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!!

Hello.

Can I please ask a slightly ridiculous-sounding question?

How much damage can be done to teeth in a week?

DS (8) doesn't have the best enamel. One of his adult molars has had to be fissure-sealed, and another may have to be at some point. I am consequently pretty careful with diet, brushing, etc., and so far he's going OK (no fillings).
However, he's going to stay with his grandparents for a week, and whatever I say to them (and them to me), I know he will be snacking on biscuits and fruit juice for a week.
Will he come back needing fillings?!

Many thanks in advance.

A week isn't long enough for a healthy tooth to develop problems like decay. Make sure he keeps brushing!

baddz it sounds within the bounds of normal to be honest but you're a grown up, you can decide if you're worried enough to need to see someone. Its not keeping you awake at night or stopping you working is it?

Thank you
It's ok unless I try to eat, yawn etc
I will.keep on.with the paracetamol.
I.was.worried.as.dh is away with work.atm and wondered.if I needed.to get it seen.before easter hols
Very odd though...never had this.before....

MrsM I have a question if I may. I have a partially erupted wisdom tooth that is partially covered by gum/ bone. All initially thought to be straightforward, was referred to dental hospital to have it out under sedation as I have severe asthma/ allergies.

Went to the dental hospital and my risk profile for biphosphonate related osteonecrosis was too high for the tooth to be removed so they are goingo to cut away the gum covering the decayed wisdom tooth and try to fill it.

I just wondered if you had come across similar treatment and what I could expect with having the gum removed. I'm on high dose steroids and don't heal that well normally but I'm hoping this will be ok. What kind of healing time is normal for this kind of procedure and is there anywhere that I can read about it?

Thank you.

No idea on healing time for someone on steroids. I treat a lot of professional musicians and we do this fairly frequently for wisdom teeth that we would just take out of anyone else due to the very small but existent risk of nerve damage. It could be career ending for my musical folk who are difficult to treat at the best of times .

The gum cutting doesn't tend to be too sore to be honest, uncomfortable more describes it IME. You could google operculectomy which isn't precisely the same procedure but involves removing the gum bits around the tooth.

That's good treatment you're getting!

Thanks MrsM I will go and have a read. That sounds like the word he was using. I was expecting to have an argument regarding sedation that I wasn't expecting to be told they couldn't take the tooth out!!

I think I got lucky that the head of the oral surgery clinic I was referred to specialises in BRONJ and seems to have taken an interest in trying to help. Always helps to find someone who has a particular interest.

Thank you very much :-)

BRONJ will be massive I think before long. Everyone who is put on the drugs should have their teeth checked beforehand just like they should when they require head and neck radiotherapy, extract the dodgy ones before they cause problems to save months of agony and lots of NHS resources. We aren't very good at joined up medicine sometimes.

No - dental and medicine seems to be a particular issue for joined up care. For instance my dentist is determined that I have a biphosphonate holiday, my GP is horrified at the thought given the amount of steroids I take. I have suggested they leave it to rheumatology to sort out .

Hopefully with more awareness people will get their teeth checked first. In fairness I didn't have wisdom teeth when I started biphosphonates 8 years ago but it's definitely something that Drs need to be made aware of. Every one I have spoken to has dismissed it as some kind of one in a million risk!

Bisphosphonate holiday won't help, they get into the bone and can cause problems even after stopped. IV more risky than oral I believe.

Hello Mrsmorton, brilliant thread.
I've read most of it but can't wait anything on sedation.
Can you please tell me how I can find a patient NHS dentist who would do sedation for free? I used to live in Edinburgh and they gave nervous patients a valium there, for free, England is another matter and I'm going round in circles with all sorts of info.......... Thank you.

Also.... I read your post about rinsing after brushing, and I was totally shocked about the NOT rinsing with water. Why are we all told to rinse with water? How about mouthwash? This is getting soooo confusing.

I meant 'can't find'.

Have you asked your current dentist? You can be sedated by tablet but it's not really recommended. Some PCTs have sedation clinics, if you're on certain benefits this would be free, otherwise you'd have to pay. Unfortunately, not many PCTs or whatever they're called actually commission sedation services and a private dentist won't do it for free.

If your dentist doesn't know, you should find out who is the dental lead at the PCT and ask them if there is any provision for it in your area.

Whereabouts in the UK are you and what treatment do you think you need?

Mouthwash is pretty useless in almost every case. Spit, don't rinse, and unless specifically recommended by your dentist, don't bother wih mouthwash.

Why is sedation by tablet not recommended? What's a PCT?

I'm in Devon and I need fillings probably. Maybe root canal I don't know.

Why is Corsodyl useless? Why are we all told to rinse from a young age?

Is IV sedation safe and does it really work? Does it really lift anxiety?

It sounds like you haven't even had a check up? Perhaps that would be a good place to start and you can ask your dentist all of these questions. Or do some googling.

Why are you so unhelpful all of a sudden?

I started this thread to give general dental advice/info, not to replace your own dentist or try to work out why we did things differently in the past.

The very best thing you could do is have a check up and as your own dentist about sedation. I think I'll hang up now, I've pretty much answered most of the common questions and being pestered by pm to come and answer things that could be easily Googled is a bit tiresome.

Thank you for the thread MrsMorton. I've found it very useful and the advice not to rinse because it just washes away all the fluoride you've just put on makes perfect sense

TerrifiedPanda - this is why we can't have nice things. Shame on you.

sleepy

I hid the thread but don't know how to unhide it

Hi
Firstly what a wonderfully helpful thread, thank you so much!
My question is regarding loose teeth
I suffer from severe depression, I don't look after myself ( I won't go into detail as it's very embarrassing) but my teeth have not been looked after properly for some time
I had a loose middle bottom tooth which has recently fallen out-I am devastated, I'm only 47
The remaining teeth either side are now also wobbly one more than the other
I am so embarrassed to visit the dentist.
Is there anything the hygienist or dentist could do to help me save these teeth? I am aware that I should have been taking care of them, if they are that wobbly can they be saved?

Hi mrs Morton can I ask you a question please

I had my wisdom tooth extracted lower and growing sideways last Tuesday. Two days later I had a bone start sticking out of my gum right at the very back of my mouth behind where my wisdom tooth was.

My dentist decided to shave this off as it was causing me pain and this was done yesterday. However today I have a feeling of a swollen throat and chest pains.

Is the swollen throat just from the inside of myouth being swollen. I am wondering if the chest pains are because I was very tense whilst they were doing it.

I also swallowed some of the pain during the procedure as I felt like I was gagging and could not help it and I feel like I have something trapped iny oesophagus could this have happened or is this just my anxiety?

Sorry should say swallowed bone