Plaque is a sticky layer of material containing germs that accumulates on teeth, including places where toothbrushes can’t reach. This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day. The toothbrush cleans the tops and sides of your teeth. Dental floss cleans in between them. Some people use waterpicks, but floss is the best choice.

Should I floss?

Yes. Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Floss is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don’t spend enough time flossing or brushing and many have never been taught to floss or brush properly. When you visit your dentist or hygienist, ask to be shown.

Which type of floss should I use?

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridgework. Tapes are usually recommended when the spaces between teeth are wide.

They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss.

How should I floss?

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don’t cur off your finger’s circulation!)

Wind the rest of the floss similarly around the same finer of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don’t pull it down hard against your gums or you will hurt them. Don’t rub it side to side as if you’re shining shoes.

Bring the floss up and down several times forming a “C” shape around the tooth being sure to go below the gum line.

The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gumline forming a “C” on the side of the tooth.

How often should I floss?

At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

What are floss holders?

You may prefer a prethreaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss, or for caretakers who are flossing someone else’s teeth.

Is it safe to use toothpicks?

In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. Toothpicks come round and flat, narrow and thick. When you use a toothpick, don’t press too hard as you can break off the end and lodge it in your gums.

Do I need a waterpick (irrigating device)?

Don’t use waterpicks as a substitute for toothbrushing and flossing. But they are effective around orthodontic braces that retain food in areas a toothbrush cannont reach. However, they do not remove plaque.

Waterpicks are frequently recommended for persons with gum disease when recommended by your dentist. Solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist’s prescription, can be added to the reservoir.

Many people have had their teeth whitened, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is common, and tooth whitening safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth whitening is dentist-supervised.

We offer several options including take-home whitening kits and in-office whitening procedures.

Is whitening for you?

Generally, whitening is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth whitening if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond best. Other types of grey stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage whitening as those conditions could cause more problems during the procedure.

What’s involved?

First, the dentist will determine whether you are a candidate for tooth whitening and which type of procedure would provide the best results.

If you’re in a hurry for whiter teeth, you may decide to have your teeth whitened in the office. Your dentist will use either an in-office whitening system or light-assisted whitening while you sit in the dental chair. Some patients choose dentist-supervised at-home bleaching, which is more economical and provides the same results with a longer treatment time.

At the next appointment the dentist or hygienist will make impressions of your teeth to fabricate a custom tray appliance for you. The tray is made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The appliance is so thin that you should even be able to talk and work while wearing your tray. You will be given instructions on how to wear the appliance and apply the whitening gel.

Some whitening systems recommend using trays from two to four hours a day. Generally this type of system requires two to three weeks to complete, and works well on patients with sensitive teeth. Other systems recommend whitening at night while you sleep and usually require only 10-14 days to complete.

How long does it last?

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee, red wine, and tea. At this point you may choose to get a touch up. The retreatment is much shorter than the original treatment time and the same trays and whitening gel is used.

How does it work?

The active ingredient in most of the whitening agents is hydrogen peroxide or carbamide peroxide, both offered in various concentrations. When the whitening agent is in contact with the tooth, the tiny “pores” absorb the chemical and change the color of the enamel, leaving the structure intact.

Is it safe? Any side effects?

Several studies, during the past five years, have proven whitening to be safe and effective. The American Dental Association has granted its seal of approval to some teeth whitening products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

What are realistic expectations?

No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two to four-shade improvement as seen on a dentist’s shade guide. The success rate depends upon the type of stain involved, the porosity of the tooth enamel, and your compliance. Bleaching does not lighten artificial materials such as resins, silicates or porcelains.

A crown is a restoration that covers or “caps” a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth.  Crowns are necessary when a tooth is generally broken down and fillings won’t solve the problem.  If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn’t get worse.  Crowns are also used to support a large filling when there isn’t enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.

How is a crown placed?

A crown typically requires two appointments.

To prepare the tooth for a crown, it is reduced so the crown can fit over it.  An impression of teeth and gums is made and sent to the lab for the crown fabrication.  A temporary crown is fitted over the tooth until the permanent crown is made.

At the second visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?

Yes.  The dentist’s main goal is to create crowns that look like natural teeth.  That is why dentists take an impression.  To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth.  Any one of these factors alone can affect your appearance.

If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit.  When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?

Crowns require more tooth structure removal,  hence, they cover more of the tooth than veneers.  Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth.  Crowns may be placed on natural teeth or dental implants.

How should I take care of my crowns?

To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects.  You also want to avoid teeth grinding.  Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns.  Floss or  inter-dental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown margin area. Plaque in that area can cause dental decay and gum disease.

Photographic Release

In our office we like to photograph our patients to aid Dr. Marye in determining dental problems and the solutions/treatment options for them. Dr. Marye sometimes uses the photographs, with the patient’s permission, for display. We are very proud of the work we have done and use only our own patient’s photographs in our marketing and advertising. All of the portraits in our office and on the website (www.smiles of texas.com) and in our ads are our own patients.

Authorization and release:

I hereby authorize Dr. Marye to use photos of my face, jaws, and teeth. I understand that the photos may be used as a record of my care and may be used for educational and advertising purposes. (Including website, magazines, phonebooks, television and professional publications). I further understand that if my photos are used in any way described above that my name and identifying information will be confidential. I do not expect compensation, financial or otherwise for use of these photos.

X-ray Information

X-rays provide invaluable information for Dr. Marye for diagnosing and treatment planning. To provide a comprehensive examination, x-rays are required. There are a variety of x-rays; each provides a variety of information. Dr. Marye will recommend x-rays based on your individual needs. Our x-ray system is digital which results in the lowest possible exposure to radiation. We are able to view the films immediately.

Insurance companies limit the types and the frequency that some x-rays are taken. It is our responsibility to provide a comprehensive evaluation to you. By limiting the allowance of x-rays, Dr. Marye cannot present a signed release of liability from you stating that you fully understand that there are conditions that cannot be diagnosed without them.

I have read the information regarding x-rays and fully understand Dr. Marye’s philosophy. I understand that my insurance company limits frequency of some types of x-rays and if I am in a situation that requires services not covered, I will be responsible for the fees associated with the service.

Patient signature: _________________________________ Date: ________________________

A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide).  Introduced in the 1960’s dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth.  Since then, composites have been significantly improved and can be successfully placed in the back teeth as well.  Composites are not only used to restore decayed areas, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

How is composite placed?

Following preparation, the dentist places the composite in layers, using a light specialized to harden each layer.  When the process is finished, the dentist will shape the composite to fit the tooth.  The dentist then polishes the composite to prevent staining and early wear.

How long does it take to place a composite?

It takes the dentist about 10-20 minutes longer to place a composite than a sliver filling.  Placement time depends on the size and location of the cavity—the larger the size, the longer it will take.

What is the cost?

Prices vary, but composites average about one and a half to two times the price of a silver filling.  Most dental insurance plans cover the cost of the composite up to the price of a silver filling, with the patient paying the difference.  As composites continue to improve, insurance companies are more likely to increase their coverage of composites.

What are the advantages of composites?

Esthetics are the main advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth.  Composites bond to the tooth to support the remaining tooth structure, allowing the dentist to take away less tooth structure during preparation, which helps to prevent breakage and insulate the tooth from excessive temperature changes.

What are the disadvantages?

After receiving a composite, a patient may experience post-operative sensitivity.  Also, the shade of the composite can change slightly if the patient drinks tea, coffee or other staining foods.  The dentist can put a clear plastic coating over the composite to prevent the color from changing if a patient is particularly concerned about tooth color.  Composites tend to wear out sooner than silver fillings in larger cavities, although they hold up as well in small cavities.

How long will a composite last?

Studies have shown that composites last 7-10 years, which is comparable to silver fillings except in very large restorations, where silver fillings last longer than composites.

There are a number of effective brushing techniques.  Patients are advised to check with their dentist or hygienist to determine which technique is best for them since tooth position and gum conditions vary.

One effective, easy-to-remember technique involves using a circular or elliptical motion to brush a couple of teeth at a time, gradually covering the entire mouth.

Place a toothbrush beside your teeth at a 45 degree angle and gently brush teeth in an elliptical motion.  Brush the outside of the teeth, inside the teeth, you tongue and the chewing surfaces and in between teeth.

Using a back and forth motion causes the gum surface to recede, or can expose the root surface or make the root surface tender.

Soft or hard bristles?

In general, a toothbrush head should be small (1” by ½”) for easy access.  It should have a long, wide handle for a firm grasp.  It should have soft, nylon bristles with round ends.  Some brushes are too abrasive and can damage your gums.  A soft, rounded, multi-tufted brush can clean teeth effectively.  Press just firmly enough to reach the spaces between the teeth as well as the surface.  Medium and hard bristles are not recommended.

How long should I brush?

It might be a good idea to brush with the radio on, since dentists generally recommend brushing 3-4 minutes, the length of an average song.  Using an egg timer is another way to measure your brushing time. Patients generally think they’re brushing longer, but most spend less than a minute brushing.

To make sure you’re doing a thorough job and not missing any spots, patients are advised to brush the full 3-4 minutes twice a day, instead of brushing quickly five or more times through the day.

Should I brush at work?

Definitely, but most Americans don’t brush during the workday.  Yet a recent survey by Oral-B Labor-atories and the Academy of General Dentistry shows if you keep a toothbrush at work, the chances you will brush during the day increase by 65 percent.  Dentists recommend keeping a toothbrush at work.

Getting debris off teeth right away stops sugary snacks from turning to damaging acids, and catches starchy foods like potato chips before they turn to cavity-causing sugar.  If you brush with fluoride tooth-paste in the morning and before going to bed, you don’t even need to use toothpaste at work.  You can just brush and rinse before heading back to the desk.  If you don’t have a toothbrush, rinsing your mouth with water for 30 seconds after lunch also helps.

The following tips may improve your work-time brushing habits:

• Post a sticky note on your desk or computer at work as a reminder to brush teeth after lunch
• Brush teeth right after lunch, before you become absorbed in work.
• Store your toothbrush and toothpaste at work in a convenient and handy place.
• Make brushing your teeth part of your freshening up routine at work.