FAQs

We are all at risk of having a tooth knocked out.  More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we may be able to actually save the tooth.  Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:

1. Please locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
2. Please DO NOT scrub or use soap or chemicals to clean the tooth.  If the tooth has dirt or debris on it, rinse it gently with your own saliva or whole milk.  If that is not possible, rinse it very gently with water.
3. Please get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

• Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
• If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk.  You can also place your tooth under your tongue or between your lower lip and gums. (depending on your age) Please  keep the tooth moist at all times. Please do not transport the tooth in a tissue or cloth.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years.  So please be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

• Wearing a mouthguard when playing sports
• Always wearing your seatbelt
• Avoiding fights

Although thorough brushing and flossing remove most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are too large to possibly fit and clean most of these areas. This is where sealants play an important role.

A sealant is a thin plastic coating that covers and protects the chewing surfaces of molars, premolars, and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and help keep these areas free of decay.

Who may need sealants?

Children and teenagers - As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of  ages 6-16.

Infants - Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity prone.

Adults - Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.

Sealants are easily applied  and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth. Sometimes a special light will be used to help the sealant material harden.

After sealant treatment, it’s important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.

Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay. 

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth.  When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function.  Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.

Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen.  Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth.  If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth.  Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.  These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth:

Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges - This type of bridge is generally made of porcelain, porcelain and gold or composite material and is anchored (cemented) permanently to a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.

Implants – Dental implants a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.

If you are missing teeth, please ask Dr. Steffens if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a whiter, brighter hollywood smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the Canadian Dental Association (CDA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which may become darker over time.  Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office and you will see results immediately.  It may require more than one visit, with each visit lasting 60 minutes or so. While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!

Cavities are produced from the bacteria and sugar in your mouth. Bacteria and sugar that stick on your teeth for a period of time produce an acid that causes the cavity. Controlling snacks that are high in carbohydrates (sugars) and more thorough home care will help to reduce cavities. Cavities in between the teeth can be decreased by flossing. If flossing is difficult, there are alternatives. Sealants can also be placed on the biting surfaces of your back teeth to help prevent decay.

Clenching and grinding your teeth is the most common reason for fillings to break. This occurs when patients are sleeping and are unaware that they maybe clenching or grinding. Signs to watch for are soreness in the jaw joint, frequent headaches, difficulty opening your jaw, and a clicking sound when chewing. A night-guard, which is a thin appliance that can be worn at night, will help prevent further wear on the teeth and also help to prevent broken fillings and teeth. Also, chewing hard or sticky foods can cause your fillings to become damaged as well.  Please try to chew softer foods and please avoid any sticky foods. Please click here to visit our healthy snacking section.

A filling may eventually wear around the edges, or it may pull away from the surrounding tooth enamel leaving a very small space between the tooth and the filling. This condition may allow bacteria to enter around the edges of the filling and may cause decay. There may be no symptoms until the decay reaches the nerve of the tooth. Please don't wait until the tooth hurts or the filling and the tooth crack. This can complicate treatment and make it more costly. Visit Dr. Steffens regularly so your fillings can be examine Please remember that fillings do not last forever!!

Over my 23 years of general practice, I have received many concerns as to the safety of amalgam (silver) fillings.  An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury.  We as dentists have used this blended metal to fill teeth for more than 150 years.  The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.

The Canadian Dental Association states that scientific studies have not verified that dental amalgam is causing illness in the general population.

Current research on the use of dental amalgam supports that amalgam continues to demonstrate clear advantages in many applications over other restorative materials, especially in relation to the average duration of restorations.

Every time a foreign substance is used in the human body for therapeutic purposes, there is an element of risk. Health professionals must constantly weigh the known risks of a particular intervention against known benefits. In the case of dental amalgam, the scientific evidence indicates that no significant risks are involved. If there were risks, they would have been clearly observed during the 150 years that this material has been in use.

Dental team members, in particular, would have shown clinically demonstrable effects due to their considerable exposure to the substance. The risks associated with the use of dental amalgam appear to be limited, and the benefits to patients are known to be large. Dental amalgam is much stronger and more durable than alternative restorative materials, and amalgam restorations can be completed at a more reasonable cost. Recent advances, such as the development of amalgam bonding techniques, have made amalgam even more advantageous as a restorative material.

Gold alloy inlay castings would be a reasonable substitute if the material and required procedures were not so costly. It is also possible that alternative materials, subjected to the same level of scrutiny as dental amalgam, will prove to have other advantages and disadvantages. The dental profession is aware of research to find more durable alternatives to amalgam, and these materials may be available within the next decade.

The general consensus is that amalgam (silver) fillings are safe.  Along with the  CDA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective.  The CDA says that the only reason not to use silver fillings is when a patient has a sensitivity or allergy to any component of this type of filling, just as there are individuals who are sensitive or allergic to other chemical substances or even foods such as milk or bread. It has been estimated that the prevalence of mercury sensitivity in the general population is approximately three per cent. They also suggest that alternatives should be considered for patients with impaired kidney function. Although dental amalgam itself is not linked to such conditions, there is evidence that total body burden of mercury is of particular concern with these patients. Amalgam may similarly be contraindicated for workers with known occupational exposure to heavy metals or for individuals with greater than average exposure to mercury because of a diet, which is primarily seafood.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels.  For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them.  However, with respect to amalgam fillings, the CDA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous options to silver fillings, including composite (tooth-colored ), porcelain, and gold fillings. Please remember that the choice is yours! 

We encourage you to discuss these options with Dr. Steffens so you can determine which is the best option for you.

The benefit of a crown will protect your tooth. Root canal treatment and or a large filling on a tooth weakens the tooth structure and causes the tooth to become brittle. This can lead to tooth breakdown and a possible fracture below the gum line. This will lead to more extensive treatment and sometimes surgery or tooth loss. A crown is fabricated with metal and porcelain, it is esthetically pleasing and lasts for many years.

• Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
• See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits.
• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
• Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem. Please try to avoid mouth rinses that contain alcohol.

In most cases, Dr. Steffens can treat the cause of bad breath.  If she determines that your mouth is healthy, but bad breath is persistent, Dr. Steffens may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Bad breath (halitosis) can be an unpleasant and embarrassing condition for many people.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are numerous reasons why one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially in the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

• Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
• Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
• Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – Dry the mouth, causing bad breath.
• Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist.

Tooth sensitivity is often experienced when the surface of the tooth has been worn down. One of the most common reasons for adults to have sensitivity  is if  the roots of the teeth are exposed because the gums are receding. This allows the effects of hot and cold to penetrate to the pulp where the nerves are located. The problem can get worse if you are not brushing your teeth probably because they are sensitive. Proper oral hygiene is the key to preventing gums from receding. If you brush incorrectly or even over brush, gum problems can result

Sensitive teeth can be treated by Dr. Steffens!!  You may try desensitizing toothpaste, which contains compounds to help block the transmission of sensation from the tooth surface to the nerve.  If the toothpaste does not ease your discomfort, Dr. Steffens may apply a desensitizing agent to the tooth  to seal the sensitive teeth.  She calls this her miracle liquid gold.

If you are experiencing pain or sensitivity, please let Dr. Steffens know so she can assess your situation and recommend the best treatment to take care of your discomfort.

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health.  Periodontal disease is one of the most common infections; often more prevalent than the common cold!  Periodontal disease is not only the number one reason people lose teeth; it may also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis.  It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth.  The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth.  When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions.  These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections.  Research suggests that periodontal bacteria in the blood stream may:

• Contribute to the development of heart disease
• Increase the risk of stroke
• Compromise the health of those that have diabetes or respiratory diseases
• Increase a woman’s risk of having a preterm, low-birth weight baby

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation.  Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember….the mouth body connection!  Taking care of your oral health will contribute to your overall medical health!

Tooth enamel is hard but also has microscopic pores. Sugar combines with the bacteria in plaque, which forms on your teeth daily, to produce acids that seep into the enamel's pores. This causes the enamel to demineralize and become weak, contributing to the formation of cavities.

Fluoride helps prevent tooth decay by slowing the breakdown of enamel and speeding up the natural remineralization process. This keeps your teeth strong and healthy. Fluoride also fights cavities by reducing the amount of acids that are produced by plaque.

Dr. Steffens uses a prescription strength fluoride which is only available at her dental office.

Brushing and flossing help control the plaque and bacteria that cause dental disease. Plaque is a  film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with  soft bristle brush and toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

The brand of the toothbrush is less important than the type of brush, your brushing technique and how often you brush your teeth.

We recommend that you have a soft-bristle brush. This type of brush will effectively remove plaque and a soft brush will not damage your gums (so long as you don't apply too much pressure when you brush). We also recommend that you brush at least twice a day.

The condition of your brush is also important. Once the bristles begin to bend, which occurs approximately every 3 months or so,  it is time to start using a new brush. When the bristles on your toothbrush are bent over, they lose their ability to remove food and plaque effectively.  It is the tip of the bristles that clean your teeth the best.

Bleeding is common during a dental cleaning but not considered normal. The dentist or hygienist cleans below the gum-line where your toothbrush and floss cannot reach. When inflammation is present, your gums will be much softer, fragile and will tend to bleed easier. Proper home care techniques can firm your gums and stop bleeding even during a cleaning appointment. Bleeding is a sign of gingivitis. Our goal is to control and reverse the signs of gingivitis, which will aid in healing your gums.

The gum evaluation acts as a road map to the dentist or hygienist. This enables them to customize your appointment to where you need the most attention. It recognizes problem areas as well as spots where you maybe healing. Oral hygiene, stress, nutrition, smoking, clenching/grinding your teeth can trigger changes in your gums. This needs to be noted and recognized to help prevent and treat periodontal disease.

Research shows that bacteria reproduce in a pocket after 60- 90 days. You can only clean approximately 2 millimeters below your gums if you are flossing. You need the help of your dentist or hygienist to reach the base of your deeper pockets and remove bacteria that may be destroying your jaw bone. This process helps to control bleeding and inflammation in your mouth reducing the risk of gum disease. Gum disease is a source of chronic inflammation. Research shows that inflammation of your gums could lead to heart attacks, colon cancer, Alzheimer's, premature births and a host of other diseases.

We are all exposed to natural radiation in our environment.  The amount of radiation exposure from a full mouth series of x-rays is equal to the amount a person receives in a single day from natural sources.

Dental x-rays produce a low level of radiation and are considered safe.  Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental x-rays.  These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each x-ray.

Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam.  Dr. Steffens uses this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan.  Without x-rays, problem areas may go undetected. X-rays also help Dr. Steffens see problems in the early stages of development; this helps her treat problems long before they become serious. If she is able to detect a cavity early, she may be able to save more of your healthy tooth. If decay is not detected soon enough, you may not know you have a problem until it is causing you some pain or discomfort. Major tooth restoration, costing thousands of dollars, may be needed to repair a tooth if the decay has advanced enough.

Dental x-rays may reveal:

• Abscesses or cysts.
• Bone loss.
• Cancerous and non-cancerous tumors.
• Decay between the teeth, under the gums and around old fillings
• Deep heavy tartar deposits.
• Developmental abnormalities.
• Poor tooth and root positions.
• Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!