Frequently Asked Questions

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What can I do about bad breath?

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If you feel constantly worried about bad breath, you’re not alone. Bad breath (halitosis) is an all too common problem, not to mention embarrassing and distracting for you and others around you. Deducing the most likely cause of your bad breath will help determine what you can do to prevent it.

Greatly reduced saliva flow during sleep (the cause of morning breath), certain foods (such as garlic, onions, and peppers), poor oral hygiene, periodontal (gum) disease, dry mouth, tobacco, dieting, dehydration, and some medical conditions (including sinus infections and diabetes) are the most common causes of bad breath. Brushing your teeth at least twice a day (in the morning and at night) is the first step toward fresher breath, and brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can loosen food particles from between teeth. Additionally, clean between your teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every couple months.

Biannual dental cleanings and checkups at our office will not only keep your teeth and gums in good shape, but seeing you regularly will also allow us to better detect any problems, such as gum disease, dry mouth (Xerostomia), or other dental conditions (like decay), that could be causing persistent bad breath. If you have gum disease, more frequent visits to our office might be recommended for your oral and overall health.

Breaking a tobacco habit (smoking or chewing) can significantly improve your oral health and the way your breath smells. Drinking plenty of water and eating healthy also keeps your mouth moist and more free of bad bacteria. Mouth rinses can help, too, but ask us which rinses actually kill the germs that cause bad breath – some only mask odor as a temporary solution.

When bad breath is a symptom of a larger bacterial problem in your mouth, Dr. Duraiappa can help. If he finds that your mouth is healthy, we may refer you to your physician for further consultation and more comprehensive treatment.

I don't have a toothache and I brush and floss regularly. Do I really need a check-up?

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Biannual teeth cleanings performed by a skilled dental hygienist are vital to keeping your teeth and gums looking, feeling, and functioning their best. If you have gum disease, more frequent cleanings will probably be recommended for your oral and overall health.

During a dental cleaning, plaque and calculus (more commonly known as tartar) are removed from teeth. Plaque is a sticky deposit in which bacteria grow, and tartar is basically calcified or hardened plaque, so it is more difficult to remove. When tartar builds up under the gumline and causes gum disease, more extensive treatment than a standard cleaning is needed to remove it and help ensure healthier gums. Hygienists also polish teeth, floss (partly to test the condition of gums), and then document any bleeding along with stains they noted during the cleaning.

You’ll then be examined by Dr. Duraiappa, who will diagnose and treat any existing problems before they grow bigger and more painful. A typical exam includes a visual assessment of teeth and occlusion (bite), along with an appraisal of current restorations. When x-rays have been taken, Dr. Duraiappa and his team will carefully review them to identify areas of decay and other possible areas of concern for cysts, tumors, and other disorders of the mouth. Panoramic x-rays are especially revealing and beneficial to this process. Dr. Duraiappa will also perform a general screening for early detection of gum disease and oral cancer.

At what age should my child first visit the dentist?

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Positive dental experiences during childhood are the foundation of a lifetime of bright and healthy smiles. Both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend establishing a dental home by the time your child is one year old. So a good rule of thumb is first visit by first birthday.

If my filling is still in place and my tooth does not hurt, why does my dentist want to replace the filling?

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Constant pressure from chewing, grinding, and/or clenching can cause dental fillings to wear away, chip, and even crack. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can infect the deeper layers of the tooth, causing an abscess or the eventual loss of the tooth. Regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.

If you have large restorations or extensive recurrent decay, there might not be enough remaining tooth structure to support a replacement filling. In these cases, we may need to replace the filling with a natural looking porcelain crown.

How can cosmetic dentistry improve my life?

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Studies have shown that a healthy and attractive smile can raise self-esteem, improve your personal and professional life, and help you make better first impressions on others. Sometimes it doesn’t take much treatment for you to feel much better about your smile, and there are a variety of subtle yet noticeable ways that smiles can be enhanced. We also offer more significant and dramatic treatment procedures, often called “smile makeovers,” that can completely transform your smile.

While there is no true “specialist” association for cosmetic dentistry, there are a number of organizations with advanced training and awards associated with cosmetic dentistry. Some dentists place greater emphasis on cosmetic dentistry, especially those with an exceptionally artistic eye.

Advancements in dental technology have made it possible for Dr. Duraiappa to address a wide variety of issues that can affect your smile’s appearance. Some common cosmetic dentistry treatments include teeth whitening, cosmetic bonding and enamel shaping, and dazzling porcelain veneers. Replacing amalgam (silver) fillings with tooth-colored composite fillings can also be considered cosmetic in nature, since it is done to improve both the health and the appearance of your teeth. Really, all dental treatment aimed to improve the appearance of your teeth, gums, or smile can be considered cosmetic in nature.

What is comprehensive dentistry?

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Our aim is to have all concerns and issues known and resolved before an emergency occurs. After all, there’s never a good time for a toothache or a broken tooth! This means that we see patients for many reasons with many different needs, from routine preventive care to life changing restorative and cosmetic treatment. We have something to offer everyone to address their personal concerns.

The second half of this equation is the development and fulfillment of ongoing maintenance plans. This minimizes the chance of original problems reoccurring. Routine cleanings are an integral part of comprehensive dentistry because Dr. Duraiappa and our team have the ability to remove plaque your toothbrush can’t, which reduces your risk of tooth decay and gum disease. We can also use panoramic x-rays and an intraoral camera to monitor structures that aren’t always obvious to the naked eye. We will do everything we can to customize your maintenance plan based on your individual situation.

In short, the term “comprehensive care” refers to our commitment to the present and the future of your smile. Not only do we want to keep it healthy, we want to make it beautiful and make it last.

I know certain foods are bad for my teeth. But are there any that are GOOD for them?

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In fact, there are! Milk, cheese, nuts, chicken and other lean meats contain calcium and phosphorous, which have been proven to strengthen bones and protect enamel. Calcium is essential for bone development, even though your teeth do not directly absorb it – a strong jawbone leads to healthy gums, and healthy gums support healthy teeth. Fruits and vegetables are just as good for your teeth as they are for your body, especially firm, crunchy ones with a high water content (apples, pears). Water is critical for your oral health because it rinses away food particles and keeps your mouth and gums moist. Dehydration can lead to dry mouth, which is a breeding ground for cavities and bad breath.

As most people know, foods high in sugar tend to stick to teeth and can lead to decay. What many people don’t know is that almost all foods contain some form of sugar – even milk products and fruit – so you can’t cut it out completely. The most important part of the “dentist diet” is brushing your teeth after each meal. If you do snack between meals, especially on starchy or sweet foods, and cannot brush, drink plenty of water or chew sugar-free gum to loosen any residue. For those of us out there with a sweet tooth, don’t despair: not all sweet snacks are off-limits. Chewing sugar-free gum that contains xylitol can actually preventcavities.

Are there any specific oral health concerns associated with diabetes?

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While having diabetes does not automatically put your dental health at risk, it does make you more susceptible to certain conditions. Uncontrolled diabetes causes high glucose levels in saliva, which can promote the growth of bacteria in the mouth and increase the occurrence of cavities. Diabetes also reduces the body’s resistance to infection, which can make an individual more likely to develop illnesses such as gingivitis or even gum disease. Gingivitis is usually signified by red, inflamed, receding, or bleeding gums. If you notice these to any degree, be sure to make an appointment with your dentist. Other less serious problems that can occur include thrush (a treatable infection in the tongue and cheeks), ulcers, and dry mouth.

Interestingly enough, this connection is a two-way street. For patients with severe gum disease, the infection in the gums can affect the blood glucose levels and the immune system, actually increasing the overall risk of developing diabetes. If you have diabetes, you know the importance of a healthy lifestyle. Smoking can be particularly damaging to diabetics, as it causes excess dryness and damage to the gum tissue. Ultimately, the most important factor is blood sugar. If you keep your diabetes under control with a healthy lifestyle and maintain good oral hygiene through regular check-ups, diabetes won’t get the best of your smile.

Hot or cold, my teeth hate both! Why are they so sensitive, and how can I stop the pain?

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If you’ve been avoiding that ice cream cone or cup of coffee because of sensitive teeth, you don’t have to. Sensitivity is a common complaint and can be caused by a number of factors. Tooth grinding, jaw clenching, gum recession, and enamel loss can all make teeth extra sensitive, because the usually-protectedlayer of dentin—the nerve-packed surface beneath the enamel—is exposed to external stimuli. Surface irritants such as braces and teeth whitening can also cause temporary sensitivity.

Because the causes of sensitivity are so diverse, and because sensitive gum tissue can indicate a more serious problem, it’s important to ask Dr. Duraiappa which treatment is best for you. A softer toothbrush is usually the first step, and special toothpastes can reduce sensitivity over time. Over-the-counter fluoride rinses and in-office procedures can help protect your enamel against further damage.

Am I candidate for dental implant restorations?

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If you struggle with ill-fitting, uncomfortable dentures or a retainer with false teeth, dental implants can give your smile a second chance. They are useful in denture stabilization and can also be used as single-tooth replacements or in conjunction with crowns and bridges. Dental Implants are not only more durable and long-lasting than traditional tooth replacements, but they also look and feel more like natural teeth. Most importantly, implants function like natural teeth, so you can chew, talk, and smile with confidence again. Because the implant procedure allows for more of your healthy tooth structure to be saved, fixed implants can even help prevent further bone loss.

Many patients suffering from advanced tooth decay, root canal failure, trauma to the mouth, or just extreme natural wear and tear on teeth are benefiting from this revolutionary restorative treatment. However, there are still some things to consider before you decide on dental implants. For example, implants are best performed after adolescence, when the teeth and jaw bone are fully developed. The implant procedure can also be more complicated for individuals with gum disease, active diabetes, immune deficiencies, and for patients who smoke. To ensure that you get the treatment that’s right for you, keep Dr. Duraiappa and his team informed and up-to-date about your entire medical history and dental habits.

Is professional teeth whitening safe?

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Yes. Numerous studies have verified the safety of whitening and bleaching procedures on teeth. Some products, including certain whitening toothpastes and take-home kits available through your dentist, have even been approved by the American Dental Association (ADA). While having the ADA seal of acceptance is a good sign, many safe and effective products don’t have an ADA seal simply because their manufacturers did not seek one. The most common side effect of teeth-whitening—both the in-office and take-home varieties—is sensitivity. This is temporary and usually subsides soon after you’ve stopped using the product.

Whitening is not recommended for children under 16, as their teeth are still developing, or for women who are pregnant.

Why is fluoride good for my teeth?

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Each day, the sugars and acids in the foods we eat feed bacteria in our mouths. When this bacteria accumulates on teeth and forms plaque, it erodes the enamel in a process known as demineralization. Fluoride is a naturally-occurring mineral that promotes the remineralization of enamel, replacing important minerals that strengthen your teeth and protect them from decay. In some cases, fluoride can even reverse some of the early stages of decay.

Children with newly-erupted permanent teeth benefit a great deal from fluoride exposure, but adults should make sure their teeth come into contact with it, too. The safe and easy way to ensure your teeth are getting enough fluoride is to use fluoride toothpaste, available at drugstores in a variety of types and flavors. If your dentist recommends more intensive fluoride treatments, there are many gels, rinses, and in-office procedures that can do the trick. Though the most fluoride is absorbed from direct contact with the teeth, many public drinking water systems contain small, safe amounts of fluoride that can have positive health effects when ingested.

When I floss, my gums bleed. If they don’t hurt and my teeth look fine, is it really a big deal?

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If your gums are not sore, it’s safe to assume that the bleeding is not a result of hard brushing or flossing. Bleeding gums that apparently have no cause can be a warning sign of gingivitis or even severe gum disease (periodontitis). Gingivitis (inflamed, bleeding gums) is not a one-way ticket to periodontitis; in fact, if it’s caught early enough, gingivitis can be treated and even reversed. The first lines of treatment are lifestyle changes. Poor oral hygiene, smoking, uncontrolled diabetes, and high levels of stress can all contribute to gingivitis. Choosing a toothbrush with soft bristles can ease gum damage, too, and getting regular dental cleanings will control plaque and tooth decay. It’s important to stop gingivitis before it progresses to periodontitis, as studies have linked severe gum disease to an increased risk of heart disease, stroke, diabetes, and even inflammatory diseases such as Rheumatoid Arthritis.

Though not the first suspect in a case of bleeding gums, oral cancer is also a possibility. Oral cancer can be difficult to diagnose because many of its symptoms are indicators of other medical conditions. Symptoms include mouth sores, difficulty swallowing or moving the jaw, bleeding gums or cheeks, and continuous pain in the mouth. If Dr. Duraiappa finds no other cause for your bleeding gums, he may recommend a visit to a specialist.

Regular check-ups are vital to cancer prevention, as are good oral hygiene, avoiding tobacco, and maintaining a balanced diet. Inform your dentist if you’re experiencing any of the above symptoms. You’d go to the doctor if a cut on your hand were infected—do your gums the same service! They’ll thank you later.

My teeth are killing me, but I can’t really tell where the pain is coming from.

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Believe it or not, you could have a sinus infection. Researchers have recently discovered a direct connection between sinus infections and impacted or damaged teeth. Sinus infections can also occur after intense dental work or cracked restorations. Because of their proximity to the roots of the upper teeth, pain in the sinuses can not only mimic the sensation of a toothache, but can actually cause one, too. If you’re experiencing chronic sinus pain with a general, unidentified toothache, ask Dr. Duraiappa to check it out. A regular dental exam and a series of x-rays should be enough to determine a tooth-related cause, but if they aren’t, he can also perform a “percussion test,” gently tapping on individual teeth to single out the source of your discomfort. After all, when deciding on a treatment plan, it’s helpful to know whether your pain is really a toothache or it’s just your nose playing tricks on you.

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Dental Health Center

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Marshall, 56258 MN



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