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Original poster

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!!

OP posts:
Original poster
Mrsmorton · 19/02/2015 16:54

gatekeeper the pp wasn't posting about the midline diastema, it was about the open bite which has a different aetiology. Glad it's closed tho!!

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Original poster
Mrsmorton · 19/02/2015 16:59

lamilly root canal treatment is very much available on the NHS. She's being naughty! Unless it's very complex and needs referral to a specialist then it's available on the NHS.
I just googled NHS dental treatment and the first link covers it all.

untamed Google halos and horns toothpaste, that's sls free. It's fruit flavoured but good for children!! Some sensodyne toothpastes are SLS free if you'd prefer mint and the prescription duraphat toothpaste is sls free but only on prescription.

HTH!

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FuckitAndStartAgain · 19/02/2015 19:02

Me again, would night guard etc be available on the NHS? I don't mind what it looks like just don't want any more cracked teeth!

Original poster
Mrsmorton · 19/02/2015 19:04

They are something of a grey area on the NHS, bite guards. They are also expensive as they attract a band 3 charge of £219. It's often cheaper to get them done privately but your NHS dentist isn't really allowed to tell you that.

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fairgame · 19/02/2015 19:21

My mouth guard was free on the nhs fuckit
However i've just had to fork out £450 for DS's brace or wait a year for it on the nhs so swings and roundabouts really.
I've just been looking at the sleep right ones which might work better for me as there is less of it than my current mouthguard.

jasper · 19/02/2015 20:40

mrsmorton you are a saint !
I'm a dentist too and used to to post in mumsnet loads in answer to dental questions but I am too old and tired now so I am guessing you are young and fresh!

I agree with everything you say and it is great to hear myths dispelled.

I am curious as to who you don't extract many teeth in the OOH clinic.
I do lots of OOH sessions and extract teeth in over half the patients I see.
most of the others are pulp extirpations .

there's the occasional Trauma, arrest haemorrhage , dry socket, pericoronitis , but the vast majority are irreversible pulpits or abscess where I give them the options of extraction or pulp extirp if they understand they have to go back to their own dentist to complete the job .

of course if they have an abscess or are swollen they are often under the misapprehension that they need antibiotics for a few days ( a myth largely spread by time rushed dentists ) but I am an expert on painlessly removing teeth from even the most swollen of faces !

Original poster
Mrsmorton · 19/02/2015 20:54

I don't extract them largely because the x ray developer isn't very reliable and we have no surgical kit (it's a kids GA assessment centre when it's not being used for access) so if something breaks then I'm fucked. I do surgicals in my normal surgery though, I'm not scared of them I just don't have the time or the patience to be digging around after roots without the proper kit!! I do simple ones like upper 8s and retained roots but otherwise, mostly extirpations with the odd interesting case. An 82 year old man who pierced his CoCr right through his tongue for example. That was fun!

Im ten years into my career, is that young and fresh? I don't feel like it but on here, the posts that say "you've got an abscess" and "you need antibiotics" just piss me off so I'm on a mission to educate!!

I'm actually trying to make a career move away from clinical dentistry, it's just not floating my boat, never really has, and the thought of 30 more years makes me want to cry...

Thanks tho jasper nice to have some validation from another dentist! Waves at armani and bonzo if she's around.

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bonzo77 · 20/02/2015 07:52

Yup I'm here. Really not enjoying my work either atm. But have temporarily solved that problem by getting pregnant, so have more maternity leave coming up, followed by more part time work. Actually I think ooh could be my thing. I love diagnosing and relieving pain far more than treatment planning (better at it too) and the hours would suit.

bonzo77 · 20/02/2015 07:53

Oh, I qualified nearly 14 years ago, and yes, 30 more years of clinical dentistry makes my heart sink.

30062015 · 20/02/2015 08:44

Hello Mrs Morton
Is it possible to have white fillings / crowns on nhs - my dentist says no and that the fillings are £120 each _ I am mature student on a low income so have an exemption certificate-she insists that it is only the silver that I could have at no cost- is this standard? Thank you

queenrollo · 20/02/2015 08:45

Mrsmorton would it be ok for me to PM you?

Original poster
Mrsmorton · 20/02/2015 09:05

White fillings on back teeth are a cosmetic choice. NHS treatment is there to secure your oral health and this doesn't include unnecessary cosmetic work really. On front teeth then absolutely, white fillings are available on the NHS. On back teeth then no not really.

Often white fillings and crowns arent the best clinical choice if a patient is needing new treatment, metal crowns are less destructive than white ones generally and silver fillings are slightly better at preventing decay. So arguably, it's a better use of public money to provide these options anyway.

If you want cosmetic work, by and large you will have to pay for it. Why do you need new work doing? It's important to address diet and hygiene before starting any treatment plan.

Yes feel free to PM.

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30062015 · 20/02/2015 09:18

Thank you Mrs Morton that makes sense. I have neglected my teeth for a few years as I have suffered from depression, anaemia fulltime student and single parent of two- but my life is back on track now and after a hysterectomy last summer's I now have the capacity to take care of myself better. Currently I am in pain especially when I eat and have opted for soft foods which tend to also be sweet or fatty - for sometime now- but I do realise that I need to address these points - thanks

blacktreaclecat · 20/02/2015 09:20

Another dentist here and I think you're brilliant mrsm :)
I like clinical dentistry though. I was v tired and a bit fed up after 12 years full time NHS but I had a year (actually 14 months) off to have my son and now work 2 days. I do the odd ooh session too and the last one I did, I did 6 xla. I do like endo though, we have protaper next at work now and it's changed my life.
And yes I do it on the Nash- it's at a loss but it has to be done every now and again (and I do advise a crown afterwards for occlusal coverage ;) )
We've run out of udas at work now which is a bit rubbish, I worry about the future of NHS dentistry. Tbh I don't think it has one but politicians want to blame the dentists for lack of access, not the fact that there is no funding and our contract is crackers. (New one will probably be worse!)
Maybe we need a dentists chat thread on mn- teachers have one
Xx

30062015 · 20/02/2015 09:30

Mrs Morton about my 6 yr old this time_ he saw the dentist yesterday and she very quickly made some comments which I got the gist but wanted a better understanding. He is 6·5 now- and has 2 ,adult teeth which aren't as white as his baby teeth
she mentioned that his chewing teeth are discoloured and weak and it sometimes happens if kids have chicken pox- which he did and was 7 weeks early- but she said it might affect his second teeth or he might have teeth removed - sorry it was all very quick and fast and we have just moved to the area so it wasn't a planned appt _ she offered to see him as he was with me and she had a space- could you explain what she meant and how much it will affect permanent set and if there is anything I can do. Thank you

Original poster
Mrsmorton · 20/02/2015 09:45

Adult teeth always look yellow next to baby teeth. Its impossible to say whether the teeth will be affected by illness, (my brothers were by measles) but they can be protected unless they are very badly affected which is rare.

My brother had sealants placed on his back teeth which have protected them, he's got no fillings and he's 34 (or 35, I can't remember).

DSF should have some big molars at the back as well as some adult teeth at the front? It's important to look for these as they appear from nowhere and need extra cleaning. These first adult molars are the single tooth that causes the most toothache in adults justr because we don't brush them properly when they erupt!! (I do have a good paper that backs this up but I've no idea where it is).

It sounds like you should ask to go back for another appointment to discuss everything in a bit more detail?

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DamFineBeaver · 20/02/2015 17:28

MrsM, I find it so heartening to hear that even slightly dodgy teeth can be protected if looked after. 2 of DS's first adult molars have now been sealed, as they had weak bits on them. I'm really pleased to hear that if we look after them well they may be fine even with the weakness. Thank you for posting this!

GwenStacy · 20/02/2015 21:50

How long do you need to be worried about dry socket for? I had my UL8 out on Monday morning - very straightforward, no real pain, swelling or bleeding - and I am super paranoid about dry socket. I'm being very careful to very gently swill salt water round it after eating, no straws, brushing very carefully…

Original poster
Mrsmorton · 21/02/2015 00:25

Five days I reckon and you'll be fine. Upper 8s are low risk for dry socket, not sure I've ever seen one? You're prob out of the woods now

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Original poster
Mrsmorton · 21/02/2015 00:26

Did anyone watch junk food kids btw?

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blacktreaclecat · 21/02/2015 08:27

Watched until first as break so far, then DS woke up.
I'm a Leeds grad so liked seeing Monty and Stephen Fayle - great guys, always so kind and patient (and nice to students, unlike some!).
Felt very sorry for Tallulah. I was a little shocked as well, I know it happens and I sometimes have to refer, but those levels of decay aren't something I see in my practice very often. Probably because I work in a fairly affluent area of Leeds.
The attitude of her mother was awful and I wonder why on earth she went on TV with that kind of attitude, she didn't come across very well!

fairgame · 21/02/2015 08:49

I watched it and was shocked. I used to be a paeds nurse and used to work in the surgical ward on dental days but never was what happened once the kids left the anaesthetic room. Dental days were always chaos, 20 kids in the morning and 20 in the afternoon every wednesday and usually there would be some familiar faces Hmm
I've always let ds have one of those little bag of haribo when he gets in from school. He is a healthy eater, skinny and brushes regular but yesterday I went out and got a load of carrot sticks and cucumber it really freaked me out seeing those teeth being pulled out.
Tallulah's mum was ridiculous. Very immature and priorities all wrong. Watching peppa pig is more important than brushing teeth?? Why not brush while you're watching peppa pig if the kids won't move? Ds can be reluctant to brush (he has asd and is very stubborn) so he brushes his teeth all over the house, I'd rather him do that then not brush at all.
It was very frustrating to watch.

blacktreaclecat · 21/02/2015 18:48

Loving Monty! He is so tongue in cheek to camera "totally not the parents fault, it's just the society we live in"
He's a great consultant and teacher.

PullUpsAreTricky · 21/02/2015 23:05

ah but Monty has aged loads... ( or I have) - now thats showing my age!

McKayz · 22/02/2015 06:08

How do you get reluctant toddlers to let you do their teeth? DD is 2.5 and just closes her mouth and screams. She's quite happy if I give her the toothbrush to put it in her mouth but she can't be doing much to clean her teeth.