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Have a question about dentistry?
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Browse these categories of common questions and answers:
- Cavities
- Children
- Cosmetic Dentistry
- Cost of Dental Treatment
- Fear of Dental Treatment
- Holistic Dentistry
- Insurance
- Payment Options
- Procedures
- Smoking
- TMJ
Q. My family has always had a lot of cavities, and I do, too. Couldn’t the cause be inherited?
A. It is very doubtful. Eating habits are "inherited" more than the tendency of tooth decay. In rare instances, gastric reflux or diseases and medicines which dry the mouth can increase the incidence of decay. But in the vast majority of cases, when we see severe decay, it is dietary origin. In children, it is the excessive intake of sweets. In adults, it is usually the excessive consumption of soda pop, or other sweetened beverages. Once in a while, habits such a sucking on lemons or sucking on throat lozenges is to blame.
Q. Could my husband's smoking be causing his cavities?
A. Smoking usually has only a trivial effect on caries, by drying the mouth. Smoking has more influence on gum disease than cavities.
Q. What is an the ideal age for child's first dental visit?
A. It varies tremendously with the maturity of the child. We can often clean the teeth of mature 3-year-olds, but 4 is the average age we see children for the first time. However, if you suspect you child has a problem, a dental visit is important no matter what the age. Just be aware that children younger than 3 are often frightened and cry during treatment, no matter how gentle our care!
A good strategy is to accustom the child to dentistry by permitting him to observe an older, well-behaved sibling having a routine cleaning.
Q. Shouldn't I use a pediatric dentist for my children?
A. We think it is unnecessary in most cases. It is a rare child that cannot be treated in our office, and our fees are much lower than the children's specialists. Dr. Henry has far more orthodontic experience than most pediatric dentists. In addition to checking for cavities, we are careful to assess each child's growth and development at each visit. We can tell you the moment we feel orthodontic intervention would be useful for your child.
Q. When should I be concerned about my child still sucking his thumb?
A. We hope that the habit disappears at least by age 4, but we really are concerned when it does not stop by age 5 ½ or 6. This is when the permanent incisors begin to erupt. A thumb is like a lever, and tends to push the upper incisors outward and lower ones inward, giving the child a "buck-toothed" appearance. If it continues, the child can actually cause excessive growth of the bone in front of the palate. The correction for this is sometimes a surgical!
Thumb sucking can stopped by many ways, but it is important not to nag or belittle the child. Instead, stress the beautiful smile that will come about if the habit is stopped. It is important that the child desire to stop the habit. In difficult cases, we construct a device for the roof of the mouth which removes the pleasure from sucking the thumb.
Q. Can you put my child to sleep for dental treatment?
A. Sedation and general anesthesia is especially risky in children outside of a hospital setting. Very few specialists give children IV anesthesia in Atlanta.
As with adults, we find we can work on most fearful children with laughing gas and distraction techniques. Occasionally, we supplement this with oral Valium. Children often fall asleep during treatment, but this is not surgical anesthesia like in hospitals.
Q. Will you let the parents be with the child during dental treatment?
Despite what parents believe, this is rarely a good idea! Occasionally I consent to parents being in the operatory with their child. Common instances are with small children, special needs children, children who need a translator, or the few times when children get hysterical for no good reason. The presence of a parent is usually not of benefit, because there needs to be one authority figure in the operatory, and that must be myself. Two authority figures confuse things. Without realizing it, a lot of parents give their kids non-verbal cues in the operatory such as grimacing, wincing, or covering their eyes. These scare children who might otherwise be calm and cooperative.
Also, think about this: Do you do your best work with your boss looking over your shoulder? Chances are, your boss would make you nervous doing this. The parent is essentially my boss, and I do not do my best work when they are looking over my shoulder.
A better idea is permitting a young child be a spectator during a well-behaved older sibling's appointment. The younger child will view the older sibling's good behavior, and try to emulate it. This is a quick and effective way to eliminate anxiety about the child's own first appointment.
Q. Do you do cosmetic dentistry like on those makeover TV programs? I have been thinking about getting all my unattractive front teeth capped with crowns or veneers.
A. We do esthetic makeovers, but our emphasis is on conservative ways of treating esthetic problems.
We avoid cutting healthy teeth down for crowns or veneers whenever possible. Once a tooth has a crown or veneer, a patient can never go back. Often these restorations cause chronic gum inflammation. The color of crowns and veneers never change; the color of natural teeth change throughout life, many times resulting in shade mismatches. As good as modern porcelain systems are, the colors are never as "alive" and realistic as those in natural teeth.
Wherever possible, we encourage patients to seek esthetic improvement by orthodontics and bleaching. We have completed orthodontics for esthetic reasons for patients as old as sixty. Why do we recommend braces so much? First, straightening teeth usually costs much less than a mouth full of crowns or veneers. Secondly, crowns and veneers have to be replaced many times in life. We regard orthodontic treatment as a more permanent form of cosmetic improvement.
Another conservative alternative we prefer is direct plastic bonding. Although this treatment can be less durable than veneers in certain types of bites, the cost is many times less, and no reduction of healthy teeth is required.
Q. How much does (some dental procedure) cost?
A. We have no secrets here. We will give you the cost of any dental procedure in our office, if you provide us with the exact procedure with its ADA code. We will even let you have a complete copy of our fee schedule for trivial cost of making a copy.
This presumes you know exactly which procedures you need. And you may be right, if another dentist has diagnosed you for treatment. Unfortunately, the hardest thing to decide is which procedures are necessary for you. We find that few patients who call us for fees really know which specific procedures they require.
Dental fees vary less than the average patient believes. It is the complexity of treatment plans that can vary tremendously. The only way to comparison shop for fees is to have a complete x-ray series done, and let various dentists examine and treatment plan your mouth.
Q. Do you have many patients as nervous as I am?
A. Most patients are nervous to start with, but very few stay that way after meeting us and having treatment in our office. We will win you over!
Q. I am very nervous about dental treatment. Can you put me to sleep?
A. No. In Georgia, only an anesthesiologist or a dentist with a sedation permit can put patients into deep sedation or complete anesthesia. Since insurance costs are so high, and the use of pulse and blood oxygen monitors is mandatory, very few dentists do deep sedation in their offices. The cost to the patient is rather high, and usually not covered by any insurance.
Through the years, we have found that the vast majority of nervous patients do not need deep intravenous sedation. Most patients do well with only laughing gas and listening to music or comedy on headphones. For the extremely nervous patient, we can supplement this with a prescription for an oral tranquilizer taken before the appointment. However, you cannot drive after taking this sedative.
Q. Are you a holistic dentist?
A. In the traditional sense of the term, yes. During my training, students at the Medical College of Georgia were taught that:
Adverse oral conditions such as uncontrolled gum disease can affect one's general health. This is now common knowledge as regards to atherosclerosis. Sub-optimal general health, and especially many medications, can adversely affect the health of the teeth and supporting structures.
Knowing the above, we seek to improve both oral and systemic health. Often we involve the physician in the process, altering medication regimens when necessary.
All holistic treatment should be based on a scientifically-tested knowledge base. The recent corruption of "holistic dentistry" involves belief in various pseudoscientific ideas disseminated on the internet. Anytime you hear dentists claiming to be "holistic" talking about dubious concepts like "detoxification," you should beware.
Q. I read that silver fillings cause all sorts of health problems. Why do you still do them?
A. There is a lot of inaccurate information written for the lay public about dentistry. Unfortunately, scaring people can be an effective way of selling them things.
Silver amalgam has been the most extensively studied filling material in history. Every reputable scientific study continues to find that silver fillings are still safe to use in children, adults, and even pregnant women. Large white plastic fillings just do not hold up well in posterior teeth. If you really want a long-lasting alternative to large silver fillings in molar teeth, the only time-tested option is gold!
Q. Do you accept my dental insurance?
A. As long as yours is a policy which allows freedom to use any dentist you wish. If your plan requires that you go to dentists on an insurance list, be aware that we choose not to be on any such lists. However, with some plans allow you the freedom to choose any dentist, but receive a lower insurance reimbursement when you choose out-of-network dentists. The restrictions of dental insurance plans vary tremendously. It is important to familiarize yourself with the specifics of your dental coverage by reading your insurance booklet, or contacting your Human Relations representative at your employer.
Q. I do not have any dental insurance. Do you give any discounts to uninsured patients?
A. First of all, it may be of some comfort to realize you are not alone. About 35% of my patients are uninsured. I wish it were possible to give uninsured patients a discount, because insured patients cost us a lot of time and postage in paperwork hassles. However, in the state of Georgia it is illegal to charge insured and uninsured patients different fees for the same procedure.
Our office has a policy of granting any patient a 5% discount for paying up front for any treatment over $500 in value. If you have major treatment to be completed, paying in advance is one way you can save money.
Q. Do you have any payment plans?
A. Much treatment, such as orthodontics, is done over a long period of time, and therefore payments can be spread over the course of treatment.
Just as you would not go to a bank for dental treatment, the purpose of a dental office is not providing long-term financing. For that, credit cards may be used, or you may qualify for one of our third party lending programs.
Q. Do you do dental implants?
A. There are two distinct parts to employing dental implants in your mouth. The first part is the surgical implantation of titanium cylinders within the bone of your jaw. I currently place most of my patients' implants, referring only the very difficult ones to surgeons with special training. After several months of healing, the restoration of the implant phase takes place. This involves placing an abutment head on the uncovered implant, taking an impression, and constructing a crown, bridge, or denture to use with the implant. This phase is always done in our office.
Q. Do you do one-appointment tooth bleaching like I hear about on the radio?
A. No, for many reasons. The end result is the same with office power bleaching or at-home nightly bleaching, and at-home bleaching is sure a lot less expensive. Much of the super-whiteness from office bleaching is due to dehydration of the teeth, and is lost in only a few hours.
Many patients have significant cold sensitivity after an appointment of office power bleaching. It is possible to control sensitivity with nightly bleaching by alternating with fluoride or by using lower strength bleaching solutions.
Q. Can you help me to stop smoking?
A. Certainly! Stopping this habit is one of the best things we can do for your health. Georgia law permits us to prescribe an artificial cigarette with nicotine cartridges, nicotine patches, or the antidepressant used to treat withdrawal symptoms. We also have a number or tips to help you kick the habit?
Q. Is smoking really that bad for the mouth?
A. Absolutely! We see the ill effects every day. In fact, it is practically impossible to maintain good gum health in patients who smoke more than one pack a day.
The noxious chemicals in cigarette smoke constrict the blood vessels of the mouth. That is why smokers heal so poorly, especially being prone to "dry socket" after extractions. Smoking is a major factor, perhaps the #1 factor, in the cause of gum disease.
Even without any teeth, smokers are at risk. The cancer-causing chemicals are concentrated on denture surfaces, and held in close contact with mouth tissues all day. It is no wonder why heavy smokers have such a high risk of mouth cancer.
Q. How can you treat my jaw joint and muscle problems?
A. We have various treatment options you can decide upon after having an exam. We treat TMJ patients with various modalities. Mild cases may respond by muscle relaxants, habit modification, and exercises. We work closely with a very good physical therapist. Sometimes we construct plastic guards for the upper arch. Worn at night and sometimes during the day, these can be very effective in controlling painful symptoms.