703-528-3336
1-855-VA-SMILE
1515 Wilson Blvd., Suite 103
Arlington, VA 22209

"I will continue to be a patient of Dr. LaVecchia and team!" — Megan J.

Frequently Asked Questions

What makes your office different?

Dr. LaVecchia and our team believe that patient education should be a top priority in every doctor/patient relationship. We strive to provide information and guidance about any treatment you need or desire—whether it's a simple cleaning or a complete smile makeover—because you should feel educated and confident when making decisions about your oral health.

Dr. Louis LaVecchia's private dental practice opened in 1971, and since his son, Dr. Greg LaVecchia, took over his father's practice, it has changed and grown in a number of ways. Their relationship reinforces our team's emphasis on friendly, gentle, and excellent customer service. Our practice is family oriented, and we treat patients like a part of ours. Everyone deserves a healthy smile and a great experience at the dentist's office!

Why do I have an out-of-pocket portion to pay? I thought my dental insurance covered this treatment.

Dental insurance plans vary greatly in coverage, and we know they can seem confusing. Most plans cover the same or similar basic preventive care, but for coverage questions beyond that we're happy to consult with you about the specifics of your benefits (based on the information provided to us by your insurance). Some plans have copays that patients pay at their appointment, some insurance covers up to a certain dollar amount for particular treatments but leave the remaining portion for the patient, and some coverage amounts are determined on a percentage basis with a fixed percentage being "covered." The vast majority of dental insurance plans don't cover 100% of very many treatments.

We are an insurance friendly office, so please contact us about your plan. Prior to scheduling any treatment, we can provide cost estimates broken down by projected insured and uninsured costs so you can plan accordingly. We look forward to the opportunity of helping you maximize your dental insurance benefits to get the most out of your dental healthcare!

Is Dr. LaVecchia a specialist in cosmetic dentistry?

Actually, there is no true “specialist” designation with cosmetic dentistry. There are a number of organizations that provide advanced training for cosmetics, but mostly this question depends on the emphasis the doctor and office place on cosmetics. Dr. LaVecchia and our team have an artistic eye for cosmetic treatments, and Dr. LaVecchia feels that any treatment his office provides is cosmetic in nature. That is, we approach everything we do with the end goal of enhancing your smile's appearance and making it as natural looking and beautiful as possible. Dr. LaVecchia has taken many smile design and cosmetic courses, and we believe he can meet and exceed your expectations for a smile makeover. Just come in and find out what we can do for your smile!

What causes tooth decay?

Tooth decay occurs as a result of a combination of diet and oral hygiene habits. Essentially, decay is the breaking down of a tooth's enamel, which creates cavities, or tiny holes in the teeth, that can lead to more serious issues. After we consume a food or beverage, sugars are left behind on the surface of the teeth; if these sugars are not removed, they can feed harmful bacteria and lead to the buildup of plaque, a sticky substance that destroys enamel.

The most important factors in the prevention of tooth decay are brushing your teeth at least twice daily, flossing at least once daily, and keeping up with your regularly scheduled dental cleanings (on average, one visit to the dentist every six months). It's also a good idea to limit the amount of sugary snacks and sodas consumed between meals and/or late at night, as these foods tend to be particularly damaging to teeth.

I haven't had a cavity since I was a kid. Why do I all of a sudden have one now?

There are several measures that you should take to help prevent cavities, including good dental hygiene habits, regular visits to the dentist, a healthy and balanced diet, and refraining from habits such as smoking that threaten oral health. Having said that, tooth decay and cavities are a constant threat, even if you're "doing everything right." We like to tell patients that cavities are like mutual funds in that they have the same disclaimer of past performance not being an indicator of future success.

There are certain aspects of oral health that inevitably change with age, unfortunately not usually for the better. Also, people tend to need more medication as they age, which can have the side effect of negatively impacting oral health. We've even seen seemingly sudden increases of cavities in patients going through their 20s and 30s, so early adulthood cavities are a real thing. No need to feel alarmed by them, let's just address the issue before the cavities get any worse.

Are dental X-rays safe?

Some people worry about the safety of dental X-rays, but rest assured, Dr. LaVecchia is committed to protecting your overall health and safety. This is one of the reasons that we chose to incorporate a digital X-ray system into our office. Although the traditional "film based" X-rays have evolved over time to emit less and less radiation, the computer enhanced sensor we use with digital X-rays even further minimizes the radition needed to produce a quality image. This advanced technology, coupled with the lead aprons we provide our patients to wear while X-rays are being taken, allows us to say with confidence that dental X-rays are very safe. Early diagnosis and treatment of a number of serious and potentially life-threatening illness are a major benefit of regular and digital X-rays, so you're safer with them than without!

Do I have to get X-rays?

X-rays are an important dental tool for determining diagnoses as well as the best treatment options. We want to be as informed as possible as we take care of you! Although we do limit all routine X-rays during pregnancy, if an emergency arises, digital X-rays are safe enough that they have been approved for use during pregnancy. We understand that patients have personal preferences when it comes to X-rays, especially in cases of pregnancy or other health concerns that warrant additional consideration. Whenever possible, we respect patients' wishes regarding X-rays. If we make a recommendation for X-rays to help us determine the best course of treatment and a patient does not wish to have X-rays, then we have a waiver for the patient or guardian to sign. If you have further questions about our policies on X-rays, please don't hesitate to contact us!

What's the best way to take care of my teeth?

Brush your teeth at least twice a day. The big question here is often, electric or manual toothbrush? When it comes down to it, it’s really all about your personal preference. Recently, electric toothbrushes have gained popularity, but not necessarily because they’re “better” than manual brushes. Both brushes are effective at removing plaque, but we have found that electric toothbrushes can make the brushing process easier and more efficient for you. Regardless of your hardware of choice, though, just keep brushing, and choose a paste that contains fluoride. Also, be sure to brush long enough! Although it takes a full 2-3 minutes to brush every tooth effectively, most people only brush for an average of 30 seconds! Give your smile the time it needs to stay healthy.

Floss at least once daily. While the majority of people brush the recommended two times a day, flossing sometimes gets placed on the back burner. However, neglecting to floss at least once a day is doing your mouth a serious disservice, as 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, there are other options. You could try a floss aid or an oral irrigator (hydrofloss). You can find both these items at most grocery and drug stores, and they are also available at our office. They could change your flossing life!

Rinse with a mouthwash. Though not as critical to your hygiene routine, many people enjoy the added benefits of a good post-brush rinse. However, there are as many different types of mouthwashes available as there are flavors, and it’s important to choose the one that’s best for you. Cosmetic mouthwashes 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 anti-cavity ingredients. Mouthwashes are particularly useful for people with canker sores, braces, and dry mouth, but they cannot replace brushing or flossing.

Combining all of these factors makes a complete and effective oral hygiene routine. Just do your part at home and stay up-to-date with professional checkups, and you'll be set to go!

What should I do in a dental emergency?

Let's face the facts: accidents happen, and especially when it comes to our teeth and mouths, they can be pretty frightening. Being careful is good prevention, but being prepared makes you confident about any possible oral health emergency. It's important to know when home care will suffice and when a trip to the dentist is necessary.

If you are ever in a situation that makes you feel like you need to speak with Dr. LaVecchia, please call our office anytime, day or night: 703-528-3336. If you call during non-business hours, our voicemail gives instructions about how to reach the on-call dentist.

With that in mind, here are some guidelines to help you through common situations:

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 teeth or gums), and see Dr. LaVecchia if the pain persists.

Chipped or Broken 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. Call Dr. LaVecchia immediately.

With recent advancements in restorative and cosmetic dentistry, you might not lose your tooth. If there’s enough remaining healthy tooth structure, there are several treatment options that may eliminate the need for root removal. While the success of these procedures depends on the severity of the break, it’s worth asking about options other than complete removal.

Knocked Out Tooth. Depending on the situation, find the tooth, make sure not to hold it by the root, and rinse it briefly with warm water. If possible (if the tooth is whole, first of all), gently reinsert the tooth into the socket and bite down on gauze or cloth to keep it in place. If you cannot reinsert it, place it in a container of milk or mild salt water solution. Call Dr. LaVecchia as soon as possible—if treated within 2 hours, the tooth may be salvaged.

Soft Tissue Injuries. Soft tissues such as gums, cheeks, lips, and the tongue tend to bleed heavily, only because the tissue contains a great deal of blood flow. To control the bleeding, first rinse with a warm, mild salt water solution. 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. In the event of a serious soft tissue injury, in which the bleeding is profuse or the damage is visibly traumatic, it's best to stay calm, keep applying pressure, and go to the emergency room.

How do I know if I am at risk for gum disease?

According to MedlinePlus, a service of the U.S. National Library of Medicine and National Institutes of Health, about 80 percent of U.S. adults currently have some form of gum disease, ranging from gingivitis to serious periodontal disease. The prevalence of gum disease increases with age, because as we age, our teeth wear down, our gums naturally recede, teeth can become more sensitive, and medications can affect some oral changes. If your gums feel tender or sore, or if they look red and swollen, you may be at risk for gum disease. Other signs include bleeding and/or receding gums, persistent bad breath, pain or sensitivity in your teeth, and even loose teeth (caused by weakening gum fibers and/or bone loss). If left untreated, gum disease can lead to tooth loss as well as various other health problems.

The more we study gum disease, the more links we are finding between the presence of dental diseases and more life-threatening illnesses. We already knew that there is a strong correlation between gum disease and heart disease, and between gum disease and uncontrolled diabetes. Studies are also showing a significant relationship between gum disease and low birthweight. Proper diagnosis and treatment of gum disease - and as early as possible - is very important to overall health.

The first thing to do is get a thorough dental evaluation. If you have any degree of periodontal disease, Dr. LaVecchia can help. He strongly believes in and focuses on the importance of healthy gums for a healthy mouth and body. Gum disease used to routinely require surgery, but while surgery is still an option and sometimes necessary, many patients can now be treated with less invasive techniques first. Deep cleanings, local antibiotics, and special rinses are just a few of the non-surgical options that Dr. LaVecchia utilizes in the treatment and prevention of gum disease. Please come in and let us help you achieve and maintain healthier gums for a healthier you.

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

There is no perfect dental filling. Over time, fillings can change shape as a result of the harsh environment they are exposed to in the human mouth. 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. When this occurs, you then run the risk of developing additional decay in that tooth. The broken down filling also interferes with our ability to diagnose the additional decay. Left untreated, this decay can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth. Again, regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.

When restorations are large, or if recurrent decay is extensive, 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.

What's a crown, and why do I need one? Will my tooth decay after getting a crown, or will it be fixed forever?

Dental crowns are sometimes called caps. They're put on top of teeth to restore them to their best size and shape after large fillings, breaks, or weakening forces such as clenching and grinding. In all these cases, crowns serve to strengthen teeth and also provide protection. Crowns are also used to restore single teeth after root canals, to attach bridges, to cover dental implants, and even as a preventive measure when a tooth is in imminent danger of cracking. Crowns and dental implant restorations can be made of various materials, each with their own advantages and disadvantages. Porcelain most closely mimics natural tooth appearance in color and texture, so we prefer it.

While crowns do provide protection, they're not a guaranteed forever fix. Most insurance companies consider a crown a success when it has optimal function for at least five years, so if the crown doesn't last during that period of time then they'll most often pay for a replacement crown. Of course we want your crown to last much longer, so we look forward to seeing you for regular dental checkups when we can monitor your dental restorations and other aspects of your oral health. As with all your teeth, the tooth with your dental crown needs proper brushing and flossing daily along with other precautions like not chewing ice or pen caps.

I've been told that I need a root canal. What should I know before I get one?

Beneath the top layer of your tooth (the enamel) and the second layer (the dentin), there is a pulp, or nerve, which delivers sensations such as heat, cold, and pain to the brain. Whether from excessive decay or physical trauma, this nerve can become damaged, causing an abscess to form at the root of the tooth. Root canal therapy is a procedure in which the diseased pulp is removed from an infected tooth in order to prevent further damage and tooth loss and, most importantly, to relieve your pain.

Symptoms of an infected root include severe toothaches, sensitivity, discoloration, and upraised lesions on your gums. X-rays and a thorough dental examination determine whether a root canal is your best option. Though root canal therapy has a reputation for being painful, the toothaches associated with an infected root are most likely causing you more pain than the treatment will. Additionally, there are a number of ways for us to maximize your comfort during treatment. Ask us about your options.

The tooth nerve is not vitally important for day-to-day function, so removing it will not affect your tooth—unless you count saving the tooth from total loss! In fact, allowing it to decay further can lead to more pain and bone loss. Usually, an over the counter pain medication takes care of immediate post-operative discomfort, and most patients return to normal activities the very next day. Root canal therapy is highly successful, and a tooth receiving the treatment can last you a lifetime. Especially when used in conjunction with a restoration (a crown or composite filling), no one will even notice a difference in your smile.

Why should someone get their wisdom teeth extracted?

Wisdom teeth are the third set of molars, and they grow in last, usually between the ages of 15 and 25. Some people are fortunate enough to have no problems with their wisdom teeth, so they can keep them like their other two sets of molars. When this doesn't happen, however, and wisdom teeth don't come in properly, they can cause serious problems. Some wisdom teeth grow in at the wrong angle or don't even make it that far, getting trapped or "impacted" under the gums. This can cause infection and pain, and we all hate a toothache! Other wisdom teeth issues include crowding that makes other teeth start going crooked, cysts that develop on the jaw, bone loss, and damage to adjacent teeth. If you come to us needing one or multiple wisdom teeth removed, we will explain the treatment and also talk with you about your sedation options. Your comfort is important to us just like your oral health is.

Am I a candidate for dental implant restorations?

Dr. LaVecchia and our team work hard to stay on the leading-edge of restorative dentistry. Quickly becoming the preferred method of replacing missing teeth, implants can be used in conjunction with crowns, bridges, and in single-tooth replacements to give your smile a second chance. Not only are they more durable and long-lasting than traditional tooth replacements, but implants 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. Successful and properly maintained implants can even prevent the bone loss that can occur after tooth loss.

Denture stabilization is yet another application for implants, as they help secure dentures in place. If you or someone you love struggles with ill-fitting, uncomfortable dentures or a retainer with false teeth, we have a permanent solution.

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 use tobacco. To ensure that you get the treatment that’s right for you, keep Dr. LaVecchia and his team informed and up-to-date about your entire medical history and dental habits.

What are my options for professional teeth whitening, and are they safe?

You have a number of options when it comes to whitening your teeth. Depending on your schedule and your brightening expectations, you and your dental team can decide which is best for you.

With a take home kit, Dr. LaVecchia fabricates custom whitening trays for you, which will allow you to whiten your teeth in the comfort of your own home. The whitening gel is more concentrated than over the counter products, and these trays can be used repeatedly and in combination with a number of other whitening methods.

Our in-office method, for example, combines these trays with the Zoom! one-visit whitening system. During this safe treatment, you can listen to music or just relax while we take your smile up to six shades brighter.

For your whitest smile possible, we also offer Deep Bleaching™, which consists of custom-made trays, peroxide whitening gel, and two light treatments. With this method, you can achieve an increase in brightness of eight shades or more!

As far as safety goes, numerous studies have examined the effects of whitening and bleaching methods. These studies have found that there are no adverse effects that result from whitening the teeth of an adult patient. Bleaching is not recommended for children under 16, as their teeth are still developing, and is also not recommended for women who are pregnant.

The common side effect of teeth whitening—both the in-office and take home varieties—is teeth and gum sensitivity. This sensitivity is usually temporary and should subside soon after you've stopped using the product. In addition, feel free to ask us about ways to lessen the sensitivity associated with teeth whitening.

What can I do about bad breath?

If you constantly worry 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 what is most likely causing 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, acid reflux, and diabetes) can all cause bad breath. Brushing your teeth at least twice a day (in the morning and at night) is the first thing to start doing, if you are not already in the habit. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can loosen food particles from between your teeth and increase saliva flow. 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 or other dental devices, 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 may be the cause of 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 tobacco) can significantly improve your oral health and the way your breath smells. Ask us about the ways we suggest to help break a tobacco habit. 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, because some only mask odor as a temporary solution.

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

I have 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 TMJ, 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 and very inconvenient.

TMJ has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of TMJ. TMJ can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.

Professional treatment of TMJ ranges from minor fixes to surgical options. If Dr. LaVecchia determines that the main cause of your TMJ pain is an irregular bite, he may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet. If it's a structural issue occurring in your jaw bone (especially if your TMJ is a result of injury), you may benefit from surgery. When it comes to TMJ treatment, it's important to choose the most conservative plan for your individual needs.

In the meantime, alleviating the pain through treating the symptoms can give you some relief. Heating pads or cold compresses can reduce swelling, and limiting your jaw movement (for example, eliminating chewy foods from your diet and stopping gum chewing) can stop the clicking or popping. Massages can temporarily relieve muscle tension, and medications (prescription or over the counter) can reduce inflammation and help you feel more comfortable.

How important is dental care for children?

Childhood is a critical stage in oral development. A great deal of growth occurs in the teeth, gums, and jaw bone during these years. Your child's dentist needs to see your child in person in order to accurately monitor this growth.

Thumb or finger sucking can dramatically alter children's bites and the appearance of their young smiles. Newly-erupted teeth tend to develop cavities easily, so parents should refrain from allowing children to sleep with a bottle of milk or juice by their side. Sugary drinks like soda will also promote decay in your child's teeth.

Baby teeth should be gently cleaned with water and a pea-sized amount of toothpaste specifically formulated for children. When they are ready, children should be encouraged to brush their own teeth, with supervision, as early as possible.

After the first year, it can be hard to adequately clean a toddler’s teeth at home. Despite the fact that they will inevitably fall out, it's critical to keep baby teeth healthy, both for your child's comfort, the overall health of his mouth, and the future of his smile.

Though it might seem early to some parents, most dentists recommend that the first visit to a pediatric dentist occur when the first tooth erupts, or by the age of 1. This is because teeth are only one part of the entire mouth. Other issues can require professional attention, too, such as the pattern, shape, and pace of teeth eruption (or loss), nutritional deficiencies, and oral hygiene habits. Dr. LaVecchia is happy to advise parents of the course of action he recommends for their children's dental needs.

My husband's snoring is keeping me up all night. Do you think it's a dental issue?

When your husband snores, you both miss out on the rest you need. If his snoring is not related to allergies, sinus problems, or a weight issue, and if you notice gasping, choking, or long periods of time during which his breathing seems to have stopped, your husband could be suffering from sleep apnea. Sleep apnea is a condition that causes a person to stop breathing for short periods of time during sleep and usually results in sudden, repeated awakenings and poor quality of sleep.

Before deciding on a treatment plan, the specific cause of his sleep apnea should be determined. Occasionally, sleep apnea originates in the central nervous system, but it's more likely that your husband is suffering from Obstructive Sleep Apnea. In cases like these, it’s a mouth matter—either a physical obstruction in the throat, nose, or mouth, or a poorly positioned jaw during sleep. If sleeping on his side, changing up his sleeping patterns, and avoiding alcohol and sleeping pill usage at night do not help his apnea, his obstruction could require surgical attention. Dr. LaVecchia can create a custom mouthguard to reposition the jaw and enable him to breathe with greater ease. Sometimes obstructive sleep apnea requires surgical attention, such as the removal of excess tissue (such as the tonsils) to open up the airway. If this is the case, we can refer you to an oral surgeon's office that we feel confident will take great care of you. Ask us about your husband's options, because everyone deserves a good night’s sleep!

What can be done about canker sores or ulcers in my mouth?

Studies show that up to 25 percent of the population suffers from recurrent canker sores, which are small but painful sores on the soft tissues (gums, tongue, and cheeks) of the mouth. Officially, the exact cause of canker sores is unknown, but they have been linked to a variety of causes that range from stress, immune deficiencies, tissue injury, the presence of other illnesses (including viral and bacteria infections), and dietary choices. Roughly textured, spicy, and acidic foods have all been linked to the formation of canker sores. Many people get canker sores after eating pineapple, nuts, or chocolate, for example.

Though canker sores usually run their course naturally in 1 to 3 weeks, you don't have to suffer with the symptoms. Applying ice to affected areas, rinsing with children's Benadryl or warm salt water, and taking over the counter pain relievers can ease the discomfort associated with canker sores. If your canker sores last longer than a couple of weeks, or are very painful, call our office so we can examine the area and recommend treatment options.

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