Dr. May Louie

Stick with the usual twice a year or every 6 months. However,  if u have wire braces u will notice it's harder to floss and brush well and food may catch in between the wires and brackets.  If u slack in ur flossing and brushing and u see swollen or red gums, maybe even with bleeding,  u have gingivitis and it may help to get ur teeth cleaned in shorter intervals,  like every 4 months or 3 months until ur dental hygiene gets up to par or the gingivitis is gone and ur back on track for 6 months going forward with good dental hygiene. If u wear Invisalign, stick to it every 6 months since there's nothing barring u from good and easier flossing and brushing. 

Yes, a filling in a matching white can be done on a front tooth. It is called bonding a resin composite onto the area of your front tooth that is being restored. However, if the size of the cavity or defect is extensive,  then, a more protective restoration with better longevity would either be a crown or a veneer. The more damage to the tooth, like back and front or a big fracture,  the greater chance a crown will be indicated. Veneers work great if the tooth is decayed more moderately on the front of the tooth or has had alot of patchwork or has had the tooth edge fractured off or you want to close a gap between teeth. White fillings on the front are great when the decayed area is small whether it's on the front or the back of the tooth.

No, for simple gingivitis, all it is is inflammation of the gingiva or gums. To clear up gingivitis, all it takes is some discipline in dental hygiene, brushing and flossing properly. Antibiotics are only for infection, not inflammation. To make sure you are brushing and flossing correctly, ask you dentist or hygienist to show u, then you demonstrate it back to them to prove you got it right!  It's also very important not to brush by feel but brush in the mirror so you can verify if the toothbrush bristles are actually touching the gumline or touching the upper most back molar and the back of the back molar. Alot of people say they brush but they miss because they brush by feel and therefor assume they got every gumline or tooth. For accuracy, ladies don't apply makeup by feel. Men don't shave by feel. Why shouldn't brushing and flossing be any different? If you brush and floss in the mirror, gingivitis will be a thing of the past.

It would depend on how MUCH bone u really have lost in the area where u want the implant. U need a cone beam cat scan to evaluate if u have enough bone and enough good bone. The doctor (oral surgeon,  periodontist, or general dentist who places the screw into the jaw) will be able to tell u if u are a candidate for implants or not.  Get a consultation first. If u need a little more bone,  u can do a bone graft to add more bone to prep for an implant. There are various ways to do this: PRP,  stem cells, traditional bone graft,  rib graft, etc. The doctor again will discuss bone augmentation options with u. But generally speaking,  since the screw is screwed into the bone,  yes, u would need enough bone to hold the screw in the jaw. It's like u want to hang a picture on a wall and ur nail or screw is 2 inches long but ur wall thickness is only  1 1/2 inches long.  It won't work.  But if u add more drywall and make ur wall 3 inches thick, ur 2-inch screw will work well,  with 1 inch to spare for reinforcement. But the best start again is to get a consultation to find out what our personal situation is.

If u really haven't lost bone over the years whether it's weight loss or long-term wear and tear or periodontal disease, the hooks or clasps can be tightened. If they are silver hooks,  ur dentist can manually tighten them with tools. If they are the flexible pink ones,  like  Valplast or Durable, u or the dentist can submerge the hooks under very hot water while pushing the hooks inward toward the part for a minute and then run cold water over a minute, that should tighten the hooks.  If u have actually lost bone then u are better off relining the partial with new material to take up the extra space between the partial and gum tissue, so that the partial and the gum are back in intimate contact.  If the denture is very old, ( dental insurance allows u a new one every 5 years, but check ur own specific dental insurance company for their own "frequency limitations" ) patched over too much,  then u really need a whole new partial. The best thing to do is to go to your dentist and get evaluated to see if u are able to tighten the hooks or get a reline or need a new one. Sent from my Verizon, Samsung Galaxy smartphone

You can gently and carefully brush the teeth around the extraction site with a dry brush or with very little toothpaste.  The idea is to not dislodge the soft, moist blood clot over the extraction site.  The clot is the only protection or "band-aid" over the socket so you do not want to accidentally brush it off or rinse so hard or so much that you rinse off the clot. If you do, the bone inside the socket will dry out, causing a complication called  "dry socket " or osteitis.  You would feel a dull,  aching pain after the 3rd or 4th day that goes away with pain pills but cones right back.  It is never sharp pain and you can work through it but it is not helping you to heal.  You must go back to your dentist to "pack" the socket with a dressing which will make you feel better in 10 minutes.  After changing the dressing once or twice more,  you are on your way back to healing on your own. As far as brushing the rest of your teeth, brush as you do normally but again, use very little toothpaste or dry brush because you do not want to vigorously rinse off the excess lather and end up losing your clot.  Put the water in your mouth and let the waterfall out passively.  Do not swish back and forth vigorously. The socket should heal over in a week if there are no complications.

Pinhole surgery is an excellent option for gum recession. It is not painful if u are well anesthetized. There are no scalpel  cuts  and no sutures. There are only 2 pinholes created by a needle that heal in 24 hours and all the work is done through the 2 pinholes,  similar to arthroscopic surgery using small slits rather than pinholes to do all the work. Basically,  Pinhole is like a facelift but instead of loosening the tissue from the bone and pulling the skin tight, you are loosening the gum from the bone and dropping the gum down to cover all the gum recession and that will be the new permanent position of the gum as it heals. The gums are weighted down with collagen to stay put in the new position. This is done to prevent gum shrinkage which is the normal way tissue heals. There are no sutures or stitches.  The healing, however,  is a process and must be strictly followed as far as instructions.  You cannot brush for 1 month.  U will only use a prescription antibacterial mouth rinse. In time,  u will be taught to brush very, very gently as the gum tissue is reattaching to the bone in its ' new position that covers all the gum recession. In 3 months,  you will be well healed and you will be very pleased with the end result. If you are patient with the process and committed to following instructions,  it will be worth it to not see the gum recession anymore.  After that,  you must never do what you did to cause gum recession again in the first place. Commonly, it is brushing too hard, too often, or too long with a medium or hard toothbrush. Like handwashing, it is possible to wash thoroughly and be clean without taking off skin in the process. You must overcome the habit of thinking clean teeth results from overkill brushing. That is what you call a thought distortion but not reality. You don't want to ruin the beautiful result once your gum recession is fixed. 

Yes, u can. If the crowns are permanently cemented and not loose, they will move with the tooth body and roots as a unit. Whether ur in wires or Invisalign, the wires or the tightness of the Invisalign trays will cause micro movement, pushing or turning, rotating, uprighting pulling, etc. of the teeth, root, and tooth body crowned or not as a unit.

Not normally,  unless u are brushing too hard, too frequently, or too long, especially with a medium or hard bristle toothbrush. Teeth have that white covering called enamel.  It's hard and isn't likely to be painful but if u tend to brush in any of the above  3 ways mentioned above,  more than likely u have overbrushed the healthy thin gum above the tooth thinner such that it has receded, like thin hair with a receding hairline, exposing the root, which DOES have nerve endings. Pain can come from the traumatized gum or from root exposure and nerve endings from overbrushing. Another reason for pain after brushing would be enamel erosion caused commonly by ducking on lemons.  The acid from the lemon erodes the protective enamel thinner that ur either very close to the yellower second layer of ur tooth called dentin or the dentin may be actually exposed. That has nerve endings too. So if ur brushing or rinsing with cold water, ur teeth can hurt from the shock of the cold temperature. The last reason may be u have decay or a hole in the tooth,  so when the toothbrush bristle digs into the cavity,  the nerve in ur tooth is responding with pain. The solution is to have a dentist check for cavities.  If u have them,  fix or fill them and the pain will go away. If u have exposed dentin from acid erosion,  stop ur habit.  Get white bonding to cover the areas where nerve endings are exposed. If u have exposed sensitive roots due to no gum coverage, switch to a soft toothbrush and brush, not scrub, in a circular fashion gently along the gum line and tooth only for 2 minutes for the whole upper and lower. Brush no more than twice a day. Ask ur dentist to prescribe a desensitizer to apply a desensitizer to block the nerve endings from shooting off the pain. Always use warm water to rinse or brush with exposed root or dentin to stop pain from cold. Finally,  if u want to restore the gum to cover the exposed root, u may consider gum grafting or Pinhole Technique with a gum specialist,  a periodontist.  If u choose not to cover the root surgically, u may consider bonding white filling material over the sensitive areas of the root, but this is not ideal,  although the last option. 

Post-operative discomfort should be about a week, however if you still have pain that never subsided or got worse, you should report that to your surgeon just to make sure there is no infection. Keep the surgical site clean. Avoid using that side to eat. The gums will be too tender just yet. If you have swelling or redness, you already have inflammation. You can ask your surgeon for an antibacterial prescription mouth rinse to kill bacteria and speed healing. Also, make sure if the pain is not coming from the gum, get a CBCT to make sure the endosseous implant (screw) is not impinging on nerve tissue and to check the condition of the bone around the screw. Never hesitate to call and ask questions with your surgeon. They want you to heal well and should be informed of what you feel. You should be seeing your surgeon in about 2 weeks for stage 2 anyways, but don't wait if the pain doesn't get better.

Hello,

Depending on the severity of the crack, you have some options. If the "crack" is visible, but you have no pain to eating with it or hot, cold, or pressure, that is a "craze line," which is simply normal wear and tear and requires no treatment. If the crack does hurt to use it and is sensitive to cold, hot, and pressure and sweet, this is cracked tooth syndrome. I would check on the health of the nerve first. If the nerve is healthy and only hurts on pressure, adjust the bite. If the nerve is healthy and is sensitive to cold and hot, the crack is open enough to let the hot and cold in, so covering the tooth with a veneer or crown will cover and support the tooth to make it strong and functional again. If there is an actual fracture and you are missing a portion of the tooth, again, depending on how big the fracture is, a white bonding or filling is sufficient for minor damage. For significant damage, a veneer or crown will take care of that. Big fractures may require an additional "build-up" first. If even after a veneer or crown doesn't solve the sensitivity to pressure, hot, and cold, then the last option is a root canal. You will not need to redo the veneer or crown, as root canal access will be tiny if done with a microscope so that tooth structure can be preserved and not require redoing the veneer or crown. 
Hope this helps. The pattern discussed here is going from conservative to more aggressive treatment, or least invasive to necessarily invasive. Thank you for your inquiry. 

From the picture, it may be lichen planus, especially since you noted burning and white, web-like appearance. Your doctor thinks it is fungal or yeast, therefore the File 400. Have it biopsied by an oral surgeon first to confirm it, then if it is lichen planus, rx may include corticosteroids, strengthening your immune system. or watching out for triggers in lifestyle, like stress, a new drug or mouthwash, or other allergen. Asking your local dental society for a referral to an oral surgeon is a good start.

An oral surgeon is better apt to answer this question than a general dentist. Asking your local dental society for a surgeon referral is a good start. Thank you.

After stitch removal, give yourself another week and you'll be able to eat and drink normally. If you still feel tender, restrict eating to the opposite side until the affected side is more healed over if it takes your body more time to heal.