What is “comprehensive dentistry”?
Our aim is to have all concerns and issues known—to us and to you—and hopefully resolved before a dental emergency. We want everyone to have healthy, attractive, and stable teeth and smiles. (Nobody likes a toothache or broken tooth, especially since they never happen at convenient times.) This means that we see patients for many reasons with many different needs. Our services range from routine preventive care to life changing restorative and cosmetic treatments, so we have something to offer everyone to address their personal chief concern and needs. The second half of this equation is the development and fulfillment of ongoing maintenance plans. This minimizes the chance of original problems reoccurring. We will do everything we can to customize your maintenance plan based on your individual situation.Maintaining good oral hygiene at home is important, but man cannot live by toothbrush alone. In-office dental exams are critical to keeping your smile clean and healthy. At Today’s Dentistry, our team has the ability to remove plaque your toothbrush can’t, which reduces your risk of tooth decay and gum disease. We also use x-rays and our intraoral camera to monitor structures that aren’t so obvious to the naked eye. In a way, “comprehensive” care really refers to our commitment to the present and the future of your smile. Not only do we want to keep it healthy, we want to make it beautiful, and make it last.
I don’t have a toothache, and I brush and floss regularly. Do I really need a check-up?
Biannual teeth cleanings performed by a skilled dental hygienist are central to keeping teeth and gums looking, feeling, and functioning well. If you have gum disease, more frequent visits to our office will probably be recommended for your oral and overall health.During routine dental cleanings, plaque and calculus (more commonly known as tartar) are removed from teeth. Plaque is a sticky deposit on teeth in which bacteria grow, and tartar is basically calcified or hardened plaque, so it is more difficult to remove. When tartar builds up under the gumline, causing gum disease, more extensive treatment than a standard cleaning is needed to remove it and help ensure healthier gums. Hygienists also polish teeth, floss (partly to test the condition of gums, to see if they bleed), and they document any bleeding along with stains they noted during the cleaning in a patient’s file.Dental exams with Dr. Kunick & Dr. Markham make it so problems can be diagnosed and treated before they grow to be big, often painful and expensive. A typical exam includes a visual assessment of teeth and occlusion (bite), along with an appraisal of current restorations. When x-rays have been taken, Dr. Kunick or Dr. Markham will carefully review them to identify areas of decay and other possible areas of concern for cysts, tumors, and other disorders of the mouth. Your dentist will perform a general screening for early detection of gum disease and oral cancer, as well.
In between cleanings and exams at our office, brushing teeth at least twice a day (in the morning and at night) is the most important thing you can do to take care of your teeth. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of teeth. Additionally, clean between teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells, and how clean it actually is. Restorations, such as bridges and partial dentures, should be cleaned thoroughly, too, just like natural teeth. Toothbrushes should be replaced every two to three months.
How do I choose the right oral hygiene product for me?
Your average Cedarburg toothpaste aisle can be pretty overwhelming. Over the past few years, companies have introduced so many options for toothpastes, brushes, flosses, and mouthwashes, that even the most discerning consumer wouldn’t know where to begin. Here are a some hints for picking the right products for your particular needs:
Toothbrush. The big question here is, electric or manual? When it comes down to it, it’s really all about your personal preference. Recently, electric toothbrushes have gained popularity, but not necessarily because they’re “better” than manual brushes. Both brushes are effective at removing plaque, but electric brushes can make the process easier for you. If you find manual brushes difficult to use, or just don’t enjoy the process, an electric one might make brushing easier and allow you to do a better job. When choosing a manual brush, opt for soft bristles with the smallest head—they’re easy on gum tissue and can fit around the back molars. Regardless of your hardware of choice, though, just keep brushing, and be sure to brush long enough! Although it takes a full 2-3 minutes to brush every tooth effectively, most people only brush for an average of 30 seconds!Toothpaste. First and foremost, always check for the ADA seal of approval. Despite the large variety of toothpastes available, most contain similar agents geared toward scrubbing, flavoring, or keeping your paste moist. It’s a good idea to choose a paste that contains fluoride, which strengthens enamel and makes teeth less prone to decay. Tartar-control toothpastes usually contain fluoride, but they also contain chemicals to break down plaque and antibacterials to kill lingering germs. After checking those off, choose your paste based on your personal needs. Whitening varieties have added abrasive agents (not bleach), that polish the surfaces of your teeth without damaging enamel. If you have sensitive teeth, certain toothpastes provide chemical compounds that, when used on a routine basis, can reduce sensitivity over time.
Floss. While most people brush the recommended two times a day, flossing sometimes gets placed on the back burner. However, neglecting to floss at least once daily is doing your mouth a serious disservice, as up to 50% of plaque accumulation occurs between teeth. That’s why you should floss before you brush, to loosen up that plaque for easier removal with your toothbrush. If you find flossing too difficult or unpleasant, try using a flosser. They’re reusable, use disposable heads, and with handles just like toothbrushes, they make flossing as neat and easy as brushing your teeth. You can find them at most grocery and drug stores.
Mouthwash. There are as many different types of mouthwashes available as there are flavors, and it’s important to choose the one that’s best for you. Cosmetic mouthwashes can rinse away debris, provide a pleasant taste, and mask bad breath temporarily. If you’re looking for a mouthwash with a purpose, look for an FDA-approved therapeutic rinse, with either antiplaque or anticavity ingredients. Mouthwashes are particularly useful for people with canker sores, braces, and dry mouth, but they shouldn’t replace brushing or flossing.
Combing all of these factors makes a complete and effective oral hygiene routine, but you don’t need the fancy, expensive products to have your healthiest smile. Just do your part at home and stay up-to-date with professional check-ups, and you’ll be set to go!
What can I do about bad breath?
If you feel constantly worried about bad breath, you’re not alone. Bad breath (halitosis) is an all too common problem, not to mention embarrassing and distracting for you and others around you. Deducing what is most likely causing your bad breath will help determine what you can do to prevent it.Greatly reduced saliva flow during sleep (the cause of morning breath), certain foods (such as garlic, onions, and peppers), poor oral hygiene, periodontal (gum) disease, dry mouth, tobacco, dieting, dehydration, and some medical conditions (including sinus infections and diabetes) can all cause bad breath. Brushing your teeth at least twice a day—in the morning and at night—is the first thing to start doing, if you are not already in the habit. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of your teeth. Additionally, clean between your teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every couple months.Biannual dental cleanings and checkups at our office will not only keep your teeth and gums in good shape, but seeing you regularly will also allow us to better detect any problems, such as gum disease, dry mouth (Xerostomia), or other dental conditions, such as decay, that may be the cause of persistent bad breath. If you have gum disease, more frequent visits to our office might be recommended for your oral and overall health.
Breaking a tobacco habit (smoking or chewing tobacco) can significantly improve your oral health and the way your breath smells. Ask us about ways we suggest to help break a tobacco habit. Drinking plenty of water and eating healthy also keeps your mouth moist and more free of bad bacteria. Mouth rinses can help, too, but ask us which rinses actually kill the germs that cause bad breath, because some only mask odor as a temporary solution.
When bad breath is a symptom of a larger bacterial problem in your mouth, Dr. Kunick & Dr. Markham can help. If he finds that your mouth is healthy, we may refer you to your physician for further consultation and more comprehensive treatment.
Is smoking really that bad for my teeth?
Smoking isn’t just bad for your teeth—it affects the health of your entire mouth, especially your gums. Lighting up stains your teeth, causes bad breath, and promotes the buildup of plaque and tartar. Cigarette smoking is also one of the leading causes of tooth loss. Worst of all, smoking has been linked to the development of periodontal disease and may lead to the loss of taste and smell. Smokers also tend to require more dental treatment, due to the damage done by smoking. Certain procedures, such as dental implants and oral surgeries, can be less successful in smokers due to damaged gum tissue. This results in a higher cost of dental healthcare and often more frequent (and complicated) treatment.Pipes and cigars aren’t any safer, causing similar rates of tooth and bone loss even if the smoke is not inhaled. Smokeless tobacco products like snuff and chewing tobacco also pose great health risks to your gums, increasing your risk for both oral cancer and cancers of the throat, esophagus, and lips. Additionally, they contain a significant amount of sugar, which when pressed against your teeth for long periods of time can lead to tooth decay.So what’s the verdict on tobacco? Seek help on how to quit using, or just don’t start.
What could be causing my dry mouth, and what can I do about it?
Symptoms of dry mouth can include a sticky, dry, or burning sensation in the mouth, chronic bad breath, an altered sense of taste, and insufficient saliva. Dry mouth is particularly common in the elderly and the very young, but it can affect anyone at any given time, and there are a number of common causes.Dry mouth is a known side effect of many medications, from prescriptions to antihistamines. Medical conditions such as diabetes can also cause recurrent dry mouth, cancer treatment (chemotherapy, radiation), hormone changes during pregnancy or menopause, and high levels of stress are other conditions that can lead to dry mouth.Dry mouth can be uncomfortable, and is one of the leading causes of chronic bad breath, but it can also make teeth more prone to decay and soft tissue more susceptible to infection. Because insufficient saliva endangers the health of your entire mouth, it’s important to ask Dr. Kunick & Dr. Markham about oral sprays, prescription drugs, or simple lifestyle changes that can provide relief.
Hot or cold, my teeth hate both! Why are they so sensitive, and how can I stop the pain?
If you’ve been avoiding that ice cream cone or cup of coffee because of sensitive teeth, you don’t have to! Sensitivity is a common complaint, and can be the result of a number of factors. Involuntary grinding, jaw clenching, gum recession, and enamel loss can all cause teeth to become extra sensitive, because the usually-protected layer of dentin—the nerve-packed surface beneath the enamel—is exposed to external stimuli. Surface irritants such as braces and teeth whitening can also cause temporary sensitivity.Because the causes of sensitivity are so diverse, and because sensitive gum tissue can indicate a more serious problem, it’s important to ask Dr. Kunick or Dr. Markham which treatment is best for you. A softer toothbrush is usually the first step, and special toothpastes can reduce sensitivity over time. There are also over-the-counter fluoride rinses to protect your enamel against further damage, and Dr. Kunick & Dr. Markham can even provide an in-office procedure to coat your teeth with a protective agent.
What should I do in case of a dental emergency?
Let’s face the facts: accidents happen, and especially when it comes to our teeth and mouths, they can be pretty frightening. Being careful is good prevention, but being prepared promises reassurance in any dental emergency. It’s important to know when home care will suffice and when a trip to the dentist is necessary, so here are some guidelines to help you through common situations:
Toothache/Sore Gums. Rinse with warm water to remove any food or debris; if you notice anything lodged between teeth, floss to remove it. Take an over the counter pain medication (but never apply the medication directly to tooth or gums), and see Dr. Kunick or Dr. Markham if the pain persists.Chipped Tooth. Save the pieces, if you can, and rinse them thoroughly. Apply an ice pack or a cold compress to the swollen lip or gum tissue near the chipped tooth to prevent swelling. If the area is bleeding, apply gauze for ten minutes, or until the bleeding has stopped. See Dr. Kunick or Dr. Markham as soon as possible.
Broken Tooth. With recent advancements in restorative and cosmetic dentistry, you might not lose your tooth. If there’s enough remaining healthy tooth structure, Dr. Kunick & Dr. Markham can create a crown that will “grab onto” your natural tooth, eliminating the need for root removal. While the success of this process, known as “crown lengthening,” depends on the severity of the break, it’s worth asking about options other than complete removal.
Knocked Out Tooth. Depending on the situation, find the tooth and, holding it by the crown only, rinse it briefly with warm water. If possible, gently reinsert the tooth into the socket and bite down on gauze or cloth to keep it in place. If you cannot reinsert it, place it in a container of milk or salt-water. See Dr. Kunick or Dr. Markham as soon as possible. If treated within 2 hours, the tooth may be salvaged.
Soft Tissue Injuries. Soft tissues, such as gums, cheeks, lips, and the tongue, tend to bleed heavily because the tissue contains a great deal of blood flow. To control the bleeding, first rinse with a warm, mild salt water solution. Apply pressure with gauze or a moistened towel for 15 to 20 minutes. Afterwards, to reduce swelling and help stop residual bleeding, apply a cold compress to the outside of your mouth. In the event of a serious soft tissue injury, in which the bleeding is profuse or the damage is visibly traumatic, it’s best to stay calm, keep applying pressure, and go to the emergency room.
My teeth are killing me, but I can’t really tell where the pain is coming from.
Believe it or not, you could have a sinus infection. Recently, direct connections have been made between sinus infections and impacted or damaged teeth. They can also occur after intense dental work or cracked restorations. Pain in the sinuses can mimic the sensation of a toothache (or actually cause one) because of the proximity between the two. If you’re experiencing chronic sinus pain with a general, unidentified toothache, you should ask Dr. Kunick & Dr. Markham to check it out. A regular check-up and a series of x-rays should be able to determine a tooth-related cause, but if they don’t, he can also perform a “percussion test,” during which he gently taps on individual teeth to discover the source of your discomfort. After all, when deciding on a treatment plan, it’s helpful to know whether it’s a toothache or just your nose playing tricks on you.
I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What’s the problem?
You could be suffering from temporomandibular joint (TMJ) dysfunction, or TMD, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.TMJ dysfunction has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of a TMJ problem. TMJ issues can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.Professional treatment of TMJ ranges from minor fixes to surgical options. If Dr. Kunick & Dr. Markham determines that the main cause of your TMJ pain is an irregular bite, he may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet. If it’s a structural issue occurring in your jaw bone (especially if your TMJ pain is a result of injury), you may benefit from surgery. When it comes to TMJ treatment, it’s important to choose the most conservative plan for your individual needs.
In the meantime, alleviating the pain through treating the symptoms can give you some relief. Heating pads or cold compresses can reduce swelling, and limiting your jaw movement (for example, cutting especially chewy foods out of your diet) can stop the clicking or popping. Massages can temporarily relieve muscle tension, and painkillers (medicated or over the counter) can reduce inflammation and make you more comfortable.
If my filling is still in place and my tooth does not hurt, why does my dentist want to replace the filling?
Constant pressure from chewing, grinding and/or clenching can cause dental fillings to wear away, chip, and even crack. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth. Again, regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.When restorations are large, or if recurrent decay is extensive, there might not be enough remaining tooth structure to support a replacement filling. In these cases, we may need to replace the filling with a natural looking porcelain crown.
A couple of my teeth have been worn down and need to be replaced. Should I opt for crowns?
Crowns, often called “caps,” cover teeth to restore them to their appropriate shape and size after large fillings, fractures, and/or weakening forces such as intense grinding. In all of these cases, crowns not only cover teeth but provide added support as well. Crowns can also be used to attach bridges, cover dental implants, restore seriously discolored or misshapen teeth, and even as a preventive measure to protect a tooth in danger of breaking. Crowns can be made of all-porcelain (ceramic) material, porcelain fused to metal (for added strength), gold alloys (high noble), or base metal alloys (non-noble). Each of these restorative materials has its advantages and disadvantages. All-porcelain restorations most closely mimic natural tooth appearance. Their strength depends on adequate porcelain thickness, thus this material requires more extensive preparation. Porcelain fused to metal alloy restorations are tooth-colored and stronger than all-porcelain crowns. Gold alloy crowns are very strong and wear resistant. They are well tolerated in terms of biocompatibility, but metal colors do not match natural teeth. Base metal alloy crowns are similar to gold for strength and durability. However, allergy to the non-noble base metals may be an issue with some patients.Crowns can be placed in as few as two appointments. For porcelain crowns, properly matching the aesthetics of teeth can take more visits but the natural looking cosmetic results are worth it to most patients. Crowns in general are very strong restorations, and they help to protect teeth. If a crown is placed before the tooth is so badly decayed or so weak that it fractures, the necessity of a root canal can often be preempted. This can also help prevent a broken tooth from becoming so bad that it needs to be removed, which would require a bridge or implant for restoration.In light of their excellent restorative capabilities, crowns have few disadvantages. As they are more extensive restorations than fillings, their relative cost is higher. However, if Dr. Kunick or Dr. Markham recommends a crown it is because he wants to help you keep your teeth healthy and looking good for years to come. The problems crowns help to prevent and repair offset the cost.
Also, while crowns are highly resistant, due to normal wear they will eventually need to be re-cemented or replaced. Six to nine percent of teeth that are damaged enough to need a crown may someday need a root canal.
My dentist told me I’m going to need root canal therapy. What should I know before my appointment?
Beneath the top layer of your tooth (the enamel) and the second layer (the dentin), there is a pulp, or nerve, which delivers sensations such as heat, cold, and pain to the brain. Whether from excessive decay or physical trauma, this nerve can become damaged, causing an abscess to form at the root of the tooth. Your dentist has recommended root canal therapy, a procedure in which the diseased pulp is removed from an infected tooth, to prevent further damage and tooth loss, and most importantly, to relieve your pain. It’s likely Dr. Kunick or Dr. Markham will recommend the same.Symptoms of an infected root include severe toothaches, sensitivity, discoloration, and upraised lesions on your gums. X-rays and a thorough dental examination determines whether a root canal is your best option. Though root canal therapy has a reputation for being painful, the toothaches associated with an infected root are most likely causing you more pain than the treatment will. In addition, there are a number of ways to relieve pain and discomfort, including nitrous oxide and oral sedation.The nerve is not vitally important for day-to-day function, so removing it will not affect your tooth—unless you count saving the tooth from total loss! In fact, allowing it to decay further can lead to more pain and bone loss. Usually, an over the counter pain medication takes care of immediate post-operative discomfort, and most patients return to normal activities the very next day. Root canal therapy is highly successful, and a tooth receiving the treatment can last you a lifetime. Especially when used in conjunction with a restoration (a crown or composite filling), no one will even notice a difference in your smile.
What causes tooth discoloration?
The two main types of tooth discoloration are extrinsic (external or surface stains) and intrinsic (internal stains). External stains affects the outside of the tooth, while internal stains discolor a tooth from within. External stains can be attributed to anything that comes into contact with the surface of the teeth, such as red wine, coffee, tea, or tobacco products. Internal discoloration reflects the actual condition of the tooth, often occurring as a result of treatment procedures, exposure to excessive amounts of fluoride (Fluorosis), and certain antibiotics.Some types and degrees of discoloration respond well to whitening methods, while others require veneers, bonding, or other restorative procedures. Dr. Kunick & Dr. Markham can determine which type of stains you have and which whitening method will work best for you.
I know certain foods are bad for my teeth. But are there any that are GOOD for them?
In fact, there are! Foods such as milk, cheese, nuts, chicken and other meats contain calcium and phosphorous, which have been proven to strengthen bones and protect enamel. Calcium is essential for bone development, and while your teeth do not directly absorb it, a stronger jawbone leads to healthy gums, and healthy gums make healthy teeth. Fruits and vegetables are just as good for your teeth as they are for your body, especially firm, crunchy ones with a high water content (apples, pears). Water is critical for your oral health, as it rinses away food particles and keeps your mouth and gums moist. Dehydration can cause dry mouth, which makes your mouth particularly prone to bacterial growth and bad breath.As most people know, foods high in sugar tend to stick to teeth and can lead to decay. What many people don’t know is that almost all foods contain some form of sugar—even milk products and fruit—so you can’t cut it out completely, and you wouldn’t want to. The most important part of the “dentist diet” is brushing your teeth after each meal. If you do snack between meals, especially on starchy or sweet foods, and cannot brush, drink plenty of water or chew sugar-free gum to loosen any residue. For those of us out there with a sweet tooth, don’t despair: not all sweet snacks are off-limits. Chewing sugar-free gum that contains xylitol can actually prevent cavities.