Question: “Dr. Arnold, I have a lot of friends having cosmetic dentistry done to improve their smiles. I’ve always put my children’s needs first, but I feel like it’s time for me to do something for myself. What is the most popular cosmetic dental service?”

Answer: It does seem like many people are focused on smile enhancement procedures. I have several patients ask me what their options are every day. That trend is indicative of the importance our society has placed on having an attractive, healthy smile. Over 90% of people in some national polls agree that having a nice smile can impact professional success and personal relationships.

Which cosmetic dental option is most appropriate for you depends completely upon the condition of your teeth and your objectives because there are many options. The first step in determining what your specific options are is to see a dentist for a consultation and comprehensive examination.

Ideally, the goal should be to achieve the desired results in the most conservative manner possible. Sometimes whitening or recontouring the teeth is all that is needed to improve one’s smile. Sometimes straightening the teeth with braces or Invisalign orthodontic treatment is a great option. These options are very conservative and can yield excellent results when used appropriately.

For people who show a lot of gum tissue when they smile, laser recontouring of the excess tissue can often give them a dramatic result. Sometimes recontouring the gums a bit can improve the gingival symmetry and give the teeth a longer appearance. Cosmetic bonding is a conservative solution to chipped or stained front teeth.

Porcelain veneers may be the most popular cosmetic enhancement modality because the improvement is often quite dramatic. They commonly help to correct stained, chipped, crooked, gapped, and cracked teeth, along with many other issues associated with unattractive smiles. It’s certainly not a “one size fits all” solution, but veneers are an excellent option for many people.

Sometimes porcelain veneers can be completed without having to reshape the teeth (with DURAthin veneers), but the majority of cases require some removal of tooth structure in order to create space for the porcelain.

Sometimes veneers are insufficient to do the job, and porcelain crowns are necessary, but the amount of tooth reshaping needed completely depends upon the case, position of the teeth, and the amount of decay or previous restorative material in the teeth in question.

It is very important that you discuss your objectives with your dental team in order to ensure an excellent result. With thorough planning, good communication, and reasonable expectations, you should be very happy with your new smile.

Dr.  Jim Arnold is a practicing dentist in Chesterton and Valparaiso.  He is also a clinical mentor with the Hornbrook Group and serves on the Advisory Board for the Academy of Comprehensive Esthetics as the Fellowship Chairman.  You may send questions to his office at:  1830 South 11th Street, Chesterton, IN 46304 or email them to:  drarnold@SmilesByArnold.com.  More information on this or many other dental topics can be found at www.SmilesByArnold.com.

Question: “Dr. Arnold, I’m looking for a new dentist, and I’m not sure what questions to ask. What should my first appointment be like?”

Answer: I feel that the new patient examination is an extremely important dental appointment that you will ever have. It helps to establish your relationship, allows the dental team to gather all necessary information, and sets the tone for future appointments.

The dental team should spend some time asking you questions and listening carefully to your answers. Discussing past dental experiences, current concerns, and your goals for your oral health is essential. This allows us to find out what kind of care you want or need.

After we get to know you, we will discuss your dental and medical histories, and let you know what to expect from us during your visits. Then dental x-rays and digital photos are likely to be taken. Some dentists will even make models of your teeth for further evaluation.

A thorough examination will include an oral cancer screening, periodontal and TMJ evaluations, and a close inspection of all of your teeth. Throughout this process, the dentist, hygienist, or assistant will carefully explain what they see and spend time educating you as to how to better care for your teeth and gums.

After the periodontal (gums and the bone that support your teeth) examination, a determination will be made as to what type of “cleaning” you will need. If the gums are fairly healthy, the teeth are often cleaned at this first visit. Some patients will require much more time than has been allotted, and will need to schedule another appointment or appointments.

If it has been quite a while since your last thorough examination and cleaning, you are more likely to have some level of periodontal disease. Depending upon the severity of the disease, patients may need multiple appointments and anesthetic to get the job done properly. Some patients may even require a referral to a specialist called a periodontist.

The most important thing is that your new patient examination is very thorough and that the dental team takes the time necessary to establish a positive relationship. Any attempt to rush through the new patient experience is detrimental to everyone. While “shopping for dentists”, I would ask about the new patient process. This will often tell you a lot about the practice and your level of comfort with it.

Dr.  Jim Arnold is a practicing dentist in Valparaiso and Chesterton. Additionally, he serves on the Advisory Board for the Academy of Comprehensive Esthetics and is involved with many other local, state, national, and international dental organizations. Questions for Dr. Arnold can be emailed to: drarnold@smilesbyarnold.com or sent to: 1830 South 11th St., Chesterton, IN, 46304. More information on this and a variety of other dental topics can be found at:  www.SmilesByArnold.com.

Question: “Dr. Arnold, my dentist says that I need a “special cleaning” with anesthetic because I have gum disease. Is this really necessary?”

Answer: Dentists and hygienists are trained to recognize the signs and symptoms of gum disease. Unfortunately, approximately seventy-five percent of American adults have some level of gum disease. This chronic problem is the number one reason for tooth loss in the United States, and bleeding of the gums is one of the most common indicators of some level of gum disease.

It can range from a low-level, chronic infection to severe periodontitis, which shows destruction of the bone that supports teeth. Additionally, an increasing number of studies show a significant correlation between the bacteria in gum disease and health problems that can affect the entire body.

Another disturbing revelation is that these bacteria can be transferred from one person to another through kissing, sharing toothbrushes, etc. Parents can even transmit bacteria from their own mouths to their children by drinking from the same glass.

The disease-causing bacteria from one’s mouth can enter the bloodstream, circulate throughout the body, and create or exacerbate health problems. Disorders such as heart disease, Alzheimer’s, respiratory diseases, diabetes, arthritis, and low birth-weight babies are just a few that have been linked to gum disease. This list seems to be growing as research continues in this area.

Obviously, the first step in avoiding this pervasive condition is to diligently brush and floss your teeth every day. This decreases the likelihood of bacterial proliferation in your mouth. Make sure that your spouse or “significant other” is doing the same. Regular, professional cleaning in a dental office is also essential.

If you suffer from symptoms including bleeding when you brush or floss, persistent bad breath, or red, swollen gums, you need to contact a dentist or periodontist who can help you overcome this problem. The help of a dental hygienist or dentist is necessary because we cannot remove hard deposits (tartar) on our own. The longer these conditions persist, the more likely you are to develop one of the aforementioned health conditions.

Dr.  Jim Arnold is a practicing dentist in Valparaiso and Chesterton. Additionally, he serves on the Advisory Board for the Academy of Comprehensive Esthetics and is involved with many other local, state, national, and international dental organizations. Questions for Dr. Arnold can be emailed to: drarnold@smilesbyarnold.com or sent to: 1830 South 11th St., Chesterton, IN, 46304. More information on this and a variety of other dental topics can be found at:  www.SmilesByArnold.com.

Question: “Dr. Arnold, the new year is approaching, and I plan to finally take better care of my teeth. What are your specific recommendations?”

Answer: That’s certainly an excellent (and timely) question. It seems as if everyone makes some sort of new year’s resolution, and it’s a terrific idea to think of improving your oral health in 2009. What you need to do specifically depends entirely upon the current status of your oral health. I will, however, speak generally of a good game plan for the year.

If it has been a while since your last “check-up and cleaning,” beginning the year with a comprehensive exam would be a great idea. Completing the appropriate professional teeth cleaning can then help you to establish a healthy foundation.

Undergoing any recommended dental treatment is the next step to ensuring a healthy mouth for the new year and beyond. The longer you postpone necessary treatment, the more likely it is to develop into a more serious problem that can cause pain and the need for further treatment.

You can maintain the results by practicing good oral hygiene. Caring for your teeth and gums should be easy. Brushing twice and flossing once a day are the most important elements of a good home care regimen. Changing your toothbrush regularly is important, and many people are more effective with an electric toothbrush.

Decrease your intake of sugary, acidic beverages. Remember that even diet pop can cause a lot of damage to teeth. A reduction in other sugary treats is also a necessity for many people, especially after the holidays.

If you are a smoker, breaking this harmful habit is essential to attain and maintain good oral health. If you grind your teeth, this can be very destructive, and a bite guard might be beneficial.

A continuing good relationship with your team of dental professionals is critical so that they can provide the support that you need in the years ahead. If you are already practicing all of these healthy habits, encourage your friends and family to do the same. This new year’s resolution is well worth the effort.

Dr.  Jim Arnold is a practicing dentist in Valparaiso and Chesterton. Additionally, he serves on the Advisory Board for the Academy of Comprehensive Esthetics and is involved with many other local, state, national, and international dental organizations. Questions for Dr. Arnold can be emailed to: drarnold@smilesbyarnold.com or sent to: 1830 South 11th St., Chesterton, IN, 46304. More information on this and a variety of other dental topics can be found at:  www.SmilesByArnold.com.

Question: “Dr. Arnold, it seems like every time I see my dentist, they rush me in and rush me out. My cleaning appointments never last more than twenty to thirty minutes. Is that really enough time for them to do a good job for me?”

Answer: A lot of times, patients look at their periodic dental check-up as “just a cleaning” when in fact, that appointment is tremendously important and is critical to maintaining excellent oral health. The amount of time necessary to complete this process thoroughly can vary from patient to patient depending upon a variety of factors.

In my office, most adult cleanings take about one hour. Sometimes the time needed is a little bit less, and sometimes it’s a bit more. However, the time needed should always be customized for each patient.

It’s important that everything that needs to be done can be completed in a non-rushed manner to ensure excellent and thorough care. A typical appointment consists of radiographs (x-rays), an oral exam, scaling the teeth, polishing the teeth, a fluoride treatment, patient education, and time to answer any questions.

The oral exam consists of evaluating the condition of each tooth, the periodontal (gum and bone) health, checking for oral cancer, and a variety of other factors. This process is really the cornerstone of the appointment.

Our dental hygienists are very well-trained to thoroughly, but gently clean patients’ teeth. Scaling is the process of removing any tartar (hard deposits) from the teeth. Polishing the teeth removes any residual plaque and smoothes everything.

Dental hygienists should be well-versed in the new protocols necessary to help keep patients healthy, and they should spend time instructing patients on the importance of doing their part with excellent home care. If there are any problem areas, our hygienists spend additional time showing our patients what needs to be done.

Every dental practice is different, and various protocols may be employed at each. That having been said, it is very important that you feel comfortable with the care that you are receiving. If you feel like your dental team is rushing you through your appointment and that your questions aren?t being given the attention they deserve, you should address this with them.

Remember that this appointment is extremely important, and you deserve excellent dental care. It isn’t “just a cleaning.” It is an opportunity to evaluate your condition, explain your situation, answer your questions, and clean your teeth thoroughly. The importance of this appointment should never be underestimated – by you or your dental team.

Dr.  Jim Arnold is a practicing dentist in Valparaiso and Chesterton. Additionally, he serves on the Advisory Board for the Academy of Comprehensive Esthetics and is involved with many other local, state, national, and international dental organizations. Questions for Dr. Arnold can be emailed to: drarnold@smilesbyarnold.com or sent to: 1830 South 11th St., Chesterton, IN, 46304. More information on this and a variety of other dental topics can be found at:  www.SmilesByArnold.com.