Frequently asked questions
- Gum Disease
- Smoking & Oral Health
- Mouth Cancer
- Root Canal Treatment
- How do I take care of my dentures?
- White Fillings
What is gum disease?
Gum disease describes the swelling, soreness or infection of the tissues supporting the teeth. There two main forms of gum disease: gingivitis and periodontal disease.
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.
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. In fact, more teeth are lost through periodontal disease than through tooth decay.
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.
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.
How will smoking affect my gums and teeth?
Smoking can also make gum disease worse. Patients who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the blood stream, so the infected gums fail to heal. Smoking causes people to have more dental plaque and for gum disease to progress more rapidly than in non smokes. Gum disease still remains the most common cause of tooth loss in adults.
What happens if gum disease is not treated?
Unfortunately, gum disease progresses painlessly on the whole so that you do not 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 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.
How do I know if I have gum disease?
The first sign is blood on the toothbrush on 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.
What do I do if I think I have gum disease?
The first thing to go is visit your dentist for 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.
What treatments are needed?
Your dentist will 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.
What else may needed?
Once your teeth are clean, your dentist may decide to carry out further cleaning of the tooth of the roots of the teeth, to make sure that the last pockets of bacteria are removed. This is known as root planning. You may need the treatment area to be number before anything is done. Afterwards, you may feel some discomfort for up to 48 hours.
Once I have had the periodontal disease, can I get it again?
The periodontal diseases are never cured. But as long as you keep up some home care you have been taught, any further loss of bone will be very slow and it may stop altogether. How you must make sure you remove plaque every day, and go for regular check ups by the dentist and hygienist.
Smoking & Oral Health
How can smoking affect my oral health?
Most people are now aware the smoking is bad for our health. It can cause many different medical problem and, in some cases, fatal disease. However many people don't realise the damage that smoking does to their mouth, gums and teeth.
Smoking can lead to tooth staining, gum disease, tooth loss and in more severe cases mouth cancer.
Why are my teeth stained?
One of the effects of smoking is staining on the teeth due to nicotine and tar content. It can make the teeth yellow in a very short time, and heavy smokers often complain that their teeth are almost brown after years of smoking.
How will smoking affect my gums and teeth?
Smoking can also lead to gum disease. Patients who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums fail to heal. Smoking causes people to have more dental plaque and for gum disease to more progress more rapidly than in non smokers. Gum disease still remains the most common cause of tooth loss in adults.
How is smoking linked with cancer?
Most people know that smoking can cause lung and throat cancer, but many people are still unaware that it is one of the main causes of mouth cancer too. Every year thousands of people die from moth cancer brought on by smoking.
Are there any special products I can use?
There are special toothpastes for people who smoke. They are sometimes a little more abrasive than ordinary pastes and should be used with care. Your dentist may recommend that you use these toothpastes alternatively with your usual toothpaste.
There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth they may be effective at removing staining and therefore may improve the overall appearance of your teeth.
What about mouthwashes?
People who smoke may find they are more likely to have bad breath than non smokers. Fresh breath products such as mouth washes may help to disguise the problem in the short term, but will only mask it.
How often should I visit my dentist?
It is important that you visit your dentist regularly both for a normal check up and a full mouth examination so that any other conditions can be spotted early.
You should visit your dentist at least once a year. However, this may be more often if your dentist feels it necessary. People who smoke are more likely to have stained teeth and therefore may need appointments more often with the dental hygienist.
What can my dentist do for me?
Your dentist will carry out a regular examination to make sure that your teeth and gums and whole mouth are healthy.
Your dentist will also examine your cheeks, tongue and throat for any signs of other conditions that may need more investigation.
They may also be able to put you in touch with organisations and self help groups who will have the latest information to help you stop smoking.
Will I need any extra treatment?
Your dentist may also refer you to a dental hygienist, for further treatment, thorough cleaning and to keep a closer check on your oral hygiene.
Your dental hygienist will be able to advise you on how often you should visit them, although this should usually be ever three to six months.
What is mouth cancer?
Most people have heard of cancer affecting parts of the body such as the lungs or breasts. However, cancer can occur in the mouth, where the disease can affect the lips, tongue, cheeks and throat.
Who can be affected by mouth cancer?
Anyone can be affected by mouth cancer, whether they have their own teeth or not. Mouth cancers are more common in people over 40, particularly men. However, research has shown that mouth cancer is becoming more common in younger patients and in women. There are, on average, over 4,300 new cases of mouth cancer diagnosed in the UK each year. The number of new cases of mouth cancer is on the increase.
Do people die from mouth cancer?
Yes. Nearly 1,700 people in the UK die from mouth cancer every year. Many of these deaths could be prevented if the cancer was caught early enough. As it is, people with mouth cancer are more likely to die than those having cervical cancer or melanoma skin cancer.
What can cause mouth cancer?
Most cases of mouth cancer are linked to tobacco and alcohol. Cigarette, cigar and pipe smoking are the main forms of tobacco use in the UK. However, the traditional ethnic habits of chewing tobacco, betel quid, gutkha and paan are particularly dangerous.
Alcohol increases the risk of mouth cancer, and if tobacco and alcohol are consumed together the risk is even greater. Over-exposure to sunlight can also increase the risk of cancer of the lips.
What are the signs of mouth cancer?
Mouth cancer can appear in different forms and c an affect all parts of the mouth, tongue and lips. Mouth cancer can appear as a painless mouth ulcer that does not heal normally. A white or red patch in the mouth can also develop into a cancer. It is important to visit your dentist if these areas do not heal within three weeks.
How can mouth cancer be detected early?
Mouth cancer can often be spotted in it's early stages by your dentist during a thorough mouth examination. If mouth cancer is recognises early, then the chances of a cure are good. Many people with mouth cancer go to their dentist or doctor too late.
What is involved in a full check up of the mouth?
The dentist examines the inside of your mouth and your tongue with the help of a small mirror. Remember, your dentist is able to see parts of your mouth that you cannot see easily yourself.
What happens if my dentist finds a problem?
If your dentist finds something unusual or abnormal they will refer you to a consultant at the local hospital, who will carry out a thorough examination of your mouth and throat. A small sample of the cells may be gathered from the area (a biopsy) , and these cells will be examined under the microscope to see what is wrong.
What happens next?
If the cells are cancerous, more tests will be carried out. These may include overall health checks, blood tests, x-rays or scans. These tests will decide what course of treatment is needed.
Can mouth cancer be cured?
If mouth cancer is spotted early, the chance of a complete cure are good, and the smaller the area or ulcer the chance of a cure. However, too many people come forward too late, because they do not visit their dentist for regular examinations.
How can I make sure that my mouth stays healthy?
It is important to visit your dentist at least once a year, even if you wear dentures. This is especially important if you smoke and drink alcohol.
When brushing your teeth, look out for any changes in your mouth, and report any red or white patches, or ulcers, that have not cleared up within three weeks.
When exposed to the sun, be sure to use a good protective sun cream, and out the correct type of barrier cream on your lips.
A good diet, rich in vitamins A, C and E, provides protection against the development of mouth cancer. Plenty of fruit and vegetables help the body to protect itself, in general from most cancers.
Cut down on your smoking and drinking.
What is a crown?
A crown is an artificial restoration that sits over the remaining part of a prepared tooth, making it strong and giving it the shape of a natural tooth. A crown is sometimes known as a cap.
Why would I need a crown?
Crowns are an ideal restoration for teeth that have been broken, or have been weakened by decay or a very large filling. A crown could be used for a number of other reasons , for instance:
- You may have discoloured fillings and would like to improve the appearance of the tooth.
- You may have had a root filling which may need a crown to protect what is left of the tooth.
- It may help hold a bridge or denture firmly in place.
What is a crown made of?
Crowns can be made of a variety of different materials and new materials are continually being introduced. Some of the most popular options are listed below:
Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and then porcelain is applied in layers over it.
Porcelain crowns: these crowns are made entirely out of porcelain and are not as strong as bonded crowns, but the can look very natural and are most often used for front teeth.
All-ceramic crowns: this modern technique offers a metal free alternative, which can give the strength of a bonded crown and the appearance of a porcelain crowns. Therefore it is suitable for use in all areas of the mouth.
Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
Glass: these crowns look very natural and are used on both front and back teeth.
Gold alloy crowns: Gold is one of the oldest filling materials. Today it is used with other metal alloys to increase it's strength, which makes it a very hardwearing restoration. These crowns are white or gold in colour.
How is a crown prepared?
The dentist will prepare the tooth to the ideal shape for the crown. This will involve 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. Once the tooth is shaped, the dentist will take an impression (mould) of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bit together.
The impressions will then be given to the dental technician, along with an appropriate shade and other information needed for the crown to be made.
What is a post crown?
In root-filled teeth it may be necessary insert post before placing a crown. A post provides support and helps the crown stay in place. The weakened crown of the tooth may be shortened to gum level.
A post can be made of prefabricated stainless steel which the dentist can fit directly into the root canal, or a custom-made post can be constructed by the dental technician to accurately fit the shape of the prepared root canal. The post is placed into the root canal and cemented in position, ready for the crown to be attached.
Are there any alternatives to post crowns for root filled teeth?
If a root filled tooth is not completely broken down, it may be possible to build it up again using filling material. This 'core' is then prepared in the same way as a natural tooth and the impressions are taken.
What will happen between visits?
A temporary crown will be made so that you can use the tooth while you wait for the crown to be made This crown may be more noticeable but is only a temporary measure.
How is the crown fitted?
When you and your dentist are happy with the fit and appearance of the new crown it will be fixed in place with special dental cement or adhesive. The cement forms a seal to hold the crown in place.
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 crowns; and the second to fit the permanent crown. There will usually be about 1 to 2 weeks in between appointments.
Does it hurt to have a tooth prepares for a crown?
No. A local anaesthetic 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 a local anaesthetic may not be needed.
Root Canal Treatment
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. You may not feel any pain in the early stages of the infection. In some cases, your tooth could darken in colour which may mean that the nerve of the tooth has died (or is dying). This would need root canal treatment.
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. An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth. The symptoms of an abscess can range from a dull ache to sever pain and the tooth may be tender when you bite. If root canal treatment (RCT) is not carried out, the infection will spread and the tooth may need to be taken out.
Does it hurt?
No. Usually the local anaesthetic is used and it should feel no different to having an ordinary filling done.
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 course 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 infection has cleared, the tooth is permanently filled.
What will my tooth look like after treatment?
In the past, a root filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance.
What if it happens again?
Root canal treatment is usually very successful. However, if the infection comes back the treatment can be repeated.
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.
Will the tooth be safe after treatment?
Yes. However, as a dead tooth is more brittle, it may be necessary to restore the tooth with a crown to provide extra support and strength to the tooth.
What is a denture?
People wear dentures to replace lost or missing teeth so they can enjoy a healthy diet and smile with confidence. Dentures are made of either acrylic (plastic) or metal.
A 'complete' or 'full' denture is one which replaces all the natural teeth in either the upper or lower jaws.
A 'partial' denture fills in the spaces left by lost or missing teeth. It may be fastened to your natural teethe with metal clasps or 'precision attachments'.
How soon can I have a denture after my teeth are taken out?
Usually dentures can be fitted straight after your teeth have been removed. These are called 'immediate dentures'. You visit the dentist beforehand for them to take measurements and impressions of your mouth.
Will dentures make me feel different?
Replacing lost or missing teeth is very good for your health appearance. A complete or full denture replaces your natural teeth and gives support to your cheeks and lips. Without this support, sagging facial muscles can make a person look older and they will find it harder to eat and speak properly.
Dentures can be made to closely match your natural teeth so that your appearance hardly changes. Modern dentures may even improve the look of your smile and help fill out the appearance of your face.,/p>
Will I be able to eat with dentures?
Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to stop the denture from moving. As you become more used to your denture, add other foods until you get back to your normal healthy diet.
Will dentures change how I speak?
Pronouncing certain words may take practice. Reading out loud and repeating difficult words will help.
If you find that your dentures occasionally slip when you laugh, cough or smile, reposition them by gently biting down and swallowing. If this continues see your dentist.
How long should I wear my dentures?
During the first few days, your dentist may advise you to wear them for most of the time, including while you are asleep. After your mouth gets used to your dentures your dentist may advise that you take them out before going to bed. This allows your gums to rest and helps keep your mouth healthy.
Should I use a denture fixative?
Dentures are custom made to fit your mouth and you shouldn't need a denture fixative. However, over time, dentures may become loose and not fit as well. When this happens, some people prefer to use a fixative for a short time before having them replaced, A poorly fitting denture may cause irritation and sores. This can often happen if you have worn immediate dentures for some time.
Must I do anything to care for my mouth?
Even with full dentures, you still need to take good care of your mouth. Every morning and evening, brush your gums, tongue and the roof of your mouth with a soft-bristled brush. This removes plaque and helps the circulation in your mouth.
If you wear partial dentures, it is even more important that you brush your teeth thoroughly every day. This will help stop tooth decay and gum disease that can lead to you losing more of your teeth. Your dentist may refer you to the hygienist to have your remaining natural teeth cleaned regularly.
How do I take care of my dentures?
Dentures are very delicate and may break if you drop them. Always clean them over a bowl of water or a folded towel in case you drop them.
To clean your dentures, the general rule is: brush, soak, brush. Brush your dentures before soaking, to help remove any food debris. Use an effervescent (fizzy) denture cleaner to help remove stubborn stains and leave your dentures feeling fresher Ð always follow the manufacturers' instructions. Then brush the dentures again, as you would your own teeth, being careful not to scrub too hard as this may cause grooves in the surface.
Most dentists advise using toothpaste and small-to medium-headed toothbrush. Make sure you clean all the surfaces of the dentures, including the surface which fits on your gums. This is especially important if you use any kind of denture fixative.
Will my dentures need to be replaced?
Over time, your dentures will need to be relined or re-made due to normal wear or a change in the shape of your mouth. Bone and gum ridges can shrink, causing your jaws to meet differently. Loose dentures can cause health problems, including sores and infections, not to mention discomfort A loose or ill-fitting denture can also make eating and talking more difficult. It is important to replace worn or poorly fitting dentures before they cause problems.
How often should I see my dentist?
Regular dental check-ups and having your teeth professionally cleaned are vital for keeping your teeth and gums healthy. Most dentists recommend a dental check up at least once a year. Regular visits allow your dentist to check the soft parts of your mouth including the tongue and cheeks. These examinations are important so the dentist can spot any infections, mouth conditions or even mouth cancer at the earliest stages. Full denture wearers should check with their dentis about how often they should visits.
With regular professional care, a positive attitude and persistence, you can become one of the millions of people who wear their dentures with a smile.
Are dentures my only option?
No. Implants are another option to consider. Ask your dentist for more information on this.
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.
Are they expensive?
Because many white fillings are classed as a cosmetic treatment, you can only have them done privately. So costs can very quite a lot from dentist to dentist. Costs usually depend on the size and type of white filling used and the time it takes to complete the treatment. Costs may also vary from region to region, but your dentist will be able to give you an idea of the cost before you agree to treatment.
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. However, any fillings provided on the NHS are automatically guaranteed for one year.
Is it worth replacing my amalgam fillings with white ones?
Is is usually best to change fillings only when your dentist decides that an old filling needs replacing. If so you can ask to have it replaced in a tooth-coloured material.
Some dentists prefer not to put white fillings in back teeth as they are not always successful. One way around this would be to use crowns or inlays, but this can mean removing more of the tooth and can be more expensive.
What are tooth-coloured fillings made of?
This can vary, but they are mainly made of glass particles, synthetic resin and a setting ingredient. Your dentist should be able to give you more information about the particular material they use.
Where can I get them done?
Most dental practices offer white fillings as a normal part of the treatment they give you.
Are there any alternatives to fillings?
Adhesive dentistry is another form of this treatment. This involves bonding the filling to the tooth. The dentist has to remove less of the tooth, which is obviously better.
As we have already said, there are alternatives such as crowns and inlays although they can cost a lot more. Veneers can be used on front teeth instead of crowns or fillings.