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Gum Disease and Gum Treatment                       


Why do I have gum disease if I brush and floss my teeth regularly?

Sometimes, even when we do all the right things, we can still develop the problem. Certain bacteria can be present, but may remain in a dormant state if your immune system is working well. Then, even subtle stresses can set in motion a chain reaction that results in one or more areas of our bodies being less than healthy. This is often the case with gum disease. Also, some people have a genetic predisposition that doesn’t manifest itself until later. And some people are just unlucky and harbor the complex of bacteria that causes the worst damage. The best advice is to make sure that your dentist and hygienist are checking for gum health and when problems show up, they are dealt with early enough so that you can avoid gum surgery or tooth loss.


Will my gum treatment hurt?

The type of non-surgical gum treatment/root planing that Dr. Milne and Kathy, RDH carry out in their practice is both successful and very comfortable. To our patients, it is much like a cleaning but different in two ways. First, you will be made numb in all the areas of the deepest pockets, usually with out needles. Second, it will take longer than a regular cleaning, depending upon your needs. Commonly, patients will tell us that the experience was much better than they expected.


Why do I have to get my teeth cleaned every 3 months after I have gum treatment?

"Didn’t the hygienist fix the problem? Plus, my insurance doesn’t cover but 2 cleanings a year."
Yes, the hygienist did her part in smoothing away the deep bacteria and tartar that caused the problem in the first place, but the same problem can come back again if allowed. Your hygienist will review the steps that you will need to carry out in your home care, but especially during the first year, you will need to have a Periodontal Maintenance cleaning every 3 months. Studies have shown that after 90 days, bacteria colonies will have reached maximum number and may start doing damage all over again. So, just as a patient with high blood pressure or diabetes is predisposed to their condition and must follow a specific regimen, the same goes for patients with gum disease. There is always the chance it will come back, and the standard treatment is every 3 month cleanings. Yes, some dental insurance policies may not have your best interests at heart. But I want my patients to have Healthy Gums for Life!


Why do you recommend a Sonic Electric toothbrush? 

Dr. Milne never wants to put down the toothbrush you currently are using. However, our experience with Sonic Electric toothbrushes over the last 20 years is overwhelming. Those patients who take the time to learn how to use it properly have exhibited excellent health results after their gum treatment. Users typically see four times the bacteria removal versus a manual toothbrush in the same amount of time spent. Plus, most people who actually DO floss, don’t do it properly. Electric toothbrushes that rotate are often too aggressive on your delicate gums.  A sonic electric toothbrush covers a multitude of errors in its simple action, without damaging your gums. So if you do have an manual toothbrush at home, and are still diagnosed with gum disease, maybe it’s time to make a change to something that will give you the best results possible.


How long do I need to use the Chlorohexidine rinse after my gum treatment?

Good news! In our practice we do not use Chlorohexidine.  Kathy our Hygienist will instruct you on the use of the Antioxidant Kit provided to you at your deep gum treatment. Chlorohexidine is a great antibacterial product, however the Periosciences kit is not only an Antibacterial but also contains a powerful Antioxidant to combat the free-radicals associated with the infection in your gums.  You will use the kit until you return for your 6 week re-evaluation, fine scale and polish.  Some patients who battle gum disease find that continuation of the AO gel is their best assurance that they are doing everything possible to fight the bacteria in between professional cleanings. And Using the AO Gel along with a sonic electric toothbrush is the best way to continue to apply the medicine to your gums for maximum benefit.


 Why do you use the Periosciences Kit instead of Chlorohexidine rinse?

The AO kit has several advantages over Chlorohexidine. Primarily it promotes wound healing using the antioxidants, unlike Chlorohexidine. It also tastes better and does not stain your teeth like Chlorohexidine. 

  • Three Part System: Toothpaste for teeth, mouth rinse for breath, and AO ProVantage gel for oral tissues. Uniquely formulated to work in synergy, imparting a hydrated feeling and sense of freshness and vitality
  • Made of a unique selection of ingredients that have the ability to attract and hold moisture, supporting the lubricating action of saliva
  • Creates an environment hostile to bacteria through pH levels
  • Targeted antioxidants phloretin, ferulic acid and silymarin counteract free radical activity

Crowns


How long will my crown last?

The life of a crown could be between 5 to 10 years, however with proper care and professional cleanings by a dental hygienist, many last up to 20 years. The use of a super strength Fluoride at home will also help to keep your crowns to last their longest. Ask one of our staff about which fluoride is best for you.


How do I know if I need a crown or a root canal?

Most of the time there is no pain with a tooth that may need a crown. An old filling that is wearing out and being replaced may leave a cavern that is too big to refill with a regular tooth colored filing. In a case such as this, a crown may be recommended. The large space that is left by removal of the old filling and decay, may leave walls that are too fragile and that will not hold up to the forces of chewing. The crown covers what is left of the tooth and strengthens it by holding the weak parts together and keeping them from splitting. Occasionally, a tooth can be sensitive to chewing only hard foods. In this case, the tooth likely has a hairline fracture within it, and a crown is needed as soon as possible to prevent the tooth from splitting in half or needing a root canal. If the crown is competed in a timely manner, a root canal may be prevented.


Will my crown have that black line around the gumline like I see on other people’s front teeth?

No, we are a metal free office. Now, we can use materials that do not have any silver metal as part of the crown. Dr. Milne will examine you to see if you are a candidate for an all All Porcelain Crown (E-MAX) or Zirconia Crown (LAVA).


Will it hurt when I get a crown?

No, having a tooth treated with a crown should not hurt. We will make certain that your tooth is completely numb before we start the procedure. Even those patients who are a little harder to get numb are treated to maximum comfort every time. Most people need only to return for their next appointed visit a few weeks later, and many don’t even need to be numbed for the cementing of their crown. Of course, if it is your preference to be numbed for a cementation of a crown, or for portions of your regular cleaning, we are happy to accommodate you.


Porcelain Veneers


Will you have to drill down my teeth for me to have veneers?

In some instances, reshaping of the tooth is necessary so that the veneers look life-like and not too bulky. However, many patients are a candidate for no prep or minimal prep veneers. Dr. Milne will be happy to discuss this with you at your initial exam and consultation to consider if that is an option.


How long will my veneers last?

Many patients see their veneers last as long as 20 years. Over time, depending on various factors, patients may see chipping and staining of the veneers at the edges. This can be avoided by stopping habits such as fingernail biting and smoking, and limiting the intake of food and drink that stain, like red wine and tea. Sometimes, just modifying certain intake habits can do the trick. For example, always using a straw to drink certain liquids is very effective in limiting stain.


Do I have to get a ‘shot’ when Dr. Milne does my veneers?

For most cases, patients want to be numbed for the initial work in creating veneers. However, during the cementation step in placement of veneers, Dr. Milne may not need to numb the area . The polishing steps will sometimes be sensitive to the gum area. The main point is that Dr. Milne and her caring staff will work out what is best for you.


Implants


Will I be able to chew with my implant just like the rest of my natural teeth?

Yes, often patients cannot tell any difference at all between their natural teeth and their implants. And denture patients are thrilled by the fact that they no longer have to have a full palate of plastic in the roof of their mouths. Some can taste food again for the first time in years.


Will Dr. Milne do all the steps of the implant herself in her office?

Dr. Milne will take the lead in the planning of your implant and the crown or bridge that is to ultimately be placed to replace your missing teeth. Dr. Milne does place dental implants however, in some cases she may elect to involve an implant surgeon for the surgical portion of your treatment. This communication in the planning stages is critical for success in the final outcome. Dr. Milne will make the temporary teeth that you will wear during the implant healing phase and of course she will create the final crown or bridge at the appropriate time.


How much do implants cost compared to other ways to replace teeth?

There are many different types of implants that serve different functions and are used in different ways. However, the combined fees to replace a single tooth with a single implant and crown is similar to the fee for a 3 unit fixed bridge, given all other factors remain the same. Call now for your complete exam and let Dr. Milne evaluate your situation to see what treatment is best for you.


White Fillings vs. Silver Fillings


I really hate these silver fillings in my teeth, but don’t think I can afford to do anything about it. I there a way I can change them to white fillings?

Yes, however Dr. Milne should decide if they are sound fillings or failing before any replacement takes place. Many old silver fillings do in fact have hidden decay under the edges, but some can last far longer than the standard life expectancy. X-rays should be examined and intro oral digital photos are also helpful in determining if old silver fillings are still keeping the seal around the margin or interface of the filling and tooth. In many cases, a picture is worth a thousand words. Also, if it is determined that your old fillings are leaking and allowing bacteria get under the edges causing secondary decay, the sooner they are replaced, the better. If nothing is done until there is pain, then unfortunately the only recourse is a root canal, post, and a crown.


What if my fillings look really big. Can I still have white fillings?

As long as the cavity space after the silver is removed doesn’t get too large, then yes we can often fill in the space with tooth colored resin filling material. Standard care is for the space to be filled not be more than one third of the chewing surface of the tooth. Sometimes the decay under an old silver filling will undermine the tooth so much that the tooth will require a crown in order to save it. Also, this is how internal cracks form….from the decay that slowly weakens the tooth. If a problem is found, then the sooner it is fixed the better and the less expensive the outcome. We encourage our patients to look at the intra oral and digital photos with Dr. Milne as she is examining each tooth and its filling, so that they can understand what is going on in their own mouths.


What if I had a filling replaced and it hurts to bite on now?

Sometimes if the filling that is placed is large, the resulting sensitivity can last for a while. It may just last for a few months. First, be sure to have the dentist check your bite for proper occlusion. If the sensitivity persists and is especially if it occurs when you bite down on something hard, you may have a crack in your tooth, and the large filling may have to be replaced by a crown. Above all, go back to the dentist who did the filling and follow all protocol that is recommended.


Teeth Whitening


Why do I still have to have trays to bleach my teeth if you do in office whitening?

ZOOM Whitening gives your teeth whitening a “Quick Start” in our office, then we make you trays for use at home because studies show that the deepest whitening to teeth takes place after the in-office procedure, by the constant contact of whitening solution with the teeth over time. This also makes it easy for you to touch up bleach every few months with our convenient touch up kits. Unless you plan to never drink coffee, red wine or eat blueberries again, your teeth will still absorb the color present in some chromogenic foods. The “Quick Start” plan gives you the best of both worlds!


How white will my teeth be after my “Quick Start” in-office Whitening?

Everyone’s teeth are different when it comes to whitening. The level of whitening that you will see depends on how disciplined you are with your trays at home. We do the in-office Whitening to jump start the whole process and open up the enamel tubules, but most of the longer term whitening takes place with the use of the trays as the bleach works its way into the dentin. Your pack will supply you with enough whitening solution to last about 10 days (given that you don’t use too much solution and have to spit out too much excess). Some patients who have tetracycline stained teeth can still expect to get bleaching results, but only after use the trays for 9 months to a year. They simply have to continue to purchase the touch-up kits for use on their trays. What a great and conservative alternative to drilling their otherwise healthy teeth for crowns!


Will my teeth be sensitive after the “Quick Start” in-office Whitening?

Generally, most people have some sensitivity with any kind of bleaching, whether it is over-the-counter or done professionally. It usually only lasts for a short time (less than 24 hrs), but can be different for everyone. IF you have tried over-the-counter whitening and have been uncomfortable, the in-office whitening will likely make you more sensitive. As mentioned above, the sensitivity is shot lived, but you have to be prepared for it. If you do not think that you can cope with the sensitivity, come in and talk with Dr. Milne about other methods of brightening your smile.


Nitrous Oxide


I have never had Nitrous Oxide before. What will it make me feel like? Will I be able to drive myself home after I use it?

Nitrous oxide (sometimes referred to as laughing gas) is a mild analgesic that is administered by inhaling it. That means that it lessens the ability to feel pain, which in a dental office is generally considered a good thing! It is very safe to use and is constantly monitored during use. Once Dr. Milne is finished with your procedure, you will be placed on 100% oxygen to clear the nitrous oxide from your system. That is why you can drive yourself home after your dental visit. Many patients tell us that it feels like a light, floating feeling, that greatly reduces their anxiety about their procedure. For many patients who have had a bad experience in the past, it is profoundly comforting that we have Nitrous Oxide available for their procedures, so that they don’t need to be heavily sedated for dental treatment.


How much extra does it cost for me to have the Nitrous Oxide?

There is a modest fee for Nitrous Oxide use. Dr. Milne wants to make sure you are comfortable for the dental procedure that you are entrusting to our care.


Care Credit and Dental Treatment Financing Options


Why should I apply for Care Credit? Can’t I just do one tooth at a time?

Our practice mission is to get rid of decay and gum disease in our city and county. In order to provide the very best treatment, we can’t just treat one tooth at a time. By the time we get around to the fourth or fifth tooth, several of them would need root canals. That would be a high price to pay for waiting. Therefore, we have access to Care Credit for our patients so that more people can have their much needed dental treatment completed and have the luxury of paying it off with no interest for a year. Yes, it means that you have to make your dental health a priority, but ask any denture patient if they could go back in time and change things…we all know that they would.


How do I get Care Credit? Can I call them myself?

Yes. You can go online at carecredit.com or call 1-800-365-8295. However, if you'd like our office to help you with the process please call 813-677-1200 and let Melinda work on your behalf with Care Credit.


I have an account with Care Credit that I have paid off, but don’t know if I can get enough credit for my dental treatment. What do I need to do?

Call our office manager Melinda now at 813-677-1200. Let her listen to your concerns and assess your needs. We will work for you and make your dreams of a new smile happen with Care Credit!