tooth to strengthen it because it is weak. We do a root canal treatment when the nerve in a tooth goes bad.

However, most root canal teeth are already very weak, and the treatment makes them even more fragile so they usually needed to have a crown.

6. What exactly is a root canal?
The nerve rests in a narrow space that runs the length of the tooth. When this nerve goes bad, we go into the tooth, take out what's left of the nerve and seal up the space.

After this procedure the tooth is technically a "dead tooth." This means that while it will function like the rest of your teeth, you will no longer be able to feel heat, cold or pain in it.

7. If you removed the nerve, why does it still hurt when I bite on this tooth?
There is a membrane that surrounds the root of your tooth and acts like a kind of "shock absorber." Sometimes when we do root canal work, that membrane swells just enough to push your tooth out of alignment. When you bite down, your other teeth hit the affected tooth first. This puts more pressure on that tender membrane. When this happens, I adjust your tooth so you won't hit it as hard. This will calm it right down.

8. I never had any pain in this tooth until you filled it. Now it hurts a lot! What's happening?
Often decay works itself so slowly into a tooth that you don't have any pain. But when I go in to clean it out, I find decay very close to the nerve.

Now the nerve is probably very agitated from all the work and the deep filling. If we're lucky, it will calm down, but sometimes in a deep cavity the nerve will actually die. I promise that I will do everything I can to keep it alive. It may get better or it may eventually die. Either way, the pain is not a permanent condition.

9. My other dentist never told me I have gum disease!
I can't speak for your former dentist, but I will say that we are learning so much more about gum disease every year. I can now spot it much earlier and help my patients get it under control faster. Believe it or not, about 80% of the population over 35 has some degree of gum disease.

10. My gums have always bled. It's normal for me.
Bleeding from your gums is no healthier than bleeding from your ears or eyes! This is your body's way of telling you that something isn't right. Bleeding gums are a sign of disease; and when we get your gums healthy, you will be able to clean your mouth thoroughly and experience no bleeding at all.

11. If I have all of this gum disease, why does nothing hurt?
In some ways, gum disease is a lot like diabetes or high blood pressure. You can have these conditions for years and never notice any symptoms. But the longer they are left unchecked, the worse your health will become.

By the time you have bleeding gums, loose teeth and constant pain, the gum disease has advanced to the point where you might actually lose your teeth. Fortunately, if we catch your problem at an early stage, we can usually get it under control.

Periodontal disease is like diabetes and high blood pressure in another way - it has no cure. However, if we work together, we can effectively manage the disease so that your smile lasts a lifetime.

12. I've been chewing without that molar for 15 years. Why do I need to get it replaced now?
When a tooth is lost, your remaining teeth will shift, drift and tip out of position. This can cause problems with your bite, gum tissue and bone. A replacement bridge or an implant stops this movement. There's no reason to let that area deteriorate when it could be helped with a bridge or an implant.

13. I can chew just fine. Why should I go to the trouble of replacing those missing teeth?
You might not realize it, but you've simply gotten used to a bad situation. Without any back teeth, you're chewing your food like a rabbit. But those front teeth aren't shaped to grind up food like your back teeth. This means that you are swallowing your food almost whole.
When your teeth aren't doing their job properly, your stomach has to work much harder. You might manage this way for a while, but sooner or later you will develop stomach problems. When you've got some back teeth to really chew your food, you'll notice the difference right away.

14. Why do I have to get my teeth X-rayed every year?
You may not see any changes when you look in the mirror, but your smile is only the tip of the iceberg. Certain diseases of the teeth and bone are visible only in X-rays. That's why X-rays are a crucial element in the big picture and absolutely vital to your long-term dental health.

15. Am I at risk if I have an X-ray taken more than once a year?
I understand and respect your concerns about the risk of radiation. However, I think you'll be glad to know that the radiation that you receive from one dental X-ray is substantially less than the radiation you receive every day from the sun and stars. Your health and safety are of vital importance to us. Rest assured, we will only take the absolute minimum of X-rays necessary.