FAQs

GUM CARE (PERIODONTALCARE)

What is 'plaque' and how does it affect my teeth?

Plaque is a colorless, sticky film of bacteria that constantly forms on teeth. If left undisturbed, it hardens to form tartar. The bacteria in the plaque produce byproducts that can not only irritate the gums and make them bleed, but it can also lead to periodontal disease. A daily regimen of proper brushing, flossing and rinsing (plus, regular dental visits), will help you keep your teeth healthy.

My gums bleed when I brush or floss. Is this normal?

Healthy tissue doesn't bleed. This is most likely a sign of early gingivitis. If you experience bleeding gums, see your dental health professional to review proper brushing and flossing techniques. Schedule a soft tissue evaluation with your dentist that will include x-rays and prophylaxis cleaning. Gum bleeding must be taken seriously because if left untreated, it will lead to periodontal disease.

How often should I have my teeth cleaned?

People accumulate plaque at different rates. Although most insurance plan coverage is for a twice a year schedule, it's sensible to get your teeth professionally cleaned as often as your dental health professional advises you, even if it's every 3 months.

How many times should I floss my teeth?

At least once a day. There's an old adage among dentists: “Floss only the teeth you want to keep.” If you don't want to lose your teeth, floss every day. Otherwise, you'll be 75% more susceptible to periodontal disease that has been documented to have serious health consequences, e.g. a higher likelihood of heart disease, diabetes, pneumonia and infections. About 45% of American adults have some form of gingivitis, and most adults over 60 have already lost their teeth. Don't be one of them. Floss at least once a day.

How Bad Breath Occurs?

Bad breath occurs when sulfur compounds are produced in the body and released into the air. The most common source of this sulfur is anaerobic (without oxygen) bacteria that live in the grooves or fibers at the back of the tongue. These bacteria produce the sulfur that gives off an unpleasant smell. This frequently occurs when the mouth is dry, creating an ideal environment for anaerobic bacteria to thrive. Sulfur compounds are also produced when certain types of food are consumed. The compounds make their way into the bloodstream and then to the lungs, where they are excreted into the air we exhale.

Causes of Bad Breath

Bad breath is caused by many factors. Normally, saliva helps wash away the natural buildup of bacteria in the mouth and on the tongue. Yet, when saliva sits on the back of the tongue and is digested by bacteria, it shows up as a white film on the tongue. This is a major source of bad breath. Bad breath is also caused by postnasal drip, a condition where the back of the tongue and throat accumulate high amounts of protein, which bacteria thrive on. Foods that are high in protein or acidity, such as fish, milk, cheese or coffee, also cause bad breath. Dieting or fasting, both of which involve a low intake of calories, causes bad breath by reducing the saliva in the mouth. Contrary to popular belief, stomach problems do not cause bad breath.

More Serious Causes

More persistent problems with unpleasant breath can indicate diseases such as diabetes, liver dysfunction, pulmonary disease, and respiratory disease. Periodontal pockets, the spaces that form between the teeth and gums, are another source of bad breath. These pockets, which occur in the latter stage of periodontal disease, create spaces for bacteria to grow, and give off a chronic unpleasant odor. Dental work may be required in order to remove these pockets of bacteria. Periodontal disease is detected by the presence of bleeding gums, loose teeth, receding gums, or pain when chewing.

For more information on this condition, please refer to the Periodontal Disease section of our Patient Education Library.

Prevention

Proper oral hygiene eliminates many cases of bad breath. Daily brushing and flossing removes the plaque and bacteria that often cause bad breath. While brushing, take special care to thoroughly brush the back of the tongue where bacteria normally collect. Mints and mouthwashes can hide bad breath, but do not eliminate this condition. Avoid foods that have powerful odors and drink lots of water to insure that the mouth is cleansed and full of oxygen (an environment in which bacteria do not thrive). For information on current treatments, contact a dentist in your area regarding current products on the market that can eliminate bad breath

ORAL SURGERY

What are wisdom teeth?

Also called third molars, wisdom teeth usually make their first appearance in young adults between the ages of 15 to 25. Because most mouths are too small for these four additional molars, an extraction procedure, sometimes immediately after they surface, is often necessary.

When should wisdom teeth be removed?

The following symptoms may indicate that the wisdom teeth have erupted and surfaced, and should be removed before they become impacted -- meaning, the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently.
Symptoms may include:
pain infection in the mouth, facial swelling, swelling of the gum line in the back of the mouth. Most oral health specialists will recommend an immediate removal of the wisdom teeth, as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar.

What problems are often associated with impacted third molars?

  • Bacteria and plaque build-up
  • Cysts development (a fluid-filled sac)
  • Tumor development
  • Infection
  • Jaw and gum disease

What is involved in the extraction procedure?

Wisdom tooth extraction surgery involves removing the gum tissue that presides over the tooth, gently detaching the connective tissue between the tooth and the bone, removing the tooth, and suturing the opening in the gum line.

What is a Dry Socket?

Dry Socket is the most common complication of extraction. (removing a tooth) Most commonly associated with wisdom teeth extractions & lower molar extraction. Dry Socket is one in which the patient is having pain due to the loss of the blood clot from the socket following extraction, thus exposing the bone to air, food, and fluids. Patient experiences excruciating pain along with an offensive odor. This often occurs two or more days after an extraction and can last about 5-6 days.

This condition occurs most commonly -

  1. In individuals who smoke before their recommended time. Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue and the negative pressure of sucking removes the blood clot from the surgery site.
  2. If you do not care for your extraction site as instructed by staff.
  3. Not following your home care instructions.
  4. Sucking action from smoking, sneezing, coughing, spitting or sucking, within the first 24 hours.
  5. Women taking oral contraceptives are more susceptible.

DENTAL EMERGENCIES

How to handle a Dental Emergency?

According to the American Dental Association, the difference between saving and losing a knocked out tooth, is the thirty minutes following the incident.

To save the tooth, follow these steps:

  • Rinse the tooth in tap water.
  • Avoid scrubbing the tooth.
  • Insert the tooth into the empty socket quickly.
  • If you are uncomfortable inserting the tooth, put the tooth in milk or water Get to the dentist immediately.

Common Dental Emergencies

Broken tooth/Fractured tooth

Although teeth are the strongest substance in the whole body, they may chip or break due to various reasons. Some of the most common reasons are biting into something hard accidentally, tooth with a large filling, root canal treated tooth that is not capped and tooth undermined due to decay.

What to expect

Depending on the extent of fracture your tooth may be sensitive to temperature and pressure changes. Rinse your mouth gently with lukewarm water. Take a pain reliever if needed. See your dentist as soon as possible so he can determine the course of treatment.

How is it treated?

Fractures may involve only the superficial outer part of the tooth (enamel). In such a case your dentist may lightly polish the area to smooth the rough surfaces or place a filling and observe the tooth for further changes.

If the fracture involves the enamel and the inner sensitive dentin your dentist may have to place a crown due to the extent of involvement. This will protect the tooth and prevent further damage.

Sometimes fractures may involve the enamel, dentin and the nerve tissue inside the tooth. This will necessitate a root canal treatment and a crown. If the crack extends beyond the gum line it may require a crown lengthening procedure, which involves removal of bone to grasp enough healthy structure for the crown.

However, if the crack extends to the root the tooth cannot be saved and will have to be removed.

Canker sores

Canker sores are shallow, painful sores in your mouth. They are usually red or may sometimes have a white coating over them. You may get them on the inside of your lips, the insides of your cheeks, the base of your gums or under your tongue. Canker sores are different from fever blisters, which usually are on the outside of your lips or the corners of your mouth.

Anyone can get canker sores, but women people in their teens and 20s get them more often. Canker sores may run in families, but they aren't contagious. Causes of canker sores are unknown but they may be triggered by stress, poor nutrition, food allergies, spicy foods and menstrual periods.

Treatment
Canker sores usually go away without treatment. However, for pain relief your dentist may recommend medicines such as Anbesol, Oragel, Orabase and Zilactin-B, which may prevent your canker sores from becoming irritated by eating, drinking or brushing your teeth. These medicines can be applied directing on the sore with your finger tip or a Q-tip. Gently dry the sore with a swab before applying. Do not eat or drink anything for 30 minutes after applying.

Prevention
Unfortunately, causes of canker sore formation are unknown. However, using toothpaste that does not contain SLS (sodium lauryl sulphate), avoiding hard, crunchy or spicy foods and chewing gum may help reduce mouth irritation. Brushing your teeth after meals, using a soft toothbrush and flossing every day will also keep your mouth free of food that might cause a canker sore. If you get canker sores often, or if they're very painful, talk to your dentist.

Operculitis

Operculitis is an inflammation of the gum tissue found over partially erupted teeth. The most frequent site is the mandibular third molar region. The heavy flap of gingival tissues covering portions of the tooth crown of the tooth makes an ideal pocket for debris accumulation and bacterial incubation. In the acute phase, pain and swelling in the area are prominent features. Symptoms of a sore throat and difficulty in swallowing may be present. A partial contraction of muscles of mastication, causing difficulty in opening the mouth (trismus), may also be experienced. Abscess formation in the area may occur, leading to marked systemic symptoms of general malaise and fever.

Treatment involves careful cleaning below the flap and saline irrigation. It may also require antibiotic therapy if the condition warrants. Your dentist may decide to incise the gingival flap to make the area self cleansable. If in the third molar area it may require the extraction of the tooth.

MISCELLANEOUS

BRUXISM – (Paranormal tooth grinding)

What is bruxism?

Bruxism is the term that refers to an incessant grinding and clenching of the teeth, unintentionally, and at inappropriate times. Bruxers (persons with bruxism) are often unaware that they have developed this habit, and often do not know that treatment is available until damage to the mouth and teeth have been done. Damage caused by bruxism often includes the following symptoms. However, each individual may experience symptoms differently.

Symptoms may include:

  • Abraded teeth
  • Facial pain
  • Oversensitive teeth
  • Tense facial and jaw muscles
  • Headaches
  • Dislocation of the jaw
  • Damage to the tooth enamel, exposing the inside of the tooth (dentin)
  • A popping or clicking in the TemporoMandibular Joint (TMJ)
  • Tongue indentations
  • Damage to the inside of the cheek

The symptoms of bruxism may resemble other conditions or medical problems. Consult a dentist or your physician for a diagnosis.

What causes bruxism?

Although this habit is unintentional, oral health specialists often point to excessive stress and certain personality types as typical causes of bruxism. Bruxism often affects persons with nervous tension such as anger, pain, or frustration, and/or persons with aggressive, hurried, or overly-competitive tendencies.

Treatment for bruxism:

Treatment may involve:

  • Behavior modification
  • Night Guard
    - A specially-fitted plastic mouth appliance may be worn at night to absorb the force of biting. This appliance may help to prevent future damage to the teeth.
  • Biofeedback
    - Biofeedback involves an electronic instrument that measures the amount of muscle activity of the mouth and jaw -- indicating to the patient when too much muscle activity is taking place so that the behavior can be changed. This is especially helpful for daytime bruxers.

Office Hours

Monday 8:30 AM 5:00 PM
Tuesday 8:30 AM 5:00 PM
Wednesday 8:30 AM 5:00 PM
Thursday 8:30 AM 5:00 PM
Friday 8:00 AM 2:00 PM
Saturday Closed Except Emergencies
Sunday Closed Except Emergencies

Our Address

Dr. Sam F. Khoury
3000 Alamo Drive, Suite 206,
Vacaville, California 95687

707-451-1311

707-451-1325

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