Sal Longo D.D.S.
Northridge Professional Building
77 Quaker Ridge Road, Suite 211
New Rochelle, NY 10804
Frequently Asked Questions
What is fluoride and why is it controversial?
Can my teeth be whiter?
What are implants?
Why should I replace a missing tooth?
Is flossing really important?
Should I replace my silver fillings?
What are wisdom teeth?
When should I take my baby to the dentist?
What is the difference between a cap and a crown?
What is bonding?
Can I get AIDS from a dental visit?
What exactly is a root canal?
Q. What is fluoride and why is it controversial?
A. Fluoride is a substance that strengthens the enamel
(outer coating) of teeth. It can be administered in a number
of ways. In many communities fluoride is added to the drinking
water so that every time you have a glass of water you get a
small amount of fluoride internally. Most toothpastes contain
fluoride and there are over-the-counter mouthrinses that contain
fluoride. In addition many dentists will give
their patients fluoride treatments as part of a standard recall
appointment. In communities where the water supply is not fluoridated
many pediatricians will prescribe fluoride supplements to their young
Fluoride is controversial because like many substances it can be
harmful in large doses. If a child swallows a significant amount of
toothpaste or a fluoride mouthrinse it can make them sick and discolor
their teeth. Also, many extremists believe that water fluoridation by the
government is an unethical way to mass medicate the population against
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Q. Can my teeth be whiter?
A. Hardly anyone is born with pure white teeth and so most everyone can have
whiter teeth. There are many ways of achieving this. One of the easier and
more cost-effective methods is teeth-bleaching. There are two general ways
of doing this. One is called Nightguard bleaching or home bleaching and it
involves wearing a thin plastic form over your teeth (usually while you
sleep) containing the bleaching material. This method usually takes about
two to three weeks but sometimes the full effect won't be realized for
several months. The second method is usually referred to as in-office or
laser bleaching. This type of bleaching is done in the dental chair and
consists of several visits of about 45 minutes in length. A more potent
bleaching material is placed on the teeth and activated by a laser or high-intensity light. Since the bleaching material is very strong, the lips, gums
and tongue must be protected by a dental dam. This procedure is also a
little more costly than home bleaching.|
Another way of whitening the teeth is through porcelain laminate veneers.
These are very thin layers of porcelain which are bonded to the fronts of
teeth to whiten and sometimes even correct some other abnormalities like
chipped teeth or slightly crooked teeth. The advantage to veneers
is that the outcome is much more predictable than bleaching. The
disadvantages are that veneers are more costly and they do involve some
minor drilling, though often the drilling can be done without an
A third mode of teeth whitening is cosmetic bonding. Bonding is the placement
of a white filling material over the faces of the teeth similar to veneering.
The difference is that the bonding material does not last as long as porcelain
and does not have the same luster. An advantage is that it takes less time
and is less costly.
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Q. What are implants?
A. Implants are tooth replacements that are anchored right into the jawbone.
Unlike bridges, which are fastened to adjacent teeth or dentures which are
removable, an implant is a tooth replacement that feels more like a natural
tooth. The disadvantage to getting an implant is that it is a surgical
procedure so there is healing time to take into account, and they tend to
be very costly. However the end result tends to look and feel more like
a natural tooth than other replacements. Implants can also be used to
anchor bridges and dentures.|
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Q. Why should I replace a missing tooth?
A. Many people feel that it is unnecessary to replace missing teeth especially
if they are in the back of the mouth. This isn't so. When there is a space in
the mouth other teeth tend to drift into that space. Teeth behind the space drift
forward. Teeth above drift down. And teeth below actually drift up. This can
cause problems with your bite and your gums and can also create a situation
where cavities are more likely. Wisdom teeth are the only teeth that do not
need to be replaced.|
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Q. Is flossing really important?
A. Flossing is very important because it helps remove plaque and food particles
from between the teeth and under the gums. These are places that toothbrushes
generally have a hard time reaching. This is important in controlling gum disease
and avoiding cavities between teeth. New studies have found that flossing may
be even more important in maintaining the health of other parts of the body.
When plaque accumulates between teeth it contributes to gum disease. The
gums become inflamed and this causes them to bleed easily. The bacteria in
the plaque can then get into your bloodstream and travel to other parts of
the body like the lungs, heart and brain. This is thought to contribute to
heart disease, stroke, lung problems and even memory loss.|
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Q. Should I replace my silver fillings?
A. Some dentists advocate the removal of silver fillings because of the presence
of mercury in the fillings. These fillings are called amalgams and are the
subject of lots of controversy. Certain studies have linked mercury levels in
the blood with all sorts of diseases and disorders from arthritis to multiple
sclerosis. However the ADA (American Dental Association) has done studies and
has not found any evidence linking amalgam mercury to any systemic problems.
Although the blood level of mercury does rise when a person has several silver
fillings, it is generally thought that this increase is insignificant. It is
believed that the wholesale removal of amalgam fillings is unnecessary.
However since white bonded fillings are now very strong and durable, it does make sense to replace defective old silver fillings with white fillings.
It also makes sense to replace some silver fillings with white fillings for cosmetic reasons.|
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Q. What are wisdom teeth?
A. Wisdom teeth are the third molars. They are the last teeth in the mouth. There
are four of them: one upper left, one lower left, one upper right, one lower
right. They're called wisdom teeth because they usually come in much after
the rest of the teeth, in the late teens or early twenties. The reason that
so many people run into trouble with them is that through evolution our
faces got flatter and our mouths often can't accomodate those last four
teeth. So they become impacted. That means that they are either partially or
fully under the gums, wedged behind the second molars, or even fully embedded
in the jawbone. Many times these impacted teeth can cause serious infections,
and so they are usually pulled. Another reason that wisdom teeth can cause
problems, even if they are not impacted, is because they are so far back in
the mouth, most people have a hard time keeping them adequately clean and that can cause big cavities or gum problems.|
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Q. When should I take my baby to the dentist?
A. It used to be thought that a good age to begin taking kids to the dentist was between three and four years old. Now the thinking is that sooner is better than later. If minor problems are noticed they can be corrected before they worsen. Younger children don't necessarily need to have a full formal visit but it's a good idea for them to come to the office and experience the sights and sounds of a dentist office. Early visits where no major work is done can accustom them to later appointments where they may need a filling or more. At that point they will be desensitized to the dental environment and it will prove to be less traumatic for patient and parent. It is also important for young children who do not live in fluoridated communities to get fluoride supplements. (see "What is fluoride...?")|
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Q. What is the difference between a cap and a crown?
A. Generally speaking, a cap and a crown are just different words for the same
thing, although there are different types of crowns. One type is called the
porcelain-metal crown which has a metal framework for strength and a porcelain
coating for esthetics. The all-gold crown used to be very popular but is not
very common these days. Gaining in popularity, due to the advent of stronger,
more durable porcelains, is the all-porcelain crown. In the old days, they
were called Porcelain Jackets or PJ's and they were only done on front teeth.
Nowadays they can be used anywhere and we even make all-porcelain bridges.|
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Q. What is bonding?
A. Bonding is a term that is used for white fillings that are bonded to a
tooth. Metal fillings are held in teeth mechanically but white fillings, also called composites are chemically bonded to the tooth (usually by use of a high-intensity blue light). Bonding can be done on any tooth, but when many people
talk about bonding they are referring to cosmetic bonding which is the placement
of composites on the front teeth either to whiten or to improve their look.
(see "Can my teeth be whiter?")|
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Q. Can I get AIDS from a dental visit?
A. Your chances of contracting AIDS from a dental visit are extremely slim
perhaps even zero. In order for a person to be infected with HIV (Human
Immunodeficiency Virus) there must be either blood to blood or semen to
blood contact. For you to catch AIDS from your dentist he must somehow
cause himself to bleed then transfer enough blood into an open wound in
your mouth. This is an extremely unlikely occurrence to happen by accident.
Even if the doctor did not practice good sterilization techniques and there
were traces of blood on an instrument from a previous patient, the virus
that may have been in the blood would have died already from exposure to
air. Even if the dentist bleeds into your mouth and you swallow some blood,
the virus is killed by stomach acids.
Several years ago there was a
celebrated case of a dentist in Florida who evidently infected a few of his
patients. After exhaustive studies of the case the CDC (Center for Disease
Control) ultimately decided that there was something more to the story;
perhaps the dentist actually infected the patients purposely. Before and
since there have been no other instances of AIDS being passed from a dentist
to a patient.
Dentists (as well as all other health care providers)
routinely use what is known as "Universal Precautions". This means that they
assume that any patient or staff member can theoretically be carrying an
infectious disease and therefore all precautions are taken, with every
patient, to prevent any spread of disease. This involves the use of
disposables where applicable and the sterilization of all non-disposable
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Q. What exactly is a root canal?
A. A root canal or more precisely root canal therapy is basically the removal of the nerve from the root or roots of a tooth. The reason for this is that the nerve is either dead, dying or infected. The procedure consists of gaining access to the nerve by drilling through the top or back of the offending tooth and then physically removing the nerve from the tooth. Once the nerve is gone the canal is cleaned and shaped with small instruments so that it is wider and smoother. Then a root canal filling is placed within the canal.|
Root canals vary in many ways. Some teeth have only one canal while molars typically have three or more. A root canal procedure can take one visit or many and sometimes a dentist may use what is called a dental dam to isolate the tooth. Many times a general dentist will do the root canal therapy but sometimes you may be referred to a specialist in root canal treatment called an endodontist. In some cases antibiotics may be necessary. Many people breeze through root canals without any discomfort, while a few may experience severe pain. This usually depends on how badly the tooth has been infected prior to starting the treatment.
Once the root canal therapy is completed oftentimes a post and a crown need to be made for the tooth. The reason for this is that after a root canal the tooth is compromised both by loss of tooth structure and by loss of the blood supply to the tooth. This makes the tooth more brittle and more likely to fracture. Sometimes a tooth will discolor after a root canal procedure.
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Sal Longo, DDS;