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Top Dentist Questions

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Can tooth whitening damage tooth enamel? Is it suitable if teeth have already received white fillings? Show

Tooth whitening treatments, if performed according to manufacturer's instructions, do not appear to cause any long lasting damage to tooth enamel. The main side effect of using bleaching agents is tooth sensitivity, which eases after a few days. Tooth whitening is not suitable for use on teeth if these teeth have been crowned or if they have white fillings. Only natural tooth structures can be lightened, not tooth coloured fillings, tooth coloured bonded restorations, crowns or veneers. Different people’s teeth react differently to bleaching. Some individuals experience temporary tooth sensitivity or gum irritation from bleaching agents. A 10% carbamide peroxide treatment in a tray made by your dentist and used at night time is the safest, most cost effective and best researched whitening treatment available. Tooth whitening should always be carried out under the supervision of your dentist, especially when higher strength treatments greater than 10% carbamide peroxide are being used. In situations where whitening is not effective, you may want to investigate other alternatives like veneers with your dentist.

I have heard that you shouldn't brush your teeth immediately after drinking coffee. Is this true? Show

Yes, it is true. However, the problem is not with the coffee itself. It is the milk and sugar in the coffee which can be metabolised by bacteria in your mouth into acid.The acid causes the outside layer of enamel (hard white material on the outside of the tooth) to demineralise (soften) temporarily. If you brush your teeth during this period you may brush away the top layer of enamel. If you leave the brushing for another 20 to 30 minutes, the enamel rehardens itself as your saliva buffers the acid in your mouth. Food and drinks which are acidic, including most soft drinks, fruit juices and sports drinks have this effect on your teeth. It is best if you brush your teeth with fluoride toothpaste first thing in the morning and last thing at night.

I had a wisdom tooth extracted yesterday. It is still bleeding and clotting. Is this normal? Show

Apply a mouth pack (available from your local pharmacy) to the wound and bite on it for a half hour to an hour. A small amount of bleeding is not harmful. However, losing a large amount of blood is not normal and may require follow up in the form of some extra stitches to give more stability and protection to the blood clot. The blood clot is the focus of healing for the wound and should not be disturbed if at all possible. You can help the clotting process, by limiting the amount of mouth rinsing and by not applying any sucking pressure near the socket. Keep on liquids for a few days and drink through a straw. If bleeding continues after these simple measures have been applied, return to your dentist for a full assessment to rule out any other cause for the bleeding.

I am pregnant and my gums bleed every time I brush. Is there anything I should be doing? Show

There is no need to be concerned at this increased tendency for your gums to bleed when you are pregnant. It is caused by the elevated hormone levels in your blood that you get when you are pregnant. It makes your gums more sensitive to the presence of plaque bacteria. The gums become inflamed more easily, leading to redness, swelling and bleeding when you brush. Continue cleaning, brushing and flossing your teeth and gums as best you can with the aid of a mouthwash if necessary. Visit your dentist and hygienist, this is a good time to have your teeth checked and cleaned. You will also learn how to improve your oral hygiene technique. Your gums will return to normal after your baby is born.

My two year old daughter drinks a lot of orange squash. Will this damage her teeth? Show

Try to wean her off this as soon as you can and replace it with ordinary tap water. The orange squash is potentially harmful in two respects. It is usually heavily sweetened, so bacteria in plaque can metabolise acid and over time infiltrate the enamel and dentin causing dental decay. The orange squash is also acidic, so this can lead to chemical erosion or wearing away of the tooth enamel causing sensitivity and further risk of dental decay. Fruit juice unsweetened, and diluted one measure to five measures of water given in a cup at mealtimes is the ideal and safest way for a child to receive a fruit juice

My 3 year old son fell and banged his mouth and his front tooth has turned grey. Will he lose the tooth? Will it affect his permanent teeth? Show

There is no need to worry; your son will probably lose his front baby tooth at around six years of age, just before the permanent front tooth comes into the mouth. The grey colour is the result of some bleeding that has occurred into the baby tooth after receiving the trauma. The grey colour may be a temporary or a permanent feature, depending on the status of the tooth. Sometimes, the nerve of the tooth dies following trauma. This would be a good time to take your son to see a dentist who could advise you whether the tooth is dying or not and if any intervention is required.

What is your advice regarding breastfeeding and having dental work done involving amalgam silver fillings? Show

The scientific advice regarding silver amalgam fillings is that they are perfectly safe and offer many advantages over other types of fillings because of their lower cost, easy placement and durability. However, as in all things in life, it is wise to use precautions when dealing with the very young even if the possibility of harm is remote. For your own peace of mind, why not postpone any type of non urgent operative dental treatment until you have finished breastfeeding. Having old fillings removed is more hazardous than placing new ones, because an aerosol containing amalgam particles is created by the dental drill. Other materials have disadvantages also, so it is preferable for a rapidly developing infant to have as little contact as possible with these types of substances.

I suffer from a recurring mouth ulcer on the tip of my tongue which generally lasts approximately two weeks. Is this normal? Show

A recurring mouth ulcer should always be followed up and investigated further, initially by your own dentist and sometimes by your own doctor and if necessary by an expert in oral medicine. A reassuring aspect of your ulcer is that it appears to heal; this differentiates it from a more serious ulcer that does not heal. A very important aspect of the investigation of your ulcer is to look for predisposing factors. There may be a sharp tooth, filling or denture which is traumatising your tongue. Alternatively, you could be having a reaction to some foods containing certain preservatives, or you may have an iron deficiency. Your own medical doctor will test you for the iron deficiency. Tell your dentist about your ulcer on your next visit and ask for advice about relieving symptoms, if these are a concern to you.

My three year old daughter grinds her teeth while sleeping. Is there anything I can do or do I need to take her to the dentist? Show

Teeth grinding (bruxism) is a common habit in young children and usually disappears on its own as children grow older. The two peak periods for bruxism are when the baby teeth arrive and again when the permanent teeth begin to come in at five to six years of age. Usually there is no need to intervene as damage to the baby teeth is limited by their shorter life span. Thankfully the habit usually stops for most children before any damage is done to the adult teeth. Stress has been identified as a cause in some children. An important tip is to try and relax children as much as possible before going to bed. If the habit persists into adolescence, a dentist may make an appliance like a sports mouth guard to help break the habit. If you are still concerned why not mention the problem to your own dentist at your next dental appointment.

When is the best time to visit the dentist for a check up and clean during pregnancy? Show

Ideally you should visit the dentist for a check up if you are planning to become pregnant or as soon as you find out you are pregnant. Your dentist will be able to assess your oral health status and plan any dental visits you may need during your pregnancy. The initial emphasis will be on a healthy diet and good oral hygiene practices. It is a general convention that as little operative treatment as possible be carried out during pregnancy in order to avoid any possible distress to you or your developing baby. However, it is also accepted that you can have emergency dental treatment at any time. If you require planned treatment, which is considered essential, the middle of the second semester and the earlier part of the third semester is the time when it will be most comfortable for you. This would be an ideal time to have light treatment like a cleaning carried out.