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What can I do about bad breath?

Deducing the cause of your bad breath is the first step toward preventing it. The most common causes of bad breath are reduced saliva flow during sleep, certain foods (such as garlic, onions and peppers), poor oral hygiene, gum disease, dry mouth, tobacco, dieting, dehydration and some medical conditions (including sinus infections and diabetes).


Brushing your teeth in the morning and at night is the best way to prevent bad breath, and brushing after every meal is even better. If you can’t brush, chewing sugar-free gum can loosen the food particles from between your teeth. Clean between your teeth at least once a day with floss or an inter-dental cleaner, and don’t forget to brush your tongue! If you wear dentures, remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every three months. Mouthwash can help too, but ask us which rinses actually kill the germs that cause bad breath, because some only temporarily mask odor.

I know certain foods are bad for my teeth, but are there any that are GOOD for them?

In fact, there are! Milk, cheese, nuts, chicken and other meats all contain calcium and phosphorous, which have been proven to strengthen bones and protect enamel. Calcium is essential for bone development, and while your teeth do not directly absorb it, a stronger jawbone leads to healthy gums and healthy gums make 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 cause dry mouth, which makes your mouth more prone to bacterial growth 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, and you wouldn’t want to. 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 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 prevent cavities.

I brush and floss regularly. Do I really need a check up?


Biannual teeth cleanings performed by our Pittsburgh dental team are central to keeping your teeth and gums looking, feeling and functioning well. If you have gum disease, more frequent visits to our office will probably be necessary for your oral and overall health. During cleanings, our hygienist removes plaque and tartar from the surface of your teeth. Plaque is a sticky deposit on teeth in which bacteria grow, and tartar is hardened plaque that is more difficult to remove. When tartar builds up under the gum line, causing gum disease, more extensive treatment than a standard cleaning is needed to remove it and help ensure healthier gums. During your cleaning our hygienist will also polish your teeth, floss to test the condition of your gums and document any bleeding or stains they noted during your exam.


Your dentist will then perform a visual assessment of your teeth, bite and existing restorations. When X-rays have been taken, he will carefully review them to identify areas of decay and other possible areas of concern for cysts and tumors. Finally, he will perform a general screening for early signs of gum disease and oral cancer.


In between cleanings and exams at Fox Chapel Family Dental, it’s important to keep up with proper at-home oral care. Brush your teeth at least twice a day, floss at least once and thoroughly clean prosthetics like dentures and bridges.

If my tooth doesn't hurt, why do I need to replace my filling?

Constant pressure from chewing, grinding your teeth and clenching your jaw can cause dental fillings to wear down 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, which can progress to deeply infect the tooth and cause an abscess. All from one tiny little crack!

Replacing a damaged filling often prevents the need for more invasive restorative treatments like root canal therapy, crowns and extraction. If one of our Pittsburgh dentists recommends replacing one of your fillings, it’s because he truly believes that it’s the best way to save your tooth.

How can I tell if I am at risk for gum disease?

Roughly 50% of American adults currently have some form of gum disease, and many of them don’t even know it. The signs of gum disease are usually mild and painless, ranging from red, swollen gums to gums that bleed every time you floss. The prevalence of gum disease increases with age, because as we age our teeth wear down, our gums naturally recede and many of us take medications that make us more susceptible to developing cavities. While the signs of gum disease are mild, the dangers aren’t. Gum disease has been linked to a higher risk of stroke, heart attack and uncontrolled diabetes, so it’s important to remember that healthy gums are the foundation of a healthy smile.

At Fox Chapel Family Dental, our dentists take a comprehensive and conservative approach to gum health. Gum disease used to require surgery more often than not, but we can now treat many cases with deep cleanings, local antibiotics and special rinses. If you suspect you might have gum disease, schedule an appointment with one of our skilled Pittsburgh dentists today. You’ll be glad you did!

How can cosmetic dentistry improve my life?

Studies have shown that a healthy and attractive smile can raise your self-esteem, increase your confidence and even help you make better first impressions. Our Pittsburgh dentists have completed extensive training in cosmetic dentistry, but it doesn’t always take a big change to make a big difference in the way you feel about your smile.

Advancements in dental technology have made it possible for Drs. Michael and Marc Johnson to address a wide variety of cosmetic issues right here at Fox Chapel Family Dental, including professional teeth whitening, porcelain veneers, Invisalign® aligner therapy, Six Month Smiles® adult cosmetic braces and express orthodontic tray therapy. Replacing old silver fillings with one-visit tooth-colored fillings can also be considered cosmetic in nature, as it improves both the health and the appearance of your teeth. In a way, all dental treatment is cosmetic in nature because our goal at Fox Chapel Family Dental is to give you a smile that’s as healthy as it is beautiful.

I have crooked teeth, but I feel that metal braces are for kids. Are there other options?

Metal braces can be a hassle and can take up to three years to straighten your teeth. With the recent advancements in orthodontics, you can fit braces into your busy life and get the smile you’ve always wanted in less time than you ever thought possible.

One option is Invisalign® aligner therapy. The Invisalign system involves a series of custom-made aligner trays that are replaced every two weeks to straighten your teeth step by step. The trays are comfortable for the sensitive tissues of your gums and cheeks, and you can even remove them while you eat and brush your teeth normally. Because the trays are made from a transparent plastic material, Invisalign clear braces are hardly noticeable. If you don’t tell them, people might not even notice you’re wearing braces!

Another orthodontic solution is Six Month Smiles® adult braces, which gives you great results in less time than traditional braces. Six Month Smiles uses clear brackets and ultra thin wires to realign the teeth that show when you smile. Because they are not intended to dramatically change your bite, Six Month Smiles braces use low force, decreasing the risk of root or structural damage. The average treatment lasts only 4–9 months, and once your treatment is complete your dentist will provide a retainer that will ensure the longevity of your straight, beautiful smile.

Dr. Mike also provides an express orthodontic tray therapy. This treatment is only for correcting minor alignment issues like relapse or minimal crowding. Depending on the wanted outcome, Dr. Mike will help plan out your treatment with a set number of clear orthodontic trays. Similar to Invisalign, these trays are clear, comfortable and can be removed during eating and brushing. Each tray is worn for approximately three weeks and the length of treatment is dependent on the number of trays needed to achieve the desired results.  

These alternatives to metal braces are great options for patients with mild to moderately crowded teeth, widely spaced teeth, overbites, crossbites and underbites. If you’re looking for a Six Month Smiles or a clear aligner/Invisalign dentist in Pittsburgh, call Fox Chapel Family Dental today!

The smile of your dreams could be closer than you think.

What is comprehensive dentistry?

Our goal at Fox Chapel Family Dental is to have all concerns and issues known and resolved before a dental emergency occurs. After all, it’s never a good time for a toothache or a broken tooth! Our Pittsburgh dentists see patients with many different needs for many different reasons, from routine preventive care and dental emergencies to life-changing restorative and cosmetic treatments.

The most important aspect of comprehensive dentistry is quality preventive care, which helps minimize the chance of original problems recurring. After your exam and consultation, your dentist will work with you to customize a treatment plan that fits your individual needs. Restorative and cosmetic care are also important components of comprehensive dentistry, because sometimes preventive care just isn’t enough to keep your teeth looking and feeling their best. In a way, our commitment to comprehensive care is simply our commitment to the present and the future of your smile. Not only do we want to keep it healthy, but we want to make it beautiful, and make it last.

Hot or cold, my teeth hate both!

Why are my teeth so sensitive and how can I stop the pain?

Involuntary tooth grinding, jaw clenching, gum recession and enamel loss can all cause teeth to become extra sensitive, because the usually-protected layer 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. On the other hand, some people are just born with very sensitive teeth.

Because the causes of sensitivity are so diverse, and because sensitive gum tissue can indicate a more serious problem, it’s important to ask our Pittsburgh dentists which treatment is best for you. A softer toothbrush is usually the first step, and special toothpastes can reduce sensitivity over time. There are also over-the-counter and in-office rinses that will protect your enamel against further damage. Ask us about your options at your visit to Fox Chapel Family Dental!

I get really nervous about dental visits—in fact, it’s so bad that I’ve avoided them for years. Is there anything that can make dental visits easier on me?

If you experience severe anxiety or even fear about dental treatment, oral conscious sedation could be just what you’ve been waiting for. Oral conscious sedation involves taking a carefully-prescribed anti-anxiety medication shortly before your appointment. By the time you arrive at our office, you will feel significantly relaxed but still awake and able to communicate with our team.

When your dentist is working with you to choose the right medication, he takes such factors as age, weight and level of dental anxiety into careful consideration. Your health history, medications (prescription, over-the-counter, vitamins and supplements), alcohol consumption and tobacco habits are also important. Prior to your sedation visit he will guide you through the proper preparation steps, from diet adjustments and possibly taking a sleep agent the night before, to having a companion drive you to your appointment and what to expect after treatment.

Most patients experience little to no discomfort or lingering effects from a sedation dentistry visit. Immediately after treatment, you might feel a little wobbly while the medication wears off, but your dentist will give you specific instructions for the rest of your day.

What should I do in case of a dental emergency?

Accidents happen, and they can be especially frightening when they involve our teeth and mouths. It’s important to know when home care will suffice and when a trip to our Pittsburgh dental office is necessary. Here are some guidelines to help you through common dental emergencies:

Toothache/Sore Gums. Rinse with warm water to remove any food or debris. If you notice anything lodged between teeth, floss to remove it. Take an over-the-counter pain medication (but never apply the medication directly to your teeth or gums), and schedule an appointment at Fox Chapel Family Dental if the pain persists.

Chipped Tooth. Save the pieces if you can, and rinse them thoroughly. Apply an ice pack or a cold compress to the swollen lip or gum tissue near the chipped tooth to prevent swelling. If the area is bleeding, apply gauze for ten minutes or until the bleeding has stopped. See your dentist as soon as possible.

Broken Tooth. Call Fox Chapel Family Dental immediately! With recent advancements in restorative and cosmetic dentistry, you might not lose your tooth. If there is enough remaining healthy tooth structure, our Pittsburgh dentists can create a crown that will extend your natural tooth, eliminating the need for root removal. While the success of this process, known as “crown lengthening,” depends on the severity of the break, it’s worth asking about alternatives to complete removal.

Knocked Out Tooth. Holding the tooth by the crown (top) only, rinse it briefly with warm water. If possible, gently reinsert it into the socket and bite down on gauze or cloth to keep it in place. If you cannot reinsert the tooth, place it in a container of milk or mildly salty water. Visit Fox Chapel Family Dental as soon as possible—if treated within two hours, the tooth may be salvaged.

Soft Tissue Injuries. Our gums, cheeks, lips and tongue tend to bleed heavily when injured, because the soft tissues in our mouths contain a great deal of blood flow. To control the bleeding, rinse with warm salt water and then apply pressure with gauze or a moistened towel for 15 to 20 minutes. Afterwards, to reduce swelling and help stop residual bleeding, apply a cold compress to the outside of your mouth. If the bleeding is profuse or the damage is visibly traumatic, it’s best to keep applying pressure and go to your nearest emergency room.

Am I candidate for dental implant restorations?

The skilled Pittsburgh dentists at Fox Chapel Family Dental work hard to stay on the leading-edge of restorative dentistry. If you’re missing teeth or struggling with ill-fitting, uncomfortable dentures, we have a permanent solution that could change your life. Dental implants are quickly becoming the most popular method of replacing missing teeth, and they’re so versatile that they can even be used to stabilize dentures and fixed bridges.

Permanent implants are not only more durable and long-lasting than traditional tooth replacements—they also look and feel more like natural teeth. Most importantly, they 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 preserved, fixed implants can even prevent some of the bone loss that commonly occurs after the loss of a tooth.

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 option in restorative dentistry. However, there are still some things to consider before you decide on dental implants. For example, they are best performed after adolescence, when the teeth and jaw bone are fully developed. Additionally, the implant procedure can be more complicated for individuals with periodontal (gum) disease, active diabetes, immune deficiencies and for patients who smoke. To ensure that you get the treatment that’s right for you, keep our Pittsburgh dental team informed and up-to-date about your entire medical history and dental habits.

I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What’s the problem?

You could be suffering from temporomandibular joint disorder, or TMD, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing and all other jaw movements, the pain can be severe.

TMD has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite places pressure on the jaw joint, forcing the muscles to work overtime to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but also causes a good deal of fatigue and pain in the facial muscles. Headaches, toothaches and jaw popping are other common signs of TMD. TMD can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or re-positioned.

Professional treatment of TMD ranges from minor in-office procedures to surgery. If our Pittsburgh dentists determine that the main cause of your jaw pain is an irregular bite, they may recommend a retainer-style mouthguard or even a reshaping of the biting surfaces of your teeth, which subtly changes the way your upper and lower jaws meet. If it’s a structural issue occurring in your jaw bone (especially if your TMD is a result of injury), you may benefit from surgery. Whatever the case, the team at Fox Chapel Family Dental will help you choose the most conservative plan for your individual needs.

How do I choose the right oral hygiene product for me?

Over the past few years, companies have introduced so many options for toothpastes, toothbrushes and mouthwashes that even the most discerning consumer often doesn’t know where to begin. Here are a some hints for picking the right products for your needs:

Toothbrush. The big question here is, electric or manual? It’s really all about your personal preference. Both brushes are effective at removing plaque, but electric brushes make the process significantly easier. If you find manual brushes difficult or unpleasant to use, an electric one might make brushing easier and allow you to do a better job. Many electric brushes have a built-in timing mechanism, too, so there’s no cheating the required 2–3 minutes for a quality, full-mouth brush. If you’re going manual, opt for soft bristles with the smallest head, since those are easier on gum tissue and can fit around the back molars. And make sure you’re brushing long enough!

Toothpaste. Most toothpastes contain the same basic agents geared toward scrubbing, flavoring or keeping your paste moist. It’s a good idea to choose a paste that contains fluoride, which strengthens enamel and makes teeth less prone to decay. Tartar-control toothpastes usually contain fluoride, but they also contain chemicals that break down plaque and antibacterials to kill lingering germs. After checking those two qualities off, choose your paste based on your personal needs. Whitening varieties have added abrasive agents (not bleach) that gently polish the surfaces of your teeth without damaging enamel. If you have sensitive teeth, certain toothpastes provide chemical compounds that, when used on a regular basis, can reduce sensitivity over time.

Floss. While most people brush the recommended two times a day, flossing often gets placed on the back burner. Neglecting to floss at least once daily is doing your mouth a serious disservice, because up to 50% of plaque accumulation occurs between teeth. That’s why you should floss before you brush, to loosen up that plaque for easier removal with your toothbrush. If you find flossing too difficult or unpleasant, try using a flosser. They’re reusable and have handles and disposable heads, making flossing as neat and easy as brushing your teeth. You can find them at most grocery and drug stores.

Mouthwash. There are as many different types of mouthwashes available as there are flavors. Cosmetic mouthwashes can rinse away debris, provide a pleasant taste, and mask bad breath temporarily. If you’re looking for a mouthwash with a purpose, look for an FDA-approved therapeutic rinse with either antiplaque or anticavity ingredients. Mouthwashes are particularly useful for people with canker sores, braces and dry mouth, but they can’t replace proper brushing and flossing.

Why do I need dental X-rays?

X-rays give our Pittsburgh dentists a comprehensive, detailed overview of all of your teeth as well as the roots, upper and lower jawbones, sinuses and other hard surfaces in your mouth. Many problems with teeth and the surrounding tissues go unnoticed during a visual examination.

An x-ray examination is needed to reveal:


  • Small areas of decay between teeth or below existing restorations
  • Deep cavities

  • Infections that can develop in the mouth bones

  • Periodontal (gum) disease

  • Abscesses or cysts

  • Developmental abnormalities

  • Some types of tumors

  • TMJ dysfunction

Detecting and treating dental problems at an early stage can save you unnecessary discomfort, money and time. In cases where x-rays help us detect oral cancer and periodontal disease early, they can even help save your life.

Why is fluoride good for my teeth?

Each day, foods and acids feed bacteria in your mouth, which can accumulate on your teeth to form plaque. Plaque wears away at a tooth’s enamel in a process known as demineralization. Fluoride is a naturally-occurring mineral that can promote the remineralization of enamel, replacing important minerals that strengthen your teeth and can protect them from decay. Fluoride can also help reverse 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 intense fluoride treatments, there are a number of 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.

Image by Johannes Plenio
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