Dental FAQs

Creating Smiles That You Will Love!

Dental Care Cosmetics FAQs

Here are some of the FAQ we’ve received from our patients. Have additional questions or concerns, call us: (203) 324-6171
Tooth Whitening
Dental Implants
Teeth & Fillings
For many people porcelain veneers and crowns can be an ideal solution. They create natural, beautiful results quickly and can address a wide variety of problems like: Dark or discolored teeth Crooked teeth Missing teeth Disproportionately sized teeth Worn or chipped teeth Old unsightly dental work Spaces between teeth Crowded teeth Protruding teeth
Porcelain veneers last for many years. As long as the patient exercises proper home care to prevent decay or gum problems, gets regular professional cleanings at least twice a year and avoids unreasonable force on their teeth, they can expect many years of service from porcelain veneers. You cannot abuse them by using your veneered teeth to crack open nuts, pull pins out of shirts, or as one of our patients said, “use your teeth like a Swiss Army Knife”. Doing so would likely cause breakage.
Porcelain veneers can be done in as little as one to two weeks.
Porcelain veneers are very strong and the glazed surface is generally impervious to stains. Just like a porcelain dinner plate can be washed, porcelain veneers can be cleaned and professionally polished to keep them looking great.
You can eat normally with veneers. Foods like corn, apples, chicken, ribs, fresh fruits and vegetables, carrots, etc., are all fine. So are sandwiches and bagels. You cannot use your teeth to break open nuts or eat stale breads that would require a hacksaw without causing veneers to develop cracks or actually break. Repeated abuse of veneered teeth will weaken them and then, one day, something might break while you are eating a tuna fish sandwich on white bread. This would only happen if the veneers had been damaged by prior abuse.
If a veneer chips or cracks, it can usually be repaired successfully. If it completely breaks, it may need to be replaced.
Porcelain veneers are an excellent way to close spaces in between teeth in just two weeks with no braces.
Porcelain veneers are an excellent way to make crooked teeth straight in just two weeks with no braces.
A classical porcelain veneer covers just the outside and biting edge of a tooth and requires a minimal amount of tooth reduction. A crown would go completely around a tooth and require more then twice the amount of tooth reduction. That is why we recommend porcelain veneers unless the tooth is extensively decayed beyond the point where a crown is necessary. Sometimes, in one patient, we use a combination of porcelain veneers and crowns to get the best most conservative result.
The dark area at the gum line with traditional caps is usually due to metal in the crowns. At Dental Care of Stamford, with teeth that show when you smile, we avoid metal in crowns whenever possible and use all ceramic crowns.
Getting a cap does not require that the tooth get a root canal.
Yellow teeth can be whitened by bleaching them or by putting porcelain veneers or crowns on them. If the teeth are not extensively decayed or filled and generally good looking, except for the yellow color, bleaching is the easier, most conservative and least expensive option.
Tooth whitening is absolutely safe and many studies have demonstrated that tooth whitening does not weaken or damage the teeth.
Bleaching only takes the dark pigments out of teeth and does not weaken them in any way.
The bleaching materials we use today were actually developed originally as a treatment for periodontal disease. Researchers noticed that, while they had no long term benefits for gum disease, the oxygen released during the bleaching process did help kill certain types of bacteria during the actual bleaching sessions.
The company who supplies us with the tooth whitening materials we use recommends that it is safe and effective for people age 12 and up.
You cannot be too old to whiten your teeth. Some of our most excited tooth-whitening patients have been in their seventies and eighties as they found that tooth whitening quickly and easily takes years off their appearance.
Bleaching is an inexpensive process that is designed to take the dark pigments out of the teeth. It will not whiten fillings or crowns on teeth. In addition, certain types of discolorations tend to respond better to bleaching than others. Based on our experience bleaching several thousand people’s teeth, we can give patients a reasonably accurate predication of the results they can expect with tooth bleaching, but there can be no guarantee of results.
Bleaching only affects natural tooth structure, not artificial fillings or crowns.
If you have old fillings or crowns, don’t be concerned. Bleach your teeth and then, when you are happy with the results, we can replace old fillings or crowns to match your new whiter smile.
It depends on how they are whitened. The same process that lets us bleach teeth can let them darken again. Teeth are permeable. That means stains can go in and out. Generally teeth that have been bleached will darken a little over time but it would take at least several years for them to return to their original color. If the teeth are whitened with veneers or crowns, they will not darken significantly at all.
If they darken more than you want, you can bleach them again. As long as you save your models and bleaching trays, you can do a touch up bleaching for a few days at any time in the future by purchasing an inexpensive touch-up kit of bleach material.
Some people simply start out with darker teeth than other people. Anything that could stain a white cloth can cause your teeth to darken. The worst offenders are smoking of any kind, dark beverages like red wine and cokes, and dark gravies and sauces. Skipping regular cleanings also lets deposits build up and penetrate into the tooth to darken them.
Regardless of your habits, you can have whiter teeth. If your teeth are dark and your habits tend to stain your teeth, you will get a less than desirable result from the tooth bleaching and will have to do it longer and more frequently. You do have other options, such as porcelain veneers, that can give you the color you want without relying on tooth bleaching.
You can always start with bleaching and then use veneers later. In your consultation with the doctors, they will let you know what results you can expect from bleaching and then you can decide what you want to do. Some people may decide to start with bleaching and contouring and then do veneers in the future.
Pain is a good indicator that there is a problem, but it is also a late indicator. All dental problems start small and don’t hurt. That is the time to fix them, before they hurt. When a tooth hurts, it may already be abscessed and require a root canal. Don’t wait for pain.
From a decay point of view, two good brushings a day will clean the places a brush can reach. The problem is that the brush can’t go between the teeth where most decay forms. No amount of brushing will replace flossing. They just don’t do the same spots. Just like cleaning the kitchen 6 times a day doesn’t make the bedroom clean. You need to brush and floss.
To help your kids avoid decay, make sure they are getting optimal fluoride in water or by prescription and minimal sugar. In addition, make sure they are getting dental check-ups twice a year to catch problems while they are small and practice effective plaque removal at home.
Most commonly, teeth break due to large cavities weakening the remaining tooth structure. That is why, with large cavities, they usually need to be fixed with a material that can strengthen the tooth, such as a crown. The other reason teeth sometimes break is from the pressure of tooth clenching or grinding, which is far more common than most people think.
A tooth with a cap is much less likely to decay than one with a big silver filling that is more prone to cracking and leaking. However, a cap is not a permanent solution to prevent decay. You still have to brush and floss and avoid sugar foods because where the cap ends the tooth can still decay.
Yes. A tooth that is filled is actually weaker than a tooth that has not been filled because the seam between a filling and a tooth is not as good as a solid undecayed tooth. Teeth that are filled can get more decay if the filling chips or cracks open and starts to leak. That is why the material selected must be strong enough. In addition, if the person does not practice effective plaque control and continues to eat too much sugar for their own system, decay can start in the remaining unfilled tooth structure.
To check for decay, you need to use a combination of dental x-rays to “look” in between the teeth where you cannot see. In addition, it is necessary to use a video enhanced system to magnify the size of the image so small cracks or chips in the filling that allow decay can be found. Very large cavities often form under what appears to be acceptable old fillings. These cavities can easily be missed unless the teeth are carefully evaluated.
You need dental x-rays because there are some areas like in between the teeth or under the gum line that are just not visible any other way. If the doctor does not catch decay, infection or bone tumors while they are small, and waits for the patient to complain of pain or other symptoms, little cavities can grow to the point where root canal is needed.
X-rays, when used properly, are definitely safe. Over the years, the amount of radiation has been going down as better systems have been developed. Today, the average set of dental x-rays provides far less radiation than a day in the sun. And remember, the dental technician uses a lead apron to cover your neck, chest and stomach to minimize radiation exposure.
At Dental Care of Stamford, we believe that we must strike a reasonable compromise between making sure that problems are detected and minimizing x-ray exposure of our patients. Therefore, in the absence of any specific problems, we take cavity-detecting x-rays once a year and a low dose panoramic x-ray, which checks all the tooth roots and jaw bones, once every two years.
If you have decay, an x-ray may not find it depending on where the decay is located on the tooth and whether there is a metal filling in the tooth that could block the x-rays. That is why you need to combine dental x-rays and a careful, video enhanced dental examination.
Just like the three little pig’s houses, some people’s teeth are definitely stronger than others. However, even the little pig with the straw house was doing fine until the Big Bad Wolf came along. People with naturally harder teeth, like the pig living in the brick house, can take more sugar without crumbling, but people with naturally weaker teeth won’t get decay either if they limit their sugar contacts.
Yes, it does. Adults can get great benefits from fluorides applied to their teeth on a daily or weekly basis because fluoride hardens the outside of the tooth. If the outside is harder, decay can’t start.
No. The body cannot turn table sugar directly into energy. The body must convert table sugar (sucrose) into glucose to burn it for energy. This is exactly what happens to all carbohydrates and fats we eat, like breads, pasta and potatoes, as well as fruit sugar (fructose) and sugar from grains (maltose). You actually never need any table sugar at all. Ever.!
The germs in the plaque begin to eat the sugar as soon as it enters your mouth. By the time you start to brush it’s way too late.
If you cut the number of sugar contacts down below your own threshold, you won’t get decay. Period. Since you don’t know the number for yourself, you can make a simple food diary. Simply write down everything you eat or drink for four consecutive days including weekends and weekdays. Then circle anything that either has sugar in it or that you add sugar to. Then count them up. If you are decay prone, cut the number of times you eat sugar down to three times a day. You’ll watch decay disappear.
This is one of the biggest lies of all. Natural just means grown from the soil. There are other “natural” substances like alcohol, tobacco and cocaine that aren’t very good for you either. The only difference between brown or “natural” sugar and white processed sugar is the color. Sugar is sugar.
More frequent sugar contacts cause much more decay. The truth is that the number of times per day that you eat sugar is more significant than the total amount of sugar you eat. Follow this logic. The germs in the plaque are very small. In the first bite of a sugar food, they get all the sugar they can eat. It takes the germs about 30 minutes to digest the sugar and turn it to acid before they are ready to eat more sugar. After the first bite of sugar, they are full. If you eat a pie in one sitting, that’s one sugar contact. If you cut it up into 24 pieces and eat one per hour, it is 24 sugar contacts. It may be no less fattening, but it is twenty- four times as decay causing as eating it in one sitting.
Most of the sugar consumed in America, about 150 pounds per person per year, is not in candy and cakes. The problem is that manufacturers put sugar into all sorts of things like ketchup, white bread, spaghetti sauce, mayonnaise and most processed foods. That Big Mac with special sauce on a bun is just as decay producing as the ice cream shake.
That is like saying that you can outgrow the damaging effects of bullets. In our office, the real truth is that the number of cavities per adult patient is much higher than the number of cavities per child patient.
The filling doesn’t seal the tooth as well as a solid tooth that has no filling. Sugar can seep into these cracks more easily so filled teeth are actually more likely to decay again than unfilled teeth. Always ask the dentist if a cavity is a new one, and caused by sugar, or due to a broken old filling so you understand what your problem is.
You don’t have to keep getting cavities. You have to stop what is causing them. Cavities are due to either eating too much sugar relative to the strength of your teeth and not flossing, or due to old fillings leaking and letting decay under them. You need to discover the problem and then cut down your sugar, start flossing and fix leaking old fillings. Using a prescription strength fluoride is helpful too.
No one likes the numb feeling, but most people prefer numbness to pain. If the cavity is small, you may be able to do it without Novocain. Also, air abrasion, which does not use a drill, can sometimes be used for smaller cavities without Novocain.
As a matter of fact, Novocain is actually not used any more at all. There are several different types of local anesthetics used by dentists. Some are longer and some are shorter lasting.
The heart pounding is an annoying but temporary effect of a chemical in the local anesthetic that helps it work better. If it is a problem for you, there are local anesthetics that do not have that chemical. Often those don’t last as long, so for a longer procedure, the numbness might not last long enough, requiring re-injection of additional local anesthesia. Ask your dentist what would be best for you.
Today, you do not need to have old fashioned metal fillings in your mouth. Bonded fillings, inlays and crowns are all natural tooth color and can be used to replace old fillings to give you a younger, natural look.
Yes. Many dentists today do not even use dark silver mercury fillings at all. In our practice we have not used anything but modern, bonded tooth colored fillings for over 15 years.
The safety of mercury fillings is very controversial. The American Dental Association and many other organizations says it is. Many other people are concerned that it may not be safe. Several European countries do not permit its use in children. The instructions supplied by manufacture of silver mercury fillings in the USA say not to use it in patients with kidney disease or compromised immune systems. The Environmental Protection Agency says that when dentists do a silver mercury filling in a patients tooth, any unused filling material must be stored in a covered container and disposed of as medical waste. Dentists are not allowed to store scrap filling material in an open container. This leads us to believe that there may be a problem, so we do not use silver mercury fillings at all.
We do not use silver mercury fillings for several reasons. First, they tend to corrode and leak, permitting further decay. Second, they have a tendency to expand over time like ice cubes and can cause otherwise healthy teeth to fracture. Third, they are unattractive and tend to darken teeth. Fourth, although the ADA says that they are acceptable for continued use, there is some concern about the safety of mercury and some people are intolerant to mercury in fillings
Gold is a very excellent material but some people object to its appearance, even in back teeth. Now there are several choices of materials to repair decayed or broken teeth. Laser bonded composite fillings are used for small-to-medium-sized cavities. They are natural tooth color. Gold or porcelain inlays are used for very large cavities. The traditional gold, while an excellent material in terms of durability and strength, is generally not selected in areas where it would be visible. Porcelain, on the other hand is very natural looking. In the case of even more extreme tooth damage, a porcelain crown can be used.
There are three reasons why a restoration in a tooth could fail. First, the material could break or wear out. Second, the remaining tooth could break or start to decay. And third, some conditions such as gum disease could damage the support of a tooth or cause gum recession that would cause a cosmetic problem with an otherwise successful restoration. Based on this, considering that people bite, chew and swallow 24 hours a day, eat cold foods and drinks as low as 35 to 40 degrees (F) to hot beverages as warm as 150 degrees (F), there is nothing that could be considered “permanent”. That said, if the material selected is appropriate for the size of the cavity and the individual brushes and flosses daily, eats minimal sugar and uses prescription strength fluoride, most dental repairs will be very long-lasting.
You don’t have to keep getting cavities. You have to stop what is causing them. Cavities are due to either eating too much sugar relative to the strength of your teeth and not flossing, or due to old fillings leaking and letting decay under them. You need to discover the problem and then cut down your sugar, start flossing and fix leaking old fillings. Using a prescription strength fluoride is helpful too.
Sensitivity to cold means that the nerve of the tooth is inflamed. If the sensitivity goes right away after the cold food or beverage is swallowed, the inflammation is usually reversible by fixing the cause, such as a deep cavity, grinding your teeth or gum recession. If the cold sensitivity lingers, the tooth may need a root canal. Sensitivity to hot is usually more serious. That often means that the tooth inflammation is more advanced and may not be reversible unless root canal is done.
Usually these sensitive areas are caused by tooth clenching or grinding. The solution is to try to desensitize them by using a prescription-strength fluoride product, such as Prevident, if over the counter products like Sensodyne don’t help. Also, you need to determine the cause, such as tooth clenching or grinding or gum recession, and correct that to prevent the problem from getting worse.
Generalized sensitivity of teeth is usually due to gum recession caused by gum disease or tooth grinding due to a bite problem. You need to find the source of the problem and fix it. If it is only one tooth, then it could also be due to decay.
Biting down on hard foods means that there is inflammation at the top of the root, just like walking with a stone in your shoe would cause your foot to hurt. If it is due to biting too hard on the tooth, such as would be the case with a new filling that is too high, or tooth clenching or grinding, fixing the bite will help. If it is due to an infection in the tooth, a root canal is probably needed.
Chips in teeth are caused by mechanical trauma such as a blow to the tooth or, more commonly, tooth grinding. You can see if the chipping is due to tooth grinding by putting your top and bottom teeth together edge to edge, and seeing if the chips or worn spots on the top and bottom teeth line up. See the article by Dr. Simon on Bio Mechanical Dental Disease on the web page.
We used to think that little notches in teeth along the gum line were due to brushing too hard. Now we know that they are actually due to tooth grinding or clenching that literally bends the tooth breaking off the enamel.
Except for wisdom teeth, teeth that are lost should generally be replaced because when a tooth is lost, several things happen. The other teeth may start to shift, causing food traps which can lead to more decay or gum disease. In addition, it can throw the bite off leading to bite problems. The last problem is difficulty with chewing, leading to poor digestion and eating processed foods which aren’t as healthy as harder to chew fresh fruits and vegetable and high fiber breads and cereals.
Food traps between your teeth may be due to cavities between the teeth, fillings that are breaking or your teeth may be shifting if you have lost and not replaced missing teeth. It is important to fix these problems because the trapped food can cause gum disease in addition to being annoying.
Some people do have weaker than average teeth. These people can use prescription-strength fluoride, like Prevident, to make their enamel stronger and more decay-resistance.
If you have fillings that do not match the color of your teeth, you can have them replaced with new bonded fillings. Over time, tooth-colored fillings, especially the older ones, can discolor, or the color of your teeth may have darkened due to food or beverage stains. Modern bonded fillings hold their color for much longer than older materials.
Silver mercury fillings can be removed easily and replaced with tooth colored materials. The dentist does it all the time if there is decay or if they are leaking or broken. They can be removed for cosmetic reasons to lighten dark teeth as well, as if the patient requests it.
Smile Improvement
Veneers & Crowns
Braces & Straighter Teeth
Cosmetic dentistry can give you the smile you want. Here are some common problems that can be addressed: Dark, yellow or discolored teeth Crooked teeth Worn, chipped or broken teeth Missing teeth Disproportionately sized teeth Spaces between the teeth Crowded teeth Protruding teeth Replacing old unsightly dental work Gum recession
Cosmetic dental procedures can be accomplished in as few as two visits over as little as a week or two. Of course, every patient’s situation is different so you need to discuss your specific requirements and circumstances with us prior to starting any cosmetic work.
Many cosmetic procedures, such as tooth whitening and cosmetic contouring, which reshapes crooked and misaligned teeth are not very expensive and can make a big difference in your smile.
A dentist trained in proper cosmetic dental procedures does not create the “white chicklet” tooth look you may have seen. We can discuss the shape, color and arrangement of your teeth so you get a great “natural” looking smile.
Yes, you absolutely can get a preview before your work is done. Cosmetic Imaging is a system where we take a picture of your smile and then, in our computer, change your teeth so you can see how great you would look with cosmetic dental treatment.
In addition to fixed and removable braces (like Invisalign), teeth can be straightened by using porcelain veneers or crowns. This method is especially useful with adults who want a result in two weeks, instead of two years. In addition, if the teeth are dark or have decay or unattractive old fillings, that can all be corrected at the same time.
For many people porcelain veneers and crowns can be an ideal solution. They create natural, beautiful results quickly and can address a wide variety of problems like: Dark or discolored teeth Crooked teeth Missing teeth Disproportionately sized teeth Worn or chipped teeth Old unsightly dental work Spaces between teeth Crowded teeth Protruding teeth
Braces can either be fixed on the teeth or they can be removable. The removable type of braces usually are for more minor tooth movement so most orthodontic work is done with non-removable braces. If the orthodontist makes a removable appliance for you, you must still wear it almost all the time, except when eating, in order for it to create the tooth movement you want. Taking it in and out frequently lets the teeth move back and it will take a much longer time to get the results you want.
Braces can sometimes be done on the inside so they are not visible, but not always. Also, it is more difficult to work with braces on the inside and so it usually takes longer and is more expensive.
A typical orthodontic case takes around two years but can vary considerably due to the specifics of the individual case. Sometimes young children are treated in two stages, for example, with one to several years in between.
Braces can be used for both adults and children. Typically most orthodontists have 30% to 50% of the patients as adults.
In the past, many patients had some permanent teeth removed in the process of braces. Now, modern orthodontic treatment prefers to keep all of the permanent teeth unless there is severe crowding and there is just no room for all of the teeth.
Braces do not cause white spots on the teeth. White spots are due to the person having braces on their teeth and not properly cleaning their teeth.
Braces do not cause decay. Too much sugar and plaque accumulation cause decay. However, braces make it a lot harder to effectively clean your teeth. As a result, we recommend adults and children with braces get their teeth cleaned every three months, use a Water Pik or Hydrofloss irrigator to assist in home care and prescription strength home fluoride daily.
The objective of braces is to move teeth into a position where the bite is good, the smile looks great and the teeth are stable so they won’t shift back. Sometimes this is not done and long-term retainers need to be used or the teeth will tend to shift.
There is no easy way to keep teeth clean with braces. We recommend that anyone with braces come for professional cleanings every 3 months, and in addition to a special Prodentec tooth-brush, use a Hydrofloss irrigator.
Placing dental implants is a surgical procedure, so there is definitely some mild discomfort after the surgical phase, but generally less than a tooth extraction because it is a precise, gentle controlled procedure. After the initial healing phase passes, there is nothing to be fearful of in so far as pain is concerned.
Dental implants can be made to look great. Patients with dental implants report that biting and chewing feel perfectly natural.
Placing an implant requires one surgical visit and several follow up visits to check the healing and remove the sutures. The purpose of the dental implant(s) is to replace missing teeth, so in addition to the surgical placement of the implants, the patient must wait 3 to 6 months while the bone heals and then another month or two for the final dental bridgework.
You cannot be too old for dental implants. The issue is your health. As long as you are a candidate for elective surgery, you can have dental implants. A person with medical conditions such as uncontrolled diabetes, heart disease, severe hypertension etc., would not be an appropriate candidate for dental implants. With regards to being too young, dental implants are usually done for patients whose jaw bones are fully formed, so that would be late teenage years. If you are not ready yet for implants there are temporary options so you don’t have to go without teeth
Medical conditions that would preclude the placement of dental implants would include people with problems healing, such as people with AIDS and people who are not candidates for elective surgery, such as people who have uncontrolled diabetes, severe high blood pressure or heart disease.
Dental implants are a good way to replace a single missing tooth.
Absolutely. Dental implants are often used to replace one or several missing teeth when there aren’t sufficient teeth for fixed bridgework.
Many patients who get dental implants do so because they are uncomfortable with the old removable bridgework that they had.
Placing dental implants and then putting a cap on it is a great way to replace a missing tooth if you do not want to put caps on the teeth adjacent to the missing tooth, or if there aren’t enough strong teeth to support a fixed bridge near the missing tooth. This is especially true if the adjacent teeth are perfectly healthy, straight, decay free-teeth and the patient would rather avoid capping them.
The disadvantage of the implant is that two surgical procedures need to be done to place the implant and then place the supporting post in the implant so that a cap can be placed to replace the missing tooth. This takes several months. And the cost for a dental implant, plus the post and crown, might be greater than a conventional fixed bridge. If the patient has perfectly good teeth adjacent to the missing tooth, the benefits of not having to cap those teeth may be worth the extra time and expense.
If the teeth adjacent to the missing tooth are crooked, decayed or already have big leaking fillings, and need to be capped anyway, it makes no sense to go through the time and expense of a dental implant and then have to cap the adjacent teeth anyway. Also, if there is not an adequate amount of jaw bone to hold the dental implant, bone grafting procedures may need to be done and the patient would need to evaluate the benefits of the implant approach versus the time and expense of the implants and bone graft.
Dental Implants are way to improve your comfort, health and appearance and that is why at Dental Care of Stamford we have a whole team of cosmetic dentists and surgeons to see what is best for your individual situation and why we offer free consultations. There are times when dental conditions such as bone loss or gum recession may allow a dentist to use a dental implant to adequately replace a missing tooth but not restore the normal shape and contour of the gum tissue. In the back of the mouth, where it doesn’t show, this may not matter. In the front of the mouth, it could result in a chewing success but an appearance failure. That is one reason why dental implants, as great as they are, are not a panacea for the replacement of all missing teeth.