Resources

What To Do When You Have a Dental Emergency
What is "At Home" Tooth Whitening?
What to do about bad breath
What's the difference between tooth colored and silver fillings?
What to do with a cracked tooth
Care for new dentures
Mortenson Family Dental policy on Infection Control?
Do I really need a dental x-ray?
What is Periodontal or gum disease?
What is "Periodontal Therapy?"
What are dental Sealants?
Can those superficial spots on my teeth be removed?
What is TMJ, Temporomandibular Joint Irregularity?
What are the treatments for (TMJ)?

What to do in a dental emergency
Being prepared for a dental emergency is no accident. Knowing how to handle a dental emergency can mean the difference between saving or loosing a tooth. The most important thing is to remember to see a dentist as soon as possible.
If you have a toothache: Rinse your mouth with warm water. Use dental floss to remove any food that might be trapped between the teeth. Do no place aspirin on the aching tooth or gum.
If you have a knocked out tooth: Do not scrub the tooth or remove any attached tissue fragments. If the tooth is dirty, rinse it with running water. If possible gently insert the tooth back into the socket and hold it in place. If this is not possible place the tooth in a cup of milk.
If you have a broken tooth: Rinse your mouth with warm water especially if you have been injured and the injured area needs to be cleaned out. Place cold compresses on the injured area to decrease swelling.
If you have bitten your tongue or lip: Apply direct pressure to the bleeding area with a clean cloth. if swelling is a concern, apply cold compress. If bleeding continues, go to a hospital emergency room.
If you have something caught between your teeth: Try to remove the object with floss. Guide the floss carefully or use a floss threader to avoid cutting the gum tissue. If you are not successful in removing the object, call us immediately.
If you have a possible broken jaw: Do not move the jaw but secure it instead by tying a handkerchief, necktie or towel around the jaw and over the head. If swelling is a concern, apply cold compresses. Go immediately to the hospital emergency room.
If you have problems with braces or retainers: If a wire is causing irritation, cover the end with orthodontic wax and call Mortenson Family Dental Center for an appointment. If a wire is stuck in your cheek, tongue or gum, do not attempt to remove it. Instead, call us immediately. If an appliance becomes loose or breaks, call Mortenson Family Dental Center for an appointment and remember to bring your appliance with you.

At Home Whitening
Hydrogen peroxide has been used for many years to whiten teeth. In past years, it was usually applied only by dentists, who used heat and/or light to accelerate its bleaching action. In recent years, a highly effective technique has been found that allows patients to whiten their teeth at home-although only when supervised by a dentist.*
The "at home" technique of whitening teeth does not require heat or light, and allows you to monitor your own progress. The amount of color change depends on the length of time you wear the tray each day and the number of weeks you continue the treatment. The results can be unpredictable. Although effects may be noticed as early as a few days, many patients report that a minimum of two weeks is required to see a color change. Peroxide whitening in custom-filled trays is thus the fastest and most painless method known.
The Procedure:
Brush and floss your teeth, in order to clean them before placement of the tray. Rinse well.
Place one or two drops of whitening gel in the tray at each tooth position to be bleached. Use the gel only in the tray provided by us to fit your teeth.
Place the tray firmly over your teeth. Wipe away or spit out any excess gel and foam, and wear the loaded trays over night (a minimum of four hours) for Nite White or for a half hour to an hour in the morning and evening for Day White.
When you remove the tray from your mouth, rinse the tray with water and rinse your mouth with water. Do not eat or drink for a half hour after removing the tray.
Continue the treatment for 10 days to two weeks or until your teeth have become as white as you like.
Possible Side Effects:
Some patients have reported that teeth become sensitive to cold and biting pressure for a short time during and after treatments. The discomfort normally does not last for an extended time. If, however, your teeth continue to be sensitive, stop using the bleaching gel and call us. To reduce sensitivity use a sensitive toothpaste such as Crest Sensitive, Sensodyne, or a stronger fluoride toothpaste like prevident.
Your gingiva or gums may react to the whitening gel by creating gum sensitivity. If it does, simply decrease the amount of gel in the tray, or return to the office so we can trim the appliance in order to reduce the amount of whitening gel in contact with your gum tissue.
If whitening trays are worn too long during any given day, discomfort in your jaw points may occur. This discomfort will go away when the bleaching trays are removed.
*In the past, hydrogen peroxide was considered to be a cosmetic agent only. However, the US Food and Drug administration is now considering registering this chemical as a drug to assure its proper use and dentist supervision.

Trouble with Bad Breath? We can HELP!
For Fresh Breath and Optimum Oral Health, follow all of these steps two times per day with Breath Rx (available only at our office)
Brush with Purifying Toothpaste: Complete whitening action, Tartar Control, 1,100 ppm Flouride protection,Breath cleansing Zytex, Refreshing clean mint taste.
Scrape with the Gentle Tongue Scraper and Anti-bacterial tongue gel.
80% of bacteria is found on your tongue and brushing doesn't even come close.
Place a small amount of gel on your tongue and take it to the roof of your mouth to dispense the gel evenly. Next take your tongue scraper and fold it in the shape of a U. Place scraper as far back on the tongue as possible and scrape forward. Take scraper also on the sides of the tongue to remove that harmful, odor causing bacteria.
Rinse with the anti-bacterial/alcohol-free mouth rinse.
Rinse with the Anti-bacterial mouth rinse for 30 seconds. Zytex keeps working for hours to neutralize the sulfur compounds that cause malodor, and to kill the bacteria responsible for producing the sulfuric compounds, plaque and gingivitis.
Refresh: Use 1 of these three products for people on the go for that all-day freshness.

• Breath Rx halispheres sugar free gum: cleans the mouth, and contains xylitol, a natural sweetener which is proven to inhibit the growth of bacteria found in tooth decay while helping reduce xerostomia (dry mouth).
• Breath Rx sugar-free breath mints: pop a mint in to keep all day fresh breath. Over-the-counter mints use sugar and flavor to merely mask odor allowing it to resurface even stronger.
  Breath Rx anti-bacterial breath spray: just a spritz or two will tide you over until you can brush-scrape-rinse again.
• By using the Breath Rx management system you are well on the way toward attaining the fresh, clean breath you want and deserve

Composite VS Silver Fillings
Here at Mortenson Family Dental Center we are dedicated to providing the highest quality of dental care possible for our patients. This includes filling cavities with white composite materials (as opposed to mercury containing fillings).
The average amalgam (silver filling) is 50% mercury bonded to 30% silver and a bit of copper, tin, and zinc.
We, at Mortenson Family Dental Center, prefer not to use amalgams for the following reasons:
A tooth colored filling is stronger because it actually bonds to your tooth. The composite bonds all the remaining walls of the tooth together. Because amalgams do not bond to tooth structure, there is a gap between the filling and to tooth which significantly decreases the strength of the tooth. This gap provides a pathway for bacteria and acids to get into and cause further decay.
Amalgam fillings expand and contract so much, they create a wedge in the tooth leading to a weakened tooth structure. The tooth, over time, will eventually break apart and the only thing remaining in your mouth will be the filling.
Silver fillings are ugly. We like to give people beautiful teeth.
Currently insurance companies cover to 80% of amalgam fillings but do not cover 80% of composite fillings. Although we realize there is an increased cost to our patient, we feel that the quality of dental care associated with composite fillings greatly outweighs the added cost incurred.
Mortenson Family Dental Center will always offer our patients leading edge technology with a caring and professional attitude. We will only recommend to you what is best for your dental health and what we provide for ourselves and our families.

Cracked Tooth Syndrome
Teeth may crack when subjected to the stress of chewing hard food or ice, or by biting on an unexpected hard object. Teeth with or without restorations may exhibit this problem, but teeth restored with typical silver-alloy restorations are most susceptible. Symptoms and Signs of Cracked Teeth (some or all of the following):

• pain while chewing;
• pain upon cold air application;
• unsolicited pain (usually leakage of sugar into a tooth crack);

Treatment of Cracked Teeth:
Simple Crack. The majority of cracked teeth-about 9 out of every 10-can be treated by placement of a simple crown (cap) on the tooth. When the tooth is prepared for the crown, and a temporary restoration is placed, the pain usually leaves immediately. If this is the case with your tooth, we will place the final crown on your next appointment, and the condition should be resolved.

Your New Dentures

1. Sore spots may occur under new dentures. Do not cut or grind on the dentures-we will adjust them for you. If the soreness remains more than one day, return to our office with the dentures in your mouth so we can find the sore spot and adjust the denture for you
2. Don't overwork your dentures, they are artificial. If you had a wooden leg you wouldn't expect to run a mile in four minutes, so take it easy. Learn slowly to use your new teeth. No one can teach you how to wear your dentures. It will take time for you to learn the best technique to chew.
   Talking and eating will be difficult at first. Your mouth will seem full of water (saliva) and your tongue will feel boxed-in. Don't try to eat a juicy steak, fresh apples, corn on the cob, and similar foods, for the first few weeks. Gradually change from soft foods to harder varieties, but avoid sticky foods.
3. Keep your dentures clean to prevent staining and bad breath. Brush them at least twice a day (in your hand). You may leave the dentures in or out of your mouth at night, depending on your preference. If the dentures are out of your mouth, leave them soaking in a water and mouthwash solution.
4. We do not recommend powder adhesives when your dentures become loose (your mouth shrinks-the denture doesn't change). We suggest that you avoid drugstore denture reliners since using them can cause irreparable damage to your mouth. Have a dentist reline your dentures for best results. If you should break, chip or crack your denture, return to our office with all the pieces of the denture. We are usually able to repair your denture

Infection Control
To reduce the chance of cross-contamination of disease from patient to patient we take these important measures:

1. Face Masks: All of our staff wear face masks during active patient care. These masks preventthe spread of bacteria.
2. Rubber Gloves: New gloves are worn for every patient, and disposed of immediately after their one and only use.
3. Disinfection of Counters and Other Office Surfaces: This standard of health and sanitation procedures is performed routinely after each patient visit in every operatory and throughout all public areas of our office.
4. Equipment Sterilization: Items attached to each dental operatory-handpieces, air blowers, suction, etc. are all disinfected by heat sterilization. Our practice proudly meets and exceeds all OSHA regulations for operatory equipment sterilization.
5. Continuing Education: We are very conscious of the fact that health-threatening viruses, bacteria, and other conditions are constantly changing and evolving into new, sometimes more virulent strains. We are absolutely committed to intensive continuing education by which we remain current, informed, and capable of state-of-the-art patient protection.

But do I really need a dental x-ray
If you think you can't afford x-rays this time around, just think about whether you can afford to skip them . . .
· In the United States, 29,6000 people were diagnosed with oral cancer in 1999 and 7,925 will die from it.
· In Kentucky, 350 people will be diagnosed with oral cancer this year and 100 will die from it.
· Besides tobacco consumption, drinking more than 3 oz of alcohol a day (2 beers per week) puts you at an increased risk for oral cancer.
· About 1 of 2 people diagnosed with oral cancer will survive 5 years.
· In the early stages, oral cancer is usually not painful. This is the ideal time for your dentist to identify it in the mouth or by x-ray. Without regular dental x-rays, it's no surprise that by the time it's detected, the cancer has grown, perhaps spread, and survival rates drop.
· The American Cancer Society recommends getting a dental examination every 6 months. Also, according to the American Cancer Society: "Most medical and dental x-rays are adjusted to deliver the lowest dose possible without sacrificing image quality.
Dental X-Rays are the only way your dentist can see if tumors are growing in your jaws and beneath the surface of your gums

What is "Periodontal Disease?"
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.
Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.
In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

What is "Periodontal Therapy?"
Periodontal (gum) disease is not curable-but it is controllable.
Periodontal Therapy is a "conservative" (non surgical) program consisting of a series of 2, 4, or 6 visits to control gum disease.
If you are diagnosed with periodontal disease; pockets deeper or greater than 3 mm with bleeding points upon non-traumatic toothpick probing; your dentist may recommend a periodontal therapy program to control your disease. The severity of the periodontal disease determines the length of your program. Our goal is to eliminate bleeding and mouth odor, as well as reduce pocket depths to eliminate bacterial re-infection. Remember: healthy gums never bleed!
The therapy consists of ultrasonic scaling (a device utilized for the removal of calculus, stain, and bacterial toxins on teeth utilizing the principle of high frequency vibrations), hand scaling, root planing (smoothes roots) and curettage (removes diseased tissue), and irrigation with antibiotics. Depending on the severity of disease, we may recommend oral antibiotics, fluoride treatment, and antibacterial rinses. Also, a home-care regimen of tooth brushing and flossing is instructed in conjunction with other home-care devices (specific electric toothbrushes) which may be required for the continued health of your tissues.
We want your Periodontal Therapy to be a pleasant, comfortable, healthy and personally rewarding experience. For your comfort, topical anesthetic and local anesthetic are routinely used. As always, nitrous oxide, oral valium and tranquilizers are available for your relaxation.
After therapy, your hygienist will see you for a periodontal maintenance visit to evaluate the success of your Periodontal Therapy. Pocket depths and bleeding points will be remeasured, checked, and treated as needed.
It takes six months to one year before new gum attachment fibers become mature and more resistant to bacterial re-infection, therefore the doctor/hygienist recommends a three month recall/continuing care interval so that your level of periodontal health can be monitored and maintained. As your mouth continues healing, the interval between hygiene appointments will be evaluated according to your individual progress and the rate of calculus formation.
Your personal home care is the determining factor in the continued success of your treatment. We will do our best to assist you in any way necessary to have healthy tissues surrounding your tooth for a lifetime.

What are Dental Sealants?
Dental sealants are thin plastic coatings which are applied to the chewing surfaces of the back teeth to prevent decay. Most tooth decay in children and adolescents occurs on the chewing surfaces of these back teeth, which are called molars. This is because molars have irregular surfaces with pits and grooves which tend to trap food and bacteria debris. Sealants flow into and coat these pits and grooves so that bacteria cannot multiply and cause decay.
Why is Sealing a Tooth Better Than Filling a Cavity?
Sealants help maintain sound teeth. Decay destroys the structure of the tooth. Each time a tooth is filled or a filling is replaced additional tooth structure is lost. Amalgam fillings last an average of six to eight years before they need to be replaced. Appropriate use of sealants can save time, money, and the discomfort associated with restorative dental procedures.
How are Sealants Applied?
Applying sealants is quite simple. First, the teeth are cleaned. Then the teeth to be sealed are dabbed with a very mild acid solution similar in strength to vinegar or lemon juice. This roughens the tooth surface very slightly so that the sealant will bond to it properly. After the tooth is prepared, the sealant is painted onto the tooth. It flows into the pits and grooves and hardens in about 60 seconds. After sealing, bacteria cannot reach the pits and grooves, therefore cannot cause decay. Applying sealants requires no drilling or removal of tooth surface. Tooth structure is left intact-healthy teeth are protected from decay forming bacteria.
How Long Will Dental Sealants Last?
A sealant application can last five years and often times even longer. Sealants should be checked regularly and reapplied when they appear to have worn off. Because teeth are most susceptible to decay when they are young, preventing decay during the first 5 to 14 years after a tooth erupts is critical.
How do Sealants Fit into a Preventive Dentistry Program?
For maximum benefit, sealants should be used as part of a child's total preventive dental care. A dentist should examine the child's teeth and gums regularly to check bite, tooth eruption, and the condition of both hard and soft tissues. A complete preventive dentistry program also includes: brushing and flossing, use of fluorides, good nutrition, and regular dental check-ups.
Do Sealants Cost More Than Fillings?
The cost of sealing a tooth is significantly less than the cost of having a tooth filled.
Do Sealants cost More Than Fluorides?
No! Fluorides such as those used in fluoridated water, fluoride toothpaste, and fluoride mouth rinse help prevent decay on the smooth surfaces of teeth; however, fluorides have less effect on the rough, pitted chewing surfaces of the back teeth where food particles and decay producing bacteria are trapped. Sealants are effective on the uneven chewing surfaces.
Have Sealants Been Thoroughly Tested?
Yes! Thousands of children across the United States and in other countries have had their teeth sealed in controlled clinical studies. These studies have shown sealants to be effective, easy-to-apply, inexpensive and non-toxic.
That is why sealants have been recommended by the American Dental Association, the National Institute of Dental Research, and the American Public Health Association.

Removal of Superficial Spots on Teeth
There are many reasons for superficial white, brown, gray, or orange spots that appear on tooth surfaces. In some cases, heredity is the cause. Cigarettes, coffee and tea also can cause superficial spots. Tetracycline has been shown to cause stains that range in color from yellow to orange to brown to blue-gray. (Tetracycline ingested between the ages of four months prior to birth to nine months after birth can often affect primary teeth-and, if taken during the first nine years of life, can affect permanent teeth with superficial spotting.)
Regardless of their origin, these spots are objectionable (unsightly), and may be removed in one or more of the following ways:
Microabrasion: For removal of a small amount of the discolored tooth structure an abrasive solution is the most conservative method used. This method, microabrasion, which is painless (requiring no anesthetics), is usually very fast, relatively inexpensive, and produces a permanent result. We will advise you if this procedure is appropriate for the superficial spots on your teeth.
Restorations: Spots or discolorations which go deeper may be eliminated through small restorations.
Veneers/Bonding: If there are multiple or very deep discolorations, thin custom-made pieces of plastic or porcelain called veneers can be bonded to the surface of the teeth to cover the spots. Veneers provide an excellent appearance and have a longevity of several years.
We recommend beginning with conservative microabrasion if possible. If this is successful, additional treatment is not necessary. When the spots are too deep, small restorations may be needed; if the spots or discolorations are very deep, veneers will be recommended at the outset.
NOTE: Smoking, coffee, and tea stains are usually superficial and will be removed by the hygienist at your routine cleaning, or by using one of our whitening products.

TMJ
Temporomandibular Joint Irregularity Some 60 million Americans have TMJ. Simply put, TMJ is the syndrome that happens when the muscles in the jaw and the temporomandibular joint are out of alignment or misaligned, causing problems when chewing. In plain English, the ligaments, muscles, bones and joints do not line up, causing pain.
Some Symptoms Associated with TMJ:
a clicking, popping or grating sound when opening or closing the mouth
headaches and/or dizziness
tenderness in the jaw muscles
ear ache
jaws that sometimes lock open when yawning or if mouth is held open
spasm or cramps in the jaw area (very common)
What Causes TMJ? These are the most common causes:
accidents
developmental (natural) defects, including the wearing-down of teeth or fillings causing a misalignment of the teeth
surgery
orthodontics
stress that causes clenching of the jaws and grinding of the teeth
naturally misaligned teeth
What Can be Done to Correct TMJ?
If the temporomandibular area has been damaged by arthritis or as a result of an accident, surgery may be needed to correct the TMJ and re-establish the proper occlusion. Far more likely, your doctor will recommend a therapy that may include a bite splint and specific exercises to keep the teeth from touching and to allow the joint to remain lined up, allowing the jaw's hinge area to relax. Such therapy increases your comfort by diminishing the TMJ pain. If a splint is prescribed for you, it is very important that you follow your doctor's instructions regarding the amount of time and time of day you must wear it.
If your condition is temporomandibular joint irregularity (TMJ), you need to wear your splint all the time unless directed otherwise. Do not remove the splint when you eat, as this would compromise your treatment and diminish its effect. The splint stops tooth-to-tooth contact and keeps your jaw lined up properly, allowing the muscles and joint area to heal. As this healing takes place and the symptoms gradually disappear, your doctor will adjust your splint to keep your teeth properly aligned. During this period of your therapy, you will begin wearing the splint fewer hours of the day and, after a period of time, you will no longer need to wear a splint.
Grinding ("bruxism") and Clenching: These conditions require you to wear your splint only at night while sleeping.
Clean the splint by brushing it. Keep it in water and mouthwash solution when it is not in your mouth.

Physical Therapy for Temporomandibular Joint Irregularity (TMJ)
The purpose of this therapy is to "train" your lower jaw to function freely and without pain. Many situations cause the malfunction of your lower jaw. Examples are: accidents, surgery, developmental defects, peculiar oral habits, numerous fillings placed over many years, orthodontics, stress, bruxism (clenching or grinding of teeth), and other conditions.
The following therapy will usually relax the jaw muscles considerably if you are consistent in carrying them out. Approximately 80% of patients with muscular jaw problems feel better when doing this therapy.
Therapy:
Heat. Apply heating pad, hot washcloth, hot water bottle, or other heat source to the affected areas for five (5) minutes before beginning exercise.
Exercises. Carry out the following exercises for one (1) minute each (total of 5 minutes):
Open-Close. Place fist under front of jaw to resist opening movement. Do not cause pain. Be gentle. Open and close jaw 30 times in one (1) minute.
Forward. Move jaw forward and back with fist on front of chin.
Right. Move jaw to right with fist on right front of chin to resist movement.
Left. Move jaw to left with fist on left front of chin to resist movement.
Neck Turn. Sit up very straight. Rotate head as far right as possible and gently force turn once every two (2) seconds for 30 seconds. Turn head to left and repeat.
Heat. Apply heat for another five (5) minutes.
Further treatment may be needed to assist in your treatment. This may include a plastic bite splint to assist in making you bite in the correct position (an "occlusal splint"), or slight, careful trimming of teeth and fillings to make your teeth and jaws come together correctly ("occlusal equilibration").
Please call us if you have any questions or concerns either now, or at any time during your therapy.