Frequently Asked Questions

How do I know if I am receiving quality dental care?

In most cases, evaluating the quality of the care you receive is based more on intangibles that have nothing to do with actual dental procedures, but are nevertheless good indicators. Is the office clean, well maintained, and up-to-date in appearance? Is the staff knowledgeable and competent? Are they genuinely concerned for your comfort? What is the experience level of the dentist and staff? Are your questions answered completely and in clear terms? Does the dentist have a commitment to further education? Were you referred by a satisfied patient? Do long term patients have good things to say about the office - usually in on-line reviews. Deficiencies in these areas often correlate with clinical skill.

What infection control measures are taken in your office?

Following are measures we have taken in our office to reduce the chance of disease transmittal among patients and staff.

  • Facemasks: All of our clinical personnel wear facemasks and eye protection during patient care.
  • Gloves: New disposable gloves are worn for every patient. Nitrile gloves are used for patients with latex sensitivities/allergies.
  • Disinfection of Counters and Other Surfaces: You may notice a mild chemical odor associated when wiping surfaces. These chemicals disinfect surfaces that have been touched during patient treatment.
  • Items Attached to Dental Operating Units: Handpieces, air blowers, suction equipment, etc., are sterilized with a combination of heat and chemicals, or are disposed and replaced with new after use.
  • Barriers: Plastic or rubber is placed on chairs, switches, etc., for each new patient.
  • Instruments: All metal instruments placed in your mouth have been sterilized by a combination of heat and chemicals. Our sterilizer is tested weekly to insure proper operation.

Every possible precaution is being taken in our office to avoid any cross-contamination from patient to patient. Our infection control procedures are among the most stringent in the entire health care system. (Something to ponder - glasses and tableware in restaurants are cleaned with soap and hot water!) We welcome your questions and suggestions.

Why should I have my teeth cleaned on a regular basis?

Hard deposits form on the teeth which cannot be removed with flossing and brushing. These deposits irritate the gums, causing the seal around the teeth to break down and eventually leading to gum disease. Cavities form from exposure to sweets and acids. Fillings and crowns wear out. Teeth chip, break, and crack. Tooth and gum problems are more easily treated if caught in the early stages. Commonly, a small cavity that can be easily filled initially can require major and expensive treatment if allowed to progress for as little as 6 months without detection, which is the recommended interval between cleanings for most people. Truly, "an ounce of prevention is worth a pound of cure".

Are x-rays really necessary?

Absolutely! They show areas that cannot be examined with the naked eye. Various images allow us to examine between the teeth where cavities form, the roots of the teeth, the supporting bone, your jaw joints, and to some extent the sinuses. Along with regular check-ups, dental x-rays can help detect small problems before they become big ones.

There is a great deal of unjustified concern about radiation exposure from dental x-rays, mainly the result of poorly structured studies that are sensationalized by the media. The following graph should alleviate any concerns you might have.

To reduce radiation exposure as much as technology will allow, our office is fully digitized, employing computer sensors that require significantly less radiation than older conventional films. In addition the images are instantly available without chemical processing, and we can make as many copies as needed at any time.

Will the dentist examine my teeth every time I have my teeth cleaned?

This depends upon your dental history and personal preference. Some people prefer to be examined every time. Others, with a history of few dental problems or who have been stable for a while, can be examined once a year.

What is the best way to whiten my teeth?

Answering this question in detail would require a book, but here is the simple version. How much teeth whiten, and how long it takes, depends upon two factors – the strength of the bleaching agent applied and how long it remains in contact with the teeth. Mouthwashes and tooth pastes do little, if anything, to lighten teeth and are mostly a waste of money. Drug store kits and strips work for some people, but can be difficult and unpredictable. Laser, zoom, or "power" bleaching utilizes a very powerful bleaching agent that can easily burn soft tissues and is done entirely in a dental office under direct supervision, which makes it the fastest (and most expensive) technique. Our preference is bleaching at home using custom made trays and bleach gel provided by our office. This is safe, gentle, and effective, with the major benefit of being reusable. Teeth can be “touch up bleached” at a later time with fresh beach, obtained from the dentist. At-home bleaching with your dentist’s assistance employs thin clear trays similar to orthodontic retainers or athletic mouth guards that are custom fitted and hold a bleaching gel on the tooth, usually for an hour a day. Results are typically noticeable within days with best results occurring within a couple of weeks.

Note: No bleaching method will change the color of restorations like crowns, bridges, fillings, or plates. Some restorations may no longer match after the natural teeth are lightened. Some tooth colors are much slower to respond. These issues should be evaluated by the dentist and discussed.

Should my silver fillings be replaced?

Extensive unbiased research has failed to prove that silver fillings, and the mercury bound within, is harmful to one's health. Nevertheless, silver fillings are rarely used today due to advances in tooth colored materials, which are typically used when silver fillings must be replaced due to wear, breakage, or decay. Many people choose to replace their unattractive silver fillings with tooth colored fillings strictly for esthetic reasons.

What causes cavities?

Cavity formation can be the result of a myriad of factors. Sugar and acid consumption, the natural hardness (or softness) of your teeth, oral hygiene habits, salivary flow, medications taken, and exposure time can each or together have a huge impact. Acids contained in the item consumed or produced by sugar loving bacteria dissolve tooth enamel. Many people unknowingly consume substances that cause cavities, such as cough drops, breath mints, throat lozenges, and antacid tablets. Sports drinks, citrus fruit juices, and all carbonated beverages are acidic and can contribute to decay. Of great importance is the exposure time. Having a soda with lunch is seldom harmful, but taking small sips over an extended period of time will constantly splash fresh acid on your teeth and can do significant damage. A breath mint slowly dissolving in your mouth is providing acid producing bacteria their favorite food- sugar.

Why am I breaking so many teeth?

Unfortunately, teeth become brittle with the passage of time, especially when large fillings are present. Additionally, the bite may change as teeth wear, placing additional stress on the teeth that may result in breakage. For some people, stress or medications will increase clenching and/or grinding which may break teeth. When breakage becomes a recurring problem, it is important to determine why.

Typically broken teeth are restored with crowns, which surround, reinforce, and protect the tooth. In many cases, your dentist may recommend a crown be placed before a weak tooth breaks to avoid possible root canal treatment or losing the tooth from root fracture. Proactive treatment with a crown is an especially good idea when cracks appear in the enamel. If you wait until it hurts, it may be too late!!! We can show you large fillings and cracks on images we capture with a special intra-oral camera.

Can my missing teeth be replaced with implants?

Dental implants are now frequently used to replace the root of a diseased natural tooth with a poor prognosis, or a tooth that has been missing. The best sources of information on dental implants are the Institute for Dental Implant Awareness and the local Carolina Implant Center, with whom we frequently team for complex or difficult implant placement. Dr. Thomas, founder of the CIC, is one of the most skilled dental implantologists in the country.

What is "Site Preservation" after tooth removal?

When a tooth is removed, the bone and gum tissue in the area immediately begin to shrink, and continue to do so for quite some time. The resulting defect can make it difficult to place an acceptable replacement tooth. “Site Preservation” involves special measures to minimize the loss of gum and bone. This may include very careful removal of the tooth to protect the surrounding tissues, placement of freeze dried bone or bone-like materials into the socket, and use of special permeable membranes to guide the healing response. Several follow-up appointments are usually necessary to remove stitches and monitor healing. Benefits of site preservation include:

  • The bone and gum retain a more natural shape and appearance
  • Eliminate or minimize an unsightly defect
  • Better looking and more functional replacement teeth
  • Retain more options for replacement teeth with implants, bridges, or partials
  • No food packed into the socket
  • Less painful healing ( a closed wound versus an open wound)
  • Fewer incidences of “dry socket”
  • Eliminate or minimize need to rebuild the bone and gum later, saving time and money

Site Preservation is very important if you are interested in replacing your missing tooth with an implant, which requires bone for stability and healthy gum tissue for a good seal. Even if you are not presently a candidate for an implanted tooth, preserving the bone and gum tissue now will give you more and simpler options later.

Why should I have my tooth crowned in your office rather than the discount clinic?

Many people do not realize there are significant differences among crowns that may not be readily apparent. Let’s use an example of something with which people are more familiar – tires for a car. Though they may all look pretty much the same, some tires last longer, handle better, and ride better. Some manufacturers have better warranties and better dealer support. You basically get what you pay for. Providing quality and excellent service costs more initially, but is worth it in the long run, especially in dental care.

We use the best materials available and do not compromise on the procedures. Period. Additionally, there is the value of an established doctor-patient relationship in which your overall dental health needs are a consideration. Rarely is there one dental problem that is not related to another, and addressing one without addressing the other will result in problems later that will only grow in severity. (For example, a tooth may break because of a bad bite. If the bad bite is not corrected, the new crown or other teeth may break.)

The discount clinics, and most other dental offices for that matter, are still providing crowns that require two separate appointments so the crown can be fabricated by hand in a dental laboratory. Most of our crowns are now placed in one visit because they are fabricated in our office. (Please see below.) Offering this service required a huge investment in equipment and training, and reflects our dedication to providing state-of-the-art dental care to our patients.

Tell me about one-visit crowns, veneers and bridges. NEW!!!

We are the only office in the New Bern area to have the E4D system, which is the latest and most sophisticated device for single-visit metal-free ceramic restorations. In one visit, crowns, veneers, and some bridges are fabricated by a sophisticated computer-managed machine that mills the crown from a solid block of ceramic material using CAD/CAM technology - Computer Aided Design/Computer Aided Manufacturing. The tooth is shaped by the dentist, laser scanned, and then the restoration is designed on a computer and milled from a solid block of tooth colored ceramic. Many of our patients enjoy observing the entire process. The restoration is then fitted to the tooth and permanently bonded in place. A single crown typically requires a total time of approximately 1.5 - 3 hours to completion, but you are only needed for about half that time. There is no temporary crown to break or come out, and no second visit. Metal-free ceramic crowns look like natural teeth and have no dark line at the edges.

  • There is no mouthful of goop (called taking an impression) to record the shape of the tooth - the laser measures and a computer records the shape of the tooth.
  • The dentist has total control over the design and fabrication of the crown, and is not dependent upon anyone outside of the office, so quality is directly in the hands of the dentist. Dr. Hand is exceptionally skilled in "tooth design" and working with computer systems.
  • If modifications are necessary, they can be done right way.
  • All procedures are completed with only one numbing with anesthetic.
  • There is no temporary crown to break or come off between visits since there is no second visit.
  • The solid ceramic material is bonded to the tooth and is comparable in strength to natural tooth structure. Furthermore, they are exceptionally "life-like" with no unsightly dark line at the edge of the crown.
  • In the unlikely event of breakage, a new one can be easily fabricated from the saved data files, and the replacement completed in one appointment.

Why am I being referred to specialist?

We strive to provide a broad range of services but the simple fact is special problems or challenging situations sometimes need special skills. Our office maintains excellent relationships with many fine local specialists for orthodontics (tooth straightening), endodontics (root canal treatment), periodontics (gum disease and implants), pedodontics (young/special needs children), and oral surgery (wisdom teeth and jaw surgery). You are always "our" patient and we are responsible for your overall dental care. Think of the specialists as additional members of our team, in another office. Our area is fortunate to have some of the finest specialists in the state, if not the country.

Why are you not at "participating provider" in my plan so I can get my dental work done much more cheaply?

Dentists participating in a plan as a "preferred provider" or "network dentist" agree to accept a discounted payment for services. This limits the dentist's ability to provide services at the usual level. One of several scenarios result, none of which are conducive to quality care:

  • Other non-plan patients must pay more to make up the difference.
  • The office must reduce expenses, usually by cutting corners on materials or employees, or significantly increasing the volume of patients seen with an assembly-line atmosphere.
  • Additional charges get "tacked on" to make up for the discounted fees.

We do not discriminate or have different tiers of quality or fees. We do not tack on superfluous charges to pad your insurance bill. We do not charge any patient more in order to support reduced fees that others might be paying. We provide the same level of care, at the same fees, to all patients and strive to treat everyone fairly. We feel strongly that dental care is ideally decided by the patient and the dentist, and not a third party, like an insurance company. Look at medical health care as an example of what happens when health care decisions are dictated by 3rd parties.

You are not in my plan. Can I still be your patient?

Absolutely! The choice of dentist and treatment is yours to make, and not a legal requirement, though filing claims and receiving payments can be more challenging. If there is a difference between your dental benefits and our fee, we will do our best to work out a financial plan that will allow you to receive the quality care you deserve.