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Frequently Asked Questions


Dental Anxiety

What Causes Dental Anxiety?
It’s easy to blame mom and dad for all our shortcomings—anxieties included. The truth is your parents’ behavior toward the dentist and a dental visit can affect your experience. The way your siblings respond also plays a role.

A study at North Carolina University has shown that your own overall anxiety level is actually a better indicator of how you will react to the dentist and dental visits.

Dental fear may also stem from:
• Prior painful or negative experiences
• Feeling helpless or out of control in a dental office situation
• Feeling embarrassed about neglecting your teeth
• Fear of being ridiculed about neglecting your teeth
Ways to Overcome Dental Anxiety
Dental fear can keep patients away from the dental chair, but the longer you wait to see a dentist, the worse your dental problems can get. The fact is dental anxiety affects millions of Americans, so you’re not alone! Many fearful patients are learning that modern dental treatment has taken the pain out of dentistry.
• Yoga Techniques for Breathing and Relaxation
• Listening to your iPod during a visit
• Nitrous Oxide Inhalation Sedation
• Oral Sedation
• IV Sedation

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Baby Bottle Tooth Decay

Will my baby get tooth decay from drinking a bottle?
Baby Bottle Tooth Decay: A Problem for Parents

Tooth decay is an epidemic in young children. It starts as early as infancy with baby bottle tooth decay, which is caused when babies are exposed to sugary substances -- like milk, formula and juice -- on a frequent basis. The more children are exposed to these things, the greater their risk of baby bottle tooth decay. The simplest way to help prevent baby bottle tooth decay is by keeping baby's mouth clean and not letting baby go to sleep with a bottle.

Fluoride and dental sealants are commonly used to help prevent decay in children's teeth. Fluoride strengthens teeth and is often added to toothpaste and public water supplies. Sealants are a clear, plastic coating that are applied to molars to prevent plaque from forming.

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Does fluoride really help me reduce tooth decay?
Are you thirsty for dental health? If so, you'll be glad to learn how an ordinary glass of water can help to strengthen your teeth. Fluoride is a naturally occurring mineral so beneficial to your smile, many communities even add it to their water supply.
Water naturally contains a small amount of fluoride, as do some foods. Increasing this fluoride content creates a constant "treatment" to prevent tooth decay and rebuild weakened tooth enamel. Regular contact with these small doses helps maintain the surface and structure of your teeth.
The Function of Fluoride
Throughout the day, your teeth are exposed to acids that can break down enamel and lead to tooth decay -- fluoride helps inhibit these acids from attacking the tooth surface. More importantly, it helps restore the minerals that have been worn down and repair weak spots in the enamel. Fluoride is also especially beneficial for children because it becomes integrated with growing teeth and helps develop resistance to acids later in life.
Treat Your Teeth
In addition to the small amounts of fluoride you eat or drink, dentists recommend you brush with fluoride toothpaste. At your regular check-ups, your dentist will typically treat your teeth with a higher concentration of fluoride to protect your teeth year round. If needed, your dentist can also prescribe fluoride supplements or recommend a fluoride mouth rinse.
Dry Mouth Conditions -- Some medications and conditions reduce saliva production and cause dry mouth which makes it harder to neutralize acids on the tooth.
History of Gum Disease -- Gum disease, or gingivitis, means your teeth are exposed to more bacteria and at higher risk for cavities and tooth decay.
Frequent Dental Cavities -- A history of dental cavities is a good indication that your teeth may benefit from additional fluoride.
Dental Braces, Dental Crowns or Dental Bridges -- Anyone with dental fixtures such as dental braces, a dental crown or a dental bridge should take special care to prevent tooth decay and keep teeth healthy and strong. 
Recent Teeth Whitening -- A post-teeth whitening fluoride treatment helps reduce sensitivity to heat and cold and restores important minerals to the tooth surface.
While fluoride is important for all adult teeth, it is also highly recommended for children -- just remember that any dental treatment for children should be carefully supervised, so talk to your dentist before introducing fluoride into your kids' routine. Regular, responsible use can help the whole family keep healthy teeth and give you something to smile about!

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How do I make sure I am flossing the correct way?
You probably know that brushing alone won't take care of your oral hygiene -- you hear it all the time from commercials, your dentist, probably even from your mother. You probably know they're all right, too.

With regular dental cleanings, your dentist can help prevent the crevices between your teeth from becoming a playground for all kinds of dental diseases including cavities and bad breath. But you can also play an integral role in the health of your teeth and gums by making sure to floss at least once a day -- especially before going to bed.
If it isn't already, be sure to make dental floss part of your oral hygiene toolkit. Dental floss is great for cleaning the areas between your teeth because it can reach where your toothbrush can't.

Floss is available waxed or unwaxed, flavored or unflavored, thin or wide. The kind of floss you want is entirely up to you, though you might want to consider that waxed floss slips in between teeth easier, and smooth, soft floss provides maximum comfort for your gums. Of course, flavor doesn't hurt either.
Flossing seems easy enough, but you'll want to make sure you're doing it right to maximize the benefits of all your effort. Compare your flossing techniques to the steps below, and make adjustments to your routine wherever necessary.

  • Break off just over an arm's length of floss.
  • Loosely wind about six inches of floss around your middle finger and use your thumb to hold it in place.
  • Hold and straighten the floss with the thumb and pointer finger of your other hand.
  • Use a gentle back and forth motion to guide the floss between your teeth.
  • Make sure to never "snap" the floss into your gums.
  • When the floss reaches the gum line, curve it against your tooth and gently slide it under your gums and then away from your gum line.
  • Wind the used floss around your middle finger as you go.

Learning how to floss teeth properly can be the difference between a clean, healthy mouth and one riddled with tooth decay and gum disease. Keep in mind that while there are no guarantees when it comes to your dental health, solid oral hygiene habits, combined with regular dental visits, is the best insurance your teeth have.

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Bad Breath

What causes bad breath and how can I prevent it from getting bad?
Having bad breath can be painfully embarrassing and even put a damper on your social life or a job prospect. In this article, we'll go over bad breath basics: what causes bad breath and how to get rid of bad breath once and for all!
Causes of Bad Breath
Technically speaking, bad breath is a biological reaction characterized by the release of volatile sulfur into the atmosphere. Bad breath may also contain hydrogen sulfide and methyl marcaptan.

So what causes bad breath? Most people have had it at least once so it makes sense that there are some common culprits. As it turns out, there are! To start, anyone with bad oral habits is likely to have bad breath. That means if you're not brushing, flossing or seeing a dentist regularly, you should expect to experience bad breath soon enough. Keep in mind, however, that bad breath can also occur when food remains in your mouth or between your teeth even after brushing. Basically, these small bits of food begin to rot and start to smell.
There are other causes of bad breath, including:
Food -- Certain foods, such as garlic, onions, cheeses and dairy, are common causes of bad breath. When you eat smelly foods, the digestive process releases strong gases that smell unpleasant; these gases can be released 24 hours after you've eaten that stinky item.
Tongue -- The tongue harbors many bacteria that are some of the major causes of bad breath.
Medical Conditions -- Certain medical conditions have been identified as causes of bad breath. Severe kidney failure or diabetic ketoacidosis are two examples.
Large Dose of Vitamins -- Ever take a handful of vitamins on an empty stomach? Not only can that cause a tummy ache, but it's also one of the causes of bad breath.
Dry Mouth Syndrome (Xerostomia) -- A decrease in saliva production, known as dry mouth syndrome, can be caused by conditions such as anemia or diabetes. Taking over-the-counter medications and smoking cigarettes can also cause dry mouth; in turn, dry mouth can cause bad breath.
Cavities -- A dental cavity is the result of tooth decay, which is an oral disease. When your teeth have decayed, it's not uncommon for the decay to produce an odor -- bad breath.
Dental Abscess -- When a cavity is left untreated, a dental abscess can form around it. This pocket of pus contains bacteria that causes bad breath.
Gingivitis (or any form of gum disease) -- At its extreme, gingivitis can lead to tooth loss. But more often, it's one of the main causes of bleeding gums and bad breath.
Other causes of bad breath include undigested foods in the stomach and impacted teeth; the latter can trap food and debris in the areas where an impacted tooth is crowning (poking through the gums). The key to understanding what causes bad breath is remembering that if your mouth isn't clean or healthy, it's probably going to make your breath smell bad.
How to Get Rid of Bad Breath
Now that you know what causes bad breath, it's time to go over what you're probably most interested in: how to get rid of bad breath. The first thing to be aware of is that many of the so-called bad breath remedies like breath mints, gums or strips, offer only temporary help.
Brushing twice a day, flossing daily and using mouthwash at bedtime is your ticket to a life free of bad breath (also known as halitosis). Proper oral hygiene habits can't be stressed enough! Some even say that brushing after consuming sugar-rich foods -- including pasta, bread, potatoes and milk -- is a good idea. If you've been searching for a magical solution on how to get rid of bad breath, now you know that the formula is simple: practice good oral hygiene and go for regular dental visits. A dentist can also offer more expert advice and tips to suit your lifestyle, so be sure to ask.

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Does mouthwash really help with bad breath?
When bad breath makes an occasional appearance, you have a few options to treat it. There are two types of mouthwash for you to consider as part of your oral hygiene routine:
Cosmetic -- Cosmetic mouthwash is used to freshen breath. Although over-the-counter mouthwash masks bad breath, it doesn't cure halitosis and its effect only lasts up to three hours. But anti-bacterial mouthwashes do reduce bacteria and remove debris before or after brushing, which can give an extra boost to your oral hygiene routine.
Therapeutic -- These mouth rinses help control the oral problems that cause bad breath. Therapeutic mouthwashes may be recommended to reduce dental plaque, control gingivitis (keep in mind that mouthwash is not a gum disease treatment and periodontal disease can only be treated by a dentist) and provide relief from oral pain; fluoride rinses help strengthen teeth and prevent tooth decay. Some therapeutic mouthwashes can only be prescribed by a dentist and may be used to help keep the mouth clean after oral surgery.
Your mouthwash should contain directions for usage. Follow the directions and use only the proper amount indicated on the label to reduce the possibility of side effects. Most mouthwashes should be swished around the oral cavity for 30 seconds and spit out. Avoid swallowing mouthwash, as the ingredients can upset your stomach. After rinsing, you should not eat or drink anything for at least 30 minutes, as to not diminish its effectiveness. For lasting results, don't smoke -- smoking not only causes bad breath but also ruins the effectiveness of mouthwash.
Be On the Look Out
Some mouthwashes contain a high level of alcohol, which has no therapeutic value. Surprisingly, alcohol doesn't kill germs but is used as a preservative to sustain the mouthwash's active ingredients. Unfortunately, alcohol-containing mouth rinses can cause a burning sensation for some patients. Mouthwash is also not recommended for children under the age of 12 as it poses a risk of alcohol poisoning if swallowed.

Recently, there's been much debate as to whether these mouth rinses cause more harm than good. Some say that alcohol-containing mouthwashes may end up causing the same problem they're designed to fix. Alcohol is a drying agent -- and if your mouth is dry, you can't produce saliva. A dry mouth is a perfect environment for the bacteria that cause bad breath and tooth decay to grow. Saliva works like a natural mouthwash, helping wash away the elements that contribute to mouth odor. If you suffer from dry mouth, a mouthwash that contains alcohol may not be for you.

That isn't to say you should avoid mouthwashes with alcohol. Different substances affect people in different ways, so a mouthwash with high alcohol content may not bother you. There is also no evidence that using an alcohol-containing mouthwash increases your risk of oral cancer -- but you should read the label for other side effects, as some mouthwashes can cause tooth stains, ulcers and tooth sensitivity. Your dentist can help you decide which mouthwash is best for you.
Mouthwash can be beneficial for those who are prone to oral problems. Anti-bacterial mouth rinses can help those who are extremely susceptible to tooth decay or gingivitis, an early stage of gum disease. Mouthwashes may also be recommended for geriatric or disabled patients who might have dexterity problems or trouble managing dental products.
But for most of us, mouthwash is not meant to be a substitute for proper oral hygiene techniques. The best way to get rid of bacteria is through brushing and flossing, which you should be doing on a daily basis. Although mouthwash will reduce bacteria, it will not cure the oral problems that cause bad breath. If you want to "smack down" halitosis, visit your dentist regularly for dental treatment.

We're all fans of fresh breath, and a good mouthwash can keep us from smelling offensive. If you're interested in using mouthwash as part of your oral hygiene routine, speak with your dentist about which one is right for you.

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Electric Toothbrush

What kind of electric toothbrush should I use and is it worth the cost?
These days it seems like we have an electric version of just about everything -- electric razors, electric cars and of course, electric toothbrushes. And while you might think using a motorized toothbrush is just plain lazy, they actually provide benefits beyond making brushing easier.
Electric toothbrushes are ... exactly what their name suggests: Toothbrushes that use electricity to move the bristles during use. The brush head usually moves in a circular or back-and-forth motion powered by rechargeable or replaceable batteries.
Are They Really Better?
Dentists will tell you that a manual toothbrush can be just as effective as an electric model if used properly, but most patients simply don't brush as thoroughly or for as long as they should. In these cases, an electric toothbrush can help by maximizing the cleaning power of every stroke. In addition, some dentists recommend electric toothbrushes because they may:

  • Make it easier to clean around dental braces, dental implants or a dental bridge
  • Improve oral health in patients who are receiving gum disease treatment
  • Monitor brushing duration by beeping at certain levels
  • Help teeth look whiter by reducing surface stains
  • Remove dental plaque and combat gingivitis better than manual brushes
  • Motivate reluctant brushers to brush for longer

Lending a Hand
Electric toothbrushes also allow patients with limited manual dexterity to effectively brush their teeth. In addition, anyone who must assist a disabled or elderly person with their oral hygiene may have an easier time using a motorized toothbrush. There are many types of electric toothbrushes on the market today, so ask your dentist which model he or she recommends -- there are even some brands that dispense toothpaste, vibrate to help dislodge dental plaque and include a timer to ensure you brush for the proper amount of time. The important thing to remember is that an electric toothbrush is no substitute for good brushing. Although it may provide some additional dental benefits, it's up to you to take responsibility for your oral health -- make sure to brush for a full two minutes, floss, and visit your dentist regularly. Remember, a toothbrush is only as good as the person who uses it!

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What toothpaste will work and is best for me?
There are many types of toothpastes on the market. Each is designed to fit individual needs:
Whitening Toothpaste -- Teeth whitening toothpastes don't actually whiten teeth; they use scrubbing materials or chemicals to remove tooth stains.
Tartar Control Toothpaste -- Likewise, tartar control toothpastes don't remove dental tartar but they do help prevent dental tartar from accumulating. Dental tartar can only be removed by a dentist, so it's beneficial to start using tartar-control toothpaste after a dental checkup.
Desensitizing Toothpaste -- Tooth sensitivity often results from weakened enamel or the exposure of roots due to receding gums. Desensitizing toothpastes work by creating a barrier and blocking irritants from reaching the nerves.
Fluoride Toothpaste -- Fluoride is important to your dental health and can be added to any type of toothpaste. Not only does fluoride strengthen teeth against dental cavities but it re-mineralizes teeth worn by acid and fights sensitivity. Fluoride toothpaste is an excellent choice for those who need a little extra help protecting themselves from cavities -- especially children and seniors. Fluoride toothpastes are also recommended for those without the benefit of community water fluoridation.
Gum Health Toothpaste -- Dental plaque found under the gum line can lead to gum disease. Although gum health toothpastes are not a professional gum disease treatment, they can control dental plaque and help prevent the possibility of gum disease in the future.
Smokers' Toothpaste -- These pastes contain abrasive materials used to remove stains. Dentists do not usually recommend smokers' toothpastes, as they can further damage your teeth and delicate gum tissue.
Fresh Breath Toothpaste -- Like many mouthwashes, fresh breath toothpastes are designed to mask bad breath but do not actually treat halitosis.
Natural Toothpaste -- For those who are uncomfortable brushing with chemicals, natural toothpastes may be an option. These contain all-natural ingredients but have varied results. Some natural toothpastes may not contain fluoride, so you should check the label before buying the product.
Children's Toothpaste -- These toothpastes have been developed to meet the special needs of children. As children are extremely susceptible to dental cavities, their toothpastes often contain fluoride. Younger children should only use a small amount of toothpaste to avoid ingestion and prevent dental fluorosis and should be always supervised during brushing.
Baking Soda Toothpaste -- Baking soda has traditional significance because it was once used to clean teeth. Although baking soda has no therapeutic value, some prefer it because they enjoy the fresh feeling they get after brushing with it.
Gels -- Some gels contain mouthwash which may be why some prefer the consistency or taste of a gel over a toothpaste. While gels may make your mouth feel fresher, there's no proof that they clean teeth better than toothpastes. Also, many gels do not contain fluoride.
Tooth Powders -- Dry powders are also available to clean your teeth but they are often more abrasive than toothpaste.
Haste Makes Waste
Equally as important as the type of toothpaste you use is the way you use it. Adults usually only need a pea-sized amount to get the therapeutic effects toothpaste has to offer. How you brush also affects your oral health. Tilt your toothbrush at a 45-degree angle towards the gums and gently brush for at least two minutes using short, circular strokes. You should brush your teeth at least twice a day with a soft toothbrush that won't damage your gums.

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How do I know if my child is in need of orthodontic treatment?
We follow the guidelines established by the American Association of Orthodontists by recommending that an orthodontic evaluation take place at age 7 for all children. This early evaluation can help to determine the best time to begin any necessary treatment. Usually treatment is not necessary at this early age but orthodontic monitoring can troubleshoot some otherwise disastrous situations. It's good to have an orthodontic evaluation at any age, 7 or older.
Can you be too old for braces?
No, age is not a factor, only the health of your gums and bone, which support your teeth. About 35% of our orthodontic patients are adults and that number is still growing!
Will it hurt?
Orthodontic treatment has improved dramatically. As a rule, braces just make your teeth sore for a few days, not sharply painful. This discomfort can be relieved with an over-the-counter pain relievers, like Advil, Aleve, or Tylenol. Today's braces are smaller, more comfortable and our wires are the more space-age resilient ones, minimizing discomfort.
Can I still have braces if I have missing teeth?
Absolutely. When teeth are missing, adjacent teeth will drift into the empty space. This will cause a functional, esthetic or periodontal problem. Orthodontic treatment will correct the alignment for your dentist to replace the missing teeth.  With the use of temporary anchorage devices, almost any movement can be achieved.
Is orthodontic care expensive?
When orthodontic treatment is implemented at the proper time, treatment is often less costly than the dental care required to treat the more serious problems that can develop years later. Many insurance plans now include orthodontics. Creative financing is available and our office offers many payment programs that are sure to meet your needs. Just ask us!

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Michael W. Chang, DDS, MAGD   |   Phone: 703-385-2772   |   3903 Fair Ridge Dr., Suite 207 Fairfax, VA 22033   |   Created by Dental Branding