Dr. Gary D. Kitzis

Dental implants can last a lifetime of you take proper care of them. That means thorough daily brushing and flossing and regular visits with your dentist for professional care.
If you don't take good care of them, they have all the same potential problems as teeth with the exception that the titanium will not decay.

It depends on whether or not the nerve of the tooth is infected and/or if there is a lot of missing tooth structure and a post and core is needed to help retain the crown. You need to discuss this with your dentist making the crown.

It really is quite simple. Brush twice a day and floss thoroughly once a day and see your dentist for professional cleanings every six months. Preventive care is your best insurance to maintain good periodontal health. You should definitely have your dentist or hygienist show you how to effectively brush and floss so you do it properly.

Sealants are a composite resin material applied to the biting surfaces of the teeth. They are very effective in preventing cavities on the biting surfaces. They are especially helpful if the teeth have deep grooves which may trap plaque, causing decay. They are very beneficial for young people because of the protection they provide. Older people have less need for sealants if they have not had a history of cavities on the biting surfaces of their teeth because they are probably resistant to them.

Carefully applied sealants can last over 20 years. On the other hand, they have a poor longevity if they are hastily done. They are an excellent preventive measure.

The answer depends on what the source of the infection is. If the tooth has a root canal infection caused by decay or trauma, the infection generally will not infect other teeth. If the source of the infection is a periodontal, due to the presence of deep pockets around the teeth, the source of the bacteria can infect other teeth in the mouth. You need to see your dentist to determine the source. Antibiotics and either root canal or periodontal treatment is needed to allow healing to take place.

Daily flossing is absolutely essential to maintain good oral health. The ideal time to floss is before bedtime because while you are asleep, the flow of saliva slows down and bacterial plaque proliferates which can lead to decay and periodontal (gum) problems. Some people say they are too tired at night to floss. If that is the case, do it in the morning or any other time during the day that you can do it. Doing it every 24 hours is more important than the time of day you do it.

There is tremendous variability between people on this. Some people can have fillings done and hardly flinch, others will be in pain. Most people will be much more comfortable if they are numb. I have had patients fall asleep with only local anesthetic while having work done because they are comfortable and don't feel like they have to hold onto the chair while treatment is being done. Being numb is also a bit of a safety factor because you might not be bothered too much while most work is being done, but there might be a surprisingly sensitive spot where you might jump at a delicate point in the procedure causing damage to be done. If your problem is that you don't like the injection, have your dentist use a topical anesthetic before the shot. It's really worth it!

The biggest sign of early gum disease is bleeding when brushing and flossing. If you see "pink" or "red" when you rinse your mouth after brushing or flossing, you have gingivitis--the earliest form of gum disease. You should see your dentist for a complete examination and oral hygiene instruction to you can take good care of your mouth. Once at your dentist, he or she should do periodontal probing-a measurement of the pocket depths around your teeth. Normally the depths should be less than three millimeters. If they are deeper than five millimeters, you should see a periodontist for more comprehensive treatment. Depths in excess of five millimeters usually indicate bone loss around the teeth. Also, if you have gum recession and can see the roots of your teeth, the yellower part of the tooth close to the gum line, that is also a sign that you have gum disease and bone loss. Get into the habit of flossing at least once a day and brushing at least twice a day and that should keep your teeth and gums healthy for a lifetime.

The dentist you saw recently may have done a more thorough job cleaning your teeth by getting further under the gumline to clean out bacterial plaque and calculus (tartar) than the previous dentist. Cleaning below the gumline isn't always comfortable but it is necessary to maintain a healthy mouth. The bleeding you experienced is also due to inflammation in the gums. If you only clean above the gumline, you won't have any bleeding, but the plaque bacteria below the gumline will remain and cause further inflammation and bone loss around the teeth. You might ask your dentist to use a topical anesthetic on your gums to make the cleaning more comfortable

This is not OK. If part of a filling is missing, there may be decay in that area and the irregular surfaces where the filling is missing will collect more plaque and be susceptible to decay. Sensitivity is never a good sign and it must be addressed.

The fluoride treatment is definitely worth it. The in-office treatment after your cleaning applies a stronger than over the counter fluoride to coat your teeth right after they have been professionally cleaned and that gives you a very effective anti-cavity treatment. The home fluoride rinses only work well if you have thoroughly brushed and carefully flossed your teeth.