Dental FAQs

Dentist - The Fearful

Ambling along an innocent looking road, you pass a sign for a dental surgery. Immediately, your heart starts racing, you can feel the heat rising to your face, and you become shaky and nauseous. Uuff!! not another reminder of the dreaded D word, better cross that road and face the other way. Is that you? You may be one of the many people who suffer with dental phobia.

For kids and adults alike, going to a dentist is a dreadful experience. Recently I had a kid of a friend of mine visit the clinic and he had that fear written all over his face. Even with a slight provocation he had those tear drops running down his cheeks. He felt so betrayed lying down on that chair. In another instance, I met some people and they said “you seem to be a nice person but how come you are a dentist?” A lady friend of mine has once said “I better go thru another labor pain than going to a dentist. Then most interestingly my friend’s son told me that after he returned from a school excursion to a Dental hospital, he heard a hiss of a snake. To top it all up, Hollywood has also made a horror flick called “The Dentist”.

In terms of your dental health and overall well-being, this can have serious ramifications. Besides chronically infected gums and teeth which can affect your medical status, your ability to chew and digest can be seriously compromised. Without healthy gums and teeth, your speech can be affected as well. Your self confidence can be hampered if you are insecure about your breath and smile. This can lead to serious limitations in both your social and business environments.

Dental phobias and anxiety stem from various sources. These can lead to strongly conditioned fear response. The following are the most common origins of dental fear:

  • Previously painful or negative experiences during visits to a dentist's office. This can even include careless comments made by a dentist or hygienist during a past examination.
  • A severe discomfort with feeling helpless and/or out of control in the dental situation.
  • A sense of embarrassment of your dental neglect and fear of ridicule and/or
    belittlement when you present to the dental office.
  • Scary anecdotes of negative dental experiences learned vicariously from family and friends. Negative, menacing portrayals of dentists in movies, TV, newspapers and magazines.
  • A sense of depersonalization in the dental process, intensified by today's necessity for the use of barrier precautions, such as masks, latex gloves and shields.
  • A general fear of the unknown
  • It would be best to accept to yourself if you have dental phobia and try and deal with it. I would like you to take a simple test. Below are some questions that, if answered yes, may signify that you have some form of dental anxiety.
  • Do you feel slight uneasiness and tension the evening prior to your dental visit, which makes you cancel your dental appointment?
  • While waiting in the reception area of the dental office, do you feel nervous about the visit?
  • Have you had a prior dental experience that was unpleasant? While in the dental chair, do you feel uneasy and anxious?
  • Does the thought of having a dental injection make you feel physically ill and tense?
  • Does seeing the dentist or dental hygienist's instruments make you anxious?
  • Do you feel embarrassed that the dentist will say you have the worst mouth they have ever seen?
  • Do objects placed in your mouth during the dental visit make you panic and feel like you cannot breath correctly?
  • Do you feel that your dentist is unsympathetic only with you?

Dental phobia is serious, often paralyzing fear of seeking dental treatment. Good news is that if you have a phobia for dental treatment then you are not the only one. It is estimated that 50% of the population does not seek regular dental care. An estimated 15% avoid much needed care due to anxiety and fear surrounding the dental experience. This translates to some 30-40 million people so afraid of dental treatment that they avoid it altogether.

The forthcoming issue we will discuss about ways to deal with dental phobia.

Smile With Your Veneers

Well there is definitely one cosmetic dentistry solution that people are raving about and that's porcelain laminate veneers. Why? Its simple, people no longer have to suffer because there are unhappy with their smiles. Highly trained dentists can completely restore your smile with this life like cosmetic solution. Of course they aren't the solution for all dental problems but they certainly can solve a wide variety of common smile challenges.


What kinds of problems can porcelain veneers correct?

  • Quickly straighten crooked teeth, a form of instant orthodontics
  • Cover up stained teeth, even tetracycline stains
  • Permanently close the gaps between your teeth
  • Gummy smiles can be improved with some gum contouring combined with veneers



Often an alternative to crowns, veneers are very thin pieces of specially-shaped porcelain or plastic that are glued over the front of your teeth with little or no anesthesia needed. They are the cure for teeth that are severely discolored, chipped, have small holes or pits, misshapen or crooked, or for the correction of unwanted or uneven spaces. Unlike crowns, veneers won't require the dentist to remove much of the tooth itself in most cases. It is important to ask your dentist how much tooth will be removed. In some cases more tooth will need to be removed, which may increase the risk of trauma to the tooth. Veneers are created from an impression taken in your dentist's office. Your custom veneer is then glued directly onto your tooth. Typically costing less than crowns, veneers won't stain, making veneers a very popular solution for many people seeking that perfect smile. Strong and very durable, veneers last from ten to fifteen years, and come in colors that will brighten dark teeth without the worry of them changing color.


What causes discoloration of the teeth?

Teeth enamel discoloration can be caused by staining, aging, or chemical damage to teeth. Some of the more common causes of teeth discoloration are medications, coffee, tea or cigarettes. People who drink significant amounts of cola soft drinks can experience similar staining. Aside from staining, there are other factors that can affect the color of an individual's teeth. Genetics can play a role. Some people have naturally brighter enamel than others. Disease can also be a factor and certain medications can cause a discoloration of the teeth. If you suspect that there is an underlying medical cause for your teeth discoloration, be sure to inform your cosmetic dentist.


How are Tooth Veneers Attached to your Tooth?

In your first appointment, it is important to initially discuss with your dentist that you will want to "try in" your veneers with temporary cement that is the same color cement as will be used for the permanent attachment. During this "try-in" phase, be sure to look at your veneers in natural light in addition to the office light. Teeth are prepared for veneers by lightly buffing to allow for the small added thickness of the veneer. Veneers are thin like contact lenses, and will usually only need tooth reduction of 0.5mm to 1.0mm. If a drastic change is being made for the result you want, reduction may be 1.0mm to 2.0mm. A mold is taken of the teeth, from which the veneers are modeled after. Temporary veneers will be placed and worn until your permanent veneers are ready. While wearing the temporary veneers, advise your cosmetic dentist of any adjustments or changes you would like made, such as in shape or size. These changes will be translated into your permanent veneers, so good communication between you and your dentist is important in achieving your new smile.

Your dentist places the veneers with water or glycerin on the teeth to verify their perfect fit and the shade or color. The color cannot be changed after the veneers are adhered to your teeth. The tooth is then cleansed with chemicals to achieve a durable bond. Once the glue is between the veneer and your tooth, a light beam is used to harden the glue/cement.

The procedure for Lumineers is different than the above traditional porcelain veneers. Still two visits, but there is little to no preparation of the tooth and no need for temporary veneers.


Types of Tooth Veneer Procedures

There are two tooth veneers procedures available that correct discoloration of the teeth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and a they will recommend the most appropriate tooth veneers procedure for you.

Composite Veneer Procedure. Composite (direct) veneers are usually performed in a single visit to your cosmetic dentist. The procedure is an application of a bond and enamel directly to the tooth's surface.
Porcelain Veneer Procedure. Porcelain (indirect) veneers are a very thin porcelain material. Usually porcelain veneers require two visits and also require a dental laboratory to create the final tooth restoration piece.

Lumineer Porcelain Veneer Procedure. Made of Cerinate porcelain, Lumineers are a new type of porcelain veneers. They are contact lens-thin, roughly .2 mm thick. Little to no tooth reduction in most cases is necessary with this type of veneer and anesthetics or numbing shots are not needed.

So I feel veneers are perfect solution for people who don’t want to put braces on for a long run. It gives them a quick and permanent solution. Also it’s a permanent solution for intrinsically stained teeth which cannot be whitened with all the teeth whitening solutions available. Probably this is one of the reason why veneers have become so popular in Hollywood or Bollywood to give off that perfect smile.

Dental Implants the New Paradigm

In regular practice I come across quite a few patients who want their missing tooth to be replaced with some comfortable option. However, they do not want removable dentures and also give a big "No" to cutting their adjacent normal teeth to fit a crown and bridge. It used to be a Catch 22 situation to us dentists, but not anymore. Dental implant is here with quite a long and reliable history and it is here to stay.

Here are some must know info on Dental Implants.


History of Dental Implants

In 1952, in a modestly appointed laboratory in the university town of Lund, Sweden, Professor Per-Ingvar Brånemark had a lucky accident -- what most scientists call serendipity. Much to his irritation, Dr. Brånemark discovered that it was impossible to recover any of the bone-anchored titanium microscopes he was using in his research. The titanium had apparently bonded irreversibly to living bone tissue, an observation which contradicted contemporary scientific theory.

His curiosity aroused, Dr. Brånemark subsequently demonstrated that -- under carefully controlled conditions -- titanium could be structurally integrated into living bone with a very high degree of predictability and, without long-term negative soft tissue reaction or ultimate fixture rejection.

The first practical application of the implant using new titanium roots was done in 1965. More than thirty years later, the non-removable teeth attached to these roots are still functioning perfectly.


What are Dental Implants?

A natural tooth consists of a crown (the part you see above the gum), and the root (the part hidden under the gum). It is the root in the jawbone that actually holds the natural tooth in place. A dental implant is a small man-made titanium screw that serves as a replacement for the root portion of a missing natural tooth. Titanium is used because it is the most compatible with our human body. The dental implant is placed in the bone of the upper or lower jaw and functions as an anchor for the replacement tooth. After the bone has grown around the implant, implants can hold a crown, bridge or overdenture just like roots hold natural teeth in place. Implants provide additional support where teeth are missing without putting forces onto remaining natural teeth.


Are Dental Implants safe?

Sophisticated research for more than three decades in the United States and other countries has recognized titanium for its biological compatibility with the human body. Studies have shown that the earliest patients treated with these modern implants continue to enjoy healthy, stable smiles.


Who is a candidate for dental implants?

Anyone who is missing one or more of their teeth due to injury, disease, or decay may be a candidate for dental implants. If one or a few teeth are missing, dental implants in conjunction with a crown or bridge can replace those teeth without loosing more bone. If all or most of your teeth are missing, the dental implants may be placed to replace a loose fitting full or partial denture. Adequate bone in your jaw is needed to support the implant(s) along with healthy gum tissues that are free of periodontal disease.

Occasionally, older patients express concern that their age may prevent them from enjoying the benefits that dental implants offer. However, health is more of a determining factor than age. If you're healthy enough to have a tooth extracted, you're probably healthy enough to receive dental implants. Certain chronic diseases may contraindicate implant treatment. Your dentist will determine if you are a candidate for dental implants after a careful evaluation of your dental and medical health history.


How long does it take?

The complete implant reconstruction process may take from 4 to 9 months and in some cases longer. Time is needed for your jawbone to grow around the implant and for your replacement teeth to be made. Procedures vary, but it usually includes two surgical steps and then the restoration is fabricated. First, your dentist or a specialist places the dental implants into your jawbone, a procedure as simple as getting a tooth extracted. Bone cells grow around the implants that may take up to 3-6 months to occur. Your dentist then attaches the replacement teeth. It may take several visits and several months to complete the restoration process.


How much does implant cost?

The fee for tooth replacement with dental implants will depend on several factors, including the number of teeth being replaced and the number of implants required to support your replacement teeth. Some additional procedures may be required prior to the placement of your dental implants to ensure the long-term health of your dental implants. Typically, there is a fee for the surgical procedure and a separate fee to attach the posts and construct your replacement teeth. To obtain a specific fee estimate, it is necessary for us to examine your mouth. After a thorough diagnostic examination, we will recommend the treatment that is best for you and what your investment would be for the procedure.


Are dental implants successful?

Research and documentation studies have proven the effectiveness and long lasting results of dental implants. Good oral hygiene is one of the most critical factors to insure the health of your dental implants. Dentist will instruct you on the proper home hygiene procedures to keep your dental implants and remaining teeth clean and healthy. Regular visits to your dentist are important so we can assess the health of your replacement teeth and gum tissue. You can rely on your replacement teeth to look, feel and function like natural teeth for years to come.

Well Dental Implants are here in Katmandu and it is available in prices much cheaper than anywhere in the world. Its important to know that implant placement is a very simple procedure compared to hours of drilling for crown and bridges. Complete process can be as simple as a tooth extraction. So if you want a tooth replaced which resembles closest to the god given natural tooth, then here is the option: "DENTAL IMPLANTS".

Diabetics be Careful

If you have diabetes, you know the disease can harm your eyes, nerves, kidneys, heart and other important systems in the body. Did you know it can also cause problems in your mouth? People with diabetes have a higher than normal risk of periodontal diseases.

Periodontal diseases are infections of the gum and bone that hold the teeth in place. In advanced stages, they lead to painful chewing problems and even tooth loss. Like any infection, gum disease can make it hard to keep your blood sugar under control.


What are the changes in Diabetics that favor Periodontal Disease?

Diabetic Control. Like other complications of diabetes, gum disease is linked to diabetic control. People with poor blood sugar control get gum disease more often and more severely, and they lose more teeth than do persons with good control.

Blood Vessel Changes. Thickening of blood vessels is a complication of diabetes that may increase risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful wastes. This can weaken the resistance of gum and bone tissue to infection.

Bacteria. Many kinds of bacteria (germs) thrive on sugars, including glucose -- the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.

Smoking. The harmful effects of smoking, particularly heart disease and cancer, are well known. Studies show that smoking also increases the chances of developing gum disease. In fact, smokers are five times more likely than nonsmokers to have gum disease. For smokers with diabetes, the risk is even greater. If you are a smoker with diabetes, age 45 or older, you are 20 times more likely than a person without these risk factors to get severe gum disease.

Periodontal diseases are infections of the gum and bone that hold the teeth in place. In advanced stages, they lead to painful chewing problems and even tooth loss. Like any infection, gum disease can make it hard to keep your blood sugar under control.


Factors That Link Diabetes to Gum Disease

  • Studies show that people with insufficient blood sugar control seem to develop gum disease more frequently and more severely then people who have good management over their diabetes.
  • Diabetes slows circulation, which can also make the gum tissues more susceptible to infections.
  • Diabetes reduces the body’s resistance to infection which increases the probability of the gums becoming infected.
  • High glucose levels in saliva promotes growth of bacteria that cause gum disease.
  • People with diabetes who smoke are far more likely to develop gum disease than people who smoke and do not have diabetes.
  • Poor oral hygiene is a major factor in gum disease for everyone, but it is even more so for a person with diabetes.

Don’t let your gums bite your heart

Wake up in the morning, put a brush in your mouth, move it around for a minute or two and spit out the mixture with a splash of reddish tinge. Some do get worried and try and resolve the problem, while others have taken it as a daily routine and don’t even bother. Furthermore, few even stop cleaning the area cause they don’t like the colour red.

I do get quite a few patients who complain of bleeding gums and are not sure what exactly is causing the problem. Gum disease, also known as periodontal disease, is one of the most common infections- often more prevalent than the common cold. Common signs of gum disease include, bad breath, bleeding gums or pus between the teeth. Left untreated, this chronic infection can destroy the bone that supports the teeth and may lead to tooth loss.

However once the disease has progressed it requires a long term follow-up and maintenance which patients don’t seem to agree with. I have heard this line before “you go to a dentist once and he keeps on calling you back”. Although its true in a sense the fact is that is how it works. I personally believe in telling a patient “you have a problem” and make he/she realize all the consequences behind the disease process.

The American Academy of Periodontology (AAP) is concerned about new research linking gum disease to heart attack or stroke. A recent study presented at the American Association for the advancement of science meeting suggests that the bacteria present in gum disease may trigger blood clots, which can contribute to a heart attack or stroke.

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood steam, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of these arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by the periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. While another study has concluded that a person with the gum problem is at higher risk of heart disease than cigarette smoking which is quite an alarming fact.

Gum disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Therefore, in my opinion the rule of the game is for people who are at risk for either cardiovascular disease or have signs of gum disease, to consult a dental surgeon experienced in treating gum disease. Regular periodontal screening and evaluations, treatment, and professional maintenance are critical to the long-term management of periodontal disease.

Dry Mouth

Dry mouth is the feeling that there is not enough saliva in the mouth. Everyone has a dry mouth once in a while -- if they are nervous, upset or under stress. But if you have a dry mouth all or most of the time, it can be uncomfortable and can lead to serious health problems. It can also be a sign of certain diseases and conditions.

Dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking. It can increase your chance of developing dental decay and other infections in the mouth. This condition can be caused by certain medications or medical treatments. Dry mouth is not a normal part of aging. So if you think you have dry mouth, see your dentist or physician--there are things you can do to get relief.


Symptoms include:

  • A sticky, dry feeling in the mouth
  • Trouble chewing, swallowing, tasting, or speaking
  • A burning feeling in the mouth
  • A dry feeling in the throat
  • Cracked lips
  • A dry, rough tongue
  • Mouth sores
  • An infection in the mouth


Why is saliva so important?

  • Saliva does more than keep the mouth wet
  • It helps digest food
  • It protects teeth from decay
  • It prevents infection by controlling bacteria and fungi in the mouth
  • It makes it possible for you to chew and swallow
  • Without enough saliva you can develop tooth decay or other infections in the mouth. You also might not get the nutrients you need if you cannot chew and swallow certain foods.


What causes dry mouth?

  • People get dry mouth when the glands in the mouth that make saliva are not working properly. Because of this, there might not be enough saliva to keep your mouth wet. There are several reasons why these glands (called salivary glands) might not work right.
  • Side effects of some medicines. More than 400 medicines can cause the salivary glands to make less saliva. Medicines for high blood pressure and depression often cause dry mouth.
  • Disease. Some diseases affect the salivary glands. Sjögren's Syndrome, HIV/AIDS, diabetes, and Parkinson's disease can all cause dry mouth.
  • Radiation therapy. The salivary glands can be damaged if they are exposed to radiation during cancer treatment.
  • Chemotherapy. Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.
  • Nerve damage. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.


What can be done about dry mouth?

Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can try to determine what is causing your dry mouth.

If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage.

If your salivary glands are not working right but can still produce some saliva, your physician or dentist might give you a medicine that helps the glands work better.
Your physician or dentist might suggest that you use artificial saliva to keep your mouth wet.


What can I do?

  • Sip water or sugarless drinks often.
  • Avoid drinks with caffeine, such as coffee, tea, and some sodas. Caffeine can dry out the mouth.
  • Sip water or a sugarless drink during meals. This will make chewing and swallowing easier. It may also improve the taste of food.
  • Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow; citrus, cinnamon or mint-flavored candies are good choices.
  • Don't use tobacco or alcohol. They dry out the mouth.
  • Be aware that spicy or salty foods may cause pain in a dry mouth.
  • Use a humidifier at night.


Tips for keeping your teeth healthy

Remember, if you have dry mouth, you need to be extra careful to keep your teeth healthy. Make sure you:

  • Gently brush your teeth at least twice a day.
  • Floss your teeth every day.
  • Use toothpaste with fluoride in it. Most toothpastes sold at grocery and drug stores have fluoride in them.
  • Avoid sticky, sugary foods. If you do eat them, brush immediately afterwards.
  • Visit your dentist for a check-up at least twice a year. Your dentist might give you a special fluoride solution that you can rinse with to help keep your teeth healthy.

Full Mouth Rehabilitation

Full-mouth rehabilitation is the restoration of the mouth involving every tooth in the top and/or bottom arch. If you have short, worn, missing, or broken teeth, and suffer pain or displeasure with the appearance of your smile, you may be a candidate for full mouth restoration. Worn or damaged teeth are more than just unattractive; they can cause difficulty in chewing, poor nutrition, gastrointestinal upset, TMJ problems, headaches, pain, and facial collapse. Here are some additional signs and symptoms that might indicate you are a candidate:

  • TMJ disorder with frequent headaches or migraines
  • Unexplained loose teeth
  • Dental restorations that crack, chip, or break frequently
  • Flat, short teeth
  • The absence of teeth showing when you smile
  • Deep wrinkle in the corner of your mouth with constant sores

Combining the science of Neuromuscular Dentistry with the artistry of Cosmetic Dentistry, Full Mouth Rehabilitation creates a smile that is functional, comfortable and beautiful.

Neuromuscular Dentistry measures and determines the optimal position of the jaw. Once determined, the jaw position is corrected with the use of an orthotic (a virtually invisible appliance that fits over the top of the lower teeth, gently repositioning the jaw) or the application of dental restorations, including porcelain veneers, crowns or onlays. As an added benefit, the restorations are exceptionally attractive and strong, enhancing the smile beautifully.


Prior to the first treatment visit, there are two consultation visits.

The first visit gathers the following records:

  • Full mouth x-rays
  • History
  • Study models of both arches
  • Facial analysis
  • Photos
  • Patient intent

The second consultation addresses the smile design and goals of the treatment. A hand crafted wax-up of the proposed design is presented on the study models.

The process

The dentist measures the jaw's muscle function in both stressed and relaxed positions. If an imbalance is determined, the dentist will decide whether to treat with an orthotic appliance, or to fit the patient with dental restorations. The orthotic is a removable or fixed appliance that artificially builds up the patient's bite to a comfortable resting position. For patients that wish to eliminate the orthotic, full mouth restoration is often required.

After the orthotic has been worn for several weeks to several months, the jaw naturally drops into its most comfortable position. Only then can the doctor begin to restore the bite. He will use beautiful porcelain restorations that can raise or lower the bite to achieve the most comfortable jaw position. With this correction, patients experience decreased or eliminated pain and discomfort, and better overall health. Then, old dental work and decay are removed, and impressions are made of the healthy tooth structure. Temporary teeth are hand sculpted from the proposed design and are placed in your mouth to allow a preview and/or "test drive" of the design. The impressions are sent to the laboratory and master ceramist meticulously builds the design in about three to four weeks. This time allows for acclimation and modification if necessary. Once the restorations are shaped and polished, an appointment is set to bond the natural-looking restorations to your teeth.

All full mouth cases take hours of planning and development.

And Yes!! Full mouth restoration can restore teeth, bite, and muscles to their original health.

Get that Fear Out

The first thing you can do is to realize that your dental fear can be overcome. Fear is a learned behavior which, therefore, can be unlearned. Patient-centered behavior modification that treats you as a whole person, not as a set of teeth can help you overcome your fears. This will obviously take a team approach between you and your dentist and his/her staff. Communication is the key. You must feel comfortable expressing your fears and concerns and have sense that you are being listened to. If you feel that the Dr. and/or staff if not genuinely concerned and listening, then absolutely feel comfortable with seeking out referrals to other offices. You should never compromise the level of communication that you feel is necessary to give you a sense of control over your situation in the dental office. Modern dentistry with a compassionate dental team can be truly painless. You can desensitize yourself to your fears if you take the first step and allow the right team to help you overcome your fears.

I would suggest you keep following facts in mind to overcome your phobia.


A Sense of Control

Explanation and clarification of any and all procedures proposed is your right as a patient. If you have a question about a particular procedure, ask it! Empower yourself with the knowledge to alleviate fear of the unknown. You should have input into treatment decisions and choices. You should be honest with your dentist regarding how much treatment you think you can tolerate at first. As you build confidence in yourself and trust in the team that is caring for you, the length of your appointment and the amount of work accomplished will increase.

A Signaling System should be established allowing you to stop for any reason, whether it is because you need more anesthesia, want to rinse out, or simply need a two second break. The most common signal is raising your hand.


Never be Embarrassed

If you have been ridiculed in the past for your behavior or if you are embarrassed by your present dental condition caused by your neglect, please express yourself honestly and give your present dentist a chance to understand your concerns and show you that they care. You will be amazed at the wealth of treatment options that you might not have thought were possible. With modern dentistry, it's never too late to recreate a new smile!


Relaxation Techniques

If you feel tense in the chair, the easiest way to relax is through forms of physical relaxation. A relaxed body promotes a clear and relaxed mind. The human body cannot be physically relaxed and mentally anxious at the same time! The brain won't process these feelings simultaneously. Physical relaxation methods are easier to accomplish at first as compared to cognitive ones, so practice forms of physical relaxation first.

Examples of physical relaxation are Breathing, Progressive Muscle Relaxation, and various methods taught in yoga. There are numerous books and sources for these methods. If you induce relaxation in the presence of the stimuli that normally induces your fears (the dental environment), the fear response will be greatly diminished over multiple exposures and you will gradually desensitize yourself to these fears as you build confidence. The memories of traumatic visits will be replaced with more innocuous ones and this less threatening environment coupled with your relaxation methods will help you eliminate your fears.



As you get more comfortable in the dental environment, you can engage in various distraction techniques that many offices have. The use of a Walkman or Discman is a common technique. Many offices now are equipped with Virtual Reality-like glasses that provide both visual and auditory distraction by allowing you to view videotapes through these glasses while having dental work done. We only suggest using distraction techniques once you have established some trust and confidence because your ability to communicate will be compromised, although it is easy to stop any of these devices if need be.


Predictable Pain Control

Modern dentistry has many new techniques with regards to the administration of local anesthetics to block any possibility of pain. There are many people who have anatomical or biologic variations that do require more individualized techniques in order to predictably achieve proper local anesthesia. This variation must be respected and communicated to your dentist. All injections should be given slowly. The needle itself is not the major cause of discomfort, but in fact, it is the pressure and volume of the fluids being injected that causes the discomfort. There are also great differences in the types of tissue in various locations anatomically and from person to person that must be considered when administering injections. There are even computer-controlled machines that are now available to standardize the injection process and make it more predictable than the conventional hand-held syringe.



Going to your dentist could be as simple as a trip to the hair salon. When the anxiety and fear of going to the dentist are alleviated, you are much more likely to have an expedient and even pleasant dental experience.

Addressing the patient as a whole person and not just a set of teeth is the key to our approach to your complete care. We want you to feel comfortable and confident about coming through our doors, we must be sensitive to your needs and fears and make you feel comfortable and safe.

Get That Perfect Smile

Cosmetic dentistry has become an integral part of dental health. It helps in creating attractive smiles that function in a state of health. If your teeth are chipped, spaced or discolored, if their shape is somehow unattractive or if you simply want to have an eye-catching smile, cosmetic dentists can provide the smile you once had or the one you always wished for.

Years ago cosmetic dentistry was never discussed or let alone considered an option to plastic surgery. However, these days it is one of the highly sought after treatments that can easily and within 2 weeks or less make a dramatic impact in achieving a youthful appearance and reducing wrinkle lines.

If there is something about your smile that bothers you, holding back your smile can eventually take its toll on your facial features. Years of holding back your smile or covering your teeth with your lips to hide them will eventually cause the muscles around the smile to lose its tonicity and the lower portion of the face will begin to droop accomplishing what you’ve been trying to do all along which is cover your smile. However this shouldn’t be. Imagine your confidence if you had the smile you always dreamt about with diminished wrinkle appearance and improved muscle tonicity. Would you still hold back your smile? Or, rather look for any excuse to flash your beautiful appearance? That’s what cosmetic smile makeovers can do.


As we age:

  • Teeth get short.
  • Teeth get crooked, especially on the bottom.
  • Teeth get very dark and stained.
  • Gums recede and, we start seeing spaces forming in between teeth.
  • The amount of bone around teeth thins out.


With these changes to teeth we see important changes in muscle tone:

  • The muscles around lips begin to sag, giving a sunken-in appearance.
  • The skin around the lips begins to wrinkle since the support mechanism is lost.
  • The lip tissue flattens out and may curl over shortened teeth.

All these detrimental effects can easily be eliminated with a few visits to dentist which will save you more invasive plastic surgery treatments. Smile design includes a series of treatments which will help you achieve the perfect, dazzling smile which promotes a younger look.


Factors that influence the smile design are:

  • Your facial shape
  • Your image aspirations
  • Your age, or how old you want to appear.

With your smile design consultation, an expert cosmetic dentist will go over all of these factors. He or she may have you pick a smile from a book of photographs of smiles.

Choosing the right cosmetic dentist is very important. At this time, cosmetic dentistry is not recognized as a specialty like orthodontics or periodontics. However, it is a branch of dentistry that requires a thorough knowledge of science, technology and an artistic eye and much practice and experience.


How long does the treatment last?

There are three things that can have an impact on longevity:

  • Quality of the treatment.
  • Condition of the teeth that are considered for improvements and the level of forces that are placed on them.
  • Home care and eating habits are critical in maintaining a beautiful smile.

An attractive smile is a wonderful asset. It contributes to self-esteem, self-confidence and self-image—important qualities at every age. A pleasing appearance is a vital component of self-confidence. And all of this can be achieved by just visiting a good cosmetic dentist. Cosmetic dentistry can be a life changing event which often times paves the way for career advancements and a greater zest for life

Get that Perfect Smile you always wished for!!!

Get your Flexi Denture today!!!

In my practice I realize that some patients don’t know how they can replace there missing teeth. They want to replace there natural teeth but do not want an implant since its takes too much of time and find it very expensive. They don’t want a crown and bridge because it requires cutting a natural adjacent teeth and also don’t want to listen to the never ending sound of the drill we dentist use. Many of them complain of the bulk and refuse to adjust to the conventional removable acrylic options.

Take decades of research, add years of refinement, mix with determination, experience, and persverance. The result: VALPLAST Flexible Partial dentures. Designed for the utmost in functionality VALPLAST is formulated to provide the needed strength without bulkiness. You can confidently resume normal and comfortable mastication very soon after the insertion of the prosthesis.

In addition, the flexibility of the resin achieves the effect of a stress-breaker without complicated attachments. The gum tissue is gently stimulated under mastication, and unnatural teeth are substantially reduced. The strength of the material and resistance to chemical breakdown provides a long-lasting, unbreakable partial. By distributing the stress more naturally in the mouth (compared to conventional partials), the remaining teeth and gum typically stay healthier longer than with a conventional partial.

VALPLAST Flexible Partials are a value alternative to costly work involving implants and fixed restorations. Although slightly more expensive than conventional partials, Valplast offers a premium product with far more benefits in aesthetics, function, comfort, and reduced chairtime.


What is Valplast?

Valplast is a flexible denture base resin that is ideal for partial dentures and unilateral restoration. The resin is a biocompatible nylon thermoplastic with unique physical and aesthetic properties. Valplast allows your natural tissue tone to appear through the material, matching the basic shade categories (medium pink, light pink, and meharry). It is also guaranteed for life against breakage (when fabricated and handled according to the manufacturer's specified procedures).


When should Valplast be used?

Valplast may be used whenever you are considering a removable partial denture. Valplast provides a fully functional yet aethetically superior removable partial. The practical invisibility of Valplast makes the product ideal also for you if you prefer not to have a fixed restoration or implant, but still want an aesthetic restoration.

Patients who have worn both conventional frame partials and Valplast partials report that Valplast feels more natural in the mouth, is more comfortable because of the thinness and light weight, and gives them more confidence when eating, smiling, and appearing in public because of the excellent retention and aethetics. Patients with generally healthy mouths can expect many years of use from their Valplast partials (with many cases in use for over fifteen years without modification). Patients also have remarked on the simplicity and painlessness of fabricating a Valplast partial.


The advantages of the Valplast Denture system are:

  • Translucency of the material picks up underlying tissue tones, making it almost impossible to detect in the mouth.
  • No clasping is visible on tooth surfaces, improving aesthetics.
  • The material is exceptionally strong. The manufacturers proclaim it unbreakable, making it ideal when constant fracturing occurs.
  • Stresses are almost entirely removed from abutment teeth and underlying bone and tissue structures.
  • Free movement allowed by the overall flexibility is referred to as 'a built in stress breaker'.
  • Complete biocompatibility is achieved because the material is free of monomer and metal, these being the principle causes of allergic reactions in conventional denture materials.

Just imagine the confidence you will have. A natural tissue blend effect... with translucency exclusive to VALPLAST that picks up the patient's natural tissue tone... and there are no metal clasps to announce where the partial begins.

Patients love the aesthetic excellence of VALPLAST every time they look in their mirror. It gives them the confidence they need to face the world. It's a feeling they wouldn't expect from a removable partial.

VALPLAST is the aesthetically pleasing partial.

Gum Disease a common problem

If you have been told you have periodontal (gum) disease, you're not alone. An estimated 80 percent of American adults currently have some form of the disease.

Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

Gum disease is a threat to your oral health. Research is also pointing to possible health effects of periodontal diseases that go well beyond your mouth (more about this later). Whether it is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.


What causes periodontal disease?

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.



The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called "gingivitis." In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.



When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.") In periodontitis, gums pull away from the teeth and form "pockets" that are infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.


Risk Factors

Smoking. Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of periodontitis. Additionally, smoking can lower the chances of success of some treatments.

Hormonal changes in girls/women. These changes can make gums more sensitive and make it easier for gingivitis to develop.

Diabetes. People with diabetes are at higher risk for developing infections, including periodontal disease.

Stress. Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease.

Medications. Some drugs, such as antidepressants and some heart medicines, can affect oral health because they lessen the flow of saliva. (Saliva has a protective effect on teeth and gums.)

Illnesses. Diseases like cancer or AIDS and their treatments can also affect the health of gums.

Genetic susceptibility. Some people are more prone to severe periodontal disease than others.


Who gets periodontal disease?

People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have periodontal disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.


What can I do to prevent gum disease?

Here are some things you can do to prevent periodontal diseases:

  • Brush your teeth twice a day (with a fluoride toothpaste)
  • Floss every day
  • Visit the dentist routinely for a check-up and professional cleaning
  • Eat a well balanced diet
  • Don't use tobacco products


How do I know if I have periodontal disease?

Symptoms are often not noticeable until the disease is advanced. They include:

  • Bad breath that won't go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth


How is periodontal disease treated?

The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. Additionally, modifying certain behaviors, such as quitting tobacco use, might also be suggested as a way to improve treatment outcome.

Deep Cleaning (Scaling and Root Planing)
The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.

Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on the severity of gum disease, the dentist or periodontist may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time.

Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again.


Can periodontal disease cause health problems beyond the mouth?

Maybe. But so far the research is inconclusive. Studies are ongoing to try to determine whether there is a cause-and-effect relationship between periodontal disease and:

an increased risk of heart attack or stroke,
an increased risk of delivering preterm, low birth weight babies,
difficulty controlling blood sugar levels in people with diabetes.

In the meantime, it's a fact that controlling periodontal disease can save your teeth -- a very good reason to take care of your teeth and gums.

Oral Health for Seniors

Maintaining a good oral hygiene is a must for all ages. Seniors do have few issues which if they knew would help them achieve a better hygiene. Here are few important issues:


How Do I Maintain Good Oral Health in My Senior Years?

Your teeth can last a lifetime with proper home care and regular dental checkups. No matter what your age, you can keep your teeth and gums healthy by brushing twice a day with a fluoride toothpaste, flossing daily and seeing your dentist regularly for professional cleanings and checkups.


What Special Oral Health Issues Should I Know About as a Senior?

Even if you brush and floss regularly, you may face certain issues in your senior years when it comes to your oral health. Wearing dentures, taking medications and general health conditions are some of the issues many seniors face. Luckily, your dentist and physician can help you meet most of these challenges quite successfully.

Cavities and decay on the root surfaces of the teeth are more common in older adults. So it's important to brush with a fluoride toothpaste, floss daily and see your dentist regularly.

Sensitivity can be an increasing problem as one ages. Your gums naturally recede over time, exposing areas of the tooth that are not protected by enamel. These areas are particularly prone to pain due to cold or hot foods or beverages. In severe cases cold air, as well as sensitivity to sour and sweet drinks and foods, can occur. If you experience sensitivity, try an anti-sensitivity toothpaste. If the problem persists, see your dentist, as the sensitivity may be an indication of a more serious condition, such as a cavity or a cracked or fractured tooth.

Dry mouth is a common condition in seniors, and one that may be caused by medications or certain medical disorders. Left untreated, dry mouth can damage your teeth. Your dentist can recommend various methods to restore moisture in your mouth, as well as appropriate treatments or medications to help prevent the problems associated with dry mouth.

Existing health conditions such as diabetes, heart disease, or cancer, can affect your oral health. Be sure to let your dentist know of any general health issues you're facing, so that he or she understands the whole situation and can help you meet your special requirements.

Dentures can make life easier for many seniors, but they require special care. Follow your dentist's instructions carefully and see your dentist if any problems arise. An annual checkup is recommended for long-term denture wearers.

Gum disease is a potentially serious condition that can affect people of all ages, but especially people over 40. A number of factors can increase the severity of gum disease, including:

  • Bad diet
  • Poor oral hygiene
  • Systemic diseases, such as diabetes, heart disease and cancer
  • Environmental factors such as: stress and smoking
  • Certain medications that can influence gum condition

Because the earliest stages of gum disease are reversible, it is important to spot it early on. Regular dental checkups can insure early detection and treatment of gum disease. Best of all, it is easy to prevent gum disease from developing in the first place, by practicing proper oral hygiene.

Crowns and bridges are used to strengthen damaged teeth or replace missing ones. A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space.

Its always best to know what you should look for. With this information you know what you can do and what kind of help is possible from a dentist. Always remember your teeth can last you a lifetime if you maintain your oral hygiene.


What is orthodontics?

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities (malocclusion). It generally involves the use of such things as braces, removable appliances, functional appliances or headgear to move the teeth or jaws into an ideal relationship.

What is a malocclusion?

Malocclusion is a technical term for crooked, crowded or protruding teeth that do not fit together properly. These problems may be inherited or acquired. Common malocclusions include crowding of teeth, prominent teeth, too much space between teeth, extra or missing teeth and a variety of irregularities of the jaws and face. Thumb sucking, tongue thrusting, dental disease, premature loss of primary or permanent teeth, or accidents can cause malocclusions.

What are the benefits of orthodontic treatment?

Orthodontic treatment is frequently performed to improve a person’s appearance by straightening the teeth. However, an attractive smile is just one of the benefits. Crowded and overlapping teeth are harder to clean and can increase the risk of tooth decay, gum disease and eventual tooth loss. Having your teeth straightened will make it easier for you to look after them.

A malocclusion may also contribute to speech impairments and increase the risk of trauma if teeth are prominent. Abnormal or uneven wear of tooth surfaces can also occur if there is poor alignment of the teeth or jaws. In cases of deep bite, the lower front teeth can bite into the gum behind the upper front teeth causing damage. Bringing the teeth, lips and jaws into proper alignment results in better function, easier cleansing, increased confidence and self-esteem.

Who can benefit from orthodontics?

At one time, most people believed braces were only for children. However, teeth can be moved at any age as long as the gum and bone is healthy. Because the basic process involved in moving teeth is the same in adults as in children, orthodontic treatment can usually be successful at any age. However, because an adult's facial bones are no longer growing, some severe malocclusions cannot be corrected with braces alone. In such cases, orthodontic treatment combined with jaw surgery can achieve dramatic improvements.

When should orthodontic treatment begin?

It is usually wise to have an orthodontic consultation around nine years of age. Some orthodontic problems are easier to correct if detected early, rather than waiting until jaw growth has slowed. Early examination allows the orthodontist to detect and evaluate problems and plan appropriate treatment. Early treatment may prevent more serious problems from developing or make treatment at a later age shorter and less complicated. However, in other cases, treatment will not commence until all the baby teeth have been lost.

What are ‘braces’?

Braces are the most efficient and accurate way of moving teeth. Brackets are adhered to each tooth with special dental glue and are usually made of stainless steel or a clear plastic material. These brackets act like a handle on the tooth so that it can be moved into its correct position using wires. The brackets remain on the teeth for the entire duration of treatment. Generally adjustments are made to the braces every four to six weeks.

During treatment, patients may need to wear such items as rubber bands. These provide important extra forces for the correction of the bite.

How long will I need to wear braces?

On average, orthodontic treatment is approximately eighteen to twenty-four months in duration. However, the length of treatment will depend on the severity of the original malocclusion as well as the type of treatment carried out, and the co-operation of the patient.

At the completion of the active part of orthodontic treatment, the braces are removed and retaining appliances (retainers) are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth. Retainers play an important role in orthodontic treatment for, if they are not worn according to instructions, the teeth may move back towards their original position.

Can anyone have orthodontic treatment?

Generally orthodontic treatment is best carried out in children, but many adults have orthodontic treatment too.

Orthodontic treatment involves a full examination of your teeth, which includes taking x-rays and making plaster models of your teeth from impressions, and possibly taking photographs.

Orthodontic treatment is carried out using a range of appliances, which may be removable or fixed temporarily to your teeth, depending on your treatment needs. It is usually necessary to adjust any orthodontic appliance at 4-6 weekly intervals.

Teeth Cleaning

What technique should I use?

When brushing your teeth it is best to place your toothbrush at a 45-degree angle to your teeth, aiming the bristles of your brush toward the gum line. The join between the teeth and the gum is a nice niche for bacteria and plaque to accumulate, so it is important to get to this area.Once you have the brush at the correct angle, all you need to do is jiggle the brush gently back and forward, only brushing one or two teeth at a time. Don’t be excessively vigorous but also don’t be too mild.

Remember. Your are trying to penetrate the bristles into the gaps between teeth to remove a very soft plaque. You need to be systematic – brushing all teeth in order, inside and outside – and you really should do it in front of a mirror so you can see what you are doing.


How long should I brush?

Proper brushing should take two to three minutes.


How often should I brush?

You should brush your teeth at least twice a day. Remember it is important to have the right brushing technique as poor brushing techniques can cause harm to the teeth and gums.


Is brushing alone enough?

NO. Good brushing is very important to help prevent dental decay and periodontal disease, however brushing alone is not enough. It is also very important to clean between your teeth. This is why flossing is so important.


How often should I floss?

You should floss every day.


What is the correct way to floss?

Holding floss is the key. You should have a decent length and make sure it is tightly wrapped around and locked onto the middle finger of each hand. Some companies also make small flossing aids. You should floss using a gentle sawing motion, against the sides of your teeth. If you find this tricky — speak to your dentist. They will be able to advise you on the best oral hygiene aids for you, and show you exactly how to use them. Remember — prevention is the aim!!


What should I do if brushing or flossing makes my gums bleed?

If your gums bleed or become sore after flossing, do not panic. If you have not been flossing regularly then the gums will be inflamed and will bleed more easily. If the bleeding persists — see your dentist.


Choosing a toothbrush

The best toothbrush is one with a small head and soft bristles. Electric toothbrushes can also be very good, particularly for people who find proper brushing techniques difficult to master.


Choosing a toothpaste

Always use a toothpaste containing fluoride. Fluoride combines with minerals in your saliva to toughen your tooth enamel and help stop decay.

Why Sensitive teeth?

No matter what flavor ice cream you choose, it always ends up tasting bittersweet—so luscious on your tongue, so painful to your teeth. Everyone occasionally experiences fleeting pain in their teeth when they bite into something cold. Sensitive teeth can make life miserable. The pain and discomfort make even favorite hot or cold foods impossible to enjoy.

Tooth sensitivity can be defined as a painful reaction in one or more teeth triggered by hot, cold, sweet, or sour foods and drinks. This pain can be sharp, sudden and shoot deep into the nerve endings of your teeth. That's usually because teeth have lost some of their enamel protection. And beneath the enamel lies a honeycomb of tiny, fluid-filled tunnels called dentinal tubules. These tubules lead directly to the tooth's inner core, which contains pulp—and the tooth's sensitive nerve. Normally, saliva helps deposit calcium on the enamel to cover and protect the tubules' openings. However, once the tubules are exposed, extreme changes in temperature cause fluids inside them to flow back and forth quickly leading to sensitivity in your tooth.


What Causes Sensitive Teeth?

  • Brushing too hard: Excessive hard brushing (especially with abrasive tooth polishes) can erode the protective covering, baring the ends of the tubules. Almost 50-90% of people brush with too much pressure. Over weeks, months and years of brushing they erode the protective covering-enamel and remove significant gum tissue exposing the tooth roots.
  • Movement of gums away from the tooth: Poor oral hygiene can lead to plaque build-up around teeth and gums. Over time this plaque hardens into tartar. Bacteria in this tartar are responsible for the gum recession.
  • Cracks in the teeth and loose fillings also expose the tubules or even the pulp itself.
  • Grinding of teeth
  • Excessive consumption of acidic foods like lemon, and carbonated beverages.


Preventing Sensitive Teeth

The key to preventing tooth sensitivity is to maintain good oral hygiene. Reducing the pressure we use to brush our teeth helps tremendously in prevention of erosion of enamel. The problem with this is that our tooth brushing is an unconsciously ingrained habit reinforced after decades of brushing and therefore nearly impossible to change. I usually advise people to use advanced electric toothbrushes (plaque remover).

Preventing gingivitis and periodontal disease with proper oral hygiene is also crucial in preventing gum recession. Remember, it takes 2 to 3 minutes to properly brush all your tooth surfaces. Most people spend less than 45 seconds leaving areas untouched where plaque and tartar can build up. Flossing is crucial in order to reach the 35% of the tooth surfaces where brushing can not reach.

Avoid acidic food and beverages. Acidic foods and drinks—tomatoes, lemons, colas and other carbonated soft drinks—will very quickly eat the enamel off your teeth and make them much more vulnerable to sharp temperature changes.


Treating sensitive teeth

Home Care: Few tips that you can apply on your own

Plug up touchy teeth. Toothpastes for sensitive teeth work by plugging up the tubules with desensitizing toothpastes.

Do the fluoride swish. Fluoride mouthwashes also help block the tubules.

Try ibuprofen. If you're feeling sensitivity to hot or cold after a trip to the dentist, try ibuprofen to relieve the discomfort.

Try a gentler brushing technique. Always use a soft-bristle toothbrush, wet the brush before you apply toothpaste and never scrub very hard. Otherwise electric toothbrushes are a good alternative. Begin with the backs of the lower front teeth that are the most inaccessible spot in the mouth and where most of the tartar builds up, so you'll be putting most of your effort onto the most difficult area. Proper brushing will also help prevent receding gums, which can contribute to tooth sensitivity.

Professional care:
If you cannot get relief by brushing gently and using sensitivity toothpaste, your dentist has several options for relief.

  • White fillings to cover exposed root surfaces
  • Fluoride varnish applied to the exposed tooth/root surface
  • Dentin sealer applied to the exposed tooth/root surface
  • Mouth guards for patients who grind their teeth

All is not lost. In many cases, sensitive teeth can be successfully treated bringing long sought after relief.

What’s happening in your Baby’s Mouth?

Many people ask me when I start my children’s dental check-ups. I sense that many parents are totally confused about there infants oral hygiene. Care for your baby’s oral hygiene starts not only before the teeth comes out in the oral cavity but even when they are inside their mother womb.


Caring for Your Infant's Mouth

Good oral care starts from the beginning of your child's life. Even before his or her first teeth emerge, certain factors can affect their future appearance and health. For instance, tetracycline, a common antibiotic, can cause tooth discoloration. For this reason, they should not be used by nursing mothers or by expectant mothers in the last half of pregnancy.

Since baby teeth usually emerge around six months of age, standard oral health procedures like brushing and flossing aren't required for infants. However it is a good idea to get in the habit of cleaning his or her gums. Although there may be a little fussing at first, your infant will get used to having his or her mouth cleaned like other parts of the body. Many children grow to enjoy tooth brushing as part of their daily routine.

Infants have special oral health needs that every new parent should know about. These include guarding against baby bottle decay and making sure your child is receiving enough fluoride.



Between 3 and 9 months, your infant's baby teeth will begin to emerge into the mouth, starting with the lower two front teeth. While the timing varies considerably among children, the order and symmetry is very predictable. After the four incisors come in on both the lower and upper jaw, the first molars erupt, followed by canines and then the second molars further back in the mouth. Most children have a full set of 20 baby teeth by age 2½ or 3.

The time when a baby's primary teeth begin to emerge into the mouth can go by almost unnoticed or can be stressful for parents and children alike. Teething may make your child irritable or fussy and may cause restlessness, drooling or loss of appetite. However, teething has not been shown to be responsible for other childhood symptoms such as fever, vomiting or diarrhea.


You can ease your child's teething discomfort by:

  • Giving him or her a hard or frozen teething ring to chew on
  • Applying pressure over the gums by rubbing them with a clean finger
  • Using a small dab of an over-the-counter teething gel (following the manufacturer's instructions) to temporarily numb the gums


What is Baby Bottle Decay and How Can I Prevent It?

Baby bottle decay is caused by frequent exposure, over time, to liquids containing sugars. These include milk, formula, and fruit juices. The sugary liquids pool around the teeth for long periods of time as your baby sleeps, leading to cavities that first develop in the upper and lower front teeth. For this reason, you shouldn't let your baby fall asleep with a bottle of juice or milk in his mouth. Instead, at naptime, give your child a bottle filled with water or a pacifier recommended by your dentist. If you breast-feed, avoid letting the baby nurse continuously. And after each feeding, wipe your baby's teeth and gums with a clean, damp washcloth or a gauze pad.


To clean your baby's mouth:

Lay your infant in your lap with his or her head close to your chest so you can look down directly into your child's mouth. Clean the gums and the teeth when they arrive by rubbing a clean, damp, washcloth along the baby's upper and lower gums.
Do this at least twice a day once after breakfast and once after the last feeding of the day. You can continue using cloth or switch to a soft-bristled, infant-sized toothbrush after teeth first come into the mouth. By the time the molars (back teeth) first appear around age 1, it is best to use a toothbrush all the time.


Sucking Habits

It is completely normal and healthy for your baby or young child to suck on a thumb, finger or pacifier. It's not something you need to be alarmed about or discourage. Sucking is a natural reflex and something he or she did in the womb.
Children usually give up sucking habits on their own by the time they are 4 to 5 years old. If they stop the habit at this age, the shape of the jaw is usually not affected and the teeth grow in normally. However, some children find the sucking habit hard to break. Children who are still sucking on a pacifier, finger or thumb when their permanent (adult) teeth start to come in are more likely to have bite problems.


Pacifier Tips

If your child uses a pacifier, make sure it is always used safely.
Never fasten a pacifier on a string or necklace around your child's neck; your child could accidentally be strangled.

Choose a pacifier that:

  • Is one piece rather than several parts
  • Has ventilating holes on the sides
  • Is large enough so that your child can't swallow it
  • Is made of a flexible, nontoxic material
  • Has a handle that is easy to grasp

Always check the pacifier before giving it to your child. Make sure there are no tears. If there are, replace it. Never dip a pacifier in honey or any other sweet substance before giving it to your baby. This could lead to serious tooth decay.

A smile that’s good for life

An attractive smile is a wonderful asset. It contributes to self-esteem, self-confidence and self-image—important qualities at every age. A pleasing appearance is a vital component of self-confidence. A person's self-esteem often improves as orthodontic treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve a person’s general attitude toward life.

Look in the mirror. Do you like your smile now? Well, an orthodontist can make your smile look fabulous. You will end up looking great. Think about how looking great will improve your social life. You will be able to chew your food better.

Why straighten teeth?

People have orthodontic treatment to improve the appearance, health and function of their teeth. People are very aware of how teeth look and an attractive smile can play an important role in enhancing self-confidence. These days, with good oral hygiene and regular dental care, your teeth should last a lifetime - wouldn't it be nice if they looked good too?

You may be surprised to learn that straight teeth are less prone to decay, gum disease and injury. It's more difficult to clean your teeth when they are crowded and overlapping. Inadequate cleaning is a major factor in tooth decay, gum disease and eventual tooth loss. While it is possible to keep even the most crooked teeth clean, having your teeth straightened will make it easier for you to look after them. It is claimed that some bad bites lead to clenching, grinding, and excessive wear and/or uneven wear of the teeth. In severe malocclusions the teeth can damage the gum. For example, in cases of deep bite, the lower front teeth can bite into the gum behind the upper front teeth. It is claimed that some bad bites stress the jaw joint causing damage and pain in and around the joint. Some people have difficulty speaking properly because of alignment problems with their teeth and jaws. As for injuries to teeth, protruding upper teeth are more likely to be broken in an accident. When repositioned and aligned with other teeth, these teeth are most probably going to be at a decreased risk for fracture.

Chewing is the first step in digestion. If your teeth are not straight, you will not be able to chew your food correctly so partially unchewed food will go down to your stomach. That can give you an upset stomach.

You may avoid developing a breathing problem. As you get older the roof your mouth can sometimes partially block the air passages in your nose. That makes you snore loudly, and may contribute to a condition called "sleep apnea". If you get braces you can avoid this possibility.

When to start orthodontic treatment

Orthodontic treatment can be done at any age. Kids as young as 4 are sometimes advised to start orthodontics early to avoid a problem later on. Similarly, people as old as 90 sometimes get orthodontic treatment to fix crooked teeth.

However, Orthodontic problems are usually apparent by the age of seven, when most of the adult front teeth have erupted. Early examination allows the orthodontist to detect and evaluate problems and plan appropriate treatment. Early treatment may prevent more serious problems from developing and/or make treatment at a later age shorter and less complicated. Early treatment may also achieve results that are not possible once the face and jaws have stopped growing. Orthodontic treatment works best and is the least painful at the age 8 to 14 so we advise to start orthodontic treatment then. The jaw is growing the quickest at 8 or 9 years so it is usually best to expand your jaw and reshape your mouth at this age. This is called "interceptive orthodontic treatment". Usually, all the permanent teeth come in at 12 or 13 years and so are the best time to start full orthodontic treatment or braces.

However, the basic process involved in moving teeth is the same at any age and orthodontic treatment is also successful for adults. Because an adult's facial bones are no longer growing, some severe malocclusions cannot be corrected with braces alone. In such cases, orthodontic treatment combined with jaw surgery can achieve dramatic improvements.

Orthodontic Treatment

The first consultation
During this visit the patient is examined clinically. This enables the orthodontist to give advice on the treatment options available, when treatment should commence, the duration of treatment, and the approximate cost. If the patient decides to proceed with treatment, an appointment is made to collect records. Records include: plaster models of the teeth, photographs of the teeth and face, X-rays of the teeth and jaws.

Records allow the orthodontist to analyze each case accurately. They are also used to record the existing malocclusion for future reference.

Treatment Planning
At this visit the orthodontist discusses the treatment plan(s) which have been formulated using information obtained from the first consultation and records. Then, arrangements are made to commence treatment or, if it is too early, to review the patient periodically until it is an appropriate time to commence treatment.

Extractions and other preliminary procedures
Sometimes it is necessary to remove teeth to gain sufficient space to align the remaining teeth. Any decayed teeth should be filled and the teeth sometimes need to be cleaned before orthodontic treatment is started.

How Long?

Orthodontic treatment usually takes 18 - 24 months. Some cases may be finished earlier and others may take longer to complete. The total treatment time depends on the severity of the original malocclusion, the type of treatment carried out, and the co-operation of the patient.


At the completion of the active part of orthodontic treatment, the braces are removed and retaining appliances (retainers) are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth.

Retainers play an important role in orthodontic treatment for, if they are not worn according to instructions, the teeth may move back towards their original position.

Caring for teeth & gums

The key to healthy teeth and gums is proper plaque removal every day. If it is left to build up, it is one of the main causes of tooth decay and gum disease.

Follow these simple instructions and you'll be off to a great start:

  • Brush your teeth, gums and braces three times a day (especially after eating).
  • Clean between the teeth at least once daily - and definitely before you go to bed.
  • Use a fluoride toothpaste - fluoride is proven to help prevent cavities.
  • Use a fluoride mouth rinse at least once daily to help reduce the risk of cavities.

Try to carry your toothbrush and floss with you at all times so that you can clean your teeth even when you are not at home.

Do Braces Hurt?

This is one of the most common questions in an orthodontic practice. However, pain largely depends on the kind of braces used. Old fashioned braces hurt a lot of the time. However, if modern braces are used, they will not hurt except when they are first put in or when the braces are tightened. Nowadays, dentists usually use the modern designs to minimize the pain.

Keep smiling!

Wearing braces requires patience and discipline. However, the result of treatment can be more than just a healthy smile; often your orthodontist is preventing bigger problems from developing later. Proper oral care at home is important because it will help keep your treatment time on course and might even help reduce it. Furthermore, it will contribute to the long-term health of your teeth and gums.

And your reward... a lifetime of healthy, beautiful smiles!

Improve your dental health, enhance your facial appearance and even boost your self-esteem! If you think you have an orthodontic problem, the best time to see an dentist is now!

Put Your White ON

Have you ever wanted a white, attention-grabbing, perfect "Hollywood" smile? Then, you're not alone. It’s a common practice in my routine that my patients ask me “Doc is there any way you can make my teeth white?” It’s just not a fad of the 21st century that makes them say that but it is a proven psychological fact that white teeth boosts confidence. It has been observed that when someone meets a new person, he/she spends only few seconds looking at the other person’s eyes and then focuses his/her attention on the person’s dentition. Hence, the esthetic quality of the dentition gives the person confidence to flaunt his teeth while smiling. If a person is not confident of his/ her teeth then it affects the way he/she speaks and smiles.

Tooth whitening is the most common cosmetic service provided by dentists, and there are also a growing number of over –the-counter tooth whitening products to choose from. Billions of dollars are spent each year in tooth whitening products and services.

As we age, our teeth get more yellowish. Each of our teeth is made up of an inner dentin layer and a hard outer enamel layer, which protects the teeth. Use of colored food and beverages such as cigarette smoke, coffee and red wine promotes the formation of another layer over the tooth. This layer sits on your teeth for years and years, enters the porous enamel, where it simply can't be scoured away. The deeper stains are basically harmless, but many people find them unattractive.

This is where true tooth whiteners come in. Basically, the whiteners use bleaching chemicals to get down into the tooth enamel and set off a chemical reaction (specifically, an oxidation reaction) that breaks apart the staining compounds.

In the past, many attempts have been made to whiten teeth. However, the success of the treatment was minimal and not up to patients’ satisfaction. Many complained of severe sensitivity of teeth along with inadequate whitening. Moreover, the process required repeated application of whitening gels for a period of few weeks.

So recently I ordered a teeth whitening machine from United States called Zoom laser office bleach system. The chair side whitening system is a scientifically advanced tooth whitening procedure. It’s safe, effective and fast, very fast. In less than an hour your teeth will become dramatically whiter. Chair side whitening is ideal for anyone looking for immediate results. The convenience of this procedure compared to days of wearing trays or strips, makes it the perfect choice for a busy individual.

Amazingly the tooth becomes so white that the patient’s satisfaction to the treatment is something I just don’t worry about. The procedure is very simple; it begins with a short preparation to cover your lips and gums, leaving only your teeth exposed. The clinician then applies the propriety whitening gel which was designed to be used with a specially designed light. The light and gel work together to gently penetrate your teeth, breaking up stains and discoloration. With proper care your smile will sparkle for years.

Extensive research and clinical studies have shown that whitening teeth under the supervision of a dentist is safe. In fact, I think whitening is the safest cosmetic dental procedure available.

Well its here in Kathmandu so take your first step to feeling good, looking great and making a memorable impression every time you smile. You owe it to yourself.

Root Canal Treatment

Endodontics is the branch of dentistry that deals with diseases of the tooth's pulp, which is located in the center of the tooth and in canals (called root canals) within each tooth root. Pulp, consisting of connective tissue, nerves and blood vessels, nourishes the tooth when it first erupts (emerges through the gum). Once the tooth matures, the pulp can be removed safely from the pulp chamber and root canals and the tooth can be maintained. This is because the tooth also is nourished by a blood supply that surrounds the tooth. Removing the pulp is called endodontic treatment, but it is often referred to as root canal treatment or root canal therapy. Many people refer to this as "having a root canal." Root canal treatments are quite common. They save an estimated 24 million teeth each year in the United States.


Why Would You Need Root Canal Treatment?

Root canal treatment is needed for two main reasons: infection or irreversible damage to the pulp. An untreated cavity is a common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it opens into the root canal system, allowing bacteria to infect the pulp. Infections inside teeth don't respond to antibiotic treatment. The inflammation caused by the infection restricts the tooth's blood supply, so antibiotics in the bloodstream can't reach the infection very well. The reduced blood supply also limits the pulp's ability to heal itself.

The pulp also can become damaged from trauma, a fracture or extensive restorative work, such as several fillings placed over a period of time. Sometimes, a common dental procedure can cause the pulp to become inflamed. For example, preparing a tooth for a crown sometimes leads to the need for root canal treatment.

In many cases, when the pulp is inflamed, but not infected, it will heal and return to normal. Your dentist may want to monitor the tooth to see if this happens before doing root canal treatment. Sometimes, though, the pulp remains inflamed, which can cause pain and may lead to infection.

Once the pulp becomes infected, the infection can affect the bone around the tooth, causing an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty canals with an inert material. If root canal treatment is not done, the tooth may have to be extracted.

It is better to keep your natural teeth if at all possible. If a tooth is missing, neighboring teeth can drift out of line and can be overstressed. Keeping your natural teeth also helps you to avoid more expensive and extensive treatments, such as implants or bridges. If an infected or injured tooth that needs root canal treatment is ignored, not only can you lose the tooth, but also the infection can spread to other parts of your body.

Having endodontic treatment on a tooth does not mean that you'll need to have it pulled out in a few years. The reason for doing root canal treatment is often a large cavity. The tooth often is weakened, but if the tooth is covered with a crown after the root canal or, in some cases, restored with tooth-colored composite filling material, the tooth can last the rest of your life.
Signs and Symptoms

If you have an infection of the pulp, you may not feel any pain at first. But if left untreated, the infection will cause pain and swelling. In some cases, an abscess will form. Eventually, the tooth may need to be extracted. Some indications that a tooth may need a root canal are:

  • A tooth that hurts significantly when you bite down on it, touch it or push on it
  • Sensitivity to heat
  • Sensitivity to cold that lasts longer than a couple of seconds
  • Swelling near the affected tooth
  • A discolored tooth, with or without pain
  • A broken tooth

To determine whether your tooth needs root canal treatment, your dentist will place hot or cold substances against the tooth, feel surrounding tissues and gently tap on the tooth. He or she also will take X-rays.

If the condition of the pulp isn't clear from these tests, your dentist may use an electric pulp tester. This hand-held device sends a small electric current through the tooth and helps your dentist evaluate whether the pulp is alive. This test does not cause pain or a shock, but a tingling sensation that stops immediately when the tester is removed from the tooth.

Caution: An electric pulp tester should not be used if you have a cardiac pacemaker or any other electronic life-support device.


Length of Treatment

Root canal treatment can be done in one or more visits, depending on the situation. An infected tooth will need several appointments to make sure that the infection is eliminated. Some teeth may be more difficult to treat because of the position of the tooth, because they have many and curved root canals that are difficult to locate, or for other reasons. An uncomplicated root canal treatment often can be completed in one visit. Once the root canal treatment is finished, you will need to see your general dentist to have the tooth restored with a crown or filling.


Possible Complications

As with most invasive medical or dental procedures, complications can occur. Here are some possibilities.

Sometimes when a root canal is opened for treatment, the oxygen in the air will trigger some bacteria to start growing, causing inflammation and pain.

Bacteria may get pushed out through the tips of the roots. Blood vessels enter the tooth through a small hole (the apex of the root) at the bottom of the root.

Sometimes during a root canal procedure, bacteria are pushed out through this small hole into surrounding tissue. If this happens, the surrounding tissue will become inflamed and possibly infected. This can be treated with painkillers, and sometimes antibiotics, but the site could be painful until it clears up.

A root canal treatment can puncture the side of the tooth. This can happen if the canal is curved or if the canal cannot be located. The instruments are flexible so that they bend as the canal curves, but sometimes the instrument makes a small hole in the side of the tooth. If saliva can get into the hole, the tooth will have to be treated further or extracted. If the hole is far enough under the gum line that saliva can't reach it, it may heal.

A root canal may be missed or an entire canal may not be fully cleaned out. Locating canals within the tooth can be difficult. If a canal or an offshoot of a canal isn't located and cleaned out, the tooth can remain infected and the root canal procedure will have to be repeated. This also can happen if a canal isn't measured correctly and pieces of infected or inflamed pulp are left near the bottom. Occasionally, root canals have branches that are not accessible to traditional treatment.

A file may break. The tip of a file may break off inside the tooth. Usually, it's possible to leave the piece in the tooth and finish the root canal. But if the cleaning of the canal has not been finished, the file piece may have to be removed. Sometimes this can be done from the top of the tooth. However, in some cases, the file can only be removed through a surgical procedure called an apicoectomy. A small incision is made in the gum to access the root of the tooth, and the portion of the root containing the file piece is removed.

Pain, or the Lack of It

In most cases, you will not experience any pain during the root canal procedure. Your dentist will completely numb your tooth and the surrounding area. If this doesn't seem to be working, alert your dentist right away. Some people fear the anesthetic injections more than the procedure itself, but numbing gels and modern injection systems have made injections virtually painless. Let your dentist know immediately and he or she can modify the technique to avoid repeating the pain.

In addition to anesthetic, you may receive sedation, such as nitrous oxide.

So what is the wisdom behind the wisdom teeth?

Sometimes I feel that my patients are really confused about their wisdom teeth. Some tell me that I just got my wisdom tooth when they are forty. Others are really worried when I tell them its best to take their teeth out. Well worst is when some people have heard that its connected to their brain or in other case their eyes. So what is the story behind the wisdom teeth?


What are wisdom teeth?

Wisdom teeth are the upper and lower third molars, located at the very back of the mouth. They are called wisdom teeth because usually they come in when a person is between 17 and 21 years or older—old enough to have gained some "wisdom." Wisdom teeth that are healthy and properly positioned do not cause problems.


What causes problems with wisdom teeth?

Wisdom teeth may break partway through your gums, causing a flap of gum tissue to grow over them where food can become trapped and a gum infection can develop. Wisdom teeth can also come in crooked or facing the wrong direction. Or, if your jaw is not large enough to give them room, they may become impacted and unable to break through your gums. You may have trouble properly cleaning around wisdom teeth because they are so far in the back of your mouth and may be crowded.


What are the symptoms of wisdom tooth problems?

Wisdom teeth often cause no symptoms. Symptoms that may mean your wisdom teeth need to be removed include:

  • Pain or jaw stiffness near an impacted tooth.
  • Pain or irritation from a tooth coming in at an awkward angle and rubbing against your cheek, tongue, or top or bottom of the mouth.
  • An infected swelling in the flap of gum tissue that has formed on top of an impacted tooth that has partially broken through the gum.
  • Crowding of other teeth.
  • Tooth decay or gum disease if there's not enough room to properly care for the wisdom tooth and surrounding teeth.
  • Most problems with wisdom teeth develop in people between the ages of 15 and 25. Few people older than 30 develop problems that require removal of their wisdom teeth.


How are problems with wisdom teeth diagnosed?

Your dentist will examine your teeth and gums for signs of a wisdom tooth coming through your gum or crowding other teeth. You will have X-rays to find out whether your wisdom teeth are causing problems now or are likely to cause problems in the future.


What is the treatment for wisdom tooth problems?

The most common treatment for wisdom tooth problems is removal (extraction) of the tooth. Experts disagree about whether to remove a wisdom tooth that is not causing symptoms or problems. Oral surgeons generally agree that removing a wisdom tooth is easier in younger people (usually in their early 20s), when the tooth's roots and the jawbone are not completely developed. In the late 20s and older, the jawbone tends to get harder, and healing generally takes longer.

So next time you visit your dentist do not get a scare when they say that your wisdom teeth needs to be out. For gods sake its not connected to any other part of your body. Best is take it out before you reach Hawaii in your best holiday which can get badly spoiled.