How often should I visit the dentist?
It is best to visit the dentist twice a year. Regular dental exams allow us to detect dental decay, gum disease and other issues before they become complex and expensive to treat. Our goal is to keep you as free from dental problems as possible, and create a bright, healthy smile. Seeing you every 6 months, also allows us to pace the treatment you receive in order to maximize your dental insurance benefits, or to insure better affordability of care if you don’t have insurance.
How often should I brush and floss my teeth?
You should brush at least twice a day, once in the morning and once before going to bed. Additionally, you should floss or use interdental picks for cleaning between your teeth once a day.
What is the proper way to brush my teeth?
The following guidelines are important to brushing correctly:
||We recommend the use a soft bristled brush, as it is gentler on the teeth and gums. Hard bristled brushes are more abrasive and can make gum recession worse. Soft brushes, if used properly, clean just as well as hard brushes.
||Have a plan for brushing. Don't jump around randomly all over your mouth. Begin in one area, and move steadily and methodically from one side to the the other. Remember to brush not only the cheek side of your teeth, but the tongue side as well. Think "gumline" as you brush. If you get the gumline area clean, you will get the job done properly. By just brushing the tops of the teeth, you may miss most of what is important.
||Place your brush at about a 45 degree angle to your gum line. Use a gentle, but moderate pressure, along with short up and down strokes or circular movements to brush. This will insure effective cleaning without excess damage or wear to the teeth and gums.
||Spend a little extra time on the back molars. Most dental problems occur in the back of the mouth. One trick: As you brush you upper back molars, close your jaw down a bit, or even shift your jaw to the side you are brushing. This will create more room for you to get your brush back around that difficult-to-reach back corner - a spot many people miss. Make sure you feel you are getting around those back teeth. Your breath will be fresher if you do!
Can I use interdental pics instead of floss?
Yes. Cleaning between the teeth is important, and the method you use is not as important as you actually doing it. Pics should be small enough to get completely between the teeth, but not so small that they don’t do accomplish some scrubbing along the way. You should feel them contacting your tooth and gum line as you clean. Regular wooden toothpicks do not count. They are usually too big (for most people) to be effective in cleaning. If you dislike flossing, or don’t do it regularly, then try an interdental pic. We recommend the Softpick brand, or the Doctors pics. You will find them fast, easy and very effective.
What is the proper way to floss?
It is important to floss carefully and with good technique, or you will be wasting your time. After wrapping a length of floss around your index or middle finger, insert the floss between your teeth. While flossing the top teeth, some find it helpful to use their thumb on the cheek side to guide the floss. Also the thumb is much stronger, and it’s easier to push the cheek back out of the way, making access much easier.
One the floss is between the teeth, apply some pressure, pushing the floss toward the back most tooth, and begin an up and down scraping motions along the tooth surface. Then bring the floss forward and repeat the up and down scarping motion along the tooth surface on the front side of the space.
Once done, pop the floss our from between the teeth, and move to the next area. If you have questions about this, ask one of our hygienists. It's much easier to demonstrate this, than explain it in written form!
Because flossing requires some practice and dexterity, we find many patients prefer the interdental pics. If you are not a good flosser, don’t just give up. Try the pics instead. Or visit with us about which type of interdental cleaning would be best for you.
What is plaque?
Plaque is a sticky, bacterial film which constantly is forming on the teeth and tongue. If plaque is not removed, it can lead to gum disease and cavities. Brushing and flossing/picking every day, along with tongue brushing, will help prevent plaque buildup and the disease that goes along with it. In addition, avoiding sugary snacks and carbohydrates will help control plaque accumulation.
What is periodontal (gum) disease?
Periodontal (gum) disease is an infection of the gums and bone that hold your teeth in place. Typically, periodontal disease occurs when bacterial plaque and tartar builds up on the teeth and under the gum line. The gums become swollen and red in the early stage of the disease, called gingivitis. As the disease advances, periodontal disease can lead to sore and bleeding gums, loss of bone support for the teeth, deep periodontal pockets around the teeth, loose teeth and ultimately tooth loss.
What are the signs of periodontal disease?
The following are signs of periodontal (gum) disease, and you should contact your dentist if you experience any of these:
||Gums that bleed while brushing
||Red, swollen or tender gums
||Gums that have pulled away from the teeth
||Bad breath that doesn't go away
||Pus between your teeth and gums
||A change in the way your teeth fit together when you bite
||A change in the fit of partial dentures
How can I prevent periodontal disease?
Periodontal disease can be prevented by practicing good oral hygiene. This includes daily brushing (good technique is mandatory!), daily flossing/picking and visiting your dentist regularly for exams and cleanings. Also make sure to eat a healthy diet to get the required vitamins and minerals necessary for your teeth and overall health.
Why do our teeth turn yellow?
While our teeth normally start out pearly white, they naturally discolor as we get older. This is due to changes in the internal structure of the tooth, as well as to dietary factors that gradually deposit dark colors on the teeth, which are then are absorbed into the tooth structure.
What are the different types of teeth whitening options?
Below are the three most popular teeth whitening options available today:
||In-office Teeth Whitening - In-office teeth whitening works by producing a significant color change in your teeth in an appointment of about one and a half hours. The procedure is done here at the office, by applying a high-concentration peroxide gel on the teeth. This is the fastest way to lighten the color of your teeth.
||Professionally Dispensed Take-home Whitening Kits - These whitening kits are purchased from your denstist for use at home. A custom made tray is fabricated for your mouth, in which you place a peroxide based whitening gel. You then insert the tray in your mouth and wear for 1 hour. You will repeat this daily for 6 to 10 days, or until you achieve a color that you like or until the teeth lighten as much as they can.
||Over the Counter Whitening - Over the counter teeth whitening kits are those which you buy in a store and do yourself. While they are less expensive, they are typically less effective than methods that can be performed by your dentist. Additionally, these products have much less bleaching product in them, and do not have a custom tray fitted to your teeth. As a result, over the counter products are just moderately useful in our view. Try them if you like. If you are not satisfied, then contact us for a professional bleaching.
How long does teeth whitening last?
Teeth whitening usually lasts from one to three years, before darkening of the teeth is noticed. Additionally, once your teeth have been initially whitened, typically only "touch ups" are required to maintain the whiteness.
What are dental implants?
Dental implants are used for two primary purposes:
||Replacing missing teeth.
||Providing anchorage and improving stability for full and partial dentures. Implants are made of a high grade titanium metal. In the case of missing teeth, the implant is placed in the space where the tooth was lost. It is allowed to heal and integrate with the bone for a period of time. After healing, a crown is fabricated which is fastened onto the implant. For denture anchorage, the process is the same, except different attachments are fastened to the implant, which then connects with your denture or partial denture.
Implants are our preferred method for replacing missing teeth - as opposed to traditional bridge work. Dental implants are very successful, and we have been utilizing them for more than 20 years on patients in our practice.
Are implants or bridges a better choice?
In the past, a missing tooth would be replaced by a bridge or removable partial denture. With bridgework, the teeth on either side of the space must be prepared for full crowns. This means that the solution to a one tooth problem (the lost tooth), is now extended to the two teeth on either side of the space. In other words - a one tooth problem gets a three tooth solution. And if there is ever a problem anywhere on that three tooth bridge - the whole bridge is lost.
In our view, a one tooth problem ( a lost tooth for example) is best treated with a one tooth solution, that does not involve the destruction or compromising of other teeth. An implant is such a solution, and for patients who have adequate health and bone, it our treatment of choice.
Can implants be used to restore multiple teeth?
- Yes. Implants can be used to replace not only single teeth, but also multiple teeth, and even all the teeth if needed. As described above, implants can also provide much improved stability and retention for those patients who have difficulty with their full or partial dentures.
Are implants expensive?
Implant are one of the more expensive treatment options - generally running about 25% higher in cost versus a traditional bridge. However, they deliver the most realistic, true-to-form replacement for a lost tooth. We feel the advantages to an implant far outweigh their somewhat higher cost, and are the treatment we would all use in our own mouths.
How long do implants last?
Research has shown that implants are 98% successful if placed and restored by a competent dental team. We have been working with several oral surgeons for nearly 20 years placing and restoring implants - literally every week. We use only top tier laboratories and manufacturers of surgical and restorative components, to insure that you receive the best possible outcome. As such, most people find that implants will last a lifetime. We have implants that are still functioning for patients of ours 20 years after they were first placed.
What if I do not have enough bone in my jaw for implants?
Insufficient amounts of bone can be an issue for some situations and some people. We will have your bone evaluated to insure that bone levels are adequate for a good outcome. If not, grafting can be done to augment bone so that sufficient bone is created. In extreme cases, some people are not good candidates for implants. If that is the case, traditional bridgework or partial dentures can be considered.
When an implant is surgically placed, how long until I get my new tooth?
It depends - there are several possibilities. The protocols for our team involve well tested amounts of time for full integration of the implant into the surrounding bone. Here, we do not cut corners.In our view, it is not worth the risk of failure. Generally, the time frame until full completion is between 4 and 8 months, depending on your particular case. During that healing period, there are several options for temporization which we will discuss with you. You do NOT have to be without a tooth for the healing time.
What are veneers?
A porcelain veneer is a thin shell of porcelain that is bonded to the front of your tooth. It may only cover the front of your tooth, but if circumstances require, may be extended in between the teeth, covering the biting edge, and a small portion of the back of the tooth. Veneers are used primarily for cosmetic purposes: to refresh stained, discolored or worn teeth, and as a means to straighten the appearance of slightly to moderately crooked teeth.
How much of my tooth is removed with veneers?
This varies depending on what your particular needs and desires are. There are 3 possible scenarios:
||No Prep Veneers: - "No-prep veneers", are only possible in certain situations. A no-prep veneer requires no preparation or grinding of your natural tooth, which makes the process very conservative. Little or no anesthetic is required. No temporary veneers are needed. The process is 100% reversible. No-prep veneers work well when little to no color correction is needed; when there is no concern for having slightly thicker than normal front teeth; when teeth are already somewhat retruded or when teeth are already fairly straight. Spaces are easily closed with this technique, and it offers a very conservative option for creating a dynamic, highly esthetic smile.
||Minimal Prep Veneers: - Minimal prep veneers, means that your teeth are only lightly prepared. Some slight shortening of the length and/or reduction of very prominent tooth rotations may be needed. The aim of this type of preparation, is to preserve the enamel of the tooth, and avoid having to reduce into the underlying dentin. This is not only more conservative and better for our tooth, but the presence of enamel preserves our ability to obtain the strongest possible bond of the veneer to your tooth - which is real advantage in maximizing the long term retention and stability of your veneers. As with no-prep veneers, this process is best when little to no color correction is needed.
||Standard Veneers: - The more standard veneer that came into being during the 1990’s, involves a more aggressive preparation that is essentially a ¾ crown. In covers the front, sides, and part of the back of the tooth. This is done in situations where a substantial change in the form and anatomy of the teeth is required, and where needed color correction is much more pronounced. This type of veneer, though more aggressive, gives our dental laboratory technicians (“artists” is really a better term) more ability to totally remake your smile.
||Crowns: - There are some cases where teeth are so badly worn, cracked, chipped, discolored, or mis-aligned, that full crowns are needed in order to provide an optimum esthetic result and maximum durability.
Invisalign and Veneers
Invisalign is an orthodontic process to move teeth without wires and brackets. Many adults find this preferable to traditional orthodontics. There are times when some patients have such profound bite and crowding issues, that it is not possible to give them the smile they desire without first moving the teeth. Veneers and crowns can only "move" teeth so far, so in some cases, we may recommend some tooth straightening before doing any of the veneers or crowns described above. Moving the teeth prior to cosmetic procedures, may allow us so prepare the teeth less in the veneer phase of your treatment.
The material used in Veneers
Veneers are made of porcelain, and are strong and highly esthetic. Remember, there is a considerable amount of artistry involved in the design and fabrication of porcelain dental work and not all veneers are created equally. We have been working with our laboratory technicians for nearly 20 years, and have full confidence in the exceptional quality, technical and artistic excellence they bring to each and every case we do with them.
Should I bleach my teeth before doing my veneers?
Yes! We recommend bleaching as the first step in most every cosmetic case we do. Establishing a color you are happy with, or the maximally brightest color you can achieve, will then help us in deciding the most appropriate and conservative approach for your particular case.
Will my veneers change color?
Porcelain is very stain resistant and will not change in color over time. Be aware, your underlying tooth structure can darken over time, and the color of the natural tooth UNDER the veneer does impact the overall shade to some degree. Thicker veneers will cover underlying color more effectively than thinner no-prep veneers.
How long does it take to get a set of veneers, or even just one?
From the date of preparation, the time normally needed to make the veneers is 2 weeks. In certain cases, we may be able to shorten that time if special arrangements are made in advance. There is considerable artistry in cosmetic dentistry, and we don’t feel that rushing the case is normally in your long term best interest. Our goal is your satisfaction and an outstanding and brilliant smile.
Can I preview what my veneers might look like?
Yes - this is easy. First, we take impressions of your teeth and create a model. Our lab can then do what we call a “diagnostic wax up” where your case is crafted on the model in tooth colored wax. This allows you to preview exactly what we are anticipating in your case. Seeing these before and after models, relieves the anxiety that many people have in not knowing quite what their case might look like when we are done.
Secondly, if you wish, we can use this same wax up to do a mock up in your mouth, using a temporary crown material. That way you can see what the wax up would like by actually having it in your own mouth. You can even wear this home for your spouse to see if that is your wish. The mock up will last for a day or maybe two. If you find that you want to make some changes to the shape or length or any other variable - this is a great time to do that - while we are in the wax stage. Any changes needed can be incorporated into the final porcelain work.
How many veneers do I need?
It all depends on what you want, and what the deficiencies are in your smile. Sometimes we combine some bleaching, with some conservative tooth reshaping and 2 veneers - and that is all a patient might want or need. Others need 6 upper veneers to refresh their smile. Some people with very broad, or "toothy" smiles that display a lot of their teeth may need 8 veneers on the top. Some may need just upper veneers. Some may need both upper and lower. Schedule a smile analysis with us, and we’ll visit about all possible options with you.
How long do veneers last?
Ceramic veneer porcelains are very strong and they bond to your tooth very well. But remember that dental work is subject to all kinds of abuse, from extreme hots and colds, to tens of thousands of chewing cycles per year, night time clenching and grinding, not to mention the huge variation in how hard some people are on their teeth. Our goal is for all of our veneer work to last many years, and we unconditionally guarantee your case for 1 year. This is sufficient time to allow any unintended defects in materials or workmanship to present themselves. If you have an issue within 1 year, we will replace it for no charge. For people who have had a history of grinding, or worn or broken teeth, we feel it mandatory for patients to wear a night guard, or other night time appliance in order to protect their investment, and their beautiful smile. This will help to alleviate early failure, debonding or breakage of your veneers.
What is cosmetic dentistry?
Cosmetic dentistry generally comprises an elective group of procedures that are focused on appearance and esthetics - as opposed to the more routine treatment of decay, gum disease and missing teeth. Having said that, ALL of the procedures we do have a certain cosmetic component: We want all the dental work you have to look fantastic, giving you health and confidence in your everyday life.
Dr. Scott Morrell has studied extensively and has committed a large part of his practice to offering exceptional smile transformations, from the most subtle nuanced changes to extreme Hollywood style makeovers, as seen on television and in magazines.
What is the easiest way to improve my smile?
There are several steps that may be considered to transform a smile:
||Bleaching or Whitening: - For most people, the first step in any cosmetic program is to lighten the teeth. This is the most popular cosmetic procedure in the US, as well as being the least invasive and the most affordable.
||Tooth Reshaping: - We offer conservative tooth reshaping to align uneven edges and diminish overly prominent or rotated teeth. At times, a little reshaping can make a substantial improvement in the smile, and even make it appear as if you’ve had your teeth straightened.
||Bonding: - "Bonding" is the placement of composite filling material on the tooth -usually without any preparation - in order to close spaces, gaps, fix chips or fractures, or to just generally reshape the tooth. This can be very limited in scope, or depending on the case, can involve considerable reshaping and re-sculpting of the teeth. Dr. Morrell has a particularly good eye for esthetics, and has done hundreds of bonding cases over the years.
||Porcelain Veneers: - See the descriptions of veneers above. This is a more comprehensive and all encompassing approach to smile make overs, for those who have the greatest need or desire for cosmetic improvements to their smile.
||Invisalign: - Invisalign is a way of moving the teeth orthodontically without the use of wires and brackets. Straightening the teeth is not just about esthetics. Straighter teeth are healthier teeth and are easier to clean and maintain. Invisalign may be done alone, or in conjunction with the other cosmetic procedures described above.
||Gingival/Gum Reshaping: For many people asymmetry of the gingiva (gums) is a very important reason their teeth don’t look quite right. We provide reshaping procedures -which alter and improve the tissue architecture to improve smile symmetry.
What are composite fillings?
Composite is a tooth colored resin/ceramic filling material that can be bonded to your teeth to create an excellent restoration. Composite is our standard filling material for front and back teeth, and is also used to make cosmetic corrections on our patients front teeth. We have not used dental amalgam (silver fillings) for more than 22 years.
Should I get my mercury fillings removed for health reasons?
While there is no definitive data that conclusively condemns the use of silver amalgam fillings, we do not use it as a restorative material, opting instead for tooth colored composite materials or ceramics. If you have various health issues, or are concerned about having amalgam filling in your mouth, you are absolutely free to talk to us about removing and replacing them, which we are happy to do if that is your wish. We do not represent, nor promise that removal of mercury fillings will improve their health, or cure chronic or acute disease.
What are the options for mercury filing replacement?
It depends on the situation. Small to medium size cavities or fillings can easily be replaced with tooth colored composite fillings. These bond to your tooth, look great and have very good durability. Much larger size fillings can be replaced with either pressed ceramic onlays or crowns. For those even concerned about the use of composite, we can place ceramic inlays instead, though insurance will not normally cover ceramic inlays as a reimbursable service. If you have additional questions, please do not hesitate to contact us!
Is the mercury dangerous to remove?
For those concerned about the metal debris, we are prepared to use special measures to protect you. However, removal is not considered a health risk by the profession. In every case, we use high speed evacuation suction and copious water irrigation to quickly and effectively remove the filling from your mouth as it is being excavated.
What can I do about bad breath?
Bad breath is caused by a variety of factors, including the types of food you ingest, periodontal disease, dry mouth, and other causes. Seeing us will help us determine the cause of your bad breath, so you can take steps to eliminate it.
Regardless of the cause of your bad breath, good oral hygiene and regular checkups with the dentist will help reduce it. Brushing and flossing will eliminate particles of food stuck between your teeth, which emit odors. It will also help prevent or treat periodontal disease (gum disease) caused by plaque buildup on your teeth, which can lead to bad breath. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by your dentist). Finally, make sure to brush your tongue regularly to eliminate the odor causing plaque which resides on the surface of the tongue.