Dental FAQs: Answers from Your Newburyport, MA Dentist

Please plan at least one hour for your first appointment. The length of the appointment will vary depending on your specific needs.

We ask that new patients arrive 10-15 minutes early to their first appointment. This allows for finding the office, gives time to review any insurance benefits/questions, and complete any paperwork that was not filled out ahead of time.

After our initial intake phone call, we will email you the New Patient forms to fill out. You may either fill them out on your computer, and email them back to us, or print them out and bring them with you. Having forms filled out prior to your visit allows us to dedicate the entire appointment time to your care and time with the doctor.

Having a fear of coming to the dentist is a genuine response to a negative experience and we get it! We understand that going to the dentist can be a challenging task for some patients. Our office is designed in a manner that it feels like a home when you walk in. We have set up our office with patients in mind with comfortable chairs, clean and organized environment, using state of the art technology to make appointments quick and painless. Our front desk team and clinical staff are trained to support anxious patients and put them at ease. Before your first visit, plan a visit to come by, tour the office, and meet the staff. We're happy to accommodate you. During treatment, we encourage anxious patients to bring their own earbuds with music, an audiobook, or a podcast to tune out external noise.

If your doctor has prescribed a premedication for dental appointments, please be sure to request a prescription from your healthcare provider PRIOR to your appointment with us. For specific questions about premedication, please call our office.

We ask that new patients arrive with identification, insurance cards if applicable, and any forms that may be relevant including health history or medication list. We will ask you at each appointment for any updates to this information as many medications, procedures and health history can play a role in dental health.

Yes! Our practice is multi-faceted in terms of dental procedures provided; including endodontics. Consultations are always free for general and specialty dental services.

All of our new patients begin by seeing the dental assistant for necessary x rays. Afterward they will see the dentist for their comprehensive exam. During the exam, the dentist will review your dental x-rays and perform an oral cancer screening which includes an examination of your jaw, neck, tongue and inside of your mouth. At your first visit, you will likely not receive a cleaning. A cleaning may be completed after the doctor ensures it is the appropriate treatment for your specific oral health. There are certain conditions that determine whether a cleaning is the first BEST course of treatment for you.

Dentistry of Newburyport is open one Saturday every month (typically the second Saturday).

Dentistry of Newburyport makes evert accommodation possible for patients with disabilities. Please call the office for specific accessibility information (978) 465-8492.

A parent or legal guardian must accompany anyone under the age of 18 during an office visit.

The American Dental Association recommends brushing after each meal. The best way to be sure you are caring for your teeth properly is to discuss your homecare regimen and techniques with your hygienist and dentist at your appointment.

You can schedule an appointment over the phone (978) 465-8492, you may email the office [email protected] or you may text the office at the phone number above.

For serious injuries to your mouth or jaw, go to the nearest hospital emergency room. For other emergent dental situations including toothaches and pain, contact our office for a same-day appointment. If your emergency is taking place when the office is closed, please call to leave a message or for instructions on how to reach the dentist after hours.

The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age 2 or within six months after the first tooth erupts. Primary teeth typically begin growing in around 6 months of age.

Yes, it is absolutely imperative to continue to have dental checkups and cleanings at least every six months if you have braces. Food may be caught in places your toothbrush cannot reach causing dangerous bacteria to build up. This can lead to cavities, gingivitis, and gum disease.

A serious injury like a knocked-out tooth should be promptly assessed/treated by a dentist. Carefully rinse the tooth to remove any dirt and place the clean tooth in your mouth between your check and gum or under your tongue. If you cannot do so, wrap the tooth in a clean cloth and immerse in milk. Successful re-implantation can be possible in the right circumstances if the treatment is performed promptly, so get to your dentist as soon as possible.

Fluoride is a mineral that occurs naturally in many foods and water. Fluoride helps prevent tooth decay by making your tooth enamel more resistant to acid attacks from plaque bacteria in your mouth. Fluoride can also reverse early decay. City water often contains fluoride, so by drinking tap water you will acquire fluoride. If your drinking water does not have fluoride, supplements are available. Talk to your dentist or dental hygienist about whether you are getting the daily amount of fluoride you need. The ADA recommends fluoride for adults as well as children.

Bleeding gums are likely a sign of periodontal disease (i.e. gingivitis) which, if caught early, can be reversible. It is important to visit our dentists as soon as possible to have a periodontal screening to determine if you have gum disease and the best course of treatment. When gums are inflamed, brushing and flossing can help reduce the inflammation, so continue to follow your oral health protocols. Ignoring the problem will only exacerbate the situation and can lead to more serious problems including tooth and bone loss.

There are many different orthodontic solutions including braces and removable appliances. The cost of treatment is dependent on what solutions are recommended and the length of recommended treatment. A typical orthodontic case can range from $3,000 - $11,000 depending on the needs. If you have dental insurance, you may have a lifetime Orthodontic benefit which would help cover a portion of the treatment total. Orthodontic treatment requires a down payment, but the remaining balance can be paid through comfortable monthly payments with a card on file. We accept third party financing like Care Credit and offer an in-house Wellness Plan that offers a 15% discount on orthodontic treatment.

Yes! Actually pregnancy is one of the most important times in your life when your oral health is extremely important due to hormonal changes that can impact the health of your gums. It’s important for both mom and baby! Make sure to tell the dentist you are expecting, when you’re expecting and any new medicines or supplements you are taking. Some procedures are better scheduled during certain periods of your pregnancy so it’s important to communicate this with your dentist.

At Dentistry of Newburyport, for patients without insurance we offer an in-house Wellness Plan that offers steep discounts on our preventative care (cleanings exams and x rays) as well as 15% off all procedures (minus implant placement). Call the office to discuss these offers.

The dentists at Dentistry of Newburyport will review your health history, complete an exam, take x rays and speak with you regarding your dental health goals to work together with you to create a personalized, unique treatment plan just for you. In the exam the doctor will assess your entire mouth to evaluate your overall oral health. Your treatment plan will make recommendations for your long-term overall health as well as plans to correct any immediate problems.

Replace your toothbrush or toothbrush head every three months. For patients with periodontal disease, it is recommended to replace your toothbrush every four to six weeks. If you have been sick, be sure to replace your toothbrush as soon as possible.

Sealants are a thin plastic/resin coating that is “painted” onto the chewing surfaces of permanent molars and premolars. They act as a barrier, protecting your teeth against decay-causing bacteria. The sealant bonds into the grooves in your teeth forming a protective shield over the enamel of the tooth. Sealants have proven effective at preventing cavities in adults as well as children but are most commonly used on children. Ask your dentist whether sealants are a good choice for you and/or your family.

For the first 2 days after oral surgery, you should only drink liquids and eat “soft” foods like white fish, potato, warm soups etc.

Hot liquids and foods should be avoided. On the third day, you should eat foods that are easy to chew. You should be able to return to a normal diet after 5 to 7 days.

We offer both custom whitening trays as well as prefabricated whitening trays. With upkeep, teeth whitening can last for months. Bear in mind, things like drinking coffee, tea, or soda, smoking, and not brushing with an electric toothbrush regularly will cause teeth to stain and return to their original shade quicker.

Teeth whitening is a safe and effective treatment that has been used for decades. Your dentist can review any individual risks and answer specific questions you may have.

Flossing reduces the number of bacteria in your mouth. There are millions of these microscopic creatures feeding on food particles left on your teeth. These bacteria live in plaque which can be removed by flossing. Brushing your teeth only gets rid of some of the bacteria in your mouth. Flossing gets rid of the bacteria the toothbrush isn’t able to get to. That's the bacteria hiding in the tiny spaces between your teeth. If you do not floss, you allow plaque to remain between your teeth, and eventually it will harden into calculus/tartar therefore inducing periodontal disease. Plaque can be removed by brushing. Only the dentist or dental hygienist can remove calculus/tartar. Ask your dental professional to show you the proper way to floss. You will both notice the difference at the next cleaning appointment.

The scientific research shows that oral irrigation, such as the Waterpik, is superior to string floss in reducing plaque and gingivitis. However, most dentists continue to recommend flossing before or after using a Waterpik.

A cavity is a hole on the surface of your tooth (the enamel) that has been weakened leading to decay inside the tooth. Cavities form when plaque builds up on your tooth and combines with sugar from the foods you eat, creating an acid that eats away the enamel on your tooth. If a cavity is left untreated, it can lead to more serious oral health problems. Cavities can be prevented by brushing and flossing regularly, avoiding acidic foods and seeing your dentist regularly for checkups and cleanings.

A dentist uses a “filling” to fill a cavity. First all tooth decay is removed, and then a synthetic material is used to fill in the hole. Fillings in our office are made of composite resin or glass ionomer and we do our best to match them to the color of your teeth.

Gum disease, also known as periodontal disease, is mostly caused by plaque and bacteria buildup that is not treated in its early stage. Other causes of periodontal disease include tobacco use, teeth grinding, some medications, and sometimes, genetics.

Gingivitis is the beginning stage of gum disease. If detected, it is treatable. Gingivitis left untreated may turn into gum disease. Advanced gum disease will lead to tooth and bone loss, and is a permanent condition which can not be reversed. You can not “grow back” the bone that is lost due to periodontal disease, however you can STOP bone loss and maintain it where it is.

Brushing your teeth regularly and visiting our office every six months will help prevent gingivitis and more severe cases of periodontal disease. Once you have diagnosed periodontal disease the likely recommended treatment will be a deep cleaning (Scaling and Root Planing) and every 3 months periodontal maintenance appointments with your dentist and hygienist.

Common signs of gum disease:

• Red, irritated, bleeding, or swollen gums
• Chronic bad breath
• Loose teeth, or loss of teeth
• Extreme tooth sensitivity
• Receding gum lineAbscessed teeth

At Dentistry of Newburyport, for patients without insurance we offer an in-house Wellness Plan that offers steep discounts on our preventative care (cleanings exams and x rays) as well as 15% off all procedures (minus implant placement). We also offer payment plans for established patients (with a card on file), we work with Care Credit which offers 0% interest for 12 months and we take most private insurance plans. Call the office to discuss any of these options further.

The timing for baby teeth differ for each individual but all 20 baby teeth are usually in by 3 years of age. The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age 2 or within six months after the first tooth erupts. Primary teeth typically begin growing in around 6 months of age. Baby teeth are just as susceptible to cavities as adult teeth.

If a baby tooth is lost early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room. Proper oral hygiene is important as soon as your baby is born and it is critical to establish good oral health habits early.

Many diseases of the teeth and surrounding tissues cannot be seen when the dentist examines the mouth with the naked eye. An X-ray examination may reveal: small areas of decay between the teeth or below existing restorations (fillings), infections in the bone, periodontal (gum) disease, abscesses or cysts, developmental abnormalities, and some types of tumors. Finding and treating dental problems at an early stage will save time, money and often unnecessary discomfort due to treatment that could have been prevented. X-rays can detect damage to oral structures that are
not visible during a regular exam. If you have a hidden tumor, X-rays may even help save your life. Your dentist will evaluate and prescribe your need for X-rays based on the conditions present and your dental history. There are many benefits to having X-rays taken. Any additional questions or concerns should be discussed with your dentist.

What is Tissue Grafting/Allografting

If you’re reading this, it’s likely you or a loved one has been recommended for a gum/tissue graft. From your dentist’s examination of your mouth they have found that you would benefit from a procedure to treat areas where the roots of your teeth have become exposed. This procedure is necessary to cover the exposed roots as well as provide a zone of dense, tough tissue to help prevent continued or future recession of your gums. Coverage of the roots reduces root sensitivity, reduces risk of root decay, and enhances appearance. Failure to correct this problem leaves you at risk for
additional gum recession, root decay and potential loss of teeth. This tissue is used widely in medicine for many applications. Studies have shown that the surgical outcome with the AlloDerm is equivalent to that with palatal tissue. Thus, we can now provide you with the same results, while avoiding the second surgical

New and Improved Tissue Grafting:

In the past, tissue grafting treatment required transplantation of tissue removed from the roof of your mouth. Many patients have reported that this was a very painful and inconvenient experience and due to this, have opted out of having this important procedure performed in more than one area. They have also shared their experience with friends and family and therefore it is widespread “word of mouth” that tissue grafting or gum grafting is “very painful.” The good news is: Now we can use AlloDerm, a tissue obtained from a tissue bank, eliminating the need for two surgery sites (roof of the mouth and and at the gum site), reducing the discomfort by leaps and bounds and because it is donor tissue, we are not limited in the number of teeth that can be addressed at once. Often times,
there is more than one site that would benefit from grafting.

What is AlloDerm:

This AlloDerm tissue comes from a person who has passed on healthily (such as in an automobile accident) and has been extensively tested and approved for organ transplantation. Tissue is then obtained from the donor and processed for future transplantation. AlloDerm is derived from skin. It has had all cells and blood removed which precludes rejection of the tissue and eliminates the possibility of viral or bacterial presence. The processed tissue is delivered to our office in a sterile and freeze-dried form. This tissue already has all vessels present, so your body can more easily revascularize the graft and provide blood supply to the graft. Your body will then begin to replace the AlloDerm with your own tissue through normal cell turn over, and after twelve months, it will be completely replaced with your own tissue.

The following information has been prepared to answer some of the questions you may have regarding the treatment recommended for you. We have recommended treatment because you have an active gum infection, bleeding, build up below the gum line and bone loss. Recent research suggests a link between the bacteria in your mouth and your total health. Once identified, we are obligated to offer you treatment for your condition.

How is my Treatment Determined?

As part of a thorough evaluation of your gum health we measure the crevice between the tooth and the gum in six locations on each tooth. These crevices are called "pockets". Pockets that bleed when measured are diseased. Bacteria living in the pocket are what cause the bleeding. If you are bleeding more than we are comfortable with (four or more areas) we collect a saliva sample to a lab to measure the bacteria type and concentration level. Once your sample is processed and evaluated we use that information, to consult with your physician (if necessary), and make recommendations that target the bacteria responsible for the bleeding. Often, this requires the use of antibiotics. This approach is accurate and is always personalized for your specific infection.

What does the treatment involve?

Scaling and Root Planing involves thoroughly removing bacterial deposits and smoothing the tooth surfaces below the gumline with dental instruments. A local anesthetic may be used to minimize discomfort during treatment.

How long will it take?

Most often, complete treatment can be accomplished in two of three appointments, depending on the individual conditions of your mouth. Each appointment will last approximately one hour.

Will I have pain or discomfort afterwards?

After treatment there may be some tenderness and sensitivity of the gum tissue. Also, the teeth may be sensitive to hot or cold food and beverages. Following your first session, we will review post-treatment instructions with you to minimize discomfort. (See more under Post Op Instructions)

Will I need gum surgery?

If there is an area that does not respond completely to the Scaling and Root Planing, a consultation with a periodontal specialist regarding surgery will be considered. We always begin with conservative treatment first and only consider surgery if absolutely necessary.

Will the gum disease come back?

With proper care, the health of the gum tissue and bone around the teeth can become stable and remain that way. Like many diseases, periodontal disease involves multiple factors. Some of these factors you can control, such as oral hygiene, diet and smoking. Factors you cannot control include genetics, disease resistance, salivary enzymes, and others. Therefore, to provide the most favorable situation, it is important for you to maintain proper oral hygiene at home and see your dental hygienist every 3-4 months as recommended.

What will happen if I postpone treatment?

We are concerned about the potential harmful effects of bacteria in the bloodstream that travels to other areas of the body. We are also concerned that without treatment, the condition will worsen. The ultimate outcome of untreated periodontal disease is tooth loss. Some cases progress faster than others—it may take months or even years to notice symptoms because the damage is occurring under the gums. Pain is typically not a symptom of periodontal disease until it is in advanced stages. Be assured, if we recommend further gum care, it is because the disease process is active and damage is being done and the recommendation is solely for your benefit.

How much will fees be?

The fee for therapy depends on your individual condition and will be discussed when the appropriate treatment plan is tailored for you. The investment in Scaling and Root Planing is substantially less than the cost of replacing a tooth lost because of untreated periodontal disease.

Scaling and Root Planing Post-Treatment Instructions

Following scaling and root planing, you may experience some temporary discomfort. This instruction sheet will help answer questions concerning discomfort, sensitivity and oral hygiene. If your mouth was anesthetized, it is best to wait until the anesthetic has worn off before eating. This will help prevent accidentally biting numb portions of your mouth.

Discomfort

You may experience some soreness after scaling and root planing. It usually subsides within 24
hours. Most patients find that their discomfort can be controlled with Motrin, Advil, Tylenol or
Aspirin.

Sensitivity

Infected gums are swollen and can hide existing areas of recession due to periodontal disease. While your gums recuperate from this procedure, normal healing results in some tissue tightening and shrinkage, and as a result, you may experience some new sensitivity to hot, cold or sweets as tooth structures that were covered by swollen gums reveal themselves. This is a common side-effect of this procedure and usually diminishes in time. If you experience
sensitivity, the following suggestions may help.

1. Continue to brush and floss to remove plaque bacteria that produce acids that contribute to tooth sensitivity.
2. Brushing with a desensitizing paste such as Sensodyne or Crest Sensitivity Protection, will help reduce the tooth sensitivity.
3. You may purchase special fluoride rinses or pastes in our office.

Oral Hygiene

If the tissues are tender, it is important that you clean your teeth and gums gently but thoroughly. This will probably require more time than usual. Running your toothbrush under hot water will soften the bristles and may help you cleanse the gum line more comfortably and effectively.

Periodontal Maintenance

Once you have had Scaling and Root Planing, the recommendation for your hygiene visits, called Periodontal Maintenances, will be set at either 3 or 4 months (based on how your tissues and structures respond to the therapy as well as your at-home care consistency. Once you have had a Scaling and Root Planing, you no longer need “regular cleanings” (also called an prophylaxis) because this service is intended for patients without bone loss and for cleaning only above the gum line.

You may encounter some bleeding when brushing/flossing. It is important to continue gentle brushing and flossing even if bleeding occurs. As healing progresses, the bleeding will gradually reduce or disappear. If you have been given any additional cleaning devices, begin using them two times daily as demonstrated by your hygienist or dentist. These devices stimulatecirculation and encourage healing.

If you have discomfort that is not alleviated by any of these matters, or if you have any areas of swelling or any other concerns, please call our office immediately 978-465-8492.

CariFree Treatment Rinse Instructions for Periodontal Disease Management

We have determined that you have active gum disease which is a bacterial infection. In order to reduce the infection, we recommend this treatment rinse protocol to kill the bacteria on the cheeks and tongue. These are additional instructions on how to use the product. Directions on the package suggest the rinse for caries (the bacteria that cause cavities). It is also effective against the bacteria that cause periodontal disease. This is the reason we ask you to use it.

• This rinse is medicine. Use all of it.
• Shake each bottle before use Measure 5ml of part A and 5ml of part B to total 10ml. Dispense into supplied measuring cup.
• Rinse and swish in your mouth for one minute. DO NOT SWALLOW.
• After the timed rinse, spit out the excess. If possible do not eat or drink for 30 minutes.
• Finish this entire product