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Dental Chronicles

455 replies

Mrsmorton · 12/02/2015 20:17

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!!

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Mrsmorton · 17/02/2015 20:36

Glad you inspired DH. We have to set an example!

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somepeoplearesomean · 17/02/2015 20:57

ooh that sounds brilliant Mrs M!
Wish you were my dentist! I think that is the secret to not being scared, have a lovely dentist you can trust!

ICallConnerie · 17/02/2015 21:08

I have an odd question...

I had hyperemesis with my pregnancies and my teeth have suffered enamel damage because of that. But my question is regarding my children's teeth. Recently a friend was told her sons teeth are bad because she had hyperemesis during pregnancy and it effects their teeth. Is there any truth in that? I guess I could kind of understand that bad nutrition intake in the first months of pregnancy may effect things...?

And s an extra bonus question... Are you seeing more adults having orthodontic treatment like braces now? Are teeth still 'movable' as an adult?

Mrsmorton · 17/02/2015 21:15

I don't do masses of childrens dentistry. Only emergency work really. The deciduous (baby) teet start to mineralise (the enamel forms) at about 15 weeks gestation and finish not long after birth. A couple of months.
So I would expect that if you had severe HG, it could affect the teeth forming in utero. I'll have a look at some research!!

Yes to adult ortho, we all want Hollywood smiles now and people get their teeth shuffled around in their 50s and 60s!

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GwenStacy · 17/02/2015 21:31

I've got awful, awful enamel which I was told was down to my mum being ill when she was pregnant with me. My teeth are all ridgy and the enamel is really thin apparently.

Mrsmorton · 17/02/2015 21:39

The adult teeth aren't forming in utero gwen so I'm afraid that's not true at all. IIRC, the permanent incisor begins mineralisation not long after birth so it's all post natal development.

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McKayz · 18/02/2015 07:22

How does the NHS work when it comes to dentists?

I was due a check up last month but can't be seen until April as my dentist has filled his nhs quota for the year.

I got my tooth out yesterday. The relief is immense. No pain! Smile

Mrsmorton · 18/02/2015 08:07

A dentist is paid a fixed amount of money to deliver a fixed amount of dentistry every financial year. Once they've used their quota of work, essentially the money has run out and they would be working for free.

There will be other dentists who haven't used their quotas and would be happy to see you if you phoned around.

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GwenStacy · 18/02/2015 08:07

Oh! That's what my dentist always told me :( just crappy luck then I guess!

DamFineBeaver · 18/02/2015 08:50

MrsMorton, this is such a great thread - thank you Flowers

May I ask a question, please?
Is it possible for adult teeth to improve after they've already emerged through the gums?
DS has had some discolourations on some of his since they came in, so I've been obsessed with assiduous about brushing (electric toothbrush, lots of fluoride toothpaste, no rinse), diet and xylitol chewing gum after eating.
And, to my delight, they seem to be looking better (and no fillings yet). Can enamel actually improve over time, or is this wishful thinking??

Many thanks again for all of this.

Mrsmorton · 18/02/2015 08:59

If the discolouration is extrinsic (on the outside) then yes, without question things can improve. Often children's adult teeth look rubbish next to their permanent ones as they're much yellower. Must sounds like you're doing really well.

If the problem is intrinsic then it can be improved with treatment at the dentist like micro abrasion or some other treatment the name of which escapes me.

Good work on the electric brush, fluoride and xylitol!! Good teeth are a gift that we can almost always give our children.

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DamFineBeaver · 18/02/2015 10:42

Thank you MrsMorton.
I have to say, I've learned more from MN on how to look after teeth than I've ever learned anywhere else.
I suspect DS doesn't have the best teeth genetically/developmentally, but I'm doing my utmost to do the best with what we have.

booksandchoc · 18/02/2015 12:26

Mrsmorton what do you think of this gap in DDs teeth? She has only turned three but still has a dummy and I think this may have caused it. I'm going to take her with me to my next check and ask the dentist but that is months away. Thanks for the thread!

booksandchoc · 18/02/2015 12:27

Sorry, by gap I mean the gap in her bit.

booksandchoc · 18/02/2015 12:27

*bite!

Mrsmorton · 18/02/2015 12:52

Yikes. That's a big open bite. It's probably from the dummy and if it is it will resolve quickly once the dummy stops.

She's only Young, problems tend to occur when the adult teeth are coming in (6 years usually) and the habit is still there.
But that's a big discrepancy, might be time for the dummy fairy... As long as the thumb doesn't replace it...

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Maomoo · 18/02/2015 13:30

Great work Mrs M!

booksandchoc · 18/02/2015 13:35

Thanks Mrsmorton, it's a work in progress but will definitely be soon.

Buttercupsandaisies · 18/02/2015 15:34

I've Pm'd you op if that's ok....my child's tooth problem would identify me I think!

Mrsmorton · 18/02/2015 21:10

Dry socket seems to be a recurring theme on here so...

Dry socket or acute alveolar osteitis occurs when the clot in an extraction site doesn't form properly or is disturbed. It happens as frequently as one in 20 extractions and the risk factors are:
Difficult extraction in the
Lower Jaw in a
Smoker who is taking the
Oral Contraceptive Pill

It is very common after the extraction of impacted wisdom teeth. The symptoms are pain, generally throbbing in nature and a bad taste or bad breath.

As the name suggests, it is an inflammatory condition, not an infection which is why antibiotics are often not the first choice of treatment. What usually happens is that the socket fills with food, badly formed blood clot and other mouth detritus. Commonly it is treated by irrigating the socket with antibacterial mouthwash and placing an "obtundant" dressing in there. This dressing (most commonly Alveogyl) fills the socket to prevent food packing, it contains oils which will reduce and sooth any inflammation and it will resorb away once it has done its job.

Essentially anything that disturbs the clot increases the risk of dry socket, smoking, vigorous rinsing, drinking through a straw, poking etc. The lower jaw has a poor blood supply so it is more prone to dry socket as well as the presence of any pre existing infections like acute gum disease (like a condition called AUG), infected wisdom tooth etc. No "normal" dry socket should last for more than a month, if pain or healing is prolonged this much then there is likely to be an additional factor involved.

When the dressing is placed, the main effect is to soothe the pain, it won't speed the healing as that will only occur as fast as the gums can repair themselves so if a dressing comes out then if the pain is manageable, you don't necessarily need to return to the dentist.

A point to note, this condition is described in textbooks as "exquisitely painful".

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Masterchuff · 18/02/2015 21:13

MrsMorton I have been directed here from chat. I have a question. I had an upper wisdom tooth removed on Friday. My dentist said it was tricky but it came out in one. Since then I have developed dry socket and an infection. (I followed her advise to the letter just unlucky I guess) I have antibiotics and the socket has been packed at lunchtime today but some of the packing is coming away. Is this normal? I have another appointment in a week.
I think this thread is amazing. You're going above and beyond here and thank you in advance

Masterchuff · 18/02/2015 21:14

Ah, immense cross post there

Masterchuff · 18/02/2015 21:16

Thank you for answering my question before I'd even asked it. Off to bed now with painkillers amd hoping not being able to open my mouth will help the waistline

Mrsmorton · 18/02/2015 21:17

I anticipated your arrival!!!

Dry socket is fucking shit. Some people get it for no reason at all and my heart goes out to them. I hope it improves soon.

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Masterchuff · 18/02/2015 21:20

Thank you. It must be bad as DH is being sympathetic