| 1. |
WHITE
FILLINGS |
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Why
should I consider white fillings?
Most people have fillings of one sort or another in their
mouths. Nowadays fillings are not only functional, but can
be natural looking as well. Many people don't want silver
fillings that show when they laugh or smile because they
are more conscious about the way they look. |
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Are
they as good as silver amalgam fillings
White fillings have always been considered less long lasting
than silver amalgam fillings. But there are now new materials
available with properties comparable to silver amalgam,
and these are proving to be very successful. The life expectancy
of a white filling can depend greatly on where it is in
your mouth and how heavily your teeth come together when
you bite. Your dentist can advise you on the life expectancy
of your fillings. |
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| 2. |
FISSURE
SEALANTS |
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What
are sealants?
Sealants are a safe and painless way or protecting your
children's teeth from decay. A sealant is a protective plastic
coating, which is applied to the biting surfaces of the
back teeth. The sealant forms a hard shield that keeps food
and bacteria from getting into the tiny grooves in the teeth
and causing decay. |
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Which
teeth should be sealed
Sealants are only applied to the back teeth - the molars
and premolars. These are the teeth that have pits and fissures
on their biting surfaces. Your dentist will tell you which
teeth should be sealed after they have examined them, and
checked whether the fissures are deep enough for sealing
to help. Some teeth naturally form with deep grooves, which
will need to be sealed, others with shallow ones which will
not need sealing. |
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What
is involved?
The process is usually quick and straightforward taking
only a few minutes per tooth. The tooth is thoroughly cleaned,
prepared with a special solution, and dried. The liquid
sealant is then applied and allowed to set hard - usually
by shining an ultraviolet light onto it. |
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How
long do they last?
Sealants usually last for many years, but your dentist will
want to check them regularly to make sure that the seal
is still intact. They can wear over time, and sometimes
the dentist needs to add or replace some sealant to be sure
that no decay can start underneath them. |
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How
do they work?
The sealant forms a smooth, protective barrier, by covering
all the little grooves and dips in the surface of the tooth.
Dental decay easily starts in these grooves. |
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When
should this be done?
Sealants are often applied as soon as the permanent teeth
start to come through. This is usually between 6 and 7 years
of age. The rest are usually sealed as soon as they appear
which can be any time between 11 and 14 years of age. |
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Do
my children still have to clean their teeth?
Yes. It is still vital that they do this. The smooth, sealed
surface is now much easier to keep clean and healthy with
normal toothbrushing. Using a fluoride toothpaste will also
help to protect your children's teeth. Pit and fissure sealing
reduces tooth decay and the number of fillings your child
might need. |
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| 3. |
ROOT
CANAL TREATMENT |
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What
is root canal treatment?
Root canal treatment (also called endodontics) is needed
when the blood or nerve supply of the tooth (known as the
pulp) is infected through decay or injury. |
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Why
is root canal treatment needed?
If the pulp becomes infected, the infection may spread through
the root canal system of the tooth. This may eventually
lead to an abscess. If root canal treatment (RCT) is not
carried out, the infection will spread and the tooth may
need to be taken out. |
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Does
it hurt?
No. A local anaesthetic is used and it should feel no different
to having an ordinary filling done. |
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What
does it involve?
The aim of the treatment is to remove all infection from
the root canal. The root is then cleaned and filled to prevent
any further infection. Root canal treatment is a skilled
and time-consuming procedure. Most courses of treatment
will involve two or more visits to your dentist. At the
first appointment, the infected pulp is removed. Any abscesses,
which may be present, can also be drained at this time.
The root canal is then cleaned and shaped ready for the
filling. A temporary filling is put in and the tooth is
left to settle. The tooth is checked at a later visit and
when all the infection has cleared, the tooth is permanently
filled. |
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What
if it happens again?
Root canal treatment is usually very successful. However,
if the infection comes back the treatment can be repeated. |
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What
if I don't have the treatment?
The alternative is to have the tooth out. Once the pulp
is destroyed, it can't heal and it is not recommended to
leave an infected tooth in the mouth. Although some people
would prefer an extraction, it is usually best to keep as
many natural teeth as possible. |
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What
about aftercare?
Root-treated teeth should be treated just the same as any
other tooth. Remember to clean your teeth at least once
a day, preferably with a fluoride toothpaste. Cut down on
sugary snacks, and keep them only to mealtimes if possible.
See your dentist for regular check-ups. |
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| 4. |
CROWNS |
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What
is a crown?
Crowns are an ideal way to rebuild teeth which have been
broken, or have been weakened by decay or a very large filling.
The crown fits right over the remaining part of the tooth,
making it strong and giving it the shape and contour of
a natural tooth. Crowns are sometimes also known as 'caps'.
An 'Anterior Crown' is a crown fitted to the front eight
teeth. |
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Why
would I need a crown?
There are a number of reasons. For instance:
- the tooth may have been weakened by having a very large
filling
- you may have discoloured fillings and would like to
improve the appearance of the tooth
- you may have had a root filling which will need a crown
to protect it
- you may have had an accident and damaged the tooth
- it may help hold a bridge or denture firmly in place
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How
is a tooth prepared for a crown?
The dentist will prepare the tooth to the ideal shape for
the crown. This will mean removing most of the outer surface,
and leaving a strong inner 'core'. The amount of the tooth
removed will be the same as the thickness of the crown to
be fitted. Once the tooth is shaped, the dentist will take
an impression of the prepared tooth, one of the opposite
jaw and possibly another to mark the way you bite together.
The impressions will be given to the technician, along with
any other information they need to make the crown. |
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Who
makes the crown?
The impressions and information about the shade of your
teeth will be given to a dental technician who will be skilled
in making crowns. They will make models of your mouth and
make the crown on these to be sure that the crown fits perfectly. |
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Will
the crown be noticeable?
No. The crown will be made to match your other teeth exactly.
The shade of the neighboring teeth will be recorded, to
make sure that the colour looks natural and matches the
surrounding teeth. A temporary crown, usually made in plastic,
will be fitted at the end of the first appointment to last
until the permanent one is ready. These temporary crowns
may be more noticeable, but they are only in place for about
two weeks. |
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How
long does the treatment take?
You will need to have at least two visits: the first for
the preparation, impression, shade taking and fitting the
temporary crown, and the second to fit the permanent crown. |
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Does
it hurt to have a tooth prepared for a crown?
No. A local anesthetic is used and the preparation should
feel no different from a filling. If the tooth does not
have a nerve, and a post crown is being prepared, then local
anesthetic may not be needed. |
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How
long will a crown last?
The life of a crown will depend on how well it is looked
after. The crown itself cannot decay, but decay can start
where the edge of the crown joins the tooth. It is very
important to keep this area as clean as your other teeth,
or decay could endanger the crown. Properly cared for crowns
will last for many years. |
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How
are crowns fixed to teeth?
Once the fit and appearance of the crown has been checked
– and approved by you – it will be cemented
in place with special dental cement. The cement also forms
a seal to help hold it firmly in place. |
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Will
the crown feel different?
Because the shape of the crown will be slightly different
from the shape of your tooth before it was crowned, you
may be aware of it to begin with. Within a few days it should
feel fine, and you will not notice it. |
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| 5. |
GUM
DISEASE |
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What
is gum disease?
Gum disease describes swelling, soreness or infection of
the tissues supporting the teeth. There are two main forms
of gum disease: gingivitis and periodontal disease. |
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What
is gingivitis?
Gingivitis means inflammation of the gums. This is when
the gums around the teeth become very red and swollen. Often
the swollen gums bleed when they are brushed during cleaning. |
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What
is periodontal disease?
Long-standing gingivitis can turn into periodontal disease.
There are a number of types of periodontal disease and they
all affect the tissues supporting the teeth. As the disease
gets worse the bone anchoring the teeth in the jaw is lost,
making the teeth loose. If this is not treated, the teeth
may eventually fall out. |
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Am
I likely to suffer from gum disease?
Probably. Most people suffer from some form of gum disease,
and it is the major cause of tooth loss in adults. However,
the disease develops very slowly in most people, and it
can be slowed down to a rate that should allow you to keep
most of your teeth for life. |
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What
is the cause of gum disease?
All gum disease is caused by plaque. Plaque is a film of
bacteria, which forms on the surface of the teeth and gums
every day. Many of the bacteria in plaque are completely
harmless, but there are some that have been shown to be
the main cause of gum disease. To prevent and treat gum
disease, you need to make sure you remove all the plaque
from your teeth every day. This is done by brushing and
flossing. |
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What
happens if gum disease is not treated?
Unfortunately, gum disease progresses painlessly on the
whole so that you do notice the damage it is doing. However,
the bacteria are sometimes more active and this makes your
gums sore. This can lead to gum abscesses, and pus may ooze
from around the teeth. Over a number of years, the bone
supporting the teeth can be lost. If the disease is left
untreated for a long time, treatment can become more difficult. |
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How
do I know if I have gum disease?
The first sign is blood on the toothbrush or in the rinsing
water when you clean your teeth. Your gums may also bleed
when you are eating, leaving a bad taste in your mouth.
Your breath may also become unpleasant. |
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What
do I do if I think I have gum disease?
The first thing to do is visit your dentist for a thorough
check-up of your teeth and gums. The dentist can measure
the ‘cuff’ of gum around each tooth to see if
there is any sign that periodontal disease has started.
X-rays may also be needed to see the amount of bone that
has been lost. This assessment is very important, so the
correct treatment can be prescribed for you. |
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What
treatments are needed?
Your dentist will usually give your teeth a thorough clean.
You’ll also be shown how to remove plaque successfully
yourself, cleaning all surfaces of your teeth thoroughly
and effectively. This may take a number of sessions with
the dentist or hygienist. |
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What
else may be needed?
Once your teeth are clean, your dentist may decide to carry
out further cleaning of the roots of the teeth, to make
sure that the last pockets of bacteria are removed. You’ll
probably need the treatment area to be numbed before anything
is done. Afterwards, you may feel some discomfort for up
to 48 hour. |
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Once
I have had periodontal disease, can I get it again?
Periodontal disease is never cured. But as long as you keep
up the home care you have been taught, any further loss
of bone will be very slow and it may stop altogether. However,
you must make sure you remove plaque every day, and go for
regular check ups by the dentist and hygienist. |
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| 6. |
BRIDGES |
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Why
should I replace missing teeth?
Your appearance is one reason. Another is that the gap left
by a missing tooth can mean greater strain on the teeth
at either side. A gap can also mean your ‘bite’
is affected, because the teeth next to the space can lean
into the gap and alter the way the upper and lower teeth
bite together. This can then lead to food getting packed
into the gap, which causes both decay and gum disease. |
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How
are missing teeth replaced?
This depends on the number of teeth missing and on where
they are in the mouth. The condition of the other teeth
also affects the decision. There are two main two ways to
replace the missing teeth. The first is with a removable
false tooth or teeth – a partial denture. The second
is with a fixed bridge. A bridge is usually used where there
are fewer teeth to replace, or when the missing teeth are
only on one side of the mouth. |
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Are
bridges expensive?
Although a bridge may seem expensive it will last many years.
It will also improve your appearance and bite. A bridge
uses the considerable skill of the dentist and technician,
and in this way, it’s similar to ordering a piece
of hand-made jewellery. The materials are also expensive
so it's fair to say a bridge will not be the cheapest treatment
you have ever had. |
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How
do I look after my bridge?
You need to clean your bridge every day, to prevent problems
such as bad breath and gum disease. You also have to clean
under the false tooth every day. Your dentist or hygienist
will show you how to use a bridge needle or special floss,
as a normal toothbrush cannot reach. |
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Are
there different types of bridge?
Yes, there are different types of bridge which use different
fixing methods. Your dentist will choose the most effective
and conservative bridge for your personal situation. |
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| 7. |
IMPLANTS |
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What
are dental implants?
A dental implant is a titanium metal rod which is placed
into the jawbone. It is used to support one or more false
teeth. In practice, both the false teeth and their supporting
rod are known as ‘implants’. |
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Can
implants always be used to replace missing teeth?
It depends on the state of the bone in your jaw. Your dentist
will arrange for a number of special tests to assess the
amount of bone still there. If there is not enough, or if
it isn’t healthy enough, it may not be possible to
place implants without grafting bone into the area first. |
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Do
implants hurt?
Placing the implants requires a small operation. This can
be carried out under local anaesthetic with sedation or
with a general anaesthetic. You will not feel any pain at
the time, but you may feel some discomfort during the week
following the surgery. This is usually due to having stitches
in place, and the normal healing process. |
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Can
I have the new teeth straight away?
No. The implants need to bond (integrate) with the bone
after they have been placed. This takes at least 3 months
in the lower jaw and 6 months in the upper jaw. If you are
having one, two or three teeth replaced, you will have a
temporary restoration in the meantime. If you have complete
dentures, then you can wear them throughout the healing
period once they have been adjusted after the surgery. |
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How
long does treatment take?
It takes about 12 months from the initial assessment to
the time when the artificial teeth or dentures are finally
attached to the implants. However, if only the lower jaw
is involved then it may only take around 5 months. A lot
depends on how complicated your treatment is. Your dentist
will be able to give you a timetable once the surgery has
been done. |
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Are
the teeth difficult to clean?
Cleaning around the teeth attached to the implants is no
more difficult than cleaning natural teeth. However, there
may be areas that give you problems and you’ll be
shown methods to help. |
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How
long does treatment take?
It takes about 12 months from the initial assessment to
the time when the artificial teeth or dentures are finally
attached to the implants. However, if only the lower jaw
is involved then it may only take around 5 months. A lot
depends on how complicated your treatment is. Your dentist
will be able to give you a timetable once the surgery has
been done. |
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Do
the implants show?
Your dentist will make sure that the implants won’t
show during all normal movements of the mouth and lips.
You will need to be able to see them, so that you can clean
them properly. |
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Do
I have an implant for each missing tooth?
No, unless you’re only having a single tooth replaced.
Normally, five or six implants are used to replace all the
teeth in one jaw, as each implant can usually support two
teeth. For a few missing teeth, two or three implants may
be used. |
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What
happens if the implant does not bond (integrate) with the
bone?
This happens very rarely. If the implant becomes loose during
the healing period or just after, then it is easily removed
and healing takes place in the normal way. Once the jaw
has healed, another implant can be placed there. Or, the
dentist can make a bridge, using the implanted false teeth
that have ‘taken’. |
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Is
the treatment expensive?
Unfortunately, yes. However, in many situations, the cost
of the treatment is only a little more than the cost of
more conventional treatment with crowns and bridges. There
are advantages to it, too. An implant to replace a single
tooth avoids the need to cut down the teeth either side
for crowns to support a bridge. Normal dentures often mean
you can’t eat or speak well, due to the dentures moving
about. But teeth attached to an implant don’t cause
this problem. |
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| 8. |
VENEERS |
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What
is a veneer?
A veneer is a thin layer of porcelain made to fit
over the front surface of a tooth, like a false
fingernail fits over a nail. |
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What
are the advantages of veneers?
Veneers make teeth look natural and healthy, and
because they are very thin and are held in place
by a special strong bond (rather like super-glue)
very little preparation of the tooth is needed. |
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When
would I need a veneer?
Veneers can improve the colour, shape and position of teeth.
A precise shade of porcelain can be chosen to give the right
colour to improve a single discoloured or stained tooth
or to lighten front teeth (usually the upper ones) generally.
A veneer can make a chipped tooth look intact again. The
porcelain covers the whole of the front of the tooth with
a thicker section replacing the broken part. Veneers can
also be used to close small gaps, when orthodontics (braces)
are not suitable. If one tooth is slightly out of position,
a veneer can sometimes be fitted to bring it into line with
the others. |
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How
long will a veneer last?
Veneers should last for many years, but they can chip or
break, just as your own teeth can. Your dentist will tell
you how long each individual veneer should last. Small chips
can be repaired, or a new veneer fitted if necessary. |
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How
are teeth prepared for a veneer?
Some of the outer enamel surface of the tooth may be removed,
to make sure that the veneer can be bonded permanently in
place later. The amount of enamel removed is tiny and will
be the same as the thickness of the veneer to be fitted,
so that the tooth stays the same size. A local anaesthetic
(injection) may be used to make sure that there is no discomfort,
but often this is not necessary. Once the tooth has been
prepared, the dentist will take an ‘impression’.
This will be given to the dental technician, along with
any other information needed to make the veneer. The colour
of the surrounding teeth is matched on a shade guide to
make sure that the veneer will look entirely natural. |
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How
long will it take?
A veneer takes at least two visits; the first to prepare
the tooth and to match the shade, and the second to fit
it. Before bonding it in place, your dentist will show you
the veneer on your tooth to make sure you are happy with
it. Bonding a veneer in place is done with a special adhesive,
which holds it firmly on the tooth. |
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What
happens after the veneer is fitted?
Only minor adjustments can be made to the veneer after it
is fitted. It is usually best to wait a little while to
get used to it before any changes are made. Your dentist
will probably want to check and polish it a week or so after
it is fitted, and to make sure that you are happy with it. |
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How
much will it cost?
It is important to discuss charges of cosmetic treatment
and treatment options with your dentist before starting
treatment. |
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| 9. |
BAD
BREATH |
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What
causes bad breath?
Most
people have bad breath problems at some time or another,
and in 9 out of 10 cases the cause originates within the
mouth. Bad breath can be a social problem, unpleasant for
others and embarrassing for the person who has it. Research
shows that it may also indicate gum disease, such as gingivitis
or periodontitis. Therefore, a comprehensive oral hygiene
regime is very important to keep your breath smelling fresh.
The bacteria on our teeth and gums (plaque) also cause gum
disease and tooth decay. Visiting your dentist regularly
will not only help you to achieve fresher breath, but will
also allow the dentist to check for and treat gum disease
and tooth decay. |
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How
can I tell if I have bad breath?
Lots of small signals can show that you have bad breath.
Have you noticed people stepping away when you start to
talk? If you think you might have bad breath, there is a
simple test that you can do. Simply lick the inside of your
unscented wrist and sniff – if the smell is bad, you
can be pretty sure that your breath is too. Or, ask a very
good friend to be absolutely honest. |
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Can
I prevent bad breath?
To keep your breath fresh, gum disease (if present) must
be treated and an effective oral hygiene regime adopted.
Also, drink water often and eat plenty of fruit and vegetables.
If you do have bad breath, try keeping a diary of all the
foods you eat and list any medicines you are taking, which
could be adding to the problem. Take this diary to your
dentist who may be able to suggest ways to resolve your
bad breath. Brush your teeth and gums twice a day, and don’t
forget to cleanse your tongue as well. Use dental floss
once a day for cleaning between your teeth. There are other
products you can buy to clean between your teeth. These
are called ‘interdental cleaners’. If you wear
dentures, take them out at night to give your mouth a chance
to rest. Do not clean them with toothpaste as it will scratch
the surface and more stains will build up. They will also
lose their shine. Hold them over a bowl of water or a towel
in case you drop them. Clean them thoroughly with a denture
cream, denture cleaning tablet or denture cleaning powder.
Use a denture brush kept just for this purpose. Remember
to clean the surfaces that fit against your gums and palate.
This will make sure your dentures are always fresh and clean,
and avoid the plaque build-up on the dentures that may cause
bad breath. |
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What products are available?
There are many specialized oral care products available,
which come as toothpaste, oral rinse and in a spray. Using
these will help you clean your teeth, give you fresher
breath and the confidence to keep you smiling all day
long. These products are designed to eliminate, not mask,
odour-causing compounds. Ask your dentist for details.
The specialist products contain a safe, effective, antibacterial
formula to fight plaque and, as part of a daily oral hygiene
program, will help keep your mouth healthy, clean and
fresh.
Mouth Rinses - you have the choice between
those containing alcohol, or not, with sweetener or without
and flavored or non flavored. Most mouth rinses are designed
to last up to eight hours.
Oral sprays - are convenient for your
pocket, handbag, car or whenever you are away from the
bathroom and want reassurance of fresh breath.
Toothpaste – some do not contain
sodium lauryl sulphate (a foaming detergent) and therefore
non-foaming. This means your mouth does not fill up with
suds, as is the case with most normal toothpastes and
you can continue cleaning your teeth for longer, which
is preferred by many dental professionals.
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How
do they work?
Even in the cleanest mouth, odour-causing molecules known
as Volatile Sulphur Compounds (VSC) are constantly being
produced by the natural breakdown of bacteria, human cells
and food debris. Ordinary toothpastes and mouthwashes only
cover up these compounds with a more pleasant smell or flavor.
The VSC are still present, causing odour in the mouth. However,
the ingredients in the specialist toothpaste, oral rinse
and spray actually changes the structure of the VSC molecules,
rendering them odourless. With regular use, the specialist
oral care range can help assure you of cleaner teeth, a
healthier mouth and fresher breath. |
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What
else causes bad breath?
Bad breath can also be caused by some medical problems.
Dry mouth (xerostomia) is a condition that affects the flow
of saliva. This causes bacteria to build up in the mouth,
leading to bad breath. Dry mouth may be caused by some medicines,
salivary gland problems or by continually breathing through
the mouth instead of the nose. Also, older people naturally
produce less saliva. If you suffer from dry mouth, your
dentist may be able to recommend or prescribe an artificial
saliva product or suggest other ways of dealing with the
problem. Other medical conditions that cause bad breath
include infections in the throat, nose or lungs, sinusitis,
bronchitis, diabetes or liver or kidney problems. If your
dentist finds that your mouth is healthy, you may be referred
to your family GP or a specialist to find out the cause
of your bad breath. Remember, only 10% of bad breath problems
originate from outside the mouth. Tobacco also causes its
own form of bad breath. The only solution in this case is
to stop smoking. As well as making your breath smell, smoking
causes staining, loss of taste and irritates the gums. People
who smoke are more likely to suffer from gum disease and
also have a greater risk of developing cancer of the mouth,
lung cancer and heart disease. Ask your dentist, pharmacist
or practice nurse for help in quitting. If you do stop smoking,
but still have bad breath, then you need to see your dentist
for advice. |
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How
can I tell someone they have bad breath?
Chances are we all know someone who has bad breath, but
very few people feel brave enough to discuss the problem.
It is obviously a very delicate matter to tell someone they
have bad breath. There is always the risk that they will
be offended or embarrassed and may never speak to you again!
However, it is always worth remembering that the bad breath
may be the result of any number of problems. Once the person
knows they have bad breath, they can deal with whatever
is causing it. You could try talking to their partner or
a family member, as the bad breath may be caused by a medical
condition, which is already being treated. |
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| 10. |
ULCERS |
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What
are recurrent mouth ulcers?
Ulcers are sores that appear inside the mouth and can be
itchy or painful. A recurrent ulcer is one that comes and
goes, sometimes every few weeks. They are different from
cold sores, which appear on the outer lips and are due to
a virus infection. |
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Are
they common?
Yes. Over 60% of the population has recurrent oral ulcers
at some time in their lives. Often they begin in childhood
but most people grow out of them by their late twenties.
In many cases several members of the family may suffer from
these ulcers, which can be due to a family tendency and
not to infection. |
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Where
and how can they appear?
Minor ulcers can appear inside the cheeks, on the lips,
tongue, gums and, more rarely, the roof of the mouth. Most
of these ulcers (minor type) are the size of the top of
a pencil and can sometimes come in clusters. Large ulcers
(major type) may appear near the tonsils and can be very
painful, especially when swallowing. It is also possible
to have up to 100 very small ulcers (herpetiform type).
However these last two varieties are very rare. You may
get ulcers in other parts of the body e.g. eyes or genital
area. It is important to tell your dentist about this.
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How
long do they last?
The ulcer is usually preceded by an itchy feeling at the
spot where it is due to appear. After 6-24 hours an ulcer
forms and can last 7-10 days. The very large ones usually
take up to six weeks to heal. |
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What
causes mouth ulcers?
Recurrent mouth ulcers cannot be caught by kissing or
sharing drinks and utensils, as they are not caused by
an infection. They may be an autoimmune disease caused
by the body attacking the cells lining the mouth. It has
been suggested that the following factors have a role
in causing mouth ulcers:
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Too little iron or a lack of vitamins,
especially B12 and C, in the diet.
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Bowel disease such as Crohn’s
disease or ulcerative colitis.
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Coeliac disease (gluten sensitivity).
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Hormonal changes; many women get
ulcers at the time of their period.
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Stress
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Certain foods
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Should
I worry about my ulcers?
No. Most ulcers heal up on their own. In order to reduce
the pain from these ulcers it is important that you keep
your mouth clean at all times. Use a diluted chlorhexidine
mouthwash once daily. You can buy this in any pharmacy.
Sprays and rinses are also available for pain relief. It
is advisable to consult your dentist in case you need additional
medications or if the ulcers persist. |
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What
will the dentist do?
The dentist may refer you to have blood tests taken and
will probably prescribe some form of medication to help
the ulcer to heal faster and so reduce the pain. However
these medications cannot stop the ulcers from appearing.
Most are steroid based but are safe to use provided they
are not swallowed. It is usually recommended to use them
as soon as you feel an ulcer coming.
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Adcortyl in Orabase. Dry the area
first with a cotton wool bud and then use a wet finger
or a wet cotton wool bud to put the cream on the sore
area. It is most effective to use this cream last thing
at night as it stays there for longer. You can use it
up to four times a day after meals. You may find it
leaves a gritty feel in your mouth. You can buy this
yourself
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Corlan Pellets are small, bitter
tasting tablets that dissolve in your mouth releasing
a drug that acts on the ulcer. Place it near the ulcer.
You can buy these yourself and can use them four times
a day
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Becotide spray is occasionally used
for those areas of the mouth which are difficult to
reach with other remedies. Use 2-3 puffs of the pump
on the area that is sore. Do NOT breathe in at the time
of puffing, hold your breath as you do not want the
spray to go down into the lungs. You can use it up to
four times a day.
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Bioplex is a non steroidal powder
that you make up as a mouthwash in a quarter of a cup
of warm water. Use up to four times a day
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| 11. |
JAW
PROBLEMS & HEADACHES |
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What
is dental occlusion?
Dental occlusion is another name for the way your teeth
meet when your jaws bite together. |
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What
is TMJ?
The letters TMJ are short for of ‘temporo-mandibular
joint’, which is the joint connecting your lower jaw
and your skull. The movement in this joint lets you open
and close your mouth and chew from side to side. |
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What kind of problems might
I have?
If your teeth don’t fit together properly, you can
have problems not only in your teeth themselves, but also
the gums, the temporo-mandibular joint or the muscles
that move your jaw. These problems are called ‘occlusal’
problems.
Teeth
Teeth that are out of line, heavily worn or constantly
breaking, fillings that fracture or crowns that work loose
may all be signs of occlusal problems. Your teeth may
also be tender to bite on or may ache constantly.
Gums
Loose teeth or receding gums can be made worse by a faulty
bite.
TMJ
Clicking, grinding or pain in your jaw joints, ringing
or buzzing in your ears and difficulty in opening or closing
your mouth could all be due to your teeth not meeting
each other properly.
Muscles
If your jaw is in the wrong position, the muscles that
move the jaw have to work a lot harder and can get tired.
This leads to muscle spasm. The main symptoms are continual
headaches or migraine, especially first thing in the morning;
pain behind your eyes; sinus pain and pains in your neck
and shoulders. Sometimes even back muscles are involved.
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How
can I tell if I have a problem?
You may find that you clench or grind your teeth, although
most people who do aren’t aware of it. Sometimes can
be caused by anxiety, but generally most people clench their
teeth when they are concentrating on a task - housework,
gardening, car mechanics, typing and so on. You may wake
up in the morning with a stiff jaw or tenderness when you
bite together. This could be due to clenching or grinding
your teeth in your sleep. Most people who grind their teeth
do it while they are asleep and may not know they are doing
it. If you suffer from severe headaches or neck and shoulder
pain, you may not have linked this with possible jaw problems.
Or you may keep having pain or discomfort on the side of
your face around your ears or jaw joints or difficulty in
moving your jaw. These are all symptoms of TMJ problems.
If you are missing some teeth at the back of your mouth,
this may lead to an unbalanced bite, which can cause uneven
pressure on your teeth. Together, all these symptoms are
called ‘TMJ syndrome’. |
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How are occlusal problems
treated?
See your dentist. He or she may be able to help you or
may refer you to a specialist who deals with occlusal
problems. Depending on the problems you are having, it
can be possible to spot the signs of an occlusal problem.
Various muscles may be sore when tested, or the broken
and worn areas of your teeth will show you are grinding
your teeth - a common sign of an incorrect bite. If your
dentist suspects that your problems are due to an incorrect
bite, he or she may help to diagnose the problem by supplying
a temporary soft night guard or hard plastic appliance
that fits over your upper or lower teeth. This appliance
needs to be measured and fitted very accurately so that
when you bite on it; all your teeth meet at exactly the
same time in a position where your muscles are relaxed.
You may have to wear this all the time or, just at night.
If the appliance relieves your symptoms then your bite
may need to be corrected permanently.
Tooth Adjustment (equilibration)
Your teeth may need to be carefully adjusted to meet evenly.
Changing the direction and position of the slopes that
guide your teeth together can often help to reposition
the jaw.
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Replacement of teeth
The temporo-mandibular joint needs equal support from
both sides of both jaws. The chewing action is designed
to work properly only when all your teeth are present
and in the correct position. Missing teeth may need
to be replaced either with a partial denture or bridgework.
Replacement is not usually done until a diagnosis has
been confirmed by using an appliance and this has fully
relieved the symptoms. Relief in some patients is instant:
in others it can take a long time.
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Medication
Some drugs can help in certain cases, but this is usually
only temporary. Hormone replacement therapy may also
help some women.
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Diet and Exercise
As with any joint pain, it can help to put less stress
on the joint. So a soft diet can be helpful, as can
Corrective exercises and external heat. Physiotherapy
exercises can often help, and your dentist may be able
to show some of these to you.
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Relaxation
Counseling and relaxation therapy may help in some cases.
These techniques help the patient to become more aware
of stressful situations and to control tension.
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Will
straightening my teeth help?
If your teeth are too far out of line or in a totally incorrect
bite position, it may be necessary to fit an orthodontic
appliance to move them into a better position. |
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How many people suffer
from these problems?
Up to 1 in 4 people may have some symptoms. Both men and
women are affected equally, although women tend to seek
treatment more often than men. The symptoms can often
start with the menopause or other hormonal changes. Many
people have imperfect occlusion and missing teeth, yet
never have symptoms because they adjust to their problems.
Occasionally, in times of increased stress and tension,
the symptoms may appear and then go away immediately.
Or, your teeth and gums may be affected straight away
and instead of headaches, you may suffer:
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flattened, worn teeth
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broken teeth, fillings and crowns
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loose teeth
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continual sensitivity of your teeth
to temperature change
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Toothache with no apparent cause
If you think you have any of these problems, ask your dentist. |
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| 12. |
ANTI-SNORING |
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What is snoring?
The noise of snoring is caused by the vibration of the soft
tissues in the upper airway. During sleep the muscles of
the upper airway relax resulting in the formation of bottlenecks
or even complete obstruction of the airways. The body reacts
by increasing the velocity of the air which in turn causes
vibration of the soft tissues which generates the noise
of snoring. |
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Who
is likely to snore?
Research has shown that approximately 40% of the adult population
snore. As a person gets older the chances of snoring increases.
(i.e. in men aged 60 this increases to 60%.) The chances
of snoring are also increased if a person is overweight
or drinks alcohol. |
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What
is Obstructive Sleep Apnoea?
This is a medical condition. People suffering from it are
heard to gasp for breath while they are asleep. Additional
symptoms are daytime drowsiness or the feeling of not having
a full night’s sleep. Where Sleep Apnoea is suspected
an anti-snoring device may still be prescribed but it is
essential that you consult your medical practitioner and
if he confirms that Sleep Apnoea is suspected, that you
are referred to the sleep clinic of a hospital for further
investigation. Not everyone that snores suffers from Sleep
Apnoea – but nearly everyone who suffers from Sleep
Apnoea will snore. |
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What
help is available?
Your dentist could make you an oral appliance which is worn
at night to prevent snoring. This will consists of two thin
plastic formings which fit over the upper and lower teeth.
They are joined together by two connectors that gently hold
the lower jaw in a forward position. Any opening of the
mouth pulls the lower jaw further forward. |
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Can
anyone use this appliance?
Research has shown that approximately 40% of the
adult population snore. As a person gets older the
chances of snoring increases. (i.e. in men aged
60 this increases to 60%.) The chances of snoring
are also increased if a person is overweight or
drinks alcohol. |
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What
happens next?
Your dentist will ask you to complete a questionnaire (if
possible with your partner) and then take moulds of your
upper and lower tooth arches. Your appliance will be custom
made to the moulds of your mouth and your dentist will fit
it. (Allow about two weeks for your appliance to be manufactured.)
You will be asked to wear it initially each night for a
week to ensure that the noise of snoring has been eliminated.
If after wearing it for a week the noise of snoring has
not been completely eliminated your appliance should be
returned to your dentist for adjustment. Unfortunately it
is not possible to guarantee that the appliance will work
on everyone. Statistics demonstrate that in 62% of people
that snore it will totally eliminate the noise of snoring.
In the remaining cases the noise of snoring may be reduced
or it will not work at all. |
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Does
the appliance require maintenance?
The appliance does require regular maintenance but
the intervals between maintenance periods are difficult
to predict because they depend on the individuals
case. If you grind your teeth at night the life
of your appliance will be reduced. |
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| 13. |
VISITING
THE HYGIENIST |
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What
is a hygienist?
Dental hygienists are specially trained to work with the
dentist in giving care to patients. They play an important
role in dental health care and are mainly concerned with
gum health, showing people correct home care and applying
preventive materials to the teeth and gums. |
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What
is the hygienists role in the practice?
The hygienist’s main role is to professionally clean
the teeth for the patient. This is usually called scaling
and polishing. However, perhaps their most important role
is showing the patient the best way to keep the teeth free
of plaque. The hygienist will work with your dentist to
provide care tailored to your needs. |
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Why
is this treatment important?
Regular professional cleaning combined with your home care
will help keep your mouth healthy. A clean and healthy mouth
will improve your appearance, help you to keep your teeth
and give you fresh breath. |
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