Steven R Dotter, DMD, MAGD

Family and Cosmetic Dentist in Lancaster, PA

Questions About Your Dental Care

Office Policy

Oral Hygiene

Our Services


Office Policy

Can I complete the new patient forms before my first appointment?

Yes, you can download and print the forms on the new patient forms page. Fill them out and either mail the forms to us or bring them with you during for your first appointment.

Which dental insurance or discount plans do you accept?

Details about plans are listed on our office policies page.

What do I do if I have a dental emergency?

Call our office any time you have an emergency, even if it's after regular hours. If the office is closed, there will be a recording with instructions on what to do and who to contact in case of an emergency.

What if I need to reschedule my appointment?

Every patient is important to us and we schedule carefully to set aside the time everyone needs to receive the best treatment possible. However, we understand that there may be times when you must change your appointment. If you need to reschedule, please call our office no later than 48 hours before your scheduled appointment. We ask that you try to avoid last-minute cancellations whenever possible.

Oral Hygiene

What are some tips for daily oral care?

The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day, twice a day, with a soft-bristled brush.

Make sure the size and shape of your brush allows you to reach all areas easily. Use toothpaste that contains fluoride, which helps protect your teeth from decay. A fluoride mouth rinse, in conjunction with brushing and flossing, can also help prevent tooth decay.

Another important procedure is to clean between the teeth once a day with floss or inter-dental cleaners; this removes plaque from between the teeth where the toothbrush can't reach, and is a key element in preventing gum disease.

We also stress the importance of eating a balanced diet and having regular dental checkups to keep teeth healthy and your smile always looking its best.

How can I tell if I have gingivitis or gum disease?

Four out of five people are walking around with periodontal disease (gum disease) they don't even know they have. Because gum disease is often painless in the early stages, many people ignore or don't notice the early signs. Since you could have periodontal disease without evident symptoms, it is essential to come in for regular dental check-ups and periodontal examinations. That way, we can help detect and correct the problems caused by periodontal disease.

Symptoms of gum disease include:

  • Gums that bleed when you brush your teeth
  • Red, swollen or tender gums
  • Gums that have pulled away from the teeth
  • Bad breath that doesn't go away
  • Pus between your teeth and gums
  • Loose teeth
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

How often should I visit the dentist?

That depends on the state of your dental health. For patients with healthy gums, little or no history of decay, good home care and no significant medical conditions, we can usually help you maintain optimal dental health with cleanings and check-ups twice a year. However, everyone is different and some patients may need more frequent cleanings or certain dental procedures. After performing a comprehensive dental exam, we will discuss your treatment needs and options, develop a customized treatment plan, and discuss all of your treatment options and the advantages and disadvantages of each one.

It is really that important to floss every day?

In a word – Yes. Regular flossing loosens food particles in the tight spaces where your toothbrush can't reach, gets rid of plaque build-up that toothbrushes can't remove, and exercises your gum tissues. These actions all help to prevent gum disease.

What causes bad breath?

Bad breath (halitosis), while an unpleasant and often embarrassing condition, is usually avoidable and treatable. It can be caused by improper dental hygiene, lifestyle or a dental condition.

Maintaining good oral health – at home as well as through regular cleanings and dental checkups – is essential to reducing bad breath. Brushing and flossing daily is critical because food particles which remain in the mouth collect bacteria, which in turn cause bad breath. Without putting too fine a point on it, food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor. Brush twice a day with fluoride toothpaste to remove food debris and plaque and brush your tongue as well. Use floss or an inter-dental cleaner once a day to clean between teeth. For our patients who need extra help in controlling plaque, we often recommend using a special antimicrobial mouth rinse.

Bad breath can also be a by-product of what you eat (such as onions or garlic); foods that have a strong odor convey that odor through the air we exhale as they are being digested and eliminated by the body. Even if you do brush, floss and use mouthwash, this only masks the odor temporarily until the food is eliminated. Tobacco products also cause bad breath. If you use tobacco, come to us for tips on kicking the habit.

Dry mouth (xerostomia), a decrease in saliva flow, is a condition which can cause halitosis (more details follow below). One of the jobs of saliva is to cleanse the mouth and remove particles that may cause odor, so a decrease in saliva flow becomes a problem. Dry mouth may be caused by various medications, salivary gland problems or continuously breathing through the mouth. If you suffer from dry mouth, we may prescribe artificial saliva or suggest you suck on sugarless candy to induce saliva flow and increase your fluid intake.

There are many medical disorders that can affect your breath such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, and liver or kidney ailment. If an exam reveals that your mouth is healthy, we might refer you to your family doctor or a specialist to determine the cause of bad breath.

If you think you have constant bad breath, keep a log of the foods you eat and make a list of medications you take (some medications may play a role in creating mouth odors). Tell us if you've had any surgery or illness since your last appointment. If you find you are constantly using a breath freshener to hide unpleasant mouth odor, come see us for an examination, as this could signal an underlying medical or dental condition of which halitosis is a major symptom.

What is "dry mouth"?

Reduced saliva flow – or dry mouth – can be caused by a number of conditions. It doesn't sound very serious but left untreated, dry mouth can damage your teeth and gums. Some medications can lead to dry mouth such as antihistamines, decongestants, pain killers and diuretics. We can help find the source of your dry mouth and recommend methods to restore moisture to your mouth once the cause is determined, such as artificial saliva, sucking on sugarless hard candy and increasing fluid intake.

What causes dulling and discoloration of teeth?

Discolorations can be caused by staining, aging, or chemical damage to teeth. Smokers and people who drink coffee or tea on a regular basis accelerate the discoloration and require cleaning more often. This is among the most common reasons for teeth whitening.

What causes sensitive teeth?

The pain of tooth sensitivity can be sharp, sudden, and shoot deep into the nerve endings of your teeth.

This discomfort, felt in one or more teeth, is triggered by hot, cold, sweet or sour foods and drinks, tooth grinding, or even by breathing cold air.

The cause of sensitive teeth is the exposure of the underlying layer of your teeth (dentin) as a result of receding gum tissue (the protective covering of the tooth roots.) There are many factors that may lead to sensitive teeth, including brushing too hard, tooth decay near the gum line, recession of the gums or plaque build-up.

Our Services

Do you do teeth whitening/bleaching?

We want you to look your best and whitening your teeth is one way we do that. At your next appointment we will take an impression of your upper and lower teeth and make a custom tray for you that you can use at home. At your convenience, you simply place the whitening gel in the tray and wear the bleaching trays for an hour once or twice a day. Whitening your teeth is painless and easy. However, some people have experienced a slight increase in tooth sensitivity during the process, so we recommend using sensitivity toothpaste for a week prior to starting and during the whitening process.

How can jagged teeth be corrected?

In some cases, simply reshaping (contouring) the front teeth may produce a dramatic result to correct jagged, chipped or slightly uneven teeth. A cosmetic dentist simply utilizes sanding discs and creativity, to create a natural look with existing teeth. In other cases, additional cosmetic consultation is desired to determine if additional treatments like bonding or veneers would create a better long term outcome.

How often should digital x-rays be taken?

In order to help us identify any underlying conditions and perform a complete examination for new patients, we take a full set of digital x-rays on your first visit; if you have had a full set taken within the last year at another dental office, we ask that you have those digital x-rays transferred to us. Depending on your overall health in general and oral health in particular, you may only need digital x-rays once a year but some people will require them more frequently depending on their continued treatment, diet, oral hygiene, and/or health-related issues.

What are dental sealants? Are they really necessary?

Dental sealants are a preventive dentistry measure that protects molars from developing cavities. They are a polymer resin that is brushed on the chewing surface of your adult teeth and then bonded to the tooth surface with high intensity light.

Because your teeth have many grooves on the chewing surface, food particles and bacteria can accumulate in these grooves. As the bacteria consume the food particles, they release an acid which destroys tooth enamel. The end result is a cavity. The sealant acts as a protective coating of the pits and grooves. They fill the deep grooves with acid-resistant resin, deny the bacteria a place to live and render the tooth surface more cleanable. This process is considerably less expensive than filling a cavity.

What can be done for missing teeth?

We will usually install a "bridge" – a false tooth or teeth which anchor to the bordering teeth – designed to replace missing teeth. A bridge is both cosmetic and restorative in that it fills the unsightly space left by lost teeth and also helps support the teeth adjacent and directly opposite to the missing teeth. Depending on your situation we might recommend a dental implant to fill in the space instead.


Why would my child need early treatment?

Early treatment, or Phase I, would be recommended if there are certain discrepancies in the development of the upper and lower jaws. Early treatment can correct these problems in the early growth phase of your child (utilizing a functional appliance), which develops the bone to a more normal size, to allow enough room for the permanent teeth to erupt.

What are the benefits of early treatment?

  • Improve profiles, smiles and self-esteem
  • Correct harmful habits
  • Improved speech from expanding the arches and making more room for the tongue.
  • Reduction of the time in fixed braces and frequently eliminates the need for the extraction of permanent teeth.
  • Prevent the fang look. Upper eye teeth (cuspids) are the last teeth to erupt on the upper arch. If the jaw is too narrow, patient will get the fang look.
  • Prevent possibility of facial asymmetry with the expansion of the upper arch and the correction of the posterior crossbite.
  • Improves head posture which helps eliminate neck pain
  • Prevents grinding of the teeth at night
  • Improves nasal breathing
  • Prevents gum recession

What is a functional appliance?

Once a thorough and proper diagnosis has been made, the best appliance to be used to correct your child's problems will be selected. A functional appliance is a tiny device designed like a mouth retainer, with micro-screws, to make the appliance able to activate and stimulate the change in bone, therefore making the jaw grow to it's potential. The initial records and x-rays, taken at the beginning of treatment, determine growth potential.

How long does Phase I treatment last?

Phase I treatment usually lasts approximately 10-12 months depending on the severity of the case. The appliance is usually active (making changes to the jaw) for 4-6 months then the appliance should be used as a holding appliance for 6 months or as a retainer to prevent any relapse in the treatment. As the permanent teeth erupt, it will be determined when it is no longer necessary to wear the holding appliance.

At what point will my child need orthodontics?

Once the early phase of treatment is finished your child will be evaluated on an ongoing basis to monitor the eruption of the permanent teeth. Once the permanent teeth are all present. We will set up a consultation appointment to determine whether there is a need for braces. Usually orthodontics, which means fixed braces, does not begin until the patent has all their permanent teeth (age 11 to 13). While braces are the most popular among younger patients, they can be worn as a teenager or an adult. More adults these days are asking for braces to help improve their smile and appearance. Set up an initial screening appointment for your child today!

What is Orthodontics?

The area of dentistry called orthodontics involves straightening of teeth with the use of braces. Orthodontics is also indicated when the patient has a bad bite, which can make you feel self conscious and can cause digestive or other health problems. Braces are now less conspicuous and more comfortable than ever before, due to the use of new high performance arch wires, which exert light continuous forces on the teeth. Children should have an orthodontic assessment before the age of five so that early treatment with functional appliances can reduce the time spent wearing braces.

How long does orthodontic treatment last?

The average length of time for orthodontic fixed braces would be 1½ to 2 years when all the permanent teeth have erupted. The treatment time obviously depends on the seriousness of the problem and when treatment is started. Our office recommends that children be evaluated before age five to see if the problem is a bone problem or a tooth problem. If the problem involves the bone, such as the upper or the lower jaw being too narrow or the lower jaw being underdeveloped, then we recommend this problem be treated immediately with functional appliances. The use of functional appliances can reduce the time the child must wear fixed braces and reduce the need for the extraction of permanent teeth. If the problem is merely crooked teeth, many times treatment will be delayed until all the permanent teeth erupt.

Are there different kinds of braces?

Most patient's today think braces are 'cool' because of all the different colours. In fact, there are more that 40 different combinations of coloured elastics, which fit over the braces to keep the wires in place. Every month the patient has their choice of coloured elastics. Most children pick the metal braces, which are much smaller today. Adults and teenagers prefer the clear braces because they blend in with the colour of the teeth and are harder to see. We have some females who prefer gold braces since they look like jewelry. The newest and latest trend is toward invisible braces, where trays that are changed periodically and move the teeth into a better position. For more information on clear braces, click here.

Will teeth move when the braces come off?

A clear retainer will be made to wear when your braces are removed. The roots of the teeth need enough time to settle in the bone, so it's absolutely imperative that you follow the instructions on wearing the retainer to maintain your beautiful smile at the end of treatment.

How long do I have to wear my retainers?

The length of time in retainers varies depending on the amount of tooth movement that was necessary. However, as a general rule of thumb, we recommend full time wear of the upper clear retainer for 1 full year and 1 year at night only. We generally like to make the lower retainer fixed, behind the lower front teeth, and it remains in place for 3-5 years.

Exciting news regarding new clear retainers! The newest retainer now has a clear labial bow which makes the retainer practically invisible. Patients love these new clear retainers.