Frequently Asked Questions

• What can I do about bad breath?

  • If you’re constantly worried about bad breath, you’re not alone. Bad breath (halitosis) is one of the most common dental concerns, and it can be embarrassing and distracting for you and others around you. Deducing the cause of your bad breath will help determine what you can do to prevent it.

    Reduced saliva flow during sleep (the cause of morning breath), certain foods (garlic, onions and peppers), poor oral hygiene, periodontal disease, dry mouth, tobacco, dieting, dehydration and some medical conditions (including sinus infections and diabetes) can all cause bad breath. Brushing your teeth in the morning and at night is the most important step, and brushing after every meal is even better. If you can’t brush, chewing sugar-free gum can loosen food particles from between your teeth. In addition to brushing, clean between your teeth daily with floss or an interdental cleaner, and don’t forget to brush your tongue. Brushing your tongue, especially the back areas, will make a big difference in how clean your mouth feels and smells. If you wear dentures, always remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every couple months.

    Biannual dental cleanings and checkups at our office will not only keep your teeth and gums in good shape, but seeing you regularly will also allow us to better detect any problems, such as gum disease, dry mouth (Xerostomia) or severe decay, that could be causing persistent bad breath. If you have gum disease, more frequent visits to our office might be recommended for your oral and overall health.

    Breaking a tobacco habit (smoking or chewing tobacco) can significantly improve your oral health and the way your breath smells. Ask us for tips on how to drop tobacco for good. Staying hydrated and having a balanced diet also keeps your mouth moist and more free of bad bacteria. Mouth rinses can help, too, but ask us which rinses actually kill the germs that cause bad breath, because some only mask odor as a temporary solution.

    When bad breath is a symptom of a larger bacterial problem in your mouth, Dr. Segrist can help. If he finds that your mouth is healthy, he might refer you to your physician for further consultation and more comprehensive treatment.

• I don't have a toothache, and I brush and floss regularly. Do I really need a check-up?

  • Biannual teeth cleanings performed by a skilled dental hygienist are central to keeping teeth and gums looking, feeling and functioning well. If you have gum disease, more frequent visits to the dentist will probably be recommended for your oral and overall health.

    During cleanings, plaque and calculus (more commonly known as tartar) are removed from teeth. Plaque is a sticky deposit on teeth in which bacteria grow, and tartar is basically calcified or hardened plaque, so it is more difficult to remove. When tartar builds up under the gumline, more extensive treatment than a standard cleaning is needed to remove it and help ensure healthier gums. Hygienists also polish and floss teeth, then document any bleeding, stains or other areas of concern that were noted during the cleaning.

    Dental exams with a dentist ensure that problems are diagnosed and treated before they become more painful and expensive. A typical exam includes a visual assessment of teeth and occlusion (bite), along with an appraisal of current restorations. When x-rays have been taken, the dentist will carefully review them to identify areas of decay and other possible areas of concern for cysts, tumors and other disorders of the mouth. Panoramic x-rays are especially revealing and beneficial to this process. Most dentists will also perform a general screening for early detection of gum disease and oral cancer.

• If I don’t have a toothache and my filling is still in place, why does my dentist want to replace it?

  • Constant pressure from chewing, grinding and/or clenching causes dental fillings to wear away, chip and sometimes break. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling and expose your tooth to more extensive damage. Untreated decay can progress to deeply infect the tooth or even cause an abscess. Though restorative materials have come a long way and many fillings can last for up to 20 years, most will eventually need to be repaired or replaced. Regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.

    When restorations are large or decay is extensive, there is sometimes not enough of the remaining healthy tooth to support a replacement filling. In these cases, your dentist may need to replace the filling with a natural looking porcelain crown.

• How can I tell if I'm at risk for gum disease?

  • According to MedlinePlus, a service of the U.S. National Library of Medicine and National Institutes of Health, about 80 percent of U.S. adults currently have some form of gum disease, ranging from gingivitis to serious periodontal disease. If your gums feel tender or look red and swollen, you could be at risk. Other signs include bleeding and/or receding gums, pain or sensitivity in your teeth and persistent bad breath. Left untreated, gum disease can lead to tooth loss and increase your risk of heart disease and stroke.

    The first thing to do is get a thorough dental evaluation. If you have any degree of periodontal disease, Dr. Segrist can help. He strongly believes in and focuses on the importance of healthy gums and offers a variety of surgical and non-surgical treatments, including deep cleanings, local antibiotics and special rinses.

• Is there anything that can calm my nerves during an exam?

  • Nitrous oxide is one of the safest anesthetics used in dentistry. Nitrous oxide is a colorless blend of oxygen and nitrous oxide gases with a sweet smell and taste. It is also known as "laughing gas." Inhaling nitrous oxide creates a sense of well-being and relaxation, and it is used effectively to help individuals who experience anxiety or fear about dental treatment feel more comfortable and at ease. Nitrous oxide increases a patient's pain threshold and, when necessary, makes the administration of anesthetic injections more comfortable. Combined with a caring dental staff, nitrous oxide has proven to be especially beneficial for children and adolescents who experience dental anxiety. It has also been found helpful for patients with a strong gag reflex that interferes with dental treatment. Nitrous oxide can help make visits to the dental office less difficult for individuals with mental or physical disabilities as well. Dr. Segrist uses specialized equipment which is routinely checked and calibrated to monitor the amount of nitrous oxide released and adjust the flow rate to each individual patient. The gas is administered by trained members of our dental team.

    Nitrous oxide has few side effects and/or risks. It is non-addictive, and patients remain fully conscious during treatment. Nitrous oxide is administered comfortably with a mask over the mouth and nose, and a pleasant feeling of calm and sedation are felt almost immediately. Normal breathing of pure oxygen for several minutes after dental treatment is finished completely reverses the effects of the nitrous oxide, so adults can usually leave the dental office of their own accord.

    Some individuals may experience nausea if nitrous oxide is administered on a full stomach. For this reason, it is advisable to limit food intake for several hours before treatment, although fasting is not typically necessary. Nitrous oxide is not effective if a patient suffers from claustrophobia (because of the mask used to administer the gas), or has extreme dental anxieties. Because nitrous oxide is inhaled, it is also not effective if the patient has blocked nasal passages. For unknown reasons, it does not affect about 10% of individuals.

• What is comprehensive dentistry?

  • Our aim is to have all concerns and issues known and resolved before an emergency occurs. After all, there’s never a convenient time for a toothache or a broken tooth. We see patients for many reasons with many different needs, from routine preventive care and dental emergencies to life changing restorative and cosmetic treatments.

    A large part of comprehensive dentistry is the development and fulfillment of ongoing maintenance plans, which helps minimize the chance of original problems reoccurring. After your exam and consultation, we will work with you to customize a treatment plan that fits your individual needs and budget. Good oral hygiene at home is also important, but man cannot live by toothbrush alone. In-office exams are critical to keeping your smile healthy, because your dental team has the ability to remove plaque your toothbrush can’t. Panoramic x-rays and intraoral cameras help them monitor structures that aren’t always obvious to the naked eye.

    In a way, comprehensive care really refers to our commitment to the present and the future of your smile. We want to keep it healthy, keep it beautiful, and help you keep it for the rest of your life.

• A couple of my teeth have been worn down and need to be replaced. Should I opt for crowns?

  • Crowns cover teeth to restore them to their appropriate shape and size after they’ve been altered by large fillings, fractures or weakening forces such as intense grinding. In all of these cases, crowns not only cover teeth but provide added support as well. Crowns can also be used to attach bridges, cover dental implants, restore seriously discolored or misshapen teeth and even as a preventive measure to protect a tooth in danger of breaking. Crowns can be made of all-porcelain (ceramic) material, porcelain fused to metal (for added strength), gold alloys (high noble), or base metal alloys (non-noble). Each material has its advantages and disadvantages. All-porcelain restorations most closely mimic natural tooth appearance, but because their strength depends on adequate porcelain thickness, they tend to require more extensive preparation. Porcelain fused to metal alloy restorations are tooth-colored and stronger than all-porcelain crowns. Gold alloy crowns are very strong and wear resistant, but they do not match natural teeth. Base metal alloy crowns are similar to gold for strength and durability; however, allergy to the non-noble base metals may be an issue with some patients.

    Crowns can be placed in as few as two appointments. Porcelain crowns can take more visits to prepare the tooth and get the color of the restoration just right, but the natural looking results are worth it to most patients. Crowns in general are very strong restorations, and if they’re placed in the early stages of decay, they can even reduce your risk of needing a root canal or dental implant in the future.

    Despite their excellent restorative capabilities, crowns have a few disadvantages. Since they are more extensive restorations than fillings, their relative cost is higher. However, if our doctors recommend a crown it is because we want to help you keep your teeth healthy and looking good for years to come. Due to normal wear, most crowns will eventually need to be re-cemented or replaced. Six to nine percent of teeth that are damaged enough to need a crown eventually require a root canal.

• My dentist told me I'm going to need root canal therapy. What should I know before my appointment?

  • Beneath the top layer of your tooth (the enamel) and the second layer (the dentin), there is a pulp, or nerve, which delivers sensations such as heat, cold and pain to the brain. Whether from excessive decay or physical trauma, this nerve can become damaged, causing an abscess to form at the root of the tooth. Your dentist has recommended root canal therapy, a procedure in which the diseased pulp is removed from an infected tooth, to prevent further damage and to relieve your pain.

    Symptoms of an infected root include severe toothaches, sensitivity, discoloration and upraised lesions on your gums. X-rays and a thorough dental examination will help your dentist determine whether a root canal is your best option. Though root canal therapy has a reputation for being painful, the toothaches associated with an infected root are probably causing you more pain than the treatment will. Your dentist also has a number of ways to relieve any discomfort during treatment, including nitrous oxide and oral sedation.

    The nerve is not necessary for day-to-day function, so removing it will have no negative effect on the tooth. In fact, allowing it to decay further will eventually lead to more pain and bone loss. An over the counter pain medication usually takes care of immediate post-operative discomfort, and most patients return to normal activities the very next day. Root canal therapy is highly successful, and a tooth receiving the treatment can last you a lifetime. Especially when used in conjunction with a restoration (a crown or composite filling), no one will even notice a difference in your smile.

• Hot or cold, my teeth hate both! Why are they so sensitive, and how can I stop the pain?

  • If you’ve been avoiding that ice cream cone or cup of coffee because of sensitive teeth, you don't have to! Sensitivity is a common complaint, and can be the result of a number of factors. Involuntary tooth grinding, jaw clenching, gum recession, and enamel loss can all cause teeth to become extra sensitive, because the usually-protected layer of dentin (the nerve-packed surface beneath the enamel) is exposed to external stimuli. Surface irritants such as braces and teeth whitening can also cause temporary sensitivity.

    Because the causes of sensitivity are so diverse, and because sensitive gum tissue can indicate a more serious problem, it’s important to ask your dentist which treatment is best for you. A softer toothbrush is usually the first step, and special toothpastes can reduce sensitivity over time. There are also over-the-counter fluoride rinses to protect your enamel against further damage, and your dentist can even provide an in-office procedure to coat your teeth with a protective agent.

• I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What's the problem?

  • You could be suffering from temporomandibular joint disorder, or TMD, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.

    TMD has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in an effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of TMD. TMD can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.

    Professional treatment of TMD ranges from minor fixes to surgical options. If your dentist determines that the main cause of your discomfort is an irregular bite, he or she may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet. If it's a structural issue occurring in your jaw bone (especially if your TMD is a result of injury), you may benefit from surgery. When it comes to TMD treatment, it's important to choose the most conservative plan for your individual needs.

    In the meantime, alleviating the pain through treating the symptoms can give you some relief. Heating pads or cold compresses can reduce swelling, and limiting your jaw movement (for example, cutting especially chewy foods out of your diet) can stop the clicking or popping. Massages can temporarily relieve muscle tension, and painkillers (medicated or over the counter) can reduce inflammation and make you more comfortable.

• Is professional teeth whitening safe?

  • You have a wide variety of options when it comes to whitening your teeth. Depending on your schedule and your brightening expectations, you and your dentist can decide which is best for you. With in-office whitening, you can get a brighter smile in about an hour. We also offer convenient take home whitening kits that help you achieve the professional results you want in the comfort of your living room.

    Teeth whitening is completely safe, and some products, including certain whitening toothpastes and take-home kits available through us, have been evaluated and approved by the American Dental Association (ADA). While having the ADA seal of acceptance is a good sign, many safe and effective products don't have an ADA seal simply because their manufacturers did not seek one. Bleaching is not recommended for children under 16, as their teeth are still developing, and is also not recommended for women who are pregnant.

    The most common side effect of teeth whitening is sensitivity. It’s usually temporary and subsides soon after you've stopped using the product.

• Why is fluoride good for my teeth?

  • Each day, foods and acids feed bacteria in your mouth, which can accumulate on your teeth to form plaque. Plaque wears away at a tooth's enamel in a process known as demineralization. Fluoride is a naturally-occurring mineral that can promote the remineralization of enamel, replacing important minerals that strengthen your teeth and can protect them from decay. Fluoride can also help reverse early stages of decay.

    Children with newly-erupted permanent teeth benefit a great deal from fluoride exposure, but adults should make sure their teeth come into contact with it, too. The safe and easy way to ensure your teeth are getting enough fluoride is to use fluoride toothpaste, available at drugstores in a variety of types and flavors. If your dentist recommends more intensive fluoride treatments, there are a number of gels, rinses and in-office procedures that can do the trick. Though the most fluoride is absorbed from direct contact with the teeth, many public drinking water systems contain safe amounts of fluoride that can have positive health effects.

• What causes tooth discoloration?

  • The two main types of tooth discoloration are extrinsic (external or surface stains) and intrinsic (internal stains). Extrinsic stains affect the outside of the tooth and can be attributed to anything that comes into contact with the tooth’s surface: red wine, coffee, tea, tobacco products or darkly colored foods. Intrinsic stains discolor a tooth from within, and they usually reflect the condition of the tooth. Intrinsic staining is commonly caused by invasive dental treatment, exposure to excessive amounts of fluoride (Fluorosis) and certain antibiotics.

    How well your teeth will react to whitening depends largely upon the type and degree of discoloration. Severely discolored teeth often benefit from veneers or cosmetic bonding. Your dentist can determine which type of stains you have and which treatments will work best for you.

• What could be causing my dry mouth, and what can I do about it?

  • Signs of dry mouth include a sticky feeling or burning sensation in the mouth, insufficient saliva and an altered sense of taste. Dry mouth is one of the leading causes of chronic bad breath, and it can also make teeth more prone to decay and soft tissue more susceptible to infection.

    Dry mouth is a known side effect of many medications, from prescriptions to over-the-counter antihistamines. Inflammatory medical conditions such as diabetes can also cause recurrent dry mouth, as can cancer treatments (chemotherapy and radiation), hormone fluctuations and high levels of stress.

    Dry mouth is especially common in the elderly and the very young, but it can affect people of all ages. Because insufficient saliva endangers the health of your entire mouth, it’s important to ask your dentist about oral sprays, prescription drugs or simple lifestyle changes that can provide relief.