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Dental FAQ


Below is a list of frequently asked questions and answers from our patients. If you have additional questions, we invite you to call Auburn Family Dental at (253) 833-2200, and we will be happy to assist you.


Answers to FAQ


How often should I visit the dentist?

You should visit the dentist at least twice a year. A dental exam can reveal early signs of decay and gum disease. Catching these conditions early can help control them before they get worse and harder to treat. Additionally, getting a cleaning by a trained professional will remove plaque in areas you may have missed or cannot reach.


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. We recommend flossing at least one time a day. The best time is before going to bed.

Brushing our teeth removes food particles, plaque, and bacteria from all the tooth surfaces, except in between the teeth.

Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.


What are the proper tooth brushing techniques?

Always use a soft bristle toothbrush.

Brush at a 45-degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles at the gum and tooth interface.

Brush the outer, inner, and biting surfaces of each tooth. Move in a specific pattern, so no surfaces are missed. NEVER brush back and forth at the gumline. It will cause gum recession.

Brush your tongue or use a tongue scraper. Replace your toothbrush every three months. Dr. Marie Durflinger recommends Sonicare Toothbrush. It is easy to use and can remove plaque efficiently. Simply place the bristles of the electric toothbrush on your gum/tooth interface and allow the high-frequency vibration to remove the plaque and kill the bacteria.


What is the proper way to floss?

Daily flossing is the best way to clean between the teeth and under the gumline.

Flossing not only helps clean these spaces, but it also disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

The following Guidelines are important to flossing correctly:

  • Take 18 inches of floss and wind it around the middle finger of each hand. You can use these fingers to take up floss as it becomes dirty. Using your thumb and forefinger, pinch the floss leaving 1-2 inches in between for cleaning.
  • Gently move the floss up and down in the spaces between your teeth. Never snap the floss down onto your gums, as it can cause damage to the gums.
  • Gently move the floss under the gum tissue until you feel resistance, curving the floss into a c-shape, move it up and down, move to the adjacent tooth, then move to the next tooth.
  • Repeat this process for all of your teeth.

Daily flossing will help you keep a beautiful, healthy smile for life!


What is plaque?

Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (acids) that cause cavities and irritate/inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens on the tooth surface and turns into calculus (tartar). This will further irritate and inflame the gums and slowly destroy the bone. This is the beginning of periodontal disease and eventually, tooth loss.


How can I tell if I have gingivitis or periodontitis (gum disease)?

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups necessary x-ray, and periodontal examinations are very important and will help detect if periodontal problems exist.

Gingivitis starts with the accumulation of plaque, a sticky colorless film of bacteria, food debris, and saliva is left on the teeth near the gums. The bacteria produce toxins (acids) that inflame the gums causing swollen and bleeding gums. At this stage, it is reversible. Once the plaque hardens (within 24 hours) it cannot be brushed or flossed off your teeth. The tartar (calculus) now is firmly attached to the tooth, and it migrates down the tooth under the gums. When the bone is affected and destroyed, the disease has now advanced to periodontal disease. Brushing and flossing regularly and properly will help ensure that plaque is not left behind to do its damage.


What are the signs of Periodontal Disease?

Signs and Symptoms of Periodontal Disease

  • Red and puffy gums – Gums should never be red or swollen.
  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
  • Persistent bad breath – Caused by bacteria in the mouth and bone loss.
  • Bone loss – Bone loss is monitored by x-rays and probing depths. Bone loss = tooth loss
  • New spacing between teeth – Caused by bone loss.
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
  • Pus around the teeth and gums – Sign that there is an infection present.
  • Receding gums – Loss of gum around a tooth due to bone loss.
  • Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

How can I prevent periodontal disease?

Dr. Marie Durflinger advocates excellent oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

If you have periodontal disease, maintenance is essential to slow or stop the disease process. We want you to keep your teeth for your lifetime. This is our goal for you.

Other than poor oral hygiene, several other factors may increase the risk of developing periodontal disease:

Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth. Nicotine constricts the blood vessels and masks warning symptoms of periodontal disease, i.e., bleeding.

Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective filling that may trap plaque and bacteria.

Medications – Many medications have side effects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums, increasing the probability of periodontal disease. These medications include steroids, cancer therapy drugs, blood pressure meds, and oral contraceptives.

Pregnancy, oral contraceptives, and puberty - Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

Systemic diseases – Diabetes, blood cell disorders, HIV/Aids, etc.

Genetics may play a role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums and seek early intervention in dental care.


How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile. Dr. Marie Durflinger and the team are trained in cosmetic dentistry and can review your options with you. Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today but also because patients are becoming more and more focused on improving their overall health. Options range from whitening to veneers to full coverage crowns to orthodontics. There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically. Ask Dr. Marie how you can improve the health and beauty of your smile with cosmetic dentistry.


What are the different whitening options?

The least invasive way to improve your smile is whitening your teeth. Options range from store purchased strips and ‘in-office’ bleaching to custom fitted bleach trays with a regulated solution in a syringe you can perform at your leisure at home. For more information, read more about whitening.


What is a porcelain veneer, and how can it improve my smile?

Veneers are thin pieces of durable tooth-shaped porcelain (custom-made) and bonded on to the front teeth to create an attractive smile. Read more about veneers.


What can be done about old, unattractive or discolored fillings?

Mercury fillings are becoming extinct! We replace these with large composite fillings or full coverage crowns depending on the percentage of missing tooth structure.

Just by removing the grey filling and replacing it with a white composite filling, it will brighten the tooth, and you will see an immediate improvement. Old composite fillings can discolor over time and can be replaced with new composite fillings to seal up the margins and freshen up the color, improving your smile. Read more about composite fillings.


What are my options if I have a missing tooth?

Implants are an excellent option for a missing tooth. Strong and stable, a dental implant restores a lost tooth so that it looks, feels, and fits closest to a natural tooth.


What if I don’t have enough bone for a dental implant?

Implants require a specific depth, width, and health of alveolar bone. Bone augmentation technique can be performed to increase the amount of bone. Dr. Durflinger works with surgeons who consult and determine your surgical options. Read more about implants.


What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning. It is caused by a variety of reasons; including the type of food you ingest, mouth breather, plaque left on the teeth, dry mouth, and periodontal disease. Going to your dentist will help determine the cause so you can take the necessary steps to eliminate it!


What causes bad breath?

Morning time – Saliva flow almost stops during sleep, and its reduced cleansing action allows bacteria to grow to cause bad breath and acid attacks on tooth enamel, increasing the risk of tooth decay.

Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the bloodstream, they are transferred to the lungs where they are exhaled.

Poor oral hygiene habits – Food particles remaining in the mouth promote multiplication of bacteria and increasing tooth decay, which causes odors.

Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums, creating a bad odor.

Not seeing your dentist for checkups and cleanings.

Dental cavities and improperly fitted dental appliances contribute to bad breath.

Dry mouth (Xerostomia) - May be caused by certain medications, salivary gland problems, or continuous mouth breathing.

Tobacco products – Dry the mouth, causing bad breath.

Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.

Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and helps wash bacteria away (dilute the acid from the bacteria).

Regardless of the cause of your bad breath, great oral hygiene and regular dental check-ups with the dentist and dental hygienist will be the start of identifying the cause and begin working on the solution.


What can I do to prevent bad breath?

Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and soft bristle toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, leave them out at night, clean them thoroughly and place them back in your mouth in the morning. Dr. Marie Durflinger dispenses a new toothbrush and floss at every cleaning appointment.

See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend treatment for periodontal disease and more frequent cleanings.

Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.

Drink water frequently – Water will help keep your mouth moist, wash away bacteria, and dilute the acid produced by bacteria.

Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask Dr. Durflinger or your dental hygienist about antiseptic rinses that not only alleviate bad breath but also kill the germs that cause the problem. Read more about CariFree

In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.


What do heart disease and other medical conditions have to do with periodontal (gum) disease?

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections; often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth. When periodontal disease is not treated, it can eventually lead to tooth loss!

Numerous studies have looked into the correlation between gum disease and major medical conditions. These studies suggest that people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections. Research suggests that periodontal bacteria in the bloodstream may:

  • Contribute to the development of heart disease
  • Increase the risk of stroke
  • Compromise the health of those that have diabetes or respiratory diseases
  • Increase a woman’s risk of having a preterm, low-birth-weight baby

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, Dr. Marie Durflinger recommends the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember….the mouth-body connection! Taking care of your oral health may contribute to your overall medical health!


Are amalgam (silver) fillings safe?

Over the years there has been some concern as to the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin, and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.

The consensus is that amalgam (silver) fillings are safe.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material.

Here at Auburn Family Dental, we elected to stop using mercury fillings several years ago. We use composite (tooth colored) fillings for adults and children. They are durable and safe. Composite fillings are bonded to the tooth compared to amalgams that require a retentive groove, which requires removing more tooth structure. Composite fillings bond to the tooth which is a more conservative procedure. The composite fillings also look more natural and are aesthetically pleasing to the eye.


When are sealants recommended?

Although thorough brushing and flossing remove most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are too large to possibly fit and clean most of these areas. This is where sealants play an important role. The sealant can be placed only if there is no decay on the tooth.

A sealant is a thin plastic coating that covers and protects the chewing surfaces of molars, premolars, and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and help keep these areas free of decay.

Sealants are easily applied by your dentist or dental hygienist, and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth. A special light will be used to harden the sealant material.

After sealant treatment, it’s important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.

Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.

Remember, if there is decay on the chewing surface of a tooth a composite restoration (filling) would be necessary and a sealant would not be recommended.


What should I do if a tooth is knocked out?

We’re all at risk of having a tooth knocked out. More than 5 million teeth are knocked out every year! If we know how to handle this emergency situation, we may be able to actually save the tooth. Teeth that are knocked out maybe possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:

Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.

DO NOT scrub or use soap or chemicals to clean the tooth. If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.

Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

Try to place the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place. Apply a cold compress to the mouth for pain and swelling as needed.

If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.

Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is placed back into the socket, the greater the likelihood it has to survive and possibly last for many years. So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

  • Wearing a mouthguard when playing sports
  • Always wearing your seatbelt
  • Avoiding fights
  • Avoid chewing hard items such as ice, popcorn kernels, hard bread, etc.

Why straighten teeth?

Straighter teeth perform chewing, biting, and speaking functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.

There are several types of malocclusion, including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to clean effectively, which means that debris, plaque, and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMJ) - Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw, and the grinding of teeth characterize this debilitating disorder.

Tooth injury – Straight teeth creates a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.

Creating a correct bite alignment and distributing pressure evenly will ensure the longevity of your bite and also coupled with a gorgeous smile.

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