Frequently Asked Questions
Your Dental Questions Answered
We answer common questions about dental care, treatments, and our practice. Complimentary consultations available, and second opinions welcome.
Getting Started at Bartram Dental
Monday through Thursday: 7:30am – 4:30pm. We’re closed Fridays through Sundays. We reserve appointment slots each day for dental emergencies, so call immediately if you have an urgent problem.
We’re in-network with Cigna, Humana, Sunlife, and Assurant. We accept most other major dental insurance plans as an out-of-network provider. We file all claims on your behalf and verify your benefits before your appointment. Many patients receive excellent out-of-network benefits. If you don’t have insurance, ask about our Wellness Program.
We provide comprehensive dental care including preventive services (exams, cleanings, X-rays), restorative dentistry (fillings, crowns, bridges), cosmetic dentistry (veneers, whitening, bonding), dental implants, orthodontics (Invisalign and clear aligners), sleep apnea therapy, sedation dentistry, emergency care, and CEREC same-day crowns. We use advanced technology including Axios 3D CT, Pearl AI, iTero digital scanning, and Solea laser.
You should have your teeth checked and cleaned at least twice a year, though we may recommend more frequent visits based on your oral health. Regular exams and cleanings prevent problems and maintain healthy teeth and gums.
During these visits, we do much more than check for cavities and polish your teeth. We review your medical history to understand how current conditions or medications might affect your dental health. Digital X-rays help us detect decay, bone loss, tumors, and cysts that aren’t visible during examination. We screen for oral cancer by checking your face, neck, lips, tongue, throat, and gums. Your gums and bone are evaluated for signs of periodontal disease, and we examine all tooth surfaces for decay using specialized instruments.
The cleaning portion removes calculus (tartar), which is hardened plaque firmly attached above and below the gumline. We remove soft plaque—a sticky film of bacteria, food debris, and saliva that produces toxins causing gum inflammation. Teeth are polished to remove stains and remaining plaque. We recommend oral hygiene aids tailored to your needs, whether that’s an electric toothbrush, special cleaning tools, fluoride treatments, or rinses. We also discuss your diet, which plays an important role in dental health.
Daily Dental Care at Home
Brush at least twice a day—especially before bed—with an ADA-approved soft bristle brush and toothpaste. Brush at a 45-degree angle to the gums using small circular motions, ensuring you feel the bristles on your gums. Brush outer, inner, and biting surfaces of each tooth. Use the brush tip to clean inside front teeth. Don’t forget your tongue, which harbors bacteria that cause bad breath.
Electric toothbrushes work well and make thorough cleaning easier. Place the bristles on your teeth and gums and let the brush do the work, several teeth at a time.
Floss daily. It’s the best way to clean between teeth and under the gumline where your toothbrush can’t reach. Take 12-16 inches of floss and wrap it around your middle fingers, leaving about 2 inches between your hands. Guide the floss between teeth using a gentle sawing motion. Curve it into a “C” shape around each tooth and under the gumline. Move the floss up and down to clean the side of each tooth. Floss holders work if you have difficulty with conventional floss.
Rinse with water after brushing and after meals when you can’t brush. If you use an over-the-counter rinse, ask us whether it’s appropriate for your needs.
Brushing removes food particles, plaque, and bacteria from all tooth surfaces except between teeth. These areas are highly susceptible to decay and gum disease, but your toothbrush can’t reach them.
Daily flossing cleans between teeth and under the gumline. It disrupts plaque colonies before they can damage gums, teeth, and bone. When plaque isn’t removed, it hardens into calculus (tartar), which further irritates gums and destroys bone. This is how periodontal disease starts.
Electric toothbrushes can remove plaque efficiently and are easy to use. Place the bristles on your gums and teeth and let the brush do the work. However, a manual toothbrush used properly with correct technique is also very effective. The most important factor is brushing thoroughly at least twice a day, regardless of which type of brush you use.
Water flossers can be a helpful addition to your oral hygiene routine and work well for cleaning around braces or dental work. However, they don’t remove plaque as effectively as traditional floss. We generally recommend using both—traditional floss daily to remove plaque between teeth, and a water flosser as a supplement if desired.
Preventive Care for Your Family
More than 75 percent of decay begins in deep grooves on chewing surfaces. Toothbrush bristles are too large to clean these pits and fissures.
A sealant is a thin plastic coating that covers and protects chewing surfaces, creating a smooth barrier that’s easier to clean. Children and teenagers should get sealants as soon as six-year molars appear or anytime during the cavity-prone years of 6-16. Baby teeth are occasionally sealed if they have deep grooves and the child is cavity-prone. Adults benefit from sealants on tooth surfaces with deep grooves that are difficult to clean.
Sealants are easily applied and take just minutes per tooth. We roughen the chewing surface with an acid solution to help the sealant adhere, then paint the material onto the tooth where it hardens and bonds. Sometimes we use a special light to help it harden.
After sealant treatment, avoid chewing ice cubes, hard candy, popcorn kernels, or hard and sticky foods. We’ll check your sealants for wear at regular checkups. Combined with good home care, proper diet, and regular visits, sealants effectively prevent decay.
Common Dental Concerns
Bad breath (halitosis) can be embarrassing. In healthy people, the main cause is microbial deposits on the tongue, especially toward the back. Studies show that brushing your tongue reduces bad breath by up to 70 percent.
Common causes include morning breath (saliva flow stops during sleep, allowing bacteria to grow), certain foods like garlic and onions, poor oral hygiene, gum disease, cavities, improperly fitted dental appliances, dry mouth from medications or mouth breathing, tobacco use, dieting (ketones released as the body burns fat), and dehydration.
To prevent bad breath, practice good oral hygiene by brushing twice daily and flossing daily. Brush or scrape your tongue, reaching the back areas. Replace your toothbrush every 2-3 months. If you wear dentures or removable bridges, clean them thoroughly. See us at least twice yearly for checkups and cleanings. Stop smoking or using tobacco. Drink water frequently to keep your mouth moist. Some rinses do more than mask odor—they kill the bacteria causing the problem. Ask us which ones are effective.
If your mouth is healthy but bad breath persists, we may refer you to your physician to determine the cause.
Four out of five people have periodontal disease without knowing it. It’s usually painless in early stages, which is why regular exams are essential.
Periodontal disease begins when plaque—a sticky film of bacteria, food debris, and saliva—is left on teeth and gums. Bacteria produce toxins that inflame gums and slowly destroy supporting bone. Gingivitis is the earliest stage, causing red, puffy, bleeding gums. If untreated, it advances to periodontitis, where bone loss occurs and teeth can eventually be lost.
Besides poor oral hygiene, risk factors include smoking or chewing tobacco (users develop more plaque and tartar), ill-fitting bridges or crowded teeth that trap plaque, certain medications that reduce saliva, hormonal changes from pregnancy or puberty, systemic diseases like diabetes or HIV/AIDS, and genetics.
Warning signs: red or swollen gums, bleeding gums (even with vigorous brushing), persistent bad breath, new spacing between teeth, loose teeth, pus around teeth and gums, receding gums, and tenderness or discomfort.
Periodontal disease is one of the most common infections—more prevalent than the common cold. It’s the number one reason people lose teeth, but it can also affect overall health.
Studies suggest people with gum disease are at greater risk of systemic disease. Research indicates that periodontal bacteria may enter the bloodstream and travel to major organs, where they can contribute to heart disease, increase stroke risk, compromise health in people with diabetes or respiratory diseases, and increase a woman’s risk of preterm, low-birth weight babies.
While researchers say more study is needed, enough evidence exists to support that infections in the mouth can affect the rest of the body. Regular dental checkups and cleanings, diligent home care, and a proper diet help reduce plaque and bacteria. Remember the mouth-body connection—taking care of your oral health may contribute to your overall health.
Poor sleep quality often relates to airway obstruction or sleep apnea, which can have serious health consequences including high blood pressure, heart disease, stroke, and diabetes. During dental exams, we look for signs like worn teeth (from grinding), a large tongue, narrow airway, or other indicators of sleep-disordered breathing. If we see these signs, we may recommend a sleep study or discuss sleep apnea therapy options like oral appliances.
According to the American Dental Association, the CDC, the World Health Organization, and the FDA, silver fillings are safe, durable, and cost-effective. While mercury in fillings has been a concern, these organizations maintain that when mercury combines with other filling components, it becomes inactive and safe.
The ADA reports fewer than 100 allergy cases to silver filling components out of countless millions of fillings over decades. The only medical reason to avoid silver fillings is if you have an allergy to any component.
There are numerous alternatives including composite (tooth-colored), porcelain, and gold fillings. We encourage you to discuss options so you can determine what’s best for you.
Cosmetic & Restorative Treatment Options
Cosmetic dentistry has become very popular due to advances in procedures and materials, and because patients are more focused on prevention and having a healthier, whiter smile. Treatments can change your smile dramatically, from restoring a single tooth to a full mouth makeover.
Common procedures include teeth whitening (bleaching lightens stained or discolored teeth), composite fillings (tooth-colored bonding repairs cavities, chips, gaps, and exposed roots), porcelain veneers (thin custom shells bonded to front teeth to create a beautiful smile), porcelain crowns (tooth-colored coverings that restore damaged teeth to original shape and size), dental implants (artificial roots surgically placed to replace missing teeth), and orthodontics (modern brackets and clear aligners make straightening teeth more appealing to adults).
Professional teeth whitening is a simple, non-invasive treatment that changes the color of natural tooth enamel. Over-the-counter products are available but are much less effective than professional treatments and may not be ADA-approved.
As we age, outer enamel wears away, revealing darker or yellower shades. The inside of teeth also darkens over time. Smoking, coffee, tea, and wine contribute to discoloration. Some medications taken during childhood (like tetracycline) or excessive fluoride during tooth development can cause discoloration.
It’s important to have your teeth evaluated to determine if you’re a good candidate. Tetracycline and fluorosis stains can be difficult to bleach—we may recommend veneers or crowns instead. Since whitening only works on natural enamel, old fillings and crowns may need replacement to match newly whitened teeth.
Professional whitening systems include home whitening (custom trays with gel worn twice daily for 30 minutes or overnight, taking several weeks) and in-office whitening (done here with immediate results, may require multiple 30-60 minute visits using a bleaching solution and special light).
Some patients experience temporary sensitivity that subsides within a few days to a week. Since whitening isn’t permanent, touch-ups may be needed every few years.
Porcelain veneers are very thin shells of tooth-shaped porcelain individually crafted to cover the fronts of teeth. They’re durable and won’t stain, making them popular for restoring or enhancing smiles.
Veneers can correct severely discolored or stained teeth, unwanted or uneven spaces, worn or chipped teeth, slight crowding, misshapen teeth, and teeth that are too small or large.
Getting veneers usually requires two visits. We create an impression of your teeth and send it to a dental laboratory where each veneer is custom-made for shape and color. With little or no anesthesia, we lightly buff and shape the front surface of your teeth to allow for the veneer thickness. The veneers are carefully fitted and bonded with special cements, and sometimes a specialized light hardens the bond.
Bonding (composite fillings) works well for minor chips, small gaps, or slight discoloration. It’s completed in one visit and is less expensive than veneers. However, composite can stain over time and isn’t as durable as porcelain.
Veneers are better for more extensive cosmetic changes, severely stained teeth, or when you want a complete smile makeover. They’re more durable, stain-resistant, and provide a more dramatic transformation. We can evaluate your specific situation and recommend the best option.
Old fillings may be dark and unattractive, making you self-conscious when you smile. They may also be defective—margins can open over time, allowing bacteria and debris to enter and cause decay. We can check your fillings and evaluate whether they need replacement.
Options include composite fillings (tooth-colored, matched to existing teeth, great for front teeth and visible areas), crowns (used when a tooth is too damaged for a filling, covers the entire tooth surface), inlays/onlays (custom-made fillings of composite, porcelain, or gold, best for posterior chewing surfaces), and porcelain veneers (for front teeth, thin shells that are durable, natural-looking, and stain-resistant).
When a tooth is lost, the jawbone that supported it begins to deteriorate. Teeth on either side shift or tip into the open space. The tooth above or below starts moving toward the gap because there’s no opposing tooth to bite against. These movements create problems like decay, gum disease, excessive wear on certain teeth, and TMJ problems. While not immediate, these issues will eventually appear, compromising your chewing ability, bite health, and smile.
Replacement options include removable bridges (economical but least aesthetically pleasing due to visible metal clasps), fixed bridges (porcelain or composite anchored permanently to adjacent teeth, very sturdy but requires crowning two healthy teeth), dentures (for when most or all natural teeth are missing in one arch), and implants (artificial roots surgically placed in the jawbone, the most stable, durable, and aesthetically pleasing option).
Not necessarily. A crown is needed when a tooth is too damaged to be restored with a filling. A root canal is needed when the nerve inside the tooth is infected or damaged. These are two different problems, though they sometimes occur together.
Same-day crowns are made in our office using CEREC technology. We take a digital scan of your tooth, design the crown on a computer, and mill it from a ceramic block—all in one appointment. You leave with your permanent crown the same day instead of wearing a temporary crown for weeks while a lab makes your restoration.
Orthodontics & Straightening Teeth
No. Invisalign and other clear aligner systems work for adults of all ages. Many adults are choosing to straighten their teeth now that less visible options are available. As long as your teeth and gums are healthy, age isn’t a barrier to orthodontic treatment.
Straight teeth perform chewing, biting, and speaking functions more effectively than crooked teeth. A straight smile also boosts confidence and helps prevent dental problems.
Crooked teeth are harder to clean, which increases risk of gum disease. They can lead to improper jaw alignment, causing TMJ disorder with severe headaches, jaw pain, and teeth grinding. Crooked teeth are weaker and more vulnerable to injury, and they create uneven wear patterns.
Teeth can be straightened with traditional braces (brackets and wires adjusted regularly) or clear aligning trays (fully removable, replaced every few weeks). Both are effective.
Emergency Dental Care
More than 5 million teeth are knocked out every year. If you act quickly and calmly, the tooth may be reimplanted successfully.
Handle the tooth only by the crown (chewing part), never by the roots. Don’t scrub or use soap or chemicals. If it’s dirty, rinse it gently with your own saliva or whole milk. If that’s not possible, rinse very gently with water.
Get to a dentist within 30 minutes. Try to replace the tooth in its socket immediately and gently bite down on gauze, a wet tea bag, or your own teeth to keep it in place. Apply a cold compress for pain and swelling. If you can’t replace it in the socket, place the tooth in a container with a small amount of saliva or whole milk, or keep it under your tongue or between your lower lip and gums. Keep it moist at all times—don’t transport it in tissue or cloth.
Consider keeping a “Save-A-Tooth” storage container in your first aid kit. The sooner the tooth is replaced, the better chance it has to survive.
Prevent knocked-out teeth by wearing a mouthguard when playing sports, always wearing your seatbelt, avoiding fights, and not chewing hard items like ice or popcorn kernels.
Call us or schedule a complimentary consultation. Dr. Lewis and Dr. Barlow are happy to discuss your specific concerns and answer any questions about your dental health.
