is my dentist short changing us??

[mumblemumhome4lunch]

We've just been for our family check up and I'm not convinced we are getting what we should from these visits!

My previous dentists(different area, pre-children) always used to give me a clean, using a brush and toothpaste as well as scraping any tartar off, and used to periodically xray my teeth.

Our current dentist just removes any tartar, counts your teeth and thats it. Nothing else at all. My kids (7, 5 and 3) have only ever had their teeth counted, nothing else. She has told us our eldest has weak enamel on one of the adult molars he has through now but given no more advice than 'make sure he brushes it well, it will probably need filling at some point'

I'm feeling rather let down but not sure if I'm expecting too much from the NHS service?!

Anyone got any advice??

Thanks

Why would you want your dentist to periodically x-ray your teeth / head unless you had a problem?

If your dentist is removing tartar from your teeth and telling you that your eldest has weak enamel, what more can be done? She has already diagnosed a problem and is observing the changes, and presumably will act when a cavity forms and needs filling.

I presume your dentist has already enquired about your health issues, dietary arrangements re sugar intake and what strength toothpaste you use for fluoride content etc?

I used to have a private dentist and now use an NHS one but haven't noticed and change in service / chair side manner!

I hope she spoke about diet with you, especially for the eldest with weak enamel.

Basically:

• NEVER brush teeth within 15 minutes of having eaten (at that point enamel is softened and you just brush it away, very bad indeed)
• combine all bad (for teeth this is) foods, eg fruit/fruit juices/sugary foods etc. don't leave the baddies to the end, end the meal with a piece of cheese to neutralise the acids
• better to not have to many meals as each meal results in an attack on the teeth, so no grazing during the day. If he must eat a big with sweets then it is better to eat them all at once then to spread it out over 1-2 hours.
• if you have to leave the house within 15 minutes of having eaten (and thus cannot brush teeth) then rinse teeth well with water or Colgate Fluoriguard AF
• at school after having eaten fruit/sweets tell him to rinse mouth with water or if that is not possible then drink quite a bit of water

You may want to discuss with dentist if painting the weak molar with fluoride paste would help to strengthen it.

I don't think your dentist sounds very good, but I also do think that you do not want any unnecessary X-rays taken.

All children between 3 and 18 should receive an application of fluoride varnish every 6 months - up to every 3 months if they have a high caries risk. This protocol is fairly new, but your dentist should be aware of it.

It would be particularly valuable on the molar with weak (hypoplastic) enamel.

Decay of this tooth is not inevitable but prevention would require scrupulous tooth brushing and keeping the sugar intake very low.

It is also now recommended that once you have brushed, you should spit out the excess toothpaste but not rinse - the fluoride continues to protect the teeth. Using a flouride based mouthwash at a different time to toothbrushing will give an extra dose of fluoride to the teeth and extra protection. (Dentists love fluoride and want to get it on your teeth at every available opportunity!)

I agree with the comments above, routine radiographs should be based on your risk - current guidelines for low risk patients are every 2 years.