Author: bwiley

If you have visited your dentist and were told that you have gum disease, they may have referred you to a periodontist without cleaning your teeth. 

That may have you asking, “Can’t I just have a regular cleaning?”

Well, the short answer is “No” because a regular cleaning cannot clean the source of your gum disease and may actually cause more harm than good.

Regular Dental Cleanings

Regular dental cleanings, called a prophylaxis, involve removing deposits and bacteria from your tooth surfaces, mainly above the gum line and slightly below your gums. When you have healthy gums, the space between tooth and gum is slight.  

But, when you have gum disease, the space between your tooth and gum is deeper, which cannot be cleaned, leaving harmful bacteria to continue to thrive under your gums.  

The only way to thoroughly clean your teeth/gums when you have gum disease is through periodontal therapy, which may involve a ‘deep cleaning’ procedure called scaling & root planing.

Scaling & root planing allows your hygienist to clean the deeper areas under your gums.  If only a regular cleaning were done in these areas, the leftover deposits and bacteria will cause progression of your disease. 

As stated earlier, if you have gum disease and only get a regular cleaning, what is left under your gums will cause your disease to progress, sometimes more severely because the harmful bacteria essentially gets trapped under your gums after a shallow gum cleaning. 

Gum Disease Risks

Untreated gum disease can result in damage to not only your teeth and supporting structures in your mouth, but can also negatively affect your health.  As gum disease progresses, your risk of tooth loss rises.  

Since gum disease is an infection, studies show links between gum disease and other health issues such as diabetes, heart disease, stroke, and certain types of cancer. So, making sure to thoroughly treat your disease is essential to avoid severe disease.

The Bottom Line

Depending on gum disease severity, they may refer you to a periodontist to evaluate your level of gum disease and explain treatment needs.  

Your dental professionals want the best for you and your oral health. They know that a healthy-looking smile is great but healthy teeth and gums are vital.  So, if your dental professionals tell you that they cannot do a regular cleaning because you have gum disease, they are giving you the best oral care information to help maintain your oral and overall health.  

Contact our office if you have any questions!

Short answer: Yes, your dentist will want to ensure your mouth is healthy and that any problems such as cavities are taken care of to avoid complications and to make your whitened smile last longer!

Whitening teeth is a very popular procedure that we perform for patients who are looking to brighten up their smile. You may decide to whiten your teeth prior to a big event such as a wedding or class reunion, or if you’re planning to go on a job hunt and intent to go into interviews. You may just want to brighten up your smile as a treat to yourself!

Before getting your teeth professionally whitened by a dentist, you should have a dental exam.

When you go to a dentist for professional teeth whitening, your dentist will want to perform an exam to determine the overall health of your teeth, gums, and mouth. This exam will allow them to identify and treat any underlying causes for the initial discoloration of your teeth as well as any problems with your teeth such as decay, cavities, gum disease, and other dental issues. 

This pre-whitening dental exam will also allow your dentist to identify if you have any existing crowns, restorations, implants, or other restorative work that may require your dentist to work to change them to match the results of your whitening treatment for a pearly-white smile!

Treating these other issues will help to keep your mouth healthier and add to the success of your teeth whitening treatment. It will also make the maintenance and additional whitening treatments more effective when you need to “touch-up” your smile in the future. 

Dental exams before teeth whitening: conclusion

When you have a thorough dental exam by your dentist before a teeth whitening treatment, your dentist can help to treat any problems in your mouth before the treatment to provide a better whitening result. This exam can also identify reasons that your teeth are stained and your dentist can work with you to lessen the factors that lead to the staining in the first place.

Teeth Whitening in Carlisle: Contact us today to set-up your professional whitening treatment or ask your dentist the next time you’re at your regular appointment!

It’s not uncommon to visit your dentist and be surprised when they discover a cavity you didn’t know was there. In the absence of pain, it might not always be easy to figure out that something is wrong. Besides, cavities are supposed to hurt, right? As it turns out, although a cavity might not be causing you a great deal of pain, it’s possible for there to be a very real problem.

Cavities are areas of your tooth that have suffered tooth decay. They might appear as tiny openings or holes in your teeth. They can be caused by a number of different things such as bacteria, snacking often, drinking a lot of sugary drinks, or missing brushings. They can also occur when the proper tooth brushing methods aren’t followed.

Signs and symptoms of a cavity

The signs that you might have a cavity depend on the location of the cavity and the extent of the decay. A cavity might be asymptomatic as it’s just beginning to develop. As it progresses though, you might experience one of these symptoms:

• Spontaneous toothache that happens without any apparent cause
• Sensitivity to temperature
• Mild or sharp pain when you eat or drink something sweet, hot, or cold
• Visible holes or pits in your teeth
• Pain when you bite down
• Brown, black, or white staining on any surface of a tooth

The pain mentioned in those symptoms above usually are a good indicator that something is wrong. However, that pain may take some time to become noticeable. There are plenty of cases where the tooth decay begins but doesn’t cause any discomfort for several weeks or months. At the beginning of the decay process, enamel is the first part of the tooth to be worn down. Enamel is the outer most part of your tooth and the part which you can see. It’s possible for the tooth decay to wear down the enamel without causing any noticeable pain.

As the decay process progresses though, the decay can reach the dentin, which is one of the inner layers of the tooth. Dentin is much softer than enamel and contains pathways to the nerve of the tooth. Once the infection from the tooth decay reaches this part of the tooth, it becomes necessary to receive a root canal to get rid of the infected pulp and receive the pain.

Although it’s possible for a cavity to progress without causing pain and discomfort, it’s important to talk to your dentist about your options for treating a cavity before it becomes more of a problem. Even without pain, damage can certainly still be done. One of the best steps to take is to ensure you’re brushing properly and often.

Taking care of your oral health is the best way to prevent a cavity. We also recommend seeing your dentist regularly. Early detection of cavities and tooth decay can save you discomfort down the road and keep your smile looking its best!

An Expanded Functions Dental Assistant (EFDA) is a certified dental assistant who has acquired additional schooling and training in order to obtain the skills and licensure that allows them to perform some procedures that you might usually associate with ones that your dentist used to do.

Because of their specialized training, EFDAs can perform the following additional procedures such as:

• Place fillings- One of the main duties of an EFDA is to place and contour fillings after the dentist has prepared the tooth. Once the dentist has prepared the tooth, the EFDA uses restorative materials to place, sculpt & polish the filling, check the bite occlusion, and make sure that the area flosses well. After completion, the dentist does a final check of the filling before the patient is dismissed.
• Perform polishing- Another procedure that an EFDA can perform is something called coronal polishing, which is like the polishing that a dental hygienist does at the end of a dental cleaning. Although polishing is often done after a dental filling, some EFDAs are utilized with dental hygienists to polish the teeth after a hygienist has finished with scaling, which is the therapeutic procedure that removes harmful deposits and bacteria during a dental cleaning. Polishing helps to remove surface stains, thus creating a smooth tooth surface.
• Apply fluoride treatments- EFDAs can apply fluoride treatments in the dental office. In-office fluoride varnish helps to prevent tooth decay by strengthening tooth structure.
• Place tooth sealants- EFDAs can place sealants, which is a preventative procedure to seal deep grooves in back teeth that are most vulnerable to decay.  

Why is the Dental Assistant Filling My Tooth?

Perhaps the last time you saw your dentist for a filling, the dentist’s assistant did some of the filling and shaping part of the procedure.

Modern dental care involves a team approach to providing you state of the art dental care. These days, dentists rely on their entire dental team to help support them in providing the most optimized & efficient care to treat your oral health needs. 

One of the most important members of the dental team is the Dental Assistant, who typically provides supportive dental duties such as taking dental x-rays and assisting the dentist with procedures. For many decades, dental assistants have been the team member who sits in during treatment while the dentist performs procedures such as fillings and crowns.  However, now the role of the dental assistant has evolved into more responsibilities than in the past.

In many states, including Pennsylvania, the role of dental assistants has advanced to add an additional level of clinician status. Currently, certified dental assistants are eligible for additional training that will allow them to become licensed professionals called Expanded Functions Dental Assistants (EFDA).  

What Training Does an EFDA Need?

In order to be accepted into an EFDA training program, one needs to be either a certified dental assistant or a registered dental hygienist. Training programs in Pennsylvania typically offer instruction over an 18-month period that involves both clinical and classroom instruction in advanced restorative techniques. Most programs require an internship with an approved dental office to finish clinical training.

Upon successful completion of training at an accredited school for expanded functions dental assistant training, students are eligible to sit for board examinations.  

Is an EFDA Certified?

Yes! If an EFDA passes the state board-approved examination, they may apply for state licensure. The PA State Board of Dentistry requires an EFDA to be licensed to practice within the state.

In order to practice, an EFDA must also have the following:

• PA State Licensure as an EFDA
• PA Certificate to take dental x-rays (radiographs)
• Completion of continuing education every two years for license renewal
• Completion of three hours of Pennsylvania Department of Human Services-approved training in child abuse recognition and state reporting requirements.
• CPR Certification 

Why Do Dentists Use an EFDA?

Sometimes, patients are surprised to know that their dentist is not doing the entire filling procedure from start to finish. Often, that is because not all patients have heard of EFDAs, or their previous dentist never utilized one. While in the past having an EFDA was less common, today, EFDAs are a strongly utilized team member in a dental practice. 

Having an EFDA among the dental team serves many benefits.  One of the most important benefits is access to care.  Because the EFDA can finish a filling, the dentist is able to begin treatment for another patient, which allows patients to get more timely appointments.

While some patients might wonder why an EFDA is doing their filling, they should know that they are being treated by a dental professional who may have already placed hundreds to maybe even thousands of fillings each year!

Your EFDA Has Professional Pride!

EFDAs are valued team members who have a strong sense of professional pride because they can use their additional skills to improve patients’ oral health. In fact, our practice has several EFDAs who are passionate about their career and helping their patients achieve their best smile!

In the event that one of your teeth shows signs of decay as the result of a cavity or other trauma, tooth fillings become a must. The cost of a filling can be a major concern. Once your dentist removes the decayed portion of your tooth, a filling is put in place to restore look and function to the affected tooth.

One of the larger cost considerations when it comes to fillings is the material that the fillings are made out of. There are several major materials available today for tooth fillings, each with its own advantages and disadvantages. The prices listed here are based on averages in the United States and will vary based on your coverage. If you’d like to save money on your dental fillings, consider checking out the Verber Dental Plan.

Composite Fillings – Between $150 and $550, depending on the number of fillings.

• The first among them is tooth-colored composite fillings. These come with several advantages, the first of which is the actual look of the filling. It’s possible to match the color of the filling to the color of the tooth, which makes it a good choice for front teeth or otherwise highly visible teeth. Often, another advantage of this type of filling is the ability for your dentist to not need to remove as much of your tooth. Generally, though, composite fillings tend to wear out faster than other types and may last at least 5 years, significantly shorter than the other types outlined below. Composite fillings also tend to be about twice the cost of amalgam fillings.

Cast Gold -Between $300 and $1,800, depending on the number of fillings.

• Another major type of dental filling is the cast gold filling. It will tend to be the most expensive of the three major types covered here, sometimes costing up to ten times more than amalgam fillings. These types of fillings do also tend to require more than one office visit for it to be placed. Gold fillings do get high marks for being durable, lasting ten to fifteen years, and not being prone to corrosion. The color of these types of fillings can be either an advantage or disadvantage to some. Patients will sometimes prefer gold as it tends to be pleasing to the eye. Others may find any color other than the natural color of teeth less than ideal. 

Dental fillings can vary greatly in cost, but one filling may be better suited to your needs than another. Contact your dentist and talk to them about your various options and coverage to find out pricing that is specific to you. If you’re in need of dental coverage, consider exploring the Verber Dental Plan to reduce the cost of your fillings.

Q: How long does a root canal take?

A: On average, a root canal procedure can take anywhere from 60 minutes to 90 minutes for the entire appointment, but sometimes more complex procedures may take longer.

The time that you’ll be in the chair for your procedure will depend on a variety of factors including the level of infection in your tooth, the tooth that needs root canal therapy, and other related oral health issues. 

But before the fear of sitting through a root canal procedure enters, we want you to know that a root canal shouldn’t be painful. There is a lot of misinformation that surrounds root canals that they’re awful, but when performed properly the root canal therapy should help to remove the pain associated with your tooth.

Root canal therapy is usually performed by your dentist and can either be in one or two appointments depending on the scope of work being performed. 

Read more to learn more about what happens during a root canal therapy.

How do I know if I need a root canal?

All teeth have a pulp which is the living tissue inside the root of your tooth that connects it to your bone and gums. The pulp of your tooth is full of blood vessels and nerves and if they become infected, this procedure can save your natural tooth while removing the infected tissues and nerves in the pulp. Teeth that often need this are usually damaged from the following:

• Cracks or large chips that damage the pulp and nerves
• Teeth that have infections from large cavities
• Teeth that are damaged from years of repeated dental work

Root canals on molars

Your molars are the most time-consuming teeth since they’re in the back of your mouth and can have up to four canals. Root canal therapy on your molars require more work to remove the infection, clean, and fill which can take up to 90 minutes or more.

Premolars:

Your premolars are the teeth behind your front teeth and before your molars and these teeth typically only have two roots and usually, only take about an hour depending on the anatomy of the tooth and the severity of the infection.

Incisors and canine tooth:

These are the teeth in the front of your mouth and they have a single root which makes them the quickest teeth to fill for a root canal. Your dentist can typically perform the procedure for your front teeth for around 60 minutes, but again it depends on the severity of the infection. 

Why can a root canal occasionally take two visits?

Depending on the severity of the infection or the tooth that requires a root canal therapy, your dentist may decide to split the procedure into two sessions. The first appointment they’ll probably focus on removing the infected tissue and if it’s severe or in a hard to access area, this may be all they do the first appointment. After they remove the infection, a temporary antibacterial medication in your tooth until your next appointment. 

The second part of your treatment will require a little more cleaning and a permanent sealant of the inside of your tooth. A filling will then be placed and in some circumstances, a crown might be placed.

Root canals, in conclusion…

A root canal therapy is a serious treatment but most patients won’t experience any more discomfort than a typical cavity filling. The main thing to remember is that the pain is much worse by letting a damaged tooth go untreated without root canal therapy and the procedure actually is intended to remove the painful infection. 

We’re here to help, if you’re experiencing tooth pain, swelling, and discomfort you should contact us at 717-243-9020 and get it taken care of before it gets worse.

Jaw popping can be alarming and sometimes painful, but there isn’t any need to panic. This popping in your jaw is caused by a dysfunction in the temporomandibular joint (TMJ), a hinge that connects the jawbone to the jaw with one on both sides of your face. It’s important to note that the term TMJ can refer to both the joint itself and to the disorder caused by issues with the joint. The disorder can also be referred to as TMD or TMJD. This hinge is what allows you to talk, chew, and even yawn. Popping in this joint can arise when it is not working properly. Certain actions can cause a TMJ disorder or make it worse, such as chewing gum too often, grinding your teeth, clenching your jaw, thrusting your jaw out, or biting your fingernails, lips, or cheeks. When these actions are taken too often, it can cause wear and tear on the joint leading to the pain and popping. 

Should you be worried?

In the absence of jaw pain, popping isn’t usually a cause for concern. Certain underlying medical conditions can cause TMJ disorders though. A few examples of these medical conditions include a broken or dislocated jaw, arthritis, malocclusion (misalignment) of the teeth, certain tumors, infection, and sleep apnea. If you are already working through one of these conditions, it’s important to talk to your doctor or dentist about how they may be affecting the health of your temporomandibular joint. 

Treatment:

If you’re experiencing popping in your jaw, you will first and foremost want to talk to your general practice doctor or your dentist about it at soon as possible. As there are some habitual actions that can cause wear and tear to the joint, it’s possible your doctor may be able to identify these and help you to begin correcting it. If your TMJD is being caused by an underlying health condition, it’s important to identify these issues early as that will have an impact on treatment moving forward. Luckily, there are many different treatments available for this condition.

In terms of least invasive, using an ice pack and then applying heat thereafter can help to relax the joint. Additionally, nonsteroidal anti-inflammatory drugs or NSAIDs, such as ibuprofen and aspirin can help to reduce pain and popping. Wearing a night guard in your mouth and eating softer foods can also help to lessen the discomfort. Exercises specifically designed to reduce the discomfort associated with TMJD are also available and can even be found on YouTube. Slightly more invasive treatments include ultrasounds, trigger point injections, radio wave therapy, transcutaneous electric nerve stimulation (TENS). 

If these treatments don’t prove successful, it is possible to receive surgery for TMJD. This would only be used as a last resort to correct the issue. However, most of the time TMJD can be corrected and alleviated with lifestyle changes and at-home treatments.

If your jaw is experiencing the issues mentioned above, schedule a visit with your dentist so they can examine your jaw and determine your next steps.

Bad breath is embarrassing and worrisome. For most of us, it’s temporary. But for 25% of the population, it’s a chronic problem that can cause significant stress.

Bad breath, also called halitosis, is one of the most common reasons why people seek dental care. While in most cases, bad breath can be easily treated, it can also be a sign of a more serious problem.

So, here are common reasons:

Poor Home Care 

The primary cause is mouth bacteria. When we practice good oral home care daily, we remove that bacteria. So, when we aren’t the best brushers or flossers, all that leftover bacteria produces a foul smell.  

Poor home care can also lead to tooth decay, which is a tooth infection that can contribute to chronic mouth odors that will not go away until your teeth are repaired.

Gum Disease

Do you brush your teeth and still feel like you have bad breath shortly after? Your bad breath may be a sign of gum disease! Harmful mouth bacteria can cause a chronic infection called periodontal disease. When you have gum disease, you cannot just brush and floss the bacteria from your mouth because it is hiding under your gums where you can no longer reach. Until you treat the gum infection, your smelly breath will continue. The best way to treat gum disease is with periodontal treatment.

Dry Mouth

If your mouth always seems to feel dry, you could have dry mouth, also called xerostomia, which is a condition that is caused by a lack of saliva flow. Since saliva is a natural way to wash your mouth throughout the day when it decreases, your mouth is less clean, and malodor forms. Some causes for dry mouth can be mouth breathing, certain medications, and salivary gland problems after cancer treatment.

Smoking

Not only can the smell of cigarettes give your bad breath, but it is also the number one risk factor for periodontal disease. Smoking can also cause dry mouth. Worse yet, smoking can reduce your taste and smell, which can make it hard for you to even recognize that you have bad breath.

Diet

You know that certain types of foods like garlic and onions can cause bad breath, but did you know that low-carb or keto diets can too? It’s true.  Ketones that are produced when fats breakdown can have a strong, unpleasant aroma. 

Medications

Some medications can cause dry mouth, which you now know can cause bad breath. But did you know that some medications can actually be the reason for your bad taste or mouth odors? Medications such as nitrates, phenothiazines, chemotherapy medications, and even vitamins can alter your breath.

Medical Issues

Mouth, nose, and throat conditions like chronic sinus, allergy, and tonsil issues can contribute to bad breath. More serious health issues such as certain types of cancer, liver failure, and GERD can also cause halitosis.  

The Bottom Line

The most important thing to remember about bad breath is that good home care is your best defense. Making sure that you are brushing and flossing daily removes the harmful bacteria that causes halitosis. Visiting your dentist regularly also helps because your dental professionals can professionally clean your teeth, diagnose any more serious dental issues, and treat them effectively.  

Your dental team is always happy to answer questions and give you custom homecare recommendations to help reduce bad breath, so you feel more confident about your mouth.

Contact us today at Noll Family Dentistry to schedule an appointment!

According to the Oral Cancer Foundation, approximately 53,000 Americans will be diagnosed with oral oropharyngeal cancer in 2020. They estimate that it will cause over close to 10,000 deaths. In the late stages, mouth cancer can be life-threatening, which is why early diagnosis is so important.

Because early detection is the key to early-stage diagnosis, your dentist is an important health partner in oral cancer detection.

How is it detected by my dentist?

When you visit your dental office, your dental professionals are screening for cancer.  At your cleaning appointment, your hygienist performs a cancer screening and reports suspicious areas to your dentist before your exam. Your dentist also performs a cancer exam and will refer you to an oral surgeon if they feel the discovered lesion or bump should be tested. Those abnormalities can be tested through a biopsy, which can definitively determine whether cancer cells are present.

Because mouth cancer symptoms can often seem like other less serious conditions, it can be missed early, which is why self-awareness is so important. Self-examination is also a way to detect abnormalities as well. So, if you have a sore, lump, or pain that doesn’t go away in about two weeks, you should seek an examination by your dentist or physician. 

Can it be treated?

Yes, oral cancer can be treated like other forms of cancer.

Your oral surgeon can perform a biopsy and remove the abnormal lesion or growth. If it is determined to be cancerous, patients are referred to an oncologist, a cancer specialist. Typically, post-surgery treatment involves treatment such as radiation and/or chemotherapy. 

Common Symptoms:

• Mouth or lip sores that do not heal after 14 days.
• Unusual red or whitish spots inside the mouth/tongue that cannot be wiped away.
• Unusual bleeding or pain inside the mouth/around gums.
• Lumps or bumps inside the mouth & lip or outside the mouth, head, and neck.
• Chronic sore throat or feeling of thickness in your throat.
• Voice changes or hoarseness.
• Trouble chewing and swallowing.

Common Risks for Oral Cancer:

• Age – Patients who are over the age of 55 are at higher risk.
• Gender – Men are at twice the risk as women.
• Tobacco Use – Tobacco users are 50 times more likely to develop oral cancer!
• Excessive Alcohol Consumption –mouth cancer is more likely in people who drink alcohol vs non-drinkers.  Some studies show that excessive alcohol users are up to 6 times more likely to get oral cancer.
• Human Papillomavirus (HPV) – Cases of oral cancer associated with HPV are rising, especially in younger people. 
• UV Exposure – Cancerous lesions around lips are more common in those who have had excessive sun exposure from a young age.

In addition to common risk factors, new research is also finding that there may be links between oral cancer and poor nutrition, and poor oral health. So, regular dental visits can help not only detect but also help reduce your risk for oral cancer.

Studies have shown that over 30% of the population suffers from dental fear with 12% having extreme fear, called odontophobia.  

Dental-related anxiety is the number one reason why patients do not seek regular care. But staying away from the dentist can hurt more than just your teeth. Dental care is important for good overall health. So, avoiding the dentist could be making you unhealthy!  

Dental anxiety = Dental Avoidance = Dental Problems!

Take steps toward overcoming your dental fears by:

• Recognizing signs of dental phobia.
• Realizing what causes your fears.
• Discovering tips on how you can help yourself reduce your fears.
• Learning ways that your dental office can help.

FAQs about Dental Fear

What Are Some Signs of Dental Anxiety?

• Avoiding Dental Visits — Do you often skip regular visits?
• Problems Sleeping the Night Before a Dental Appointment – Does the idea of an upcoming dental cleaning have you worried for days and especially the night before?
• Uneasy Feeling in the Waiting Room – Do you feel those butterflies in your stomach or even feel a bit nauseous?
• Uncomfortable in the Chair –– Once you sit in the chair, do you ever feel lightheaded, nervous, or out of breath?  

What are the Common Reasons for Dental Anxiety?  

• Fear of Pain/Needle Fear – You should know that now there are so many new ways to treat patients painlessly.  
• Worries about Expenses – Just know that dental problems usually get more expensive the longer you wait for treatment.  
• Bad Past Experiences — Unfortunately, bad experiences happen, which is why finding a caring and compassionate dental office is important.
• Embarrassed about Your Teeth – While it is understandable to be self-conscious, don’t worry because your dental office is a no-judgment zone!  

How Can I Reduce My Dental Fears?

• Communicate Your Fears – Your dental office staff wants to help. So, don’t be afraid to let them know when you make or arrive for an appointment that you have dental fears. It will help them to help you feel more comfortable.
• Schedule Early Appointments – Scheduling the earliest appointment of the day helps in two ways, by allowing you to be seen promptly and to get it out of the way and enjoy the rest of your day.
• Consider Food Choices — Avoid caffeine right before a dental visit because it can make you feel more anxious. Choose high-protein foods vs. high sugar foods because high-protein foods can produce a calmer feeling.
• Bring Headphones – Listening to music or a podcast can help distract you from some of the sights and sounds of the dental chair.
• Practice Breathing Exercises – In the chair, practice a calming breathing technique called “4-6 Breathing.” Inhale slowly for 4 breathes and exhale slowly for 6 breaths for about one minute before you start your treatment.

If you suffer from dental fears, consider choosing a dental office that is committed to:

• Creating a Calm Experience 
• Gently Managing Your Pain
• Considering Your Needs
• Taking the Time to Listen

Our dental office will go the extra mile to ensure that you feel comfortable, your dental fears will slowly fade. Who knows, you might even look forward to visiting your dentist!