Learn more from our FAQ’s!
Is there an easy way of repairing my chipped tooth?
Yes! Depending on the size and location of the chip, there are a couple options. If it is small area, bonding is an affordable, painless way to repair gaps and chips. It sculpts individual teeth by bonding composite material that blends with your natural tooth to the tooth. It rarely requires anesthetic and gives an immediate result. In a situation where the damage to the tooth is larger, our skilled laboratory technicians can make veneers or crowns that match your existing teeth and cover the damaged tooth.
Are you a denture or partial denture wearer who is tired of instability and adhesives?
Did you know that you can upgrade to implant supported and even implant retained dentures and partial dentures? Leave the removable world behind and use implants to support fixed (glued or screwed in) teeth where you are missing teeth now.
What is periodontal disease?
Periodontal disease is a bacterial infection that impacts your gums and supporting bone structure. It is characterized by red, puffy gum tissue that bleeds easily when touched with a toothbrush, floss, or dental instrument. In advanced stages, periodontal disease causes bone loss, which in turn causes eventual tooth loss. Depending on the stage in which it is diagnosed, there are both nonsurgical and surgical options for treatment. Warning signs of gum disease include permanent teeth that are loose or separating from each other, gums that are pulling away from teeth, changes in the way teeth fit together, changes in the way partials fit, persistent bad breath or foul taste, or bleeding with brushing.
What are dental implants?
An implant is a secure, durable anchor used to support a crown when a natural tooth is lost. A titanium post would be placed in your jaw to replace the tooth’s root structure. After the surrounding bone has healed (anywhere from 6 weeks to six months), a custom abutment and crown would be made to restore “above the gum” part of the tooth, giving you a very natural look.
How do I manage dry mouth?
Many medications have dryness of the mouth as a side effect. Without the natural benefit of saliva to decrease bacterial action, we see an increase of cavities on the root surfaces of these patients. If you are experiencing dry mouth, please feel free to discuss it with any member of our team. We can help you find the resources that will be the most beneficial in your situation to alleviating the problem.
What do I do if my tooth is loose or knocked out?
Know the proper first aid for saving a loose or dislocated tooth. If the tooth is loose, even extremely so, but is still attached in any way, leave it in place; do not remove it. If it is out of its socket completely and unattached, but still in the victim’s mouth, it is best to have the person hold it there, if possible, until a dentist can attempt re-implantation. If it is out of the mouth, do not let it dry out. Handle it as little as possible. Do not attempt to disinfect the tooth, or scrub it, or remove any tissue attached to it. If it is recovered from the ground or other soiled area, rinse it off in lukewarm water. Preserve it in milk until a dentist is available. If milk is not available, lukewarm water will suffice. Time out of the socket is critical in the long-term success of re-implantation. After 30 minutes, the success potential begins to decline. However, re-implantation is still possible after several hours, so the attempt can still be made even if the tooth has been out for a long period.
Why do I need an inlay or crown instead of a bigger filling?
Teeth are often restored using silver or composite fillings. If there is too much damage from decay, cracking, or chipping to your tooth, however, you may not have enough structure left to support this type of restoration. In that case, Dr. Keyser will recommend either a partial crown (inlay) or full crown. The best restoration is determined based on the amount of undamaged tooth structure remaining. If you are a candidate for an inlay or crown, you should expect two visits to our office. Dr. Keyser will prepare the tooth at the first visit and take an impression of it for our lab. After 3-4 weeks, you will return to our office for your customized restoration to be delivered.
Why should I replace silver-mercury fillings?
Until somewhat recently, dentists often used a silvery and mercury amalgam filling material because of its durability. As amalgams age, however, the bond between the tooth and the amalgam breaks down. In some situations, there is also crack damage next to the amalgams. Both cracking and the breakdown of the bond leave an opening that bacteria can access, which allows decay to form beneath the amalgams. Because decay is pain-free until quite advanced, there often is extensive damage to your tooth structure present before any symptoms appear. Dr. Keyser will closely monitor any existing amalgams you may have and will keep you informed if it appears that they are beginning to leak or if he suspects that decay is present. He no longer places amalgams because a larger amount of tooth structure must be removed to place an amalgam than a resin composite and because of the difficulty of diagnosing when they are reached the end of their life span.
Have you ever thought about what kinds of risks are associated with having dentistry done?
There are basically three kinds of risks associated with having dental procedures performed. First is the risk of irreversible harm to a person’s mouth. Second there is the risk that dentistry’s technology is not capable of meeting a patient’s wants and needs. Finally is the risk that the treating dentist does not have the knowledge, training, and experience to know that he/she does not know he or she cannot meet the patients needs and wants.
The more complex the procedure the greater the need to select your treating dentist based on their knowledge, skill, continued training, staff competence, rather than the common selection criteria of nice, fast, easy, and cheap.
How can you tell? Degrees? Accolades? Certificates? Awards? Yes, but remember, all of those are no assurance that the dentists will or can perform up to those standards for you at that time in their career. After 26 years of being in dentistry it is clear to Dr. Keyser that the best way for a patient to discern who they should choose to do their dentistry is to ask them how they have been trained to perform what you are talking with them about having done. It is important to then pay attention to how detailed and thorough they are for you at that time. For example, statistics show that the greatest incidence of preventable complications by dentists placing implants occurs in dentist’s who have either placed less than 50 or greater than 1,000 implants.
What are porcelain veneers?
Veneers are thin, durable shells designed to cover the front of your tooth. They are typically made of porcelain and are durable, stain resistant, natural-looking, and easy to maintain. Veneers are custom-fitted to your teeth by removing a small amount of enamel and bonding the lab-made veneer to your teeth using a polymer resin. They give you flexibility to lighten stains, close gaps, and change the shape, color, or length of your teeth.
Is bleaching safe?
Bleaching is a safe, effective means of producing a whiter smile. Our lab makes customized trays that you can use at home until your desired level of whiteness is reached. You can use the trays to touch up your teeth when needed, as well. Even with the advancements in whitening technology, not everyone’s teeth will whiten to the same level. We would be happy to evaluate your situation and advise you accordingly.
What causes bad breath?
Most often, bad breath is a symptom of dental decay and periodontitis. Periodontitis is a disease that affects your gums and the bone that supports your teeth. It can be genetic or can result from inadequate tooth brushing and flossing. In this disease, irritated gums pull away from teeth and form pockets between the teeth and gums. They fill with bacteria, which give off the foul odor. If you have bad breath, we recommend a complete exam. If gum disease and/or decay are detected, we can help treat the source of the problem, helping you achieve oral health.
What is tooth decay?
Tooth decay: Seems simple enough. Is there a cavity or isn’t there? Well, as straight forward as that seems, it is all but simple. Have you ever heard of those lucky people who don’t really take care of their teeth all that well and yet never or rarely have a cavity? How about those people who almost obsess in taking care of their teeth and yet often have a cavity? There are multiple factors that are involved in having cavities. Some of the more prevalent factors are: The persons immune system effectiveness with decay producing oral bacteria, saliva flow and volume, salivary pH, periodontal gum disease, systemic health, amount of time simple and complex sugars are on the tooth surfaces from drinks, sticky foods, acidity of drinks and foods teeth are exposed to, amount of flouride incorporated into the tooth structure during the formative years, pre-existing dentistry with uncleanable margins, medication side effects, long term nutrition, regular effective exercise, amount of enamel covering the teeth, and last but not least how effective one is in their brushing and flossing to prevent bacteria’s ability to build up to the level needed to produce the acid that generates the decay.
Now for decay (cavities) themselves:
When is a cavity first defined as such?
When is it reversible?
When is it not reversible?
Is it slow growing over years or is it fast growing over months?
Is it localized?
Is it generalized?
Is it in an exposed root surface?
Is it detectable by an x-ray?
Is it detectable clinically by contact with an explorer or clinically detectable visually via the tooth’s reflected optics?
Is it detectable by indicating solution?
Is it found by instrumentation using a selected light spectrum or laser and the tooth’s reflected and refracted energy?
Bottom line: Decay is not simply there or not there. It is not a present or not present phenomenon. Rather, the decay process is a continuum that often results in the decay becoming irreversible with the only way to stop it’s progression being it’s removal (excavation). Once a decay site becomes irreversible, if not found by the attending dentist, it will reveal itself by any combination of becoming obviously visual to even the untrained eye, becoming painful, or the involved tooth breaking and/or swelling.
The intrinsic variability of the stage a decay process can be in coupled with the variability of decay detection methods coupled with the variability in thoroughness by the dentist in looking for decay is why patients and the profession are aware of the ever existing inconsistent decay diagnosis from one dentist to the next. It all boils down to diagnostic experience, quality clinical time to look closely and not scan in a couple minutes, and thoroughness by the attending dentist. A decay site that is detected by virtue of pain or sensitivity is a decay site that has gone on longer than preferred. Additionally, x-rays aid in the detection of decay and digital x-rays are an improvement over dental film x-rays. However, x-rays are not reliable, dependable, or accurate enough to depend on as the sole diagnostic detection approach. As of yet, there is still not an absolute test for the presence of dental tooth decay in all of it’s possible locations and forms.
How does sedation dentistry work? Is it safe?
Oral conscious sedation is most often achieved by taking a pill one hour prior to your dental appointment. You should avoid caffeine the day of your appointment, but should eat prior to coming in. You should have a companion bring you to the office, where Dr. Keyser and his staff will monitor you and your status, increasing your dose if necessary. You will be able to communicate with Dr. Keyser if you are uncomfortable or have any needs, but won’t remember much about the day. Upon completion of treatment, your companion will take you home. You should spend the remainder of the day relaxing, and avoid making any important decisions on the day of treatment. Sedation dentistry is very safe. Dr. Keyser will evaluate your medical history to ensure that you are a good candidate for the medications used. If you have ever had difficulty getting numb, sedation dentistry will eliminate that problem. It reduces the fatigue often felt after complex dental visits. Additionally, it allows the majority of your treatment to be completed in one visit, which means you only have to heal once from the procedures.
Have you ever wondered where/how a dentist determines his/her fees?
Like medicine, a very large number of dentists use a fee schedule that is highly influenced, if not totally, based on dental insurance UCR’s. UCR stands for the dental insurance industries developed system of Usual, Customary, and Reasonable fee structures. Dental insurance companies look at what fee is Usual for any given geographic area, what fee is Customary for any given procedure in that geographical area, and then decides if a fee is Reasonable as compared to the Usual and Customary amounts.
Dr. Keyser’s fees are based on what it costs to provide discerning patients excellence and science based restorative dentistry. Our goal is to provide the highest quality service for our clients at a competitive rate. We are in-network with Ameritas and Cigna, but we will happily file claims with any insurance you may have.
Would it be important to you if your dentist used reused sterilized drills on you?
The reuse of sterilized drills is perfectly legal and approved by governing bodies, however, Dr. Keyser has never felt comfortable counting on this kind of sterilization to be sure that each used drill is totally cleaned of biological debris from other patients as the grooves on the drill and diamond pieces are very small. Therefore, Dr. Keyser chooses to use only new drills that have never been used before for every single patient without exception.
Request a Free Consultation!
Keyser Dentistry is proud to offer FREE 30-minute consultations! Contact us today to schedule your FREE 30-minute consultation in our Durham, North Carolina office.