Quick search/navigation:
- What is dental plaque?
- What are the differences between ceramic braces and metal braces?
- I have some gaps in my front teeth. Will braces help to close these gaps?
- My gum bleeds every time I brush my teeth. May I know why? Other
than going to a dentist, is there any gum specialist that I should visit?
- I visited a dentist lately and was told that my gum is weak and it may
weaken to a point when all my good teeth would be loosened. I was advised
to use a gum toothpaste and mouthwash. May I know how these would help?
- My teeth are yellowish in colour. What can I do to whiten them?
- What is crowning and when is it necessary? What should I look out for?
- My tooth chipped off when I was eating. What causes this chipping?
Should I go to a dentist? Will the whole tooth come off?
- One of my teeth is sensitive and the dentist told me that I have root infection.
The dentist proceeded to drill my tooth, spray antiseptic on the root and patch it back.
It was fine for a while but now my tooth is sensitive again. Is there a permanent solution?
- I have sensitive teeth. Is it due to receding gums? How do I solve the problem?
- I practise good oral hygiene, with frequent brushing, mouth-rinsing and I drink lots of water.
However, my breath still smells. What could be the reasons?
- Does root canal treatment ensure that the treated tooth would stay healthy permanently?
- Do I use toothpaste with or without fluoride? I have read some articles which
stated that there are some side effects of using fluoride, so it is recommended
not to look for fluoridated toothpaste. Is it true?
- I have a metal capping done some years ago. The metal cap has since come off and damaged.
Is there any danger if I don't replace the metal cap?
What is dental plaque?
Dental plaque is a sticky, tooth-coloured layer formed from food remnant
that remains on the tooth surface usually at the gum margins. It can be
easily removed by brushing. However, if it is not removed, over a period
of weeks to months, it can harden to form calculus or tartar which then
requires scaling by a dentist for its removal.
What are the differences between ceramic braces and metal braces?
Ceramic brackets (with metal slots) do not stain. It is the modules that are
transparent or opaque white that stain. You could choose coloured modules to
overcome this. Ceramic brackets are more bulky and more expensive than the metal ones.
However the treatment time is almost the same with both types of brackets.
I have some gaps in my front teeth. Will braces help to close these gaps?
Yes, braces will help close up the gaps in your front teeth. However, there is still a
chance of relapse as in the gaps opening after completion of the treatment. To prevent
this, you need to put on retainers to help retain your teeth after your braces are taken out.
Generally, it takes about 2 years or more for the treatment using braces. However, it depends
on the severity of the misalignment and hence the duration of treatment differs among individuals.
I would advise that you consult an orthodontist to discuss about your treatment, cost and duration.
[Return to Top]
My gum bleeds every time I brush my teeth. May I know why?
Other than going to a dentist, is there any gum specialist that I should visit?
There are many reasons behind bleeding gums. However, an infection of the gum (
gingivitis/periodontitis) due to plaque is more likely to be the case.
Removal of the plaque ( with correct brushing and flossing techniques) and calculus
(by the dentist) would help resolve the infection. You could get a referral letter from the
polyclinics to see a periodontitist (gum specialist) at a subsidised rate.
I visited a dentist lately and was told that my gum is weak and it
may weaken to a point when all my good teeth would be loosened.
I was advised to use a gum toothpaste and mouthwash. May I know how these would help?
From your description, you should be having gingivitis which is inflammation of the gums.
This can be cured with reinstitution of oral hygiene. Bacteria in dental plaque when not
removed cause infection/inflammation at the gum margins with the signs and symptoms of
bleeding, swollen, red and painful gums.
The treatment includes both professional scaling and polishing with regular and vigilant
dental care at home. However, if you do not seek treatment or improve your oral hygiene,
the consequences are that the gum disease will progress to become periodontitis.
Periodontitis is the infection of the whole supporting bed of your tooth and include
the supporting tissue, gums and bone around the roots of the tooth. When this happens,
you will experience the signs and symptoms of gingivitis as well as loosening of tooth,
receding gums, gum boils, loss of bone, bad breath and so on.
The gum toothpaste recommended by your dentist contains special ingredients such as Triclosan,
which has antimicrobial actions to remove bacteria that cause gum disease or stannous fluoride
to reduce gum inflammation. This type of toothpaste is modified from the normal toothpaste.
The mouth rinse has similar antimicrobial properties.
In some studies, it is shown that alcohol-based mouth rinse can cause oral cancer with prolonged usage.
As such, you may like to buy a non-alcohol based mouth rinse. Salt water can act as a mild disinfectant.
However, it does not contain the active ingredients that are found in a gum mouth rinse.
Bear in mind that both toothpaste and correct brushing action work together to remove plaque.
Hence, other than using the toothpaste recommended for gum care, ensure that you practise the
right brushing method, that is, brush at 45-degree angle in small circular motions using a
pea-sized dab of toothpaste and soft-bristled toothbrush.
[Return to Top]
My teeth are yellowish in colour. What can I do to whiten them?
There are two types of stain: Intrinsic and extrinsic. For extrinsic stains, you may use
a normal type of toothpaste or whitening toothpaste to whiten your teeth.
For intrinsic stains, you can consider bleaching to whiten them. You should
consult your dentist who can discuss your situation with you and let you know
what the best treatment for you is.
What is crowning and when is it necessary? What should I look out for?
Crowning involves the removal of some tooth structure and cementing it with a cap like
material mimicking your tooth. You should not feel much pain as your front teeth are not vital anymore.
Crowning of the teeth is not necessary if you have sufficient tooth structure and a good occlusion.
As with any procedure, there are risks involved in crowning. You should ask your dentist about the
side effects. Also, remember that crowns do not last a lifetime and you should pay more attention to it.
[Return to Top]
My tooth chipped off when I was eating. What causes this chipping?
Should I go to a dentist? Will the whole tooth come off?
Tooth has a stronger structure compared to bone as it has a higher percentage of minerals,
such as calcium, fluoride and so on. However, tooth is subjected to both physical and chemical
insults in the oral cavity. Physical trauma is a common form of injury to the tooth. It could be
a fall, road traffic accident, sudden extreme temperature change or biting on something hard like
food or accidental biting on a fork.
Sudden temperature changes cause dimensional changes on the tooth. As the thermal coefficient of
the enamel and dentine layer differs slightly, the tooth may fracture. Chemical insults result
mainly from the food/drinks we consumed such as acidic, carbonated soft drinks or lemon. These
extreme pH substances can corrode our teeth.
Often, these damages occur gradually and may not be so obvious. The physical insults can contribute
to craze lines (incomplete fracture) on the tooth surface. These craze lines weaken the tooth structure
considerably. With 'accidental' additional force applied or sudden extreme temperature changes, our
tooth may just fracture.
You have to see a dentist as soon as possible because you may experience some form of sensitivity if
the fracture involved the dentine layer. If there is pulpy exposure, the pulp may be infected and you may
get a toothache.
The tooth may drop out (avulse) if there is a strong impact acting on the tooth. This can occur in a fall
or road traffic accident. In addition, if the patient has severe periodontitis (gum disease) and the tooth
is mobile with reduced bone support, the tooth may also drop out. Otherwise, it is unlikely to happen in a
normal tooth with healthy gum.
[Return to Top]
One of my teeth is sensitive and the dentist told me that I have root infection.
The dentist proceeded to drill my tooth, spray antiseptic on the root and patch it back.
It was fine for a while but now my tooth is sensitive again. Is there a permanent solution?
For root infection, the dental treatment involved is to remove the infected pulp tissue and disinfect the root
canal and then to fill up the empty canal with a permanent filling. Sometimes, this procedure has to be repeated
to be sure that the bacteria causing the infection is removed and so you can keep the now non-vital tooth in the mouth.
The options for your treatment now is to either go back to your dentist to repeat the cleaning process or to extract
the tooth and then consider treatment options to replace the extracted tooth. This may include having an implant,
fixed bridge or denture (in order of decreasing costs).
[Return to Top]
I have sensitive teeth. Is it due to receding gums? How do I solve the problem?
There are several factors that can cause tooth sensitivity. As the tooth is innervated by nerves, we can feel
temperature changes in the oral environment especially if we drink or eat cold drinks/food. This happens more
acutely when the first layer of the tooth (enamel) is worn away leaving the second layer (dentine), which is
nearer to the pulp, exposed.
Wearing of the enamel surface can be due to abrasive and aggressive tooth brushing producing typical
notches at the outer surface of the tooth near to the gum margin, erosion of tooth due to acidic food
substances such as preserved plums and lemons, attrition due to high biting forces generated between
teeth or abnormal habits like teeth grinding for instance. Tooth decay can also cause sensitivity but is
localised to the specific tooth.
Gum recession due to aging or aggressive tooth brushing with wearing of the tooth as explained can also
be a factor causing sensitivity.
Treatment: You can try to use toothpaste for sensitive teeth or visit a dentist to fill up the notches on the
teeth with a tooth-coloured filling material or have a check-up for any decayed tooth. You should also prevent
further wearing of teeth if you grind your teeth at night by wearing a soft splint.
[Return to Top]
I practise good oral hygiene, with frequent brushing, mouth-rinsing and I drink lots of water.
However, my breath still smells. What could be the reasons?
Oral:
- Oral infections such as chronic periodontitis, acute ulcerative gingivitis,
dry socket (after recent tooth extraction, and oral abscesses.
- Dry mouth/xerstomia (Mouth-breathers tend to have drier mouths
than nose-breathers, and they tend to have less salivary flow to clear away food remnants and bacteria.
With stagnated food remnants, bacteria acts on them to release bad gases which may cause bad breath.
Hence, mouth-breathers have to take a sip of water frequently to wet their mouths.)
Food related:
- Consumption of certain food such as garlic, curries and onion. Avoiding such food will help to eliminate bad breath.
Habits:
- Tobacco-smoking and alcohol-drinking.
Drugs or medication-related; Some drugs that cause dry mouth and may cause bad breath as a result are:
- Chloral hydrate.
- Nitrates.
- Dimethyl sulphoxide.
- Phenothiazines.
- Cytotoxic drugs.
Systemic causes:
- Respiratory tract infections or tumours.
- Gastrointestinal disease.
- Hepatic cirrhosis and liver failure.
- Renal/kidney failure.
- Diabetic ketosis.
- Psychogenic.
You should consult a medical doctor regarding your problem.
Of importance too, check that your bad breath problem is not related
to food, drugs or habits as listed above.
[Return to Top]
Does root canal treatment ensure that the treated tooth would stay healthy permanently?
Much as patients would like to keep their teeth for as long as possible, dentists would also do their
best to salvage patients' teeth. However, root canal treatment is commonly the result of deep decay
that has infected the pulp or due to a large fracture. As such, after clean-up, much of the tooth
structure is taken away resulting in a weaker tooth.
If the patient does not take good care of his tooth and decay recurs, there will be more
complications involved in the treatment. For example, the decay may now be within the root
canal and extend towards the root region. Treatment is difficult as visibility is compromised
since it extends to the root region. Furthermore, after removing the decayed tooth structure,
the remaining tooth structure may no longer be functional or suitable for prosthesis such as crowning.
If there is sufficient tooth structure to re-do the crown, root canal treatment has to be repeated to
ensure that the infection is controlled. This has to be carried by endodontics (root canal specialists)
and the chances of successful treatment are lesser than the first root canal treatment.
Hence, extraction may be offered as an option in re-treatment cases. You should therefore make
every effort to prevent both decay and gum diseases in order to enjoy a healthy set of teeth
that can last you a lifetime.
[Return to Top]
Do I use toothpaste with or without fluoride? I have read some articles
which stated that there are some side effects of using fluoride, so it is
recommended not to look for fluoridated toothpaste. Is it true?
Research and epidemiological studies have shown that caries prevalence is lower in areas
where fluoride is naturally present in the water supply. Addition of fluoride to the water
supply is effective in preventing caries. Fluoride supplements in the form of tablets, drops,
salt and milk have all been shown to be effective in caries prevention. Fluoride-containing
toothpastes are also effective in preventing caries.
There are beneficial effects of fluoride, however, excessive intake of fluoride (>5mg F/kg body weight)
above the safety margin can cause acute toxicity effects which require medical attention for gastric
lavage. In addition, fluorosis in the teeth following excessive intake results in hypomineralisation
and can affect both primary and permanent teeth depending on the period of teeth formation. Effects
of fluorosis range from 'white flecks' to yellowish-brown lines, pits or patches that affect one-third
to the whole surface.
The benefits of fluoride can be classified under pre-eruptive and post-eruptive effects. Pre-eruptive
effects require systemic intake of fluoride for example in the form of tablets or through water
fluoridation programme. Fluoride ions are incorporated into enamel structure (first layer) in the
form of fluoroapatite during the period of tooth formation (six weeks in-utero to 12-16 months old;
two to 12 years old). Fluoroapatite decreases the mineral solubility thus it is more resistant to
acid attacks in tooth decay.
Post-eruptive effects occur when fluoride from topical sources such as toothpaste, mouth rinse,
tablets or gels, interacts with the tooth structure either by incorporation into the crystal
lattice or by binding to crystal surfaces. Calcium fluoride formed at the tooth surface not only
reduces the solubility of the apatite but also encourages remineralisation. In addition, fluoride
also interferes in the metabolism of decay-causing bacteria.
Historically, it was thought that fluoride availability during tooth formation for incorporation
into the hydroxyapatite was the most important. It is now realised that topical effects at the
tooth surface post-eruption is very important. Thus, methods which apply fluoride on a regular basis
are most effective.
It is strongly recommended that children use children's formulated toothpaste with reduced
fluoride concentration of either 125 or 550 ppmF compared to adult concentration of 1000-1500 ppmF.
The volume used by children should be restricted to a pea size/smear amount. This is to prevent toxicity
as some children have difficulty in rinsing thoroughly and tends to swallow the toothpaste.
[Return to Top]
I have a metal capping done some years ago. The metal cap has since come off and damaged.
Is there any danger if I don't replace the metal cap?
You definitely should not ignore the problem because it will then cause more serious problems. But if you
choose to ignore, your tooth may get infected again which will then give you a toothache.
In this case, although your tooth is dead, you will still feel the pain as the infection spreads to the root
area at the jaw bone. You will then need to re-do your root canal treatment or have the tooth extracted.
If extracted, you can opt for implant, bridge or a denture replacing the lost tooth.
If you do nothing about the space, the neighbouring teeth will begin to drift into the gap and become tilted.
As a result, spaces/gaps will appear in your teeth with food trapping in these gaps. The upper tooth because
of loss of contact with the lower tooth will also erupt downwards. Do consult your dentist for the best
course of action for your situation.
[Return to Top]
|
