Dental FAQs:

At Dentistry at Sugarloaf, we take several precautions to ensure your safety as our patient. First, our team keeps up-to-date on the latest sterilization procedures and research. Our office complies with and exceeds OSHA standards for safety. We also have 2 sterilization centers where we can maximize efficient sterilization and minimize the chance of contamination through human error. All instruments and dental drills are heat sterilized after every patient. (Some offices only disinfect the dental drills- we sterilize them EVERY time.) Many items are disposable and all counter tops are wiped with hospital grade disinfectant between patients. In addition, we place fresh plastic barriers on places we would likely touch during your treatment appointment. All areas are disinfected before the barriers are placed.

How does the dental team keep up-to-date on all of the current techniques and materials?

Because dentistry is constantly changing, we do a number of things to stay up to date on all of the current findings. The team has attended a class together to improve the function of the whole office. He and members of our team also belong to a variety of organizations that offer seminars and conferences on advances in dentistry.

What different payment options do you provide?

Our office accepts cash, checks, and credit cards (Visa, Master Card, Discover and American Express) for payment. The fee for each visit will be discussed prior to your appointment. Any amount not covered by your insurance is your responsibility. We have a multiple in-office financing options available for treatment that exceeds $500.

We believe that money should not stand in the way of your having a healthy mouth. If you need extensive dental care and are concerned about cost, we are happy to offer financing through Care Credit®. For those of you who don’t have dental insurance please ask about our Dental Wellness Plan.

How much will my insurance pay toward my visits?

Insurance companies have a certain limit for dental expenses per year – usually $1000 or $1500. This limit has not changed very much since dental insurance was introduced in the 1960s. The insurance company pays a percentage of the expense depending on the type of service provided – either preventive, basic or major. However, when an insurance company says that they cover 100% of a certain service; they mean 100% of the fee they set. This is based on the insurance plan, and not necessarily our office fees. This fee will also vary from plan to plan with the same insurance company! This may leave the patient with a balance owed for his or her treatment, even though the insurance company claims to cover 100% of that type of treatment.

For example, a typical fee in our area for an adult cleaning is $82. Most insurance companies will pay 100% of this fee; however, we have some patients with plans that pay as little as $40, although the insurance company refers to the $40 payment as “100% of usual, customary, and reasonable”.

We will always do our best to estimate how much your insurance plan will pay toward each visit and will give you a written itemized treatment plan to minimize unexpected costs.

We are occasionally asked why we don’t participate in a particular insurance plan, or if we would consider participating in a certain plan. There are many insurance plans that restrict your choice of doctors to those on a specific list of participating offices. The participation agreement between those plans and the providers requires the provider to deliver care at a large discount to patients covered by that plan. For some plans the discount is small; for some it is not. There are several insurance companies with which we are an “in network” provider. Please call our office and see if we are participating with your particular insurance company. 770-513-1312

We believe that dentistry is a service, not a product. For us, the manner in which that service is provided and the attention to details makes all the difference. We do not participate in plans that require us to deeply discount our treatment prices and encourage us to make up the difference in volume. We cannot be a “volume” practice and still provide the level of care and service that built our reputation. Our reputation has been built by using high-quality materials and technology and by providing exemplary customer service. We cannot be a “volume” practice and provide that level of care and attention to our patients.

Do you accept referrals?

We are always happy to welcome new patients to our office. We consider your referrals the highest compliment we could possibly receive. We have found that our best new patients are usually referred by our great existing patients!

How do I know when it is time to schedule an appointment?

We suggest visiting us at least every six months so that we can catch any problems in the early stages. If you have signs of periodontal disease (gum disease) we will want to see you more often to maintain the health of your gums. We recommend that children have their first visit at the age of three (unless you suspect a problem before that age) to start a lifelong habit of good dental health.

How often should I have a dental exam and cleaning?

You should have your teeth checked and cleaned at least twice a year but Dr. Norton or his dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health. These include:

Medical History Review: Knowing the status of any current medical conditions, new medications and illnesses gives us insight to your overall health and also your dental health.
Interpretation of Diagnostic X-Rays (radiographs): Essential for detection of decay, tumors, cysts and bone loss. X-rays also help determine tooth and root positions.
Oral Cancer Screening: Check the neck, lips, tongue, throat, tissues and gums for any signs of oral cancer or any abnormal tissue growth that might exist. Dr. Norton uses a special fluorescing device, which takes very little time and is totally painless, to highlight tissue that could be cancerous or pre-cancerous. For adults.
Gum Disease Evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
Examination for Tooth Decay: All tooth surfaces will be checked for decay with special dental instruments. We want to detect decay long before conventional x-rays show it. Our laser detection unit finds decay up to two years sooner, so we can often remove it with the assistance from one of our lasers without the need for anesthesia. Finding it in its earliest stages is always less costly.
Examination of Existing Restorations: Check current fillings and crowns for chipping or leakage and inspect other restorations including implants, removable partials and full dentures, along with orthodontic devices.
Removal of Calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and has firmly attached itself to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments. We have ultrasonic cleaning equipment for these procedures to minimize the scraping and digging around normally associated with a dental cleaning.
Removal of Plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums and decay the teeth. This inflammation of the gums is the start of periodontal disease!
Teeth Polishing: Removes stain and plaque that is not otherwise removed during regular tooth brushing.
Oral Hygiene Recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, rinses, etc.).
Review Dietary Habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.

When are sealants recommended?

Although thorough brushing and flossing removes 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 fit down into and clean most of these areas. This is where sealants play an important role.

A sealant is a thin tooth-colored 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 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 by your dental hygienist as well as other trained team members and the process only takes minutes per tooth. After the chewing surfaces are roughened with an etching 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 tooth. 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.

How often should I brush and floss?

Brushing and flossing helps to 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, as well as tooth decay.

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

Tooth brushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved 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 highly recommended. They are easy to use and can remove plaque very efficiently. Simply place the bristles of the electric brush on your gums and teeth in the same locations just mentioned 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 gum line. Flossing not only helps clean these spaces, it prevents plaque colonies from building up thereby preventing damage to the gums, teeth and bone.

Take about 24 inches 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 an up and down sawing motion. Never do the sawing motions from side to side.
Curve the floss into a “C” shape around each tooth and under the gum line. Gently move the floss up and down, cleaning the side of each tooth. Do this up and down movement on each surface a dozen times.

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

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.

My gums bleed after I brush. Is this something to be concerned about?

Bleeding gums are a sign of gum disease. Recent research indicates that 70% of the adult population has some sign of gum disease. This disease can contribute to a variety of health problems, including heart disease, stroke, poor diabetes control and low birth weight babies. If your gums are bleeding, we recommend that you schedule an appointment with us. We perform a comprehensive check for gum disease during your initial appointment and re-check from time to time at subsequent visits. If you have gum disease we will help you control it and restore your gums to a healthy condition.

How can I tell if I have gingivitis or periodontitis (gum disease)?

Almost four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without any noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect periodontal problems.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris and saliva is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone (in addition to causing tooth decay.) Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria. Conventional braces with bands and brackets can cause problems if not meticulously cared for.
Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives are but a few examples. Some medications have side effects that reduce saliva, making the mouth dry and therefore making it easier for plaque to adhere to the teeth and gums.
Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacterial toxins.
Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

Red and puffy gums – Gums should never be red or swollen.
Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
Persistent bad breath – Caused by bacteria in the mouth.
New spacing between teeth – Caused by bone loss.
Loose teeth – Also caused by bone loss and weakened periodontal fibers (fibers that attach the tooth to the bone.)
Pus around the teeth and gums – Sign that there is an infection present.
Receding gums – Loss of gum tissue around a tooth.
Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet and regular dental visits can help reduce your risk of developing periodontal disease.

What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition. 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 various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue; especially the back of the tongue. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent. You should brush your tongue thoroughly, extending your tooth brush as far back on your tongue as is possible. There are also tongue scrapers commercially available that can also help with the problem.
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. Less movement of the tongue during sleep is also a factor.
Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the blood stream and 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 have eaten may help identify the cause of bad breath. Also, review your current medications, recent surgeries or illnesses with Dr. Norton.

What can I do to prevent bad breath?

Practice good oral hygiene – Brush at least twice a day with an ADA approved toothpaste and toothbrush. Floss daily to remove food debris and plaque from 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 (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 currently have or have a history of periodontal disease, your dentist will recommend more frequent visits.
Stop smoking/chewing tobacco – Ask our dental hygienist what product/s are recommended 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 our dental hygienist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

In most cases, Dr. Norton’s dental hygienist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, Dr. Norton may refer you to your physician to explore other issues that may be the cause of the odor and an appropriate treatment plan for its control.

Why is it important to use dental floss?

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

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

Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.
How to floss properly:

Take about 24 inches 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. Do this up and down movement on each surface at least a dozen times.

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

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

How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth or just want to improve your smile, cosmetic dental treatments may be the answer for a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today but also because patients are becoming more and more focused on improving their overall health and appearance. This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over. Ask Dr. Norton how you can improve the health and beauty of your smile with cosmetic dentistry. He has decades of experience in this area.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink and smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree and type of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are used to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession. Our office does not do any mercury amalgam fillings. Dr. Norton has not done an amalgam filling for a patient since 1991.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped or misaligned teeth. Unlike crowns, veneers require minimal and sometimes no tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made porcelain covering that encases part or all of the tooth surface, restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed. Dr. Norton always recommends the restoration that will result in preservation of as much natural tooth structure as possible. He frequently does onlays or three-quarter crowns which save more of your natural tooth than would be kept by doing a full crown.

Dental Implants: Dental implants are artificial roots that are placed into the jaw to replace one or more missing teeth. Porcelain crowns and bridges can be made specifically to fit and attach to implants, giving a patient a strong, stable and durable solution to removable dental appliances. It is also possible to anchor partial or full dentures to implants thus giving far more stability when chewing and talking.

Orthodontics: Less visible solutions as an alternative to brackets and wires are making straightening of teeth much more appealing to adult patients. The teeth teeth may be straightened with custom-made, clear, removable aligners from Invisalign® that require no unsightly bands or brackets.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

I want my front teeth to look better, but I do not want to wear braces. What would you recommend?

There are a variety of ways to improve the appearance of your teeth without traditional metal braces. We may recommend Invisalign® clear aligners to straighten your teeth. It works through a series of invisible, removable and comfortable aligners that no one can tell you’re wearing. You can smile more during treatment as well as after. We can also improve the appearance of your teeth with veneers or bonding. If you would like to enhance the appearance of your smile, call us so we can schedule an appointment. After listening to your goals and concerns, we can suggest the best way to help you straighten your teeth and improve your smile.

What are porcelain veneers and how can they improve my smile?

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth. They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile. Some patients are good candidate for veneers that involve no removal of any tooth structure (no-prep veneers) or a minimal amount of tooth removal (minimal-prep veneers.)

Veneers may be used to restore or
correct the following dental conditions:

Severely discolored or stained teeth
Unwanted or uneven spaces
Worn or chipped teeth
Slight tooth crowding
Misshapen teeth
Teeth that are too small or large

Getting veneers requires two visits. Dr. Norton will make impressions of your teeth on the first visit. The impression is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

Sometimes very little or no anesthetic is needed for the procedure, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers. The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and a specialized light will be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.

Crowns, Veneers, Inlays and Onlays. Where can I learn more about these procedures?

At Dentistry at Sugarloaf, we believe a patient is more confident with their dental care when they are more informed. Before you come to our office, please visit other sections of our website to gain additional information. Once you come for your actual dental appointment, we invite you to participate by asking questions. We will gladly show you images of your mouth from our intra-oral camera and discuss with you the advantages of each treatment option. We can also offer a more in-depth explanation with Caesy, a multimedia patient education system. As the saying goes, “a picture is worth a thousand words,” and many of our patients have told us that the Caesy videos are very helpful.

What can I do about stained or discolored teeth?

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

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of the 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 for intra-oral use.

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker grey or yellow shade of the inner parts of the teeth. Much of the color of our teeth also comes from deeper 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 with a white speckled appearance in certain areas.

It’s important to have your teeth evaluated by one of Dr. Norton’s team members to determine if you’re a good candidate for bleaching. Occasionally tetracycline and fluorosis stains are difficult to bleach and we 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 consider replacement of any old fillings, crowns, etc. Once the bleaching is done, we 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 months or 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 takes slightly more than an hour to complete the treatment. Once your gums are protected, a bleaching solution is applied to the teeth. It stays on for a pre-determined amount of time and is then cleaned off and reapplied one or more times.

Some patients may experience tooth sensitivity during and 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!

How can I safely whiten my teeth?

There are many ways we can help you achieve a beautiful white smile. Since everyone is different, our team would like to look at your mouth before recommending a specific method. For fast results, we recommend Opalescence® Boost in-office whitening. For at home whitening, we recommend the Opalescence® home system. If your teeth are cracked, chipped, or have existing fillings, veneers or bonding may be a better choice. Please ask us for more information.

What are my options if I have missing teeth?

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, we recommended they be replaced to avoid cosmetic and other dental problems in the future.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy (shrink away), 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. 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 Partial Dentures - This method is a poor solution for replacing 1 or 2 missing and only a mediocre solution for replacing several missing teeth, especially in complex dental situations where other replacement options are not possible. They are made of tooth-colored artificial teeth combined with non-metallic clasps that hook onto adjacent natural teeth. Removable partial dentures are the most economical option for replacing missing teeth but may be the least aesthetically pleasing and certainly the most difficult for proper chewing function.

Fixed bridges – This type of restoration is generally made of a porcelain material with an underlying framework of non-metallic zirconia and is anchored (cemented) to natural teeth adjacent to the missing tooth site. The benefit is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, one or more adjacent teeth will have to be crowned (capped) to hold the bridge in place. Many times three-quarter crowns can be used so that more of the natural tooth structure can be preserved. Dr. Norton is very adamant about preserving as much of a tooth as possible.

Complete Dentures – This type of tooth replacement is used when all of the natural teeth are missing in one or both dental jaw bones (arches). Dentures are removable artificial teeth that are made to closely resemble the patient’s original teeth. Dr. Norton recommends they be anchored by implants (this is called an overdenture) for better chewing ability.

Implants – Are a great way to replace one or more missing teeth. They may also be a wonderful option to support ill-fitting dentures. A dental implant is an artificial root that is 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 of all tooth replacement options. For the teeth in the back of the mouth, the only product currently available is made of titanium metal. This may not be suitable for some people who have sensitivity to that particular metal. For teeth towards the front of the mouth there is a zirconium (non-metallic) product available but in many cases, Dr Norton doesn't recommend its use. The zirconia has far less strength than titanium and if fractured, it can be very difficult to remove.

If you are missing teeth, ask us about replacement and what options are available to you. Together we will select the best replacement solution 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.

What should I do if a tooth is knocked out?

We’re all at risk for 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:

Locate the tooth and handle it only by the crown (chewing part of the tooth that sticks out from the gum), NOT by the roots.
DO NOT scrub or use soap or chemicals to clean the tooth. If it 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.
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, you can place it under your tongue or between your lower lip and gums. You can also place the tooth in a container and cover with a small amount of your saliva or whole milk. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.
Consider buying a “Save-A-Tooth” storage container to have as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood for it to survive and possibly last for many years. So 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
Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.