Below are some of the most frequently asked questions patients have about dentistry and oral health. If you have any other questions, or would like to schedule an appointment, please contact our office today!

1. What does a new patient exam consist of?

Our office takes all the necessary steps to ensure that you receive a comprehensive dental exam. We will perform a thorough evaluation of your gums, check the condition of your teeth and existing restorations, look for any new cavities, screen for oral cancer, take photographs for a cosmetic evaluation and take a complete set of x-rays when needed. This examination is needed to understand the state of your oral health. We can then help you make the right decisions when it comes to your health and smile. With a guided tour of your mouth, we can point out to you each of the present problems. What treatment you decide to undertake and when, is always left up to you. Back to top

2. I had my teeth cleaned and checked regularly in another office but have just moved to South Florida.      Can I make a cleaning appointment only?

Yes, you may come in for a cleaning only. We recommend that all patients start by having a complete exam, before any treatment is performed but we are flexible! There are many problems that can be overlooked with just a cleaning. We will give you a brief exam to identify any problems and then proceed with the cleaning. These concerns can be addressed and discussed when an initial comprehensive examination and consultation are scheduled. Back to top

3. What can I do about stained or discolored teeth?

Professional tooth whitening (bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel. It is an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and can produce unpredictable results. Some products being sold over the counter don’t have the approval of the American Dental Association (ADA) and may be harmful.

What causes discoloration? Over time, the outer layer of tooth enamel wears away, revealing a yellower shade. Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making teeth yellow and dull. Sometimes, teeth can become discolored from taking certain medications, such as tetracycline . Excessive fluoridation during tooth development may also cause teeth to become discolored.

It is important to have your teeth evaluated by your dentist before starting any bleaching treatment. Sometimes, stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to provide more permanent solutions to stubborn stains. Since tooth whitening only works on natural tooth enamel, it is also important to evaluate and consider replacing any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, Dr. Ramirez can match the new restorations to the shade of the newly whitened teeth.

Since tooth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright. 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. Back to top

4. Is "tooth whitening" safe? What do you recommend?

Bleaching procedures are safe and approved by the American Dental Association. Bleaching does not wear away any tooth structure or make a tooth more susceptible to staining.

Since tooth whitening has now become the number one aesthetic concern for most patients, there are many products and methods available to achieve a brighter smile. If you would like more information on tooth whitening gels and procedures you can visit www.teethwhiteningreview.com, a consumer friendly educational site. Back to top

5. What is periodontal disease and how can I prevent it?

Most people are not aware that they have periodontal disease because the disease is usually painless in the early stages and symptoms go undetected. Having regular dental check-ups and periodontal examinations are very important and will help detect periodontal problems.

Periodontal disease involves inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets. 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:

•  Smokers and chewing tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
•  Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
•  Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives and many other medications can have side effects that reduce saliva, making the mouth dry and allowing plaque to more easily adhere to the teeth and gums.
•  Pregnancy, oral contraceptives, and puberty (hormonal changes increase the sensitivity of the gums and can lead to disease).
•  Diabetes, blood cell disorders, HIV / AIDS, and other systemic diseases.
•  Some patients may be predisposed to a more aggressive type of periodontal disease. Patients with a family history of tooth loss should pay close attention to their gums.
•  Tooth Loss or Tooth Movement
•  Bad Breath

Signs and Symptoms of Periodontal Disease:

•  Bleeding gums (blood on toothbrush even with gentle brushing of the teeth).
•  Bright red or red-purple appearance to gums.
•  Gums that are tender when touched, but otherwise painless.
•  Mouth sores.
•  Swollen gums.

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

6. Is gum surgery necessary if I have periodontal disease?

We have found, many times, that surgery is not necessary following a conservative course of periodontal treatment. Noninvasive procedures include a series of nonsurgical gum treatments. If surgery is required, it can be localized to a few areas of the mouth and gums with results greatly enhanced by nonsurgical treatments. Back to top

7. There are so many different toothbrushes on the market today. How do I know which one is the right one for me?

This is a good question. The brand of the toothbrush is not nearly as important as the type of bristle, the size and shape of the head and how frequently you replace your brush. We recommend a soft bristled brush with a small head. The soft bristles help to maintain the health of your gums and a small head allows you to reach each tooth surface and is less likely to injure your gums. We recommend replacing your brush once a month or at least every two months. Back to top

8. What are dental implants?

Dental implants are a wonderful way to replace missing teeth. After your dentist does a thorough examination and develops a treatment plan, the initial phase of treatment takes place. In most cases a general dentist, periodontist or an oral surgeon will place the dental implant(s) or artificial root(s) into your jaw. After the jaw and mouth have healed, the tooth or bridge segment can be placed by Dr. Ramirez. If you are considering dental implants, talk to Dr. Ramirez. Back to top

9. I have old silver (amalgam) fillings. Are they safe and what can be done to improve them?

Over the years there has been some concern as to the safety of amalgam (silver) fillings. Amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill cavities 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. Silver fillings have been determined to be safe, durable and cost effective by the ADA, Center for Disease Control (CDC), the World health Organization, the FDA and other health organizations. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to one of the metals found in the filling material.

If your concerns are for cosmetic reasons, there are many new methods available to replace your old fillings with beautiful, functional long lasting restorations. White filling materials, porcelain inlays, crowns and veneers are some alternatives that may be used to replace existing silver fillings. New reinforced hybrid materials are beautiful resin materials reinforced with fibers and are used in inlays and bridges without having to needlessly treat a whole healthy tooth. We encourage you to discuss these options with Dr. Ramirez so you can determine which options are best for you. Back to top

10. How often should I brush and floss?

Brushing and flossing help control the growth of plaque and bacteria in the mouth that cause dental disease. Plaque is a film of food debris, bacteria, and saliva that sticks to your teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal disease. Plaque formation and growth is inevitable and can only be controlled by regular brushing, flossing, dental cleanings and the use of other dental aids.

Tooth Brushing: Brush your teeth at least twice a day (especially before going to bed at night) with soft bristle brush. The American Dental Association recommends that you also brush your teeth after meals whenever possible. When brushing use a small, circular motion, brush the outer, inner and biting surfaces of each tooth. Also, brush your tongue thoroughly to remove bacteria (this will also encourage fresh breath).

Flossing: Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone. Using 12-16 inches of dental floss (or a floss holder) guide the floss gently between teeth using a sawing motion –make sure to sweep around each tooth and under the gum line –this will ensure the removal of hard to reach plague deposits.

Rinsing: It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. Swish the water around teeth, along gums and at the back of the throat to remove bacteria then spit out water. Consult with Dr. Ramirez before choosing an over-the-counter product for rinsing. Back to top

11. What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition. Everyone suffers from bad breath from time to time, especially in the morning. The major reason for halitosis is due to microbial deposits on the tongue, especially the back of the tongue. Some studies have shown that simply brushing the tongue reduces bad breath by as much as 70 percent.

In most cases, your dentist can treat the cause of bad breath.

Causes of bad breath:

•  Morning time – Saliva flow basically shuts down during sleep allowing bacteria to grow, causing bad breath.
•  Foods (Garlic, onions, etc) – These odor-causing foods enter the blood stream, lungs and then are exhaled.
•  Poor dental habits – Poor brushing and flossing leave food particles in the mouth, promoting bacterial growth.
•  Periodontal disease – Plaque and bacteria that sit under inflamed gums.
•  Dry mouth (Xerostomia) – This can be caused by certain medications, salivary gland problems, or continuous mouth breathing.
•  Tobacco products – Causes dry mouth and leads to bad breath.
•  Dehydration, hunger, and missed meals – Drinking water and chewing food thoroughly increases saliva flow and washes bacteria away.
•  Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are some of the conditions that may contribute to bad breath.
•  Dieting – Certain chemicals (ketones) are released in the breath as the body burns fat.

Bad breath prevention:

•  Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gum line. Brush the tongue or use a tongue scraper to clean and reach the back areas. Replace your toothbrush every 1 to 2 months. If you wear dentures or removable bridges, clean them thoroughly.
•  Professional dental exams – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, Dr. Ramirez will likely recommend more frequent visits.
•  Quit smoking/chewing tobacco – Ask Dr. Ramirez what she recommends to help break the habit.
•  Drink water frequently – Water helps keep your mouth moist and washes away odor causing bacteria. It is generally considered to also be conducive to overall health.
•  Use mouthwash/rinses – Look for over-the-counter antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

12. How often should I have a dental exam and cleaning?

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities and other problems. You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Your dental exam and cleaning should include the following:

•  Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
•  Examination of diagnostic x-rays: Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
•  Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
•  Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
•  Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
•  Examination of existing restorations: Check current fillings, crowns, etc.
•  Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
•  Removal of 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 acid-like toxins that inflame the gums. This inflammation is the start of periodontal disease!
•  Teeth polishing: Removes stain and plaque that is not otherwise removed during tooth brushing and scaling.
•  Oral hygiene recommendations: Review and recommend oral hygiene aids as needed.
•  Review dietary habits: Your eating habits play a very important role in your dental health.

13. What is cosmetic dentistry and how can it help improve the appearance of my smile?

Cosmetic dentistry is more popular than ever before, and for good reason. Today's cosmetic dentistry techniques yield impressive, long-lasting results. 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.

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. Ask Dr. Ramirez how you can improve the health and beauty of your smile.

Cosmetic Procedures:

Tooth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth. Veneers are less invasive than crowns.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings or are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, lasting and durable solution.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients. Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces. Back to top

14. At my last dental checkup, I was informed that my wisdom teeth are impacted and need to be removed by a specialist. They do not bother me. Is this really necessary and why?

Regular dental checkups help dentists identify some problems BEFORE they begin to bother you. An "impacted" tooth refers to a tooth that has failed to emerge fully into its expected position. This failure to grow properly might occur because there is not enough room in your jaw to accommodate the tooth, or because the angle of the tooth is improper.

There are a number of reasons for recommending removal of impacted wisdom teeth. Wisdom teeth are a frequent source of problems for many people. The biggest reason for problems is that there isn't enough room for them to erupt into the dental arch normally. Teeth also grow in sideways, causing impaction. This causes them to become impacted, which means that they are impeded from normal eruption. When they don't grow normally, our advice is to have them removed at your earliest convenience. Some people put this off, thinking that if their wisdom teeth aren't bothering them, they should leave them alone. The reason this is unwise is that complications from wisdom tooth surgery greatly increase the older you become. Waiting causes the extractions to be more difficult with risks of serious complications. If, however, the wisdom teeth are removed in the late teens or early twenties, complications are much milder and less likely to occur.

We are more than happy to talk with you about this and address your concerns. If you still have questions, you might want to see another dentist for a second opinion or schedule a consultation with a specialist.

15. How does ClearCorrect work?

By wearing a set of aligners for approximately 2 weeks at a time teeth will start moving little by little until they straighten. Aligners are replaced in a series and are worn for a maximum of 20 to 22 hours a day. They are removed when eating and for daily brushing and flossing. Total treatment time averages from 9 to 18 months.

16. How much does ClearCorrect cost?

The cost of the treatment is dependent on the complexity of the case, however it is generally less expensive than traditional braces. For more information call our office at 561-447-9505

17. How does ClearCorrect move teeth?

The Invisilign aligners move teeth by applying controlled forces on teeth. At each stage and through each series of aligners only some teeth are allowed to move. The stages of treatment are determined by your treatment plan and allows for an efficient and timed delivery of forces on the teeth.