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Table of Contents The Dentists --------------------------------------------------------------- 6 Choosing a Dentist Choosing the right dentist is a very important decision. ------------------------------- 9 What are the most common oral health problems? ---------------------------------------------------------------- 10 Cavities --------------------------------------------------------------- 11 Gum diseases ------------------------------------------------------- 11 What are some other problems I might have with my mouth? -------------------------------------------------- 12 Bad breath ----------------------------------------------------------- 12 Burning mouth ------------------------------------------------------ 14 I'm afraid of the dentist. What can I do to make my visit better? -------------------------------------------------- 15
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As a woman, why do I have to worry about oral health? ------------------------------------------------------- 17 I'm pregnant. Do I need to take special care of my mouth? ------------------------------------------------------ 18 I'm a new mother. What can I do for my baby's oral health? ------------------------------------------------------ 20 What is baby bottle tooth decay? ------------------------------21 What causes baby bottle tooth decay? -----------------------21 How can you protect your child's teeth? ---------------------22 Are baby teeth important? ---------------------------------------23 Children's Oral Health -------------------------------------------------- 24 What Parents and Caregivers Can Do ------------------------- 24 What small, easy steps can I take to have a healthy teeth and gums? -------------------------------------------- 25
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Toothache - Access to Emergency Care ---------------------------- 26 What is a denture? ------------------------------------------------------ 28 What is Root canal ------------------------------------------------------ 31 Dental Implant ----------------------------------------------------------- 32 What is dental amalgam? --------------------------------------------- 36 Tooth Discoloration ----------------------------------------------------- 38 Psychological Effect of Persons with Oral Conditions ----------------------------------------------------------------- 44 Where can I find low-cost dental care? ---------------------------- 45 What Are Medical Expenses? ----------------------------------------- 48 How Much of the Expenses Can You Deduct? -------------------- 49 Closure --------------------------------------------------------------------- 51

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The Dentists Dentists diagnose and treat problems with teeth and tissues in the mouth, along with giving advice and administering care to help prevent future problems. They provide instruction on diet, brushing, flossing, the use of fluorides, and other aspects of dental care. They remove tooth decay, fill cavities, examine x rays, place protective plastic sealants on children's teeth, straighten teeth, and repair fractured teeth. They also perform corrective surgery on gums and supporting bones to treat gum diseases. Dentists extract teeth and make models and measurements for dentures to replace missing teeth. They also administer anesthetics and write prescriptions for antibiotics and other medications. Dentists use a variety of equipment, including x-ray machines, drills, mouth mirrors, probes, forceps, brushes, and scalpels. Lasers, digital scanners, and other computer technologies also may be used. Dentists wear masks, gloves, and safety glasses to protect themselves and their patients from infectious diseases.
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Dentists in private practice oversee a variety of administrative tasks, including bookkeeping and the buying of equipment and supplies. They may employ and supervise dental hygienists, dental assistants, dental laboratory technicians, and receptionists. (These occupations are described elsewhere in the Handbook.) Most dentists are general practitioners, handling a variety of dental needs. Other dentists practice in any of nine specialty areas. Orthodontists, the largest group of specialists, straighten teeth by applying pressure to the teeth with braces or other appliances. The next largest group, oral and maxillofacial surgeons, operates on the mouth, jaws, teeth, gums, neck, and head. The remainder may specialize as pediatric dentists (focusing on dentistry for children and special-needs patients); periodontists (treating gums and bone supporting the teeth); prosthodontists (replacing missing teeth with permanent fixtures, such as crowns and bridges, or with removable fixtures such as dentures); endodontists (performing root-canal therapy); oral pathologists (diagnosing oral diseases); oral and maxillofacial radiologists (diagnosing diseases in the head and neck through the use of imaging
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technologies); or dental public health specialists (promoting good dental health and preventing dental diseases within the community). Work environment. Most dentists are solo practitioners, meaning that they own their own businesses and work alone or with a small staff. Some dentists have partners, and a few work for other dentists as associate dentists. Most dentists work 4 or 5 days a week. Some work evenings and weekends to meet their patients' needs. The number of hours worked varies greatly among dentists. Most full-time dentists work between 35 and 40 hours a week. However, others, especially those who are trying to establish a new practice, work more. Also, experienced dentists often work fewer hours. It is common for dentists to continue in part-time practice well beyond the usual retirement age. Dentists usually work in the safety of an office environment. However, workrelated injuries can occur, such as those resulting from the use of hand-held tools when performing dental work on patients.
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Choosing a Dentist Choosing the right dentist is a very important decision. There are several resources available to help you make this decision. For instance, when searching for a dentist or other healthcare professional remember to: Find out whether they are licensed in your state. Your state, county or city Consumer Protection Office will be able to help you find this information. Research whether they are board-certified in the appropriate specialty. You can find this information at: American Medical Association (AMA) - Doctor Finder American Board of Medical Specialties - Is Your Doctor Certified? Ask how often they have done the procedure you need and their success rate. You may be able to find some of this information on the Internet. For example, the Centers for Disease Control and Prevention (CDC) often reports the success rates and
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number of procedures performed. Check whether there have been any complaints or disciplinary actions taken. Your state medical board can help. In addition, the following websites provide directories to help you find health professionals, services and facilities: Healthfinder.gov - Find Services and Information Medline Plus - Directories You may also wish to view information from the National Institute of Dental and Craniofacial Research (NIDCR) about finding low-cost dental care. Finally, if you have healthcare insurance, please check with your insurance provider to help you choose a doctor or dentist. If you do not have insurance, please check your phone book for a local health department. What are the most common oral health problems? The most common oral health problems are cavities and gum disease.
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Cavities We are all at risk of tooth decay, or cavities. (Cavities look like chalky white and/or brown holes on your teeth). Bacteria (germs) that naturally live in our mouths use sugar in food to make acids. Over time, the acids destroy the outside layer of your teeth. Then cavities and other tooth harm occur. Gum diseases Gum diseases are infections caused by bacteria, along with mucus and other particles that form a sticky plaque on your teeth. Plaque that is left on teeth hardens and forms tartar. Gingivitis is a mild form of gum disease. It causes red, swollen gums. It can also make the gums bleed easily. Gingivitis can be caused by plaque buildup. And the longer plaque and tartar stay on teeth, the more harm they do. Most gingivitis can be treated with daily brushing and flossing and regular cleanings at the dentist’s office. This form of gum disease does not lead to loss of bone or tissue around the teeth. But if it is not treated, it can advance to
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periodontitis. Then the gums pull away from the teeth and form infected “pockets.” You may also lose supporting bone. If you have periodontitis, see your dentist for treatment. Otherwise your teeth may loosen over time and need to be removed. Your risk of gum disease is higher if you: • • • Smoke Have a disease such as diabetes or HIV/AIDS Use methamphetamine

What are some other problems I might have with my mouth? Bad breath Bad breath is also called halitosis. Bad smelling breath can be caused by several things, including:
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• • • • • • • •

Poor oral hygiene Some foods Dentures Gum disease Dry mouth Tobacco use Respiratory, digestive, or other health problems Some medicines

Practicing good oral hygiene and avoiding tobacco and some foods often helps people with bad-smelling breath. You may want to try using a tongue scraper to
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clean food from your tongue. You could also just brush your tongue with your toothbrush. But if doing so doesn’t seem to help or if you always need mouthwash to hide bad breath, talk to your dentist. Burning mouth People with this condition describe a burning feeling in the mouth or tongue. It is most common in postmenopausal women. The cause is unknown, but might be linked to: • • • • •
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Hormones Dry mouth (which can be caused by many medicines and such as Sjögren’s syndrome or diabetes) Taste problems Nutritional deficiencies Use of ACE inhibitors (blood pressure medicines)
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• • •

Anxiety and depression Dentures that do not fit Infections (especially fungal infections)

Talk to your doctor or dentist if you have burning mouth. Treatment depends on the cause — if it can be determined — and might include adjusting your dentures, vitamin supplements, or pain or other medicines. I’m afraid of the dentist. What can I do to make my visit better? Many people get nervous at the thought of visiting the dentist. Don’t let your nerves stop you from having regular appointments, though. Waiting too long to take care of your teeth may make things worse. Here are a few tips to make your visit easier:
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Tell the dentist and dental staff that you are feeling anxious. Getting your concerns out in the open will let your dentist adapt the treatment to your needs. Try to choose a time for your dental visit when you're less likely to be rushed or under pressure. For some people, that means a Saturday or an early-morning appointment. If the sound of the drill bothers you, bring a portable audio player and headset so you can listen to your favorite music. During the dental visit you might try visualizing yourself someplace relaxing, like on a warm beach. Ask your dentist if there are medications he or she can give you to help you relax (this is sometimes called “sedation dentistry”).

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As a woman, why do I have to worry about oral health? Everyone needs to take care of their oral health. But female hormones can lead to an increase in some problems, such as: • • • • Cold sores and canker sores Dry mouth Changes in taste Higher risk of gum disease

Taking good care of your teeth and gums can help you avoid or lessen oral health problems.

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I’m pregnant. Do I need to take special care of my mouth? Yes! If you are pregnant, you have special oral health needs. Before you become pregnant, it is best to have regular dental checkups. You want to keep your mouth in good health before your pregnancy. Also, remember that what you eat affects the development of your unborn child — including teeth. Your baby’s teeth begin to grow during the third and sixth months of pregnancy, so it is important that you eat a balanced diet that includes calcium, protein, phosphorous, and vitamins A, C, and D. If you are pregnant: • Have a complete oral exam early in your pregnancy. Because you are pregnant, your dentist might not take routine x-rays. But if you need xrays, the health risk to your unborn baby is small.
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Remember dental work during pregnancy is safe. The best time for treatment is between the 14th and 20th weeks. In the last months, you might be uncomfortable sitting in a dental chair. Have all needed dental treatments. If you avoid treatment, you may risk your own and your baby’s health. Use good oral hygiene to control your risk of gum diseases. Pregnant women may have changes in taste and develop red, swollen gums that bleed easily. This condition is called pregnancy gingivitis. Both poor oral hygiene and higher hormone levels can cause pregnancy gingivitis. Until now, it was thought that having gum disease could raise your risk of having a low-birth-weight baby. Researchers have not been able to confirm this link, but studies are still under way to learn more.

• •

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I’m a new mother. What can I do for my baby’s oral health? You can do a lot! Below are some things you need to know about your baby’s oral health. • The same germs that cause tooth decay in your mouth can be passed to your baby. Do not put your baby’s items, such as toys, spoons, bottles, or pacifiers in your mouth. Wipe your baby’s teeth and gums with a clean gauze pad or baby toothbrush after each nursing and feeding. This can help remove sugars found in milk that can cause tooth decay and also get your baby used to having her teeth cleaned on a regular basis. If you bottle-feed your baby, try to finish bottle weaning by age 1. Avoid giving your baby bottles or pacifiers at naps and bedtime. Sucking on a bottle when lying down can cause cavities and lead to "baby bottle tooth decay."
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All babies should visit a dentist by age 1. The dentist will screen for problems in your baby’s mouth. You will also be shown how to care for your child’s teeth and mouth. Talk with your doctor about the best water choices for infants. Fluoride is good for teeth. But too much fluoride can harm development of tooth enamel in infants.

What is baby bottle tooth decay? When an infant or small child develops several cavities, usually on the top front teeth, it is called baby bottle tooth decay. These cavities may look like dark pits, holes or broken teeth and may cause toothaches and make it hard for the child to eat. What causes baby bottle tooth decay? It happens when liquids that contain sugar are left in a baby’s mouth for long or frequent periods of time. Even breast milk and formula contain sugar.
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How can you protect your child’s teeth? Your child should not:  go to bed with a bottle filled with milk, formula, juice or sweetened drink  sleep at night at the breast  drink from a bottle throughout the day  use a pacifier if it is dipped in honey, syrup or anything sweet, such as Jello™ water, soda pop, fruit juice, Kool-Aid™, sugar water, milk or formula Your child should:  start drinking from a cup at 6 months of age and be weaned from his or her bottle by 1 year of age  go to bed without a bottle. If your child must have a bottle to sleep, fill it with plain water. You may need to mix the drink in the bottle with
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water, a little more water each night, until your child is drinking plain water.  have his or her teeth cleaned after each feeding with a clean washcloth, gauze pad or a soft infant toothbrush. It is very important to clean your baby’s teeth before bedtime! Are baby teeth important? Baby teeth are important for chewing food and speaking properly. They also give your child a nice appearance and help to promote a good self image. If they are lost too early, the permanent teeth can come in crowded or out of line. Be sure your child visits a dentist before 2 years of age. These early efforts will be the key to your child’s future dental health!

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Children's Oral Health Tooth decay (dental caries) affects children in the United States more than any other chronic infectious disease. Untreated tooth decay causes pain and infections that may lead to problems; such as eating, speaking, playing, and learning. The good news is that tooth decay and other oral diseases that can affect children are preventable. The combination of dental sealants and fluoride has the potential to nearly eliminate tooth decay in school-age children. What Parents and Caregivers Can Do Here are some things you can do to ensure good oral health for your child: • •
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Encourage your children to eat regular nutritious meals and avoid frequent between-meal snacking. Protect your child’s teeth with fluoride:
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o Use fluoride toothpaste. If your child is less than 7 years old, put only a pea-sized amount on their toothbrush. o If your drinking water is not fluoridated, talk to a dentist or physician about the best way to protect your child’s teeth. • • Talk to your child’s dentist about dental sealants. They protect teeth from decay. If you are pregnant, get prenatal care and eat a healthy diet. The diet should include folic acid to prevent birth defects of the brain and spinal cord and possibly cleft lip/palate.

What small, easy steps can I take to have a healthy teeth and gums? 1. Brush your teeth at least twice each day with fluoride toothpaste. 2. Have a healthy lifestyle.
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3. Get regular checkups. 4. Follow your dentist’s advice. 5. If you have another health problem, think about how it may affect your oral health.
Reference: U.S. Department of Health and Human Services, Office on Women’s Health

Toothache - Access to Emergency Care • • • Use dental floss to remove any food trapped in or around the suspected tooth. Rinse the mouth vigorously with warm water to wash away debris. If swelling is present, apply a cold compress to the outside of the cheek (20 minutes on, 20 minutes off). DO NOT USE HEAT.
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Aspirin or an aspirin substitute* may be given orally to relieve pain (dosage according to weight or age). Aspirin placed directly on or near the aching tooth will cause a chemical burn to the tissue. Oil of cloves (eugenol) may be applied with a Q-tip or swab onto affected tooth or teeth.

If a child has a toothache or other apparent dental emergency, the child's parents/caregivers should be contacted. If the child has a private dentist of record, he or she should be referred to that dentist as soon as possible. Access to emergency care If a child does not have a private dentist of record, the area dental society whether it be local or regional can be contacted for the names of those dentists in the area who are willing to accept emergency patients. These names can be given to the family. Protocol should be pre-arranged for such emergencies with everyone involved being informed of the routine. Other resources: A dental school/university, hospitals with dental emergency facilities, public school dental clinics, local health departments with dental facilities and
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other community dental clinics. Emergency funds are sometimes made available to handle those persons who cannot otherwise afford care. Check with school administration for creative financing, i.e., interest on investment accounts, area philanthropic or service organization may accept proposal for emergency funds for this purpose. Medicaid does provide funding for eligible persons. However, not all dentists accept Medicaid patients. What is a denture? Dentures are false teeth made to replace teeth you have lost. Dentures can be complete or partial. Complete dentures cover your entire upper or lower jaw. Partials replace one or a few teeth. Advances in dentistry have made many improvements in dentures. They are more natural looking and comfortable than they used to be. But they still may feel strange at first. In the beginning, your dentist may want to see you often to
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make sure the dentures fit. Over time, your mouth will change and your dentures may need to be adjusted or replaced. Be sure to let your dentist handle these adjustments. Speaking and eating may feel different with dentures. Be careful when wearing dentures because they may make it harder for you to feel hot foods and liquids. Also, you may not notice things like bones in your mouth.
Reference: NIA (National Institute on Aging)

Caring for Your Dentures It is important to clean your mouth and denture daily so your mouth will stay healthy. Soaking dentures in water or a denture cleaner is not enough. They must be brushed with a soft toothbrush or with a toothbrush made especially for dentures.
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Be sure to brush and massage your gums daily with a soft toothbrush, and brush any remaining natural teeth you may have. Do not clean dentures with boiling water. Clean all denture surfaces, both inside and outside, with a denture brush and denture cleaner that you can buy at a drug store. Do not use an abrasive cleaning powder like Ajax™ or Comet™. When cleaning dentures; hold over a bowl of water between your thumb and forefinger. If the denture slips out of your hand, it will land in the water and not break. If a denture smells, it can be soaked in a solution of 1 teaspoon of bleach (such as Clorox™) in 1 cup of water. Soak the denture for 30 minutes. Rinse well before putting it back in your mouth. Take your denture out of your mouth for at least eight hours every day. When out of your mouth, keep the denture in a bowl of water or diluted mouthwash. Do not try to adjust a denture with sandpaper or files. This will ruin the denture. Do not use denture liners or denture adhesives.
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What is Root canal? A root canal is a dental procedure to remove dead or dying nerve tissue and bacteria from inside a tooth. A dentist will use a needle to place numbing medicine (anesthetic) around the bad tooth. You may feel a slight prick when the needle is being inserted. Next, your dentist uses a tiny drill to remove the top part of your tooth and expose the pulp. Pulp is made up of nerves, blood vessels, and connective tissue. It is found inside the tooth and runs to the jaw bone. Pulp supplies blood to a tooth and allow you to feel sensations such as temperature. The infected pulp is removed with special tools called files. The canals (tiny pathways inside the tooth) are cleaned. Medicines may be placed into the area to make sure all the germs are gone and prevent further infection. The cleaned tooth area is sealed with a soft, temporary material. Once the tooth is filled, a permanent crown may be placed on top.
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You may be given antibiotics to treat and prevent infection. Why the Procedure is Performed? A root canal is done if you have an infection that affects the nerve in the root of a tooth. Generally, there is pain and swelling in the area. The infection can be the result of a tooth crack, cavity, or injury. A root canal can save your tooth. Without treatment, the tooth may become so damaged that it must be removed. Dental Implant A dental implant is a surgically implanted device. It replaces the lost roots of a tooth to which an artificial tooth, partial denture, or denture can be attached. Traditional procedures for replacing missing teeth include partial dentures, complete removable dentures, or fixed bridges that attach to existing teeth or
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rest on the gums. However, for individuals who have a weakened jawbone, who cannot manage removable dentures or cannot properly chew food, implants maybe the best option. Implant designs fall into three main categories: endosseous, subperiosteal and transosteal. Within the categories, 50 implant subtypes exist. Abutments are also numerous in design. They range from fixed (cemented) and fixed-removable (screw or clip retained) designs, to removable affixed by o-rings, clips, or snap designs. The most common implants used today are endosseous implants. These implants are surgically inserted into the jawbone and fuse with the bone. The most common endosseous implant used today is the rootform implant. Rootform implants are considered by some clinicians as the standard of care in oral implantology. The implant, a screw shaped like the original root, is screwed into the patient's jawbone. The screw's shape and size are based upon the tooth being replaced and/or the size and shape of the remaining jawbone. The implant is generally made out of titanium alloys, aluminum oxide, vitallium,
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commercially pure titanium or sapphire. Once the implant has been placed into the jawbone, a few months is required for the implant and the bone to fuse. This fusing creates a solid, secure implant to which an abutment can be attached. Who should have implants? Any toothless area can be considered for dental implants. Determining whether implants are an option and the type of implants to use include: the patient's requirements and expectations, the amount of additional work needed (i.e., bone grafting), the dentist's skill, and the long-term prognosis. A discussion with a dentist is required to decide if the toothless area is a good location for an implant. Reasons for not having an implant include: inadequate bone space existing bone that does not meet implant criteria
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diabetes, pituitary and adrenal insufficiency and hypothyroidism, which may cause considerable healing problems an inability to fight infections diseases such as tuberculosis and sarcoidosis heart disease that may cause healing and management problems bone disease such as histiocytosis X, Paget's disease and fibrous dysplasia because of poor implant and bone fusion a history of uncontrolled bleeding certain types of Periodontal disease Also, a person who smokes regularly will usually have a lower success rate than nonsmokers. Reference: Health Technology Advisory Committee (HTAC).

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What is dental amalgam? Dental amalgam is a dental filling material used to fill cavities caused by tooth decay. It has been used for more than 150 years in hundreds of millions of patients. Dental amalgam is a mixture of metals, consisting of liquid mercury and a powdered alloy composed of silver, tin, and copper. Approximately 50% of dental amalgam is elemental mercury by weight. Dental amalgam fillings are also known as “silver fillings” because of their silver-like appearance. When placing dental amalgam, the dentist first drills the tooth to remove the decay and then shapes the tooth cavity for placement of the amalgam filling. Next, under appropriate safety conditions, the dentist mixes the powdered alloy with the liquid mercury to form an amalgam putty. (These components are provided to the dentist in a capsule as shown in the graphic.) This softened amalgam putty is placed in the prepared cavity, where it hardens into a solid filling.

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What should I know before getting a dental amalgam filling? Deciding what filling material to use to treat dental decay is a choice that must be made by you and your dentist. As you consider your options, you should keep in mind the following information. Potential Benefits: Dental amalgam fillings are strong and long-lasting, so they are less likely to break than some other types of fillings. Dental amalgam is the least expensive type of filling material. Potential Risks: Dental amalgam contains elemental mercury. It releases low levels of mercury vapor that can be inhaled. High levels of mercury vapor exposure are associated with adverse effects in the brain and the kidneys.
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Tooth Discoloration Abnormal tooth color is any color other than the white to yellowish-white of normal teeth. Considerations Many different things can cause tooth discoloration. The change in color may affect the entire tooth, or just appear as spots or lines in the tooth enamel. Your genes influence your tooth color. Other things that can affect tooth color include: Congenital diseases Environmental factors Infections

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Inherited diseases may affect the thickness of enamel or the calcium or protein content of the enamel, which can cause color changes. Metabolic diseases may cause changes in tooth color and shape. Drugs and medications either taken by the mother while pregnant or by the child during the time of tooth development can cause changes in both the color and hardness of the enamel. Causes: Antibiotic tetracycline use before age 8 Eating or drinking items that temporarily stain the teeth, such as tea or coffee Genetic defects that affect the tooth enamel, such as dentinogenesis and amelogenesis High fever at an age when teeth are forming Poor oral hygiene
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Porphyria Severe neonatal jaundice Too much fluoride from environmental sources (natural high water fluoride levels) or overuse of fluoride rinses, toothpaste, and fluoride supplements Home Care Good oral hygiene will help if the teeth are stained from a food or fluid, or if the abnormal color is the result of poor hygiene. It is appropriate to consult your dentist for abnormally colored teeth. However, if the color seems to be related to a medical condition, your regular health care provider should also be consulted.

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When to Contact a Medical Professional Call your health care provider if: Teeth appear to be an abnormal color without cause Abnormal tooth color lasts even after practicing good oral hygiene What to Expect at Your Office Visit The dentist will examine the teeth and ask questions about the symptoms. Questions may include: Time pattern o Have the teeth been abnormally colored since they grew in, or did they change color over time? o When did you notice this problem? o Does it improve when good oral hygiene is maintained?
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Diet o What foods and drinks do you or your child usually consume? o Does the person drink coffee or tea? o How much milk and dairy products does the person drink? Medication history o What medications are currently being used? o What medications have been taken in the past (particularly, did the child ever take tetracycline)? o What medications did the mother take when pregnant? Health history and family history o Do other members of the family have teeth that are abnormally colored? o How has the general health been? o Was the child jaundiced as a baby? Fluoride exposure o Is the water fluoridated where you live or visit frequently?
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o Do you take fluoride supplements? Oral hygiene habits o Are there frequent problems with the teeth such as cavities or gum inflammation? o What are the dental habits? o How often are the teeth brushed and flossed? o What kind of toothpaste, mouthwash, or similar substances is used? What other symptoms are also present? Testing may not be necessary in many cases. However, if the health care provider suspects the coloration may be related to a medical condition, testing may be needed to confirm the diagnosis. Dental x-rays may be taken.

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Psychological Effect of Persons with Oral Conditions The burden of oral problems is extensive and may be particularly severe in vulnerable populations. It includes the common dental diseases and other oral infections such as cold sores and candidiasis that can occur at any stage of life, as well as birth defects in infancy and the chronic facial pain conditions and oral cancers seen in later years. Many of these conditions and their treatments may undermine self-image and self-esteem, discourage normal social interaction, cause other health problems, and lead to chronic stress and depression as well as incur great financial cost. They may also interfere with vital functions such as breathing, food selection, eating, swallowing, and speaking and with activities of daily living such as work, school, and family interactions. The social and psychological dimensions of well-being and quality of life are deeply intertwined in everyday life and so are considered together here. Findings are reported for those oral conditions where the most research has been conducted: dental diseases (primarily those that affect appearance or involve
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extensive tooth loss), pain conditions, craniofacial deformities (primarily clefting syndromes), and oral and pharyngeal cancers. Psychological distress associated with oral health problems has been measured through individual questions (e.g., items assessing worry) and through standardized psychological instruments such as the Beck Depression Inventory (Beck 1967) or the Symptom Checklist 90 (SCL-90) (Derogatis 1983). Overall, the results point to a poorer quality of life and a tendency to avoid social contact as a result of concerns over facial appearance. Persistent pain has similar isolating and depressing effects. Where can I find low-cost dental care? Dental schools often have clinics that allow dental students to gain experience treating patients while providing care at a reduced cost. Experienced, licensed dentists closely supervise the students. Contact your local dental school.
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20 Things you Need to know before going to the Dentist

Dental hygiene schools may also offer supervised, low-cost care as part of the training experience for dental hygienists. Contact your local dental hygiene school. You may also be able to find care at federally-funded health centers, where you pay what you can afford, based on your income. Health centers are in most cities and many rural areas. Locate federally-funded health centers. Centers for Medicare & Medicaid Services The Centers for Medicare & Medicaid Services (CMS) administers three important federally-funded programs: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Medicare is a health insurance program for people who are 65 years and older or for people with specific disabilities. Medicare dental coverage is limited; it does not cover most routine dental care or dentures.
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20 Things you Need to know before going to the Dentist

Medicaid is a state-run program that provides medical benefits, and in some cases dental benefits, to eligible individuals and families. States set their own guidelines regarding who is eligible and what services are covered. Most states provide limited emergency dental services for people age 21 or over, while some offer comprehensive services. For most individuals under the age of 21, dental services are provided under Medicaid. CHIP helps children up to age 19 who are without health insurance. CHIP provides medical coverage and, in most cases, dental services to children who qualify. Dental services covered under this program vary from state to state. CMS (1-800-MEDICARE) can provide detailed information about each of these programs and refer you to state programs where applicable. State and Local Resources Your state or local health department may know of programs in your area that offer free or reduced-cost dental care. Call your local or state health department
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20 Things you Need to know before going to the Dentist

to learn more about their financial assistance programs. Check your local telephone book for the number to call. United Way The United Way may be able to direct you to free or reduced-cost dental services in your community. Local United Way chapters can be located on the United Way website. What Are Medical Expenses? Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes.
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20 Things you Need to know before going to the Dentist

Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to general health, such as vitamins or a vacation. Medical expenses include the premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract. How Much of the Expenses Can You Deduct? The expense that you can deduct is the amount of your medical and dental expense that is more than 7.5% of your AGI (Form 1040, line 38). The term "7.5% limit" is used to refer to 7.5% of your AGI (annual gross income). The phrase "subject to the 7.5% limit" is also used. This phrase means
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20 Things you Need to know before going to the Dentist

that you must subtract 7.5% (.075) of your AGI from your medical expenses to figure your medical expense deduction. Example: Your AGI is $40,000, 7.5% of which is $3,000. You paid medical expenses of $2,500. You cannot deduct any of your medical expenses because they are not more than 7.5% of your AGI. You can generally include medical expenses you pay for yourself, as well as those you pay for someone who was your spouse or your dependent either when the services were provided or when you paid for them. There are different rules for decedents and for individuals who are the subject of multiple support agreements. You can include only the medical and dental expenses you paid this year, regardless of when the services were provided. You cannot include medical expenses that were paid by insurance companies or other sources. This is true whether the payments were made directly to you, to the patient, or to the provider of the medical services.
Reference: Medical and Dental Expenses IRS.gov
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20 Things you Need to know before going to the Dentist

Closure When we were just a child, we feared sessions to out doctor. As we grow up, what we thought before was just the complete opposite. We have to visit our dentist to check our mouth for better reasons. As we can see, our smile is just as beautiful when we have pearly white teeth. Our self esteem is low when we have mouth disorder/problem. Better care and better preventive measure is essential when caring our oral hygiene for healthier overall wellness. The reason for this book is to equip you with tools on how you can enhance your way of living by informing you what to do, why you do and how to do before and after going to the dentist. It is recommended that you go to the dentist once or twice a year depending on your situation but you need to be informed what better hygiene is suited for you. Thank you for purchasing the book. I hope it helped you in a little way.

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20 Things you Need to know before going to the Dentist

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