Frequently Asked Questions

We know you have questions about visiting the dentist.  That's why we made a page dedicated to our patients' frequently asked questions.  If you're unable to find the answer to your questions, we invite you to contact us by phone or email!

Oral Hygiene

Bad breath (halitosis) is caused by a number of factors such as:

  • poor oral hygiene
  • certain foods (garlic, onions, etc)
  • gum disease
  • dry mouth
  • dieting - ketone bodies have a distinct smell and are released when you burn fat
  • tobacco products
  • systemic disease (diabetes, liver and kidney disease, sinus infections, pneumonia, and bronchitis are several of many)

You can prevent bad breath by:

  • regularly brushing and flossing your teeth, and especially brushing your tongue!  Your tongue harbors bacteria that can cause bad breath!
  • visiting your dentist on a regular basis for professional cleanings and exams
  • stop smoking/chewing tobacco
  • drink water frequently
  • use mouthwashes/rinses - these only work after plaque and food debris have been effectively removed from the teeth!

The general recommendation is to brush twice a day and floss once.  We especially emphasize brushing the teeth and flossing before bed.  At night your salivary glands are almost completely inactive, which allows bacteria to grow much faster while you're asleep!

Many patients have systemic conditions or are taking medications that necessitate different daily oral hygiene habits.  Sometimes these patients may need prescription-level toothpastes or fluoride gel trays to add to their hygiene regimen.  Be sure to inform your dentist of your full medical history and ALL medications you take!

The recommendation is to visit your dentist twice a year for a regular cleaning and exam. This helps keep your gums healthy, and allows us to regularly inspect the teeth for signs of decay. Today, dentists should also be screening each patient for signs of oral cancer and oropharyngeal (throat) cancer. At our office, we also take routine dental x-rays once a year to help us screen for early signs of tooth decay and other changes in the teeth and jawbones.

Patients who are determined to be high risk for dental decay or gum disease may require more frequent visits or more frequent x-rays. Changes in the mouth can happen extremely fast, especially when a patient has demonstrated a history of frequent cavities and gum disease. More frequent visits can help us catch new signs of disease early and give us clues as to how to alter the patient's preventive care at home.

No. Bleeding from regular brushing or flossing is a sign of inflammation of the gum tissue.  This inflammation is caused by harmful bacteria that colonize on the surfaces of the teeth, often below the gum line.  Gums that bleed easily are a sign of diseases such as gingivitis and, in more severe cases, periodontal disease.

If you find that your gums bleed easily when you brush or floss, it is time to see a dentist and have your teeth and gums evaluated.  A dental cleaning will remove the bacterial colonies from your teeth.  This allows the inflammation to subside and your gums to begin healing.  In more severe cases, patients may require a "deep cleaning" with local anesthesia.  This permits us to reach the plaque and tarter found in deep pockets, while prioritizing patient comfort.  These patients will often need their teeth cleaned at more frequent intervals in order to prevent the recurrence of disease.

Brushing our teeth removes food particles, plaque, and bacteria from all 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.

Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these areas, but disrupts plaque colonies from building up. This prevents damage to the gums, teeth, and bone.

How to floss properly:

  • Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
  • Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning each side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Plaque is a sticky, white, 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 and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and will also slowly destroy the bone. This is the beginning of periodontal disease.

Brushing, flossing, and regular dental cleanings help to keep these bacterial colonies at bay and help prevent tooth decay and gum disease.

General and Preventive Dentistry

Over the years, there has been some concern about 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.

According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth. The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.

The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of the millions of silver fillings placed over the decades.

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 when we are exposed at high levels of mercury vapor and some mercury compounds. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous alternatives to silver fillings, including tooth-colored composites, ceramics, and gold fillings.  At Rathke Family Dentistry, we have not placed silver fillings for many years due to patient preference and availability of viable alternatives.

Many patients over the years have asked if they should have their silver fillings removed and replaced due to mercury concerns.  We do not recommend the "routine removal" of silver fillings, however we will replace them if requested.

We’re all at risk for 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 might be able to save the tooth.  Teeth that are knocked out can possibly be re-implanted if we act quickly and follow these simple steps:

  1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
  2. 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.
  3. 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 replace 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 replaced back into the socket, the greater the likelihood it has to survive.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

Also important to note, almost all of these cases will require root canal therapy within weeks after successful reimplantation.  This is because the blood vessels to the pulp are broken when the tooth comes dislodged, which causes the pulp to die.  Root canal therapy will help to prevent the tooth from developing an abscess in the future.

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 breads, etc.

Thanks to advances in modern dentistry, we have a wide array of options before us to replace missing teeth.  The choice of which of these methods to use is determined by:

  • the number of missing teeth
  • the location in the mouth of the missing teeth
  • the state of the bone where the teeth are missing
  • cost of replacement

Single missing teeth are typically replaced with a dental bridge or with an dental implant.  When two adjacent teeth are missing, it is still often possible to replace them with a dental bridge or two dental implants.  Some patients prefer to have a removable prosthesis made to replace multiple teeth.

When five or more teeth are missing in an arch, many patients chose the economic method of replacing all of them with a removable prosthesis, while others may prefer to have bridges or implants.

For replace entire arches of teeth, we have several options from complete dentures to full arch prostheses supported entirely by dental implants.

The bottom line is, we have a lot of options at our disposal to replace missing teeth.  To learn more about bridges and removable prosthetics, visit our general dentistry services page.  To learn more about dental implant options, visit our dental implants services page.

Signs and Symptoms of Periodontal Disease:

  • Red and puffy gums
  • Bleeding gums - including after regular brushing/flossing
  • Persistent bad breath
  • New spacing between teeth
  • Loose teeth
  • Pus around the teeth and gums
  • Receding gums
  • Tenderness or Discomfort – usually found in advanced stages

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 and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

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

  • Smoking or chewing tobacco
  • Certain tooth or appliance conditions
  • Many medications
  • Pregnancy, oral contraceptives, and puberty
  • Systemic diseases
  • Genetics may play role

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Cosmetic Dentistry

If you’re feeling somewhat self-conscious about your teeth or simply want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to advances in cosmetic dental procedures and materials, but also because patients are becoming increasingly focused on improving their overall health. This includes dental prevention and having a healthier, whiter, more radiant smile.

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, from restoring a single tooth to having a full mouth make-over.

Common cosmetic procedures:

  • Teeth whitening
  • Tooth-colored (composite) fillings
  • Porcelain veneers
  • All-ceramic crowns (commonly called "caps")
  • Dental implants
  • Orthodontics

Visit our cosmetic dentistry page to learn more!

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth structure and is an effective way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are less effective than professional treatments and might not be approved by the American Dental Association (ADA).

As we age, the outer layer of the tooth, enamel, can become damaged, stained, and discolored.  Much of the color of our teeth also comes from the dentin underneath the enamel, which tends to become darker and yellower over time. Smoking and fluids such as coffee, tea, and wine can also contribute to tooth discoloration, making teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as the tetracycline group of antibiotics.  While fluoride in your diet is critical to forming healthy bone and teeth, excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored (too much of almost anything can cause problems!).

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for whitening. Individual tooth discoloration, for example, often requires treatment other than regular whitening, and can be a sign of a serious problem.  Occasionally, tetracycline and fluorosis stains are difficult to whiten; our doctors and dental hygienists may offer alternate whitening methods or other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate any old fillings, crowns, etc. before the whitening process begins.  Once the whitening is done, we can match the new restorations to the new shade of your teeth!

Since teeth whitening tends to regress, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: Our doctors do not currently recommend in-office tooth whitening. While it is sometimes faster than home whitening systems, it is not proven to be more effective, and can cause increased sensitivity. We prefer the home bleaching method where the timing and frequency of whitening can be tailored to your comfort!

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!


Most of us have fillings in our mouths that date back many years and some may have even been placed during our childhood. These fillings may now be old, dark, and unattractive, making us feel self-conscious when we smile, laugh, and talk. Old fillings can not only be unattractive, they may also be defective. When a filling is old, the margins (space between the tooth and filling) may eventually open and allow bacteria and food debris to enter, potentially causing dental decay.

Our doctors can check your fillings and evaluate if they are defective and need replacement. Also, if you simply want to replace fillings that are unattractive, you and your doctor can decide which ones should be replaced first and what replacement options would best suit you. There are many state-of-the-art dental filling materials and procedures available today that are quick, painless, and cost effective for replacing old, unattractive or defective fillings.

Options for replacing old, unattractive, or discolored fillings:

  • Composite (tooth-colored) fillings
  • All-ceramic crowns (caps)
  • Porcelain veneers

As you can see, there are various options for replacing old, unattractive fillings. These treatments will provide strong, natural, and long-lasting replacement solutions to enhance the health and beauty of your smile.

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth.  They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.

Veneers may be used to restore or correct the following dental conditions:

  • Severely discolored or stained teeth
  • Unwanted or uneven spaces
  • Worn or chipped teeth
  • Slight tooth crowding
  • Misshapen teeth
  • Teeth that are too small or large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

Teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers.  The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.

Dental Implants

As with any surgical procedure, some post-operative swelling and discomfort can be expected from dental implant surgery.  However, any discomfort following implant surgery is usually minimal.  In fact, most patients are completely unaware of the implant being present, even on the same day as surgery!  For the procedure itself, you will always have local anesthesia, and many surgeons also elect to use oral and/or IV sedation for patient comfort.

After implants are placed, they must be given time for the bone to properly integrate with the implant surface.  This process generally takes 4 months for the lower jaw and 6 months for the upper jaw.  The reason for the difference is the upper jaw is much less dense than the lower jaw.  Thus, the body requires more time before it is safe to place chewing forces on the implant, a process called "loading".

For teeth in the front of the mouth, we will have a removable appliance made for you to smile and eat with while your implant heals.  Sometimes, 6-8 weeks after surgery, we can attach a temporary crown to an implant to fill the gap and shape the gums in preparation for making the permanent crown.

These are generalizations for the time required before we can load the implant.  The final word on when we can place load implants depends on the condition of the bone at the time of surgery and at follow-up evaluations.  Different systemic diseases such as osteoporosis and diabetes may lead us to wait longer before loading.

The main exception to this is a procedure called TeethXpress, where the remaining natural teeth are removed, 4-6 implants are placed, and a new set of temporary prosthetic teeth are immediately attached to the implants at the time of surgery.  The higher number of implants and their cross-arch placement pattern allows us the advantages of reliable immediate loading that we are unable to achieve with single implants.  To learn more about TeethXpress, visit our dental implants page or visit our TeethXpress website!

Most often the answer to this question is no!  Age does not generally affect the reliability or benefits of dental implant procedures.  The overall health of the patient is generally much more important than the patient's age.  For example, we would more readily recommend dental implants to a healthy 85 year-old patient, but we will be much more guarded with a 35 year-old patient with uncontrolled type II diabetes.  In fact, we recently completed a full upper arch restoration with 6 implants on a patient 84 years of age!

Many patients will also ask if implants are worth the cost at an older age.  Most of the time our answer to this question is yes!  This especially applies if a patient is needing to restore all of their teeth in one or both arches.  Studies have demonstrated that people with properly functioning teeth live an average of 10 years longer than patients without teeth or using regular dentures.  Patients with either healthy natural teeth or teeth supported by dental implants are less likely to suffer from gastric reflux, type II diabetes, obesity, and many other systemic conditions. 

Restoration with dental implants is less about improving your smile than it is about quality of life.  Taking advantage of dental implants now can pay huge dividends in quality of life later on.

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