Dental Chronicles

[Mrsmorton]

I have noticed a number all of the dental related questions on MN get repeated once a month or so; this may be entirely unwelcome but what I intend to do is to make a series of detailed posts answering the most common questions so that I can signpost posters to an answer. Often they disappear in chat and then resurface.

I am a dentist (that's no secret on here) but I have no way of proving my qualifications and neither do I feel the need to. I hope that this will be of some assistance to someone at some point!!

Why is nothing being done about the gym disease? You may as well pour the mouthwash into the toilet. Unless you're getting professional gum treatnent (dentist/hygienist) then it will make no difference. The teeth are moving Bcse of the gum disease. You do not want lower full dentures.

Not too concerned about the lower teeth its the top that worries me.
TBH my dentist was all over me like a rash when he thought I might upgrade to the more expensive dentures and did mention giving me something for the gums( not sure what).
Completely changed his attitude when I told him I couldn't afford them so had to go with the NHS dentures. Gum treatment not mentioned again.

Yes, I tend to switch off when people start slating their dentists. Get the gum disease treated, find another dentist if you need to.

I am very lucky with my dental practice. The only filling my DS had (the shame! the shame!) he was quite small, and I watched his hands on the dentist chair armrests, and he never clenched them once as the drill went, that's how relaxed he was there. It was amazing.

That's great annie stick with them!!

I will! It's amazing watching kids who don't realise that it's traditional to be scared of going to the dentist, as they've only ever had good experiences there.

That's they key. It's traditional and IMO a bit silly to say you're scared despite (like some of my patients) never having had any intervention let alone a bad experience. Tiresome and frustrating for dentists as well.

It's so important not to pass this on and I send parents out when they start reacting!!!

Hi mrsmorton. Great thread thankyou. But I had to bring up something you said at the beginning....
'The only thing that causes tooth decay is fermentable carbohydrates, e.g. sugar. This is digested by the bacteria that live on the teeth and attacks the enamel. Some enamel doesn't form properly and isn't as resistant to this attack and some saliva is better than others but still, without the sugar, the decay simply wouldn't happen.'

That cant be 100% true as tube fed children get tooth decay. Often pretty badly as their tongues dont move in their mouths. My son has never had food in his mouth yet we had to cap 6 of his baby teeth due to serious decay by aged 5 (molars). Now he is getting adult molars how can we prevent decay?

That's interesting clock the research (on rats) says that tube feeding absolutely prevents dental decay (even in the absence of saliva) but nothing is mentioned in there about issues such as reflux. Without sugar, decay can't happen, I don't know enough about tube feeding etc to even make an educated guess. What the guidelines say is that oral hygiene is even more important in tube feeding, as you say due to the muscles in the cheeks and tongue being inactive.

Speak to your dentist about preventing decay in the permanent teeth. Generally when children have had decay in their primary teeth, they should automatically get sealants put on their adult teeth as soon as they are sufficiently erupted. Fluoride mouthwash and toothpaste also (prescription toothpaste from age 8). And a good lesson on how to brush properly.

I have a two questions please!

1. I have gum disease. I brush my teeth twice a day and on advice from my dentist moved to an electric brush. I floss using dental tape at least once a day (not usually twice because if I am brutally honest I hate doing it). My bottom front teeth are crowded and I really struggle to floss but I do do it. I don't think my dentist believes me because last time I was there I got a lot of skeptical looks when I said I was flossing. What can I do to improve the calculus build up behind those teeth? I've had a deep clean twice with my dentist, which involved a lot of local anaesthetic and I am TERRIFIED of needles and want to avoid it again.

2. I have a little boy who is about to turn three. I've taken him to the dentist twice. Both times he has refused to open his mouth. At home we play being dentists and I let him look in mine. He'll open his mouth for me and for friends etc. We brush his teeth twice a day but we've never been able to get the dentist to look at them. How do we get him to open his mouth for her without prising his mouth open? (We don't do that by the way - she just doesn't get to look).

Have you seen a hygienist? IMO they're far better than dentists at education etc (far better than me anyway!) you will have to pay privately but they really are well worth the money. Mine have always been wonderful and great hints and tips.

Give your son time, he will get there. Don't make it a massive thing and don't bribe him. Children generally associate bribes with unpleasant things and so infer that the dentist is unpleasant...

I'm on a course and a little bored hence my instant replies today... Im usually busy!

Yes, I see the hygienest between dentist appointments. So hygienist, three months later dentist, three months later hygienist, three months later dentist and so on.

And thank you for the tip re my little boy. I try not to make a big deal out of it and hope he'll get there.

MrsMorton, thank you for your previous advice. My gum seems to be healing now and doesn't hurt as much- just dull, low-level pain. Still can't chew with that side. Anyway, just a quick question please- the healing socket is all grey coloured, is that normal?

And another question, pure curiosity- having looked at the leaflet that came with my antibiotics, it said that they can also be used for gonorrhea and syphilis. So I was just wondering- if you didn't know you had an std, would these ab's treat it as well as the primary infection that they were prescribed for? Or would it depend on the dose/ length of ab's course? There were other infections mentioned too, but std's just kinda stood out more .

Yes grey is normal.

The ABs don't know what they've been prescribed for so as long as the dose and course length were correct, they will affect the bacteria that are susceptible to them. An added bonus I think you'll agree.

That is rather amazing. Thank you Mrs M!

Thanks mrsmorton. We're planning to have them sealed asap. The paediatric dentist comes over to theatre for a good rummage when he's under a GA for something else and last month the molars werent fully erupted. More surgery in a month so hopefully they will be done then.
Our latest scare was seeing him choke (he has no swallow) and prising open his mouth to see a large baby molar tooth sat on his tongue. Luckily I managed to hook it out!

Yikes.

I'm impressed with joining up GA sessions, it doesn't always happen.

I make them email each other. One time the ENT consultant forgot so I ran down to the dental hospital and found a paediatric dental registrar much to her surprise
We often have 4 different procedures done at once to minimise GA's. He's under about 7 times a year at the moment.

We try to do it but dentistry is an unwanted child of medicine sometimes so we get ignored. I bet the registrar was chuffed to help!!

Following on from something said further down the thread, what's the best way to deal with a child who is genuinely scared of the dentist? My son had a bad experience with a grumpy dentist not long after an operation (not dental) and now tars all healthcare professionals with the same brush.
I take him to the dentist (not the grumpy one!) along with his siblings but he flatly refuses to get into the chair or open his mouth to have his teeth counted. He has a damaged front tooth from, we think, knocking it when he was toddling and I would very much like the dentist to have a look but he's completely against the idea and I don't want to waste the dentist's time by having him refuse time after time, or to make it into a phobia by taking him, having him yell and then going home. Thanks in advance and thanks for this thread. It's brilliant!

How old is he?

I'm a great admirer of yours Mrs M, and this thread is fascinating (speaking as someone who has "complex" teeth) A question on behalf of my son, aged 23, who has problems he can't seem to solve. He had very crooked teeth as a child and had a brace fitted, which worked very well and resulted in straight teeth. Almost at the time his treatment was finished he got kicked in the face by accident playing football in a school break. This resulted in a dead tooth which was root canal filled and bleached at the time. 10 years on it is now out of line with the others and has gone dark again, it seems to be small and tilted back. it is making him quite self conscious. He has seen a dentist in Poland where he is studying this year and they say that the tooth is now so much out of line a veneer is not an option. They also said the root canal wasn't done very well. There was some mention of another brace ( language difficulties meant he didn't quite understand this) but surely this wouldn't work on a dead tooth? Do you have any idea of the best way forward? Any ideas much appreciated.

Four and a half.