For Patients

Frequently Asked Questions

Answers to common questions.

Our billing and insurance experts take care of all the paperwork giving you one less thing to worry about!  We accept most major dental insurance plans and all major credit cards.

All of our dental offices are handicap accessible and our pediatric dentists have extensive experience treating patients with disabilities. We recommend these links for more information:

YES!  We offer Outpatient General Anesthesia at our new Malvern, PA Surgi-Center and at Mercy Suburban Hospital in Norristown, PA. 


Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.

Dental x-rays may reveal:

  • Abscesses or cysts.
  • Bone loss.
  • Cancerous and non-cancerous tumors.
  • Decay between the teeth.
  • Developmental abnormalities.
  • Poor tooth and root positions.
  • Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

We are all exposed to natural radiation in our environment. The amount of radiation exposure from a full mouth series of x-rays is equal to the amount a person receives in a single day from natural sources.

Dental x-rays produce a low level of radiation and are considered safe. Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental x-rays. These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each x-ray.

The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.

A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

We're Here When You Need Us...
Dental emergencies are a part of our practice. You should never hesitate to call us when you’re in pain. Our phones are answered 24 hours a day and a dentist is always on call. We schedule emergencies as best we can while taking into account our regularly scheduled patients.

Common Injuries and What You Should Do:
Injuries to the mouth may include teeth that are knocked out, forced out of position or broken. Sometimes lips, gums or cheeks have cuts. Oral injuries are often painful, and should be treated by a dentist as soon as possible.

When a tooth is knocked out you should:

  • Immediately call us for an emergency appointment.
  • Attempt to find the tooth.
  • Gently rinse, but do not scrub the tooth to remove dirt or debris.
  • Place the clean tooth in your mouth between the cheek and gum.
  • Do not attempt to replace the tooth into the socket. This could cause further damage.
  • Get to the dentist as soon as possible. If it is within a half hour of the injury, it may be possible to re-implant the tooth.
  • If it is not possible to store the tooth in the mouth of the injured person, (e.g. young child) wrap the tooth in a clean cloth or gauze and immerse in milk.
  • If the tooth is pushed out of place (inward or outward), it should be repositioned to its normal alignment with very light finger pressure. Do not force the tooth into the socket. Hold the tooth in place with a moist tissue or gauze. Again, it is vital that the injured individual be seen by a dentist within 30 minutes.

Minor Fracture
Minor fractures can be smoothed by your dentist with a sandpaper disc or simply left alone. Another option is to restore the tooth with a composite restoration. In either case, you should treat the tooth with care for several days.

Fracture Moderate

Moderate fractures include damage to the enamel, dentin, and/or pulp. If the pulp is not permanently damaged, the tooth may be restored with a full permanent crown. If pulpal damage does occur further dental treatment will be required.

Severe Fracture

Severe fractures often mean a traumatized tooth with a slim chance of recovery.

Injuries to the Soft Tissues of the Mouth

Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away and the injured person taken to the emergency room for the necessary suturing and wound repair.

Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound area.

Pediatric Dental or Orthodontic EMERGENCIES
Call the office where your child is normally seen or the office closest to you if a non-patient:

Montgomery County & Mainline
Upper Merion Dental Assoc.
(610) 337-2325

Delaware County & Mainline
Broomall Pediatric & Orthodontics
(484) 454-3230

Bucks & Montgomery Counties
Highpoint Pediatric Dental Assoc.
(215) 822-4042

Bethlehem Pediatric Dental Assoc.
(610) 954 5400

Allentown Pediatric Dental Assoc.
(610) 433-2357

Upper Merion Dental Associates
(610) 337-2325

The first visit at one of our pediatric dental offices should be an enjoyable one for both child and parent.  You should expect to meet one of your pediatric dentists to review your child's medical history and prior dental experiences.

For the younger, apprehensive patient, the dentist may choose to perform the child's examination in one of our consultation rooms, possibly with the child sitting comfortably on a parent's lap.  After talking with your child's dentist, our older first time patients, who feel comfortable in our office, often go back into our treatment area accompanied by the dentist or one of our hygienists.  Most times we prefer children to go into our treatment area alone.  With older children, doctor-child communication is often enhanced if parents remain in the reception room.

At the first visit your child will receive a thorough dental examination, dental cleaning, topical fluoride application, and if old enough, dental X-rays.  X-rays are necessary to evaluate if there is decay in places that cannot be visualized by an exam, such as in between your child’s back teeth.  They are also important to evaluate the growth and development of your child’s jaws and permanent teeth.  There is very little risk in dental X-rays.  Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed.  The dentist will inform the parent of any treatment your child will receive prior to your child going into the treatment area.

Not all children have a pleasant first visit to the dentist.  While our staff does our best to make your child comfortable, some children will be scared and get upset.  Crying is a normal reaction for children when faced with a new situation.

Our pediatric dentists are trained in many methods to help children feel comfortable with dental treatment.  For example, in the “Tell-Show-Do” technique, a pediatric dentist might name a dental instrument, demonstrate the instrument by using it to count your child’s fingers, and then apply the instrument in treatment.  We are here to make the dental office a place your child will always feel comfortable.

At the end of every visit, one of our dentists will consult with you in private to review your child's visit.  We will also inform you of what future treatment is needed and when to make your child's next appointment.

Issues discussed at the first visit may include:

  • A program of preventative home care including brushing, flossing, diet and the importance of fluorides
  • A caries risk assessment
  • Information about Early Childhood Caries, which may be due to inappropriate nursing habits or inappropriate use of sippy cups
  • The latest facts about finger, thumb and pacifier habits
  • What you need to know about preventing injuries to the mouth and teeth
  • Information on growth and development

The first visit usually ends with your child leaving the office with a new toothbrush, stickers, prizes and hopefully a large smile on his or her face.

Infants can get cavities just like older children, teens and adults. Baby bottle cavities occur when an infant is allowed to fall asleep with a bottle in his or her mouth. If the bottle contains a fermentable carbohydrate, (like formula, sugar water, juice, or milk) and the liquid is allowed to pool around the teeth, the bacteria that are present will form acid, which eventually leads to decay.

Baby bottle cavities usually form on upper front teeth and back molars first. The lower front teeth can be protected by the tongue, and decay in this area is seen more often in very advanced cases.

To prevent baby bottle cavities:

  • do not leave a bottle in your child's mouth while he or she is sleeping
  • begin brushing your child's teeth as soon as they come into the mouth, or clean them by using a wet washcloth
  • begin regular dental examinations by the first birthday or earlier if a problem is noted.

Arch Wire
The wire actually moves the teeth. The arch wire is attached to the brackets by small elastic donuts or ligature wires. Arch Wires are changed throughout the treatment. Each change brings you closer to the ideal tooth position.

Brackets are the “Braces” or small attachments that are bonded directly to the tooth surface. The brackets are the part of your braces to which the dentist or assistant attaches the arch wire. Occasionally, a bracket may come loose and become an irritation to your mouth. You can remove the loose bracket and save it in an envelope to bring to the office. Call the office as soon as possible and make an appointment to re-glue the bracket.

Band & Loop (B&L)
A Band & Loop is routinely used to hold space for a missing primary (baby) posterior (back) tooth until the permanent tooth can grow in.

Elastics (Rubber Bands)
At some time during treatment, it will be necessary to wear elastics to coordinate the upper and lower teeth and perfect the bite. Once teeth begin to move in response to elastics, they move rapidly and comfortably. If elastics (rubber bands) are worn intermittently, they will continually "shock" the teeth and cause more soreness. When elastics are worn one day and left off the next, treatment slows to a standstill or stops. Sore teeth between appointments usually indicate improper wear of headgear or elastics or inadequate hygiene. Wear your elastics correctly, attaching them as you were told. Wear elastics all the time, unless otherwise directed. Take your elastics off while brushing. Change elastics as directed, usually once or twice a day.

Functional Appliances
These are used to help modify the growth of the jaws in children. The theory behind their action is that if you hold a jaw in a specific position long enough, that it will grow into that position. What you usually get is a combination of a little jaw growth with a lot of tooth movement. These are not universally accepted, as they do not always work. The first of these appliances were removable and are still very popular. They are made of plastic and wire. Some of their names are Frankel, Bionator, and Twin-block. A different style is actually fixed to the teeth and uses a spring action to hold the jaw into position These have names like Herbst and Jasper Jumper.

Often called a “night brace”. The headgear is used to correct a protrusion of the upper or lower jaw. It works by inhibiting the upper jaw from growing forward, or the downward growth of the upper jaw or even by encouraging teeth to move forward, if that is the case.

Another appliance designed to encourage the lower jaw to grow forward and “catch up” to upper jaw growth.

Lower Lingual Arch (LLA)
A lower lingual arch is a space maintainer for the lower teeth. It maintains the molars where they are, it does not move them. This is fabricated by placing bands on the molars and connecting them to a wire that fits up against the inside of the lower teeth. It keeps the molars from migrating forward and prevents them from blocking off the space of teeth that develop later. This is used when you have the early loss of baby teeth or when you have lower teeth that are slightly crowded in a growing child and you do not want to remove any permanent teeth to correct the crowding.

Malocclusion means a poor positioning of the teeth. Types of Malocclusion include:

  • Class I - A Malocclusion where the bite is OK (the top teeth line up with the bottom teeth) but the teeth are crooked, crowded or turned.
  • Class II - A Malocclusion where the upper teeth stick out past the lower teeth.
  • Class III - A Malocclusion where the lower teeth stick out past the upper teeth. T his is also called an "underbite"

The alignment and spacing of your upper and lower teeth when you bite down. Types of Occlusion:

  • Openbite - Anterior opening between upper and lower teeth.
  • Overbite - Vertical overlapping of the upper teeth over the lower
  • Overjet - Horizontal projection of the upper teeth beyond the lower
  • Crossbite - When top teeth bite inside the lower teeth. It can occur with the front teeth or back teeth.

O rings
O rings, also called A-lastics, are little rings used to attach the arch wire to the brackets. These rings come in standard gray or clear, but also come in a wide variety of colors to make braces more fun. A-lastics are changed at every appointment to maintain good attachment of the arch wire to the bracket, enabling our patients to enjoy many different color schemes throughout treatment.

Palatal Widening Appliance
An appliance which is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone fills in the space. Care of appliance: Brush as usual. Brush the appliance and roof of the mouth thoroughly. Rinse often to clean any food lodged between the arch and appliance.

At the completion of the active phase of orthodontic treatment, braces are removed and removable appliances called retainers are placed. To retain means to hold. Teeth must be retained or held in their new positions while the tissues, meaning the bone, elastic membranes around the roots, the gums, tongue and lips have adapted themselves to the new tooth positions. Teeth can move if they are not retained. It is extremely important to wear your retainers as directed!

A plastic or rubber donut piece which the dentist uses to create space between your teeth for bands.

Avoid Sticky Foods such as:

  • Caramels or Candy with Caramel
  • Fruit Roll-Ups
  • Gum
  • Candy & Caramel Apples
  • Skittles & Starbursts
  • Toffee
  • Gummy Bears

Avoid Hard or Tough Foods such as:

  • Pizza Crust
  • Nuts
  • Hard Candy
  • Corn Chips
  • Ice Cubes
  • Bagels
  • Popcorn Kernels

Cut the following foods into small pieces and chew with the back teeth:

  • Apples & Carrots
  • Corn on the Cob
  • Pizza
  • Pears
  • Celery
  • Chicken Wings & Spare Ribs

Braces Care - Watch this Video
You will be shown the proper care of your braces when your orthodontic treatment begins. Proper cleansing of your mouth is necessary every time you eat. Teeth with braces are harder to clean, and trap food very easily. If food is left lodged on the brackets and wires, it can cause unsightly etching of the enamel on your teeth. Your most important job is to keep your mouth clean. If food is allowed to collect, the symptoms of gum disease will show in your mouth. The gums will swell and bleed and the pressure from the disease will slow down tooth movement.


  • You should brush your teeth 4-5 times per day.
  • Brush back and forth across……between the wires and gums on the upper and lower to loosen any food particles.
  • Next, brush correctly as if you had no brackets or appliances on.
  • Start on the outside of the uppers with the bristles at a 45 degree angle toward the gum and scrub with a circular motion two or three teeth at a time using ten strokes, then move on.
  • Next, do the same on the inner surface of the upper teeth.
  • Then, go to the lower teeth and repeat steps A & B.

Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.

Note: If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After 3 or 4 days of proper brushing, the bleeding should stop and your gums should be healthy again. Flossing
Use a special floss threader to floss with your braces on. Be sure to floss at least once per day.

Fluoride Rinses and Gels
May be recommended for preventive measures.

Appliance Care
Clean the retainer by brushing with toothpaste. If you are wearing a lower fixed retainer you should be extra careful to brush the wire and the inside of the lower teeth. Always bring your retainer to each appointment. Avoid flipping the retainer with your tongue; this can cause damage to your teeth. Place the retainer in the plastic case when it is re-moved from your mouth. Never wrap the retainer in a paper napkin or tissue, someone may throw it away. Don't put it in your pocket or you may break or lose it. Excessive heat will warp and ruin the retainer.

Elastics Care
If elastics (rubber bands) are worn intermittently, they will continually "shock" the teeth and cause more soreness. Sore teeth between appointments usually indicate improper wear of headgear or elastics or inadequate hygiene. Wear your elastics correctly, attaching them as you were told. Wear elastics all the time, unless otherwise directed. Take your elastics off while brushing. Change elastics as directed, usually once or twice a day.

Tip of the day

Fruit juice could be just as harmful to teeth as soda because it is a concentrated source of sugars and sometimes acids.

Read more tips

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