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!!

Mrs Morton - I have a question!! I have noticed that my 4 year old Dd has a split frenum (I think that's what it is). The gum above her front teeth goes in between the teeth and is not smooth across like my other dcs / mine. The lip is also more attached to the gum than it probably should be. We have a dentist appt next week, but do you know how this could be treated?

It can be treated with. frenectomy if necessary but there's no hurry whilst she's still so young. Cleaning the teeth next to them can be tricky so try to pay extra attention. No need to worry.

I've found reading through this thread really helpful. Your posts have cleared up lots of questions I've thought about, thank you

Mrs Morton sorry if this has been covered before but my 17 year old DD went to her dentist last week with tooth ache, after an X-ray she was told she has an infection in one of her molars and needed antibiotics. The dentist said she could then return for either root canal or have her tooth removed. Unfortunately I didn't go with her as my DD got a bit confused as she thinks her roots are at an angle and the dentist said it would be difficult to do root canal and she would probably have to see a specialist. I'm not sure what to recommend to her really, what would your advice be? Thanks

MrsM, I'm just going to say thank you to you while I see you on this thread because I thought pm-ing would be a bit weird! You were very helpful to me on my slightly panicky thread about my wobbly false tooth on a Maryland bridge and being away from home for a year. I went to a cosmetic dentist in the end (a friend recommended them) and they basically took out the false tooth, took all the bonding off the back of the canine, and then re-bonded it. I went back to my own dentist last week, and he said they'd done it brilliantly - I'm so pleased you told me to go and talk to them about what I wanted - while they did talk about an implant being better long term they were happy to replace the bridge when I explained why

There was one funny bit - the false teeth and strip behind them are all composite (no metal). The dentist had never seen that before, so went and fetched a parade of people in to look and ask me questions!

Also, can I ask a question please? It's just interesting me and google hasn't helped. (And I've only just been to the dentist, so might forget to ask by my next appointment!).

How exactly do roots work? Odd question I know

My adult canines knocked out my baby laterals, and I know from my pre-orthodontic x-rays, the tooth and root weren't in a straight line - the root was sort of diagonally inwards, then the tooth went straight down. Those were then moved back to their 'normal' position and the gaps filled with the aforementioned Maryland bridge. So, how did the root unkink?

Thank you. I looked up frenectomy - is that just the removal of the skin that hangs too low? I'm not sure if this is the same thing, but my dd's gum seems to be in two halves (seems best way to describe it) - it's like both halves end in the middle between the front teeth and you can see and feel a big dip in if you look at it. I thought I read something about the muscle needing connecting together?

polka erm, no idea. I can't quite work it out. Which tooth and root? Which way we're they pointing? How bent were they? "Baby" roots generally resorb away, sometimes even without the adult tooth.

stompy can you post a pic? The frenulum is a pretty major attachment that goes upright into the bone, I'm guessing from your description that it's causing the gum to look different?

Hope you don't mind me jumping in and asking a question....?

..?

Her gum definitely looks different - it goes right in between her front teeth. will try to post a pic tomorrow.

Sorry, I'll try to be more precise! It isn't really important, just something I was wondering about

My adult canines knocked out my baby laterals. My teeth went (working in) premolar, baby canine, adult canine, central incisor, then the same on the other side (nice and symmetrical!).

On pre-orthodontic work x-rays the roots of the adult canines started in canine position, but sloped in towards the middle because the teeth were one position further in - imagine ten to six with the hour hand as the tooth and the minute hand as the root. (Does that help at all?) The roots passed over the top of the baby canine roots.

The baby canines were taken out (both a bit wobbly anyway) and the canines moved to their proper place and false laterals added. So I presume the roots must have rotated or unbent in my jaw somehow? But how? Does bone even work like that?!

Sorry, didn't realise you'd replied.
I had a tooth infection which required 2 lots of antibiotics then eventually was removed. It was pretty straight forward apart from taking a lot of numbing.
I've been in agony with my jaw ever since...numerous painkillers even oramorph were not touching the pain.
Returned to the dentist and he suggested that my jaw had gone into a spasm and that my teeth clenching is possibly making it worse. A trip to A and E later that night because I really could not cope with the pain and I'm now taking codeine, paracetamol, ibuprofen and diazepam. That just about helps me sleep and takes the edge off.
At times I can barely open my mouth the pain is my ear cheek, all around the jaw and my front teeth ache.
I also get the sensation that I'm dribbling on that side when I talk but I'm not.
Do you think he may have damaged a nerve during the injections?
I'm back to see him on Thursday but I was told to only do the medication for 3 days...the 3rd day is today. I really cannot see me being able to cope without them.

What tooth was it and what timescale are you talking about? Doesn't sound like nerve damage from what you've said.

Sorry, just re-read. Is the problem opening your mouth or is it always painful?

It was the last tooth at bottom right.
Had it removed last Wednesday.
The pain is there constantly but sometimes worse than others. When it's at it worse is when I can't open fully.

The opening issue is called trismus and is a well recognised adverse outcome of both local anaesthetics in the lower jaw and removing wisdom teeth (assuming that's what was removed). It's caused by trauma to or bleeding in one of the muscles on the inside of your jaw at the back there.

Tell me more about the dribbling feeling. Can you whistle for example, is there any numbness or tingling of your lip on that side? Has it changed at all since the anaesthetic wore off?

You have had jaw surgery and aren't even a week down the line. The mouth is a dirty environment and healing can be prolonged, particularly in the lower jaw which has a fairly poor blood supply.

It's fairly difficult to damage nerves during injections because it's painful and patients jump, repeated anaesthetic injections possibly make it more likely. Any damage is almost always temporary as it would be incredibly hard to totally divide the nerve during injection, it is possible to nick the nerve sheath and cause bleeding in the area which can compress the nerve, causing some altered sensation until the bruising disappears.

Thank you.
Only just been able to get back on.
Wasn't a wisdom tooth as they've already been removed years ago.
I can whistle but when I talk I feel like I'm going to dribble out that corner of my mouth.
No numbness or tingling but sometimes sudden shooting pain near where ear and jaw meets.
Otherwise just full general ache all around now, some difficultly chewing also.

its very rare to get permanent issues after this anaesthetic so give it a bit longer. Sounds nasty but my money is on it improving. You've got a review appointment?

Just testing whether I have changed my username successfully....

I did! I will ask my question.....

Hi MrsMorton I'd be really grateful whether you could let me know whether dentist training includes how to deal with patients with phobias that stem from childhood abuse? I worked really hard to get over my issues, but had a massive panic attack during my last visit to the dentist and haven't been back - it is 5 years now. I feel so ridiculous (I'm in my 50s).
Thanks

silvercat not specifically when I trained but most dentists will have come across that as an issue IME. That doesn't mean that most dentists will be able to deal with it so it could be worth finding someone who specialises in phobic patients. SAAD is a good start, have a Google. They're all about anxiety and not necessarily just drugging people but about hypnosis and treating the phobia.

Good luck.

Thanks very much.

Yes, I'm back on Thursday.
Yes I'd say it is improving. Not as many painkillers needed today.
Thank you so much for you help.
It's appreciated