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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!!

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blacktreaclecat · 22/02/2015 08:02

I have a 2.8 year old boy. I'm afraid having his teeth brushed is non negotiable (and I'm a pushover with lots of stuff!) I sit on the bed, lie him with between my legs and brush. If H is around, he tickles him. He is given his toothbrush to finish off when I've done.
I live in fear of him getting a cavity - I 'd be mortified!

elderflowergin · 22/02/2015 09:16

Mrsmorton, I might be being silly as I worry a lot about my teeth but I had a bottom molar extracted on Friday (it was a failed root filling) , and I am still in a lot of pain, is this normal ? I have had toothache since December despite two lots of metronidazole and the root filling,hence having it out and I am worried that it will never stop hurting!! When could I expect it to.stop? I can feel that the gum is swollen , but it looks ok inside. Thank you!

Original poster
Mrsmorton · 22/02/2015 12:18

Essentially, you've had jaw surgery so two days is a little optimistic! It will be sore for a week although after three days it shouldn't be getting worse, only better (or staying the same).

In my experience, if the tooth was symptomatic before the extraction, it's more likely to be sore afterwards but that's anecdote.

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elderflowergin · 22/02/2015 14:48

It is getting slightly better so I am obviously being paranoid! Thanks Mrs M (and for the whole thread as well which is very useful ) Blush

Original poster
Mrsmorton · 22/02/2015 15:25

Good. Be reassured its normal and you'll be fine. A small level of paranoia about teeth is actually a good thing, "a stitch in time" is the truest thing for your mouth!!!

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MegCleary · 22/02/2015 16:06

I have had LR6 Filled last March and the filling came out in jan. The dentist is now saying it will be hard to fill as it is a little below the gum line. He is suggesting try refill, Or root canal which will require more of the tooth to be removed, or an extraction.
He put in a temporary filling two weeks ago. I have no pain. Would it be reasonable to try for a refill and theN Hold the other options in reserve. The X-ray showed minimal infection, I have bad gum disease, had a deep clean in dec and just want minimal intervention at present.
Many thanks
Would a second opinion be worth it, he is very nice but keeps giving options and I do not have the knowledge to decide

PullUpsAreTricky · 22/02/2015 22:49

Meg- if the filling is below the gum line, this will compromise the success of the root canal, as it is essential to be able to get seal. If it has a minimal infection, and you put a seal on it, it could cause an abscess.
We have to give options give pros and cons, its all about enabling the patient!
I'm guessing that the prognosis for this tooth is quite poor, but as its not causing problems its hard to justify its removal.
Also if you have active gum disease, you aren't really a suitable candidate for root treatment. This needs to be under control before definitive root treatment.

MegCleary · 23/02/2015 07:55

Thank you am teary at the thought of this mornings visit. Would it It be reasonable to ask for a Refill and hold the other options for later?

RudolphUcker · 23/02/2015 18:47

Hello, can I ask a Q? My DD (8) hs fluorosis on her upper front teeth. She had hypoplasia on the baby teeth, was treated with fluoride at the dentist and (my fault) anal levels of brushing, which obviously made her ingest more fluoride than we thought.
The dentist says thee's no pitting, but the very top of her front teeth has a brownish line where it joins the gum, and the four front teeth look mottled. Is there any chance this will improve, or can anything be done? I hate the idea of her being teased as a teenager (currently none of her friends have noticed, but I imagine this may change when they all get more image obsessed).

Original poster
Mrsmorton · 23/02/2015 19:25

It won't improve on its own but the dentist may be able to do "micro abrasion" which can dramatically improve the appearance.

This may not be available on the NHS, when I worked under NHS regs I had to apply for permission to do it (prior approval IIRC) but I wouldn't be surprised if there is no NHS code for it anymore.

It's a really good, minimally destructive way of removing the stained enamel, just polishing doesn't work but this treats the tooth with an acid and then uses pumice to remove tiny amounts of enamel, much much much less than a filling for example. It's not painful, needs no injections etc but it does require a good patient... this has some pictures. It may be worth asking your dentist about this?

I used to enjoy doing it because the paste was purple and sparkly Smile

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TeacupDrama · 23/02/2015 19:28

Hi another dentist here, really good explanations Mrs Morton. I work in Scotland as NHS dentist, dentistry in Scotland works differently to England and Wales, as you pay per item not in bands so 2 fillings costs twice one filling etc.
I qualified about 24 years ago though

Original poster
Mrsmorton · 23/02/2015 19:33

That just seems to make so much more sense than our system..?

I don't work for long under fee per item but it seemed so much fairer.

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seoda24 · 23/02/2015 20:53

Such an informative well worth a read thread.I suffer from multiple allergies and am always treated latex free as advised.However, even with these precautions in place I still got a rash from mouth to neck that went down hours later.Happened recently.I don't know what I am coming into contact with as it was just a filling and my wonderful dentist is baffled too.It just adds more pressure on me outside teeth worries! I haven't met anyone ever with such reactions so I maybe alone!!I react to perfume so maybe it's something in the air there....

Original poster
Mrsmorton · 23/02/2015 20:58

Well, there are lots of chemicals floating around a practice Altho most places I've worked in the last five years are latex free. If you're sensitive to anything, a dental surgery is a bad place to be in my opinion.

The advice is normally to go first thing in the morning to reduce the amount of stuff in the air. Other than that... Confused

Must be stressful for you (and your dentist)!

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seoda24 · 23/02/2015 21:12

Thank you so much! Yes I am finding it very stressful and am even advised by my allergy specialist to increase allergy medication before a visit.I am hypersensitive and it starts with itchy eyes as soon as dentist started the last day.She is so patient, an angel and could do without the allergy nuisance/ me!! Many thanks I love reading your posts :0)

OeufieTheEggaphant · 24/02/2015 11:02

Hi Mrs Morton, great thread!
Over the last approx 2.5 years since I saw my dentist I have developed lots of problems. I'm pretty sure one of my wisdom teeth is impacting my tooth, on tooth was filed down to make room for the crown below it and it seems like that's caused it to decay? It's a horrible colour and I get lots of toothache from all of the above but I'm so embarrassed and scared to go to the dentist. My teeth are in such a state and the longer I leave it the worse it gets but I'm so worried about what they're going to say Sad sorry I know that sounds really stupid, I don't know what advice you can give me but thought I'd post anyway...

smee · 24/02/2015 11:51

Mrs Morton, you are a saint! :)

Quick question from me if you've time. I've been seeing a dentist for years, then she took a sabbatical so I saw a newer younger dentist in her place. I went because I had a tooth cracked round a root canal filling - so a dead tooth, but it's been there/ okay for years. New dentist seemed a bit baffled as I've got good teeth besides that/ regularly go the dentist, so asked why I'd never had it capped and said that was usually standard to try and prolong the tooth's life. So now I'm wondering if the old dentist was remiss. She never mentioned capping the tooth. We're all in her care, but I don't want to stay with her if she's basically lost me a tooth..!

Original poster
Mrsmorton · 24/02/2015 12:21

Most dentists would crown a tooth after a root canal treatment. The times when I'm reluctant to do this are: if I didn't do the root canal treatment and I'm not totally happy with it. If the fillings in the tooth are too big already. If I think a patient will accuse me of trying to make money out of them.

Your original dentist hasn't done anything wrong, it's a matter of opinion to be fair, most of us would do the crown. Some of us wouldn't.

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Original poster
Mrsmorton · 24/02/2015 12:24

oeuffie you know what the answer is dont you?

I just want to clear up a myth, wisdom teeth DO NOT cause your other teeth to crowd. They can't move your other teeth, the forces just arent enough. If it was that simple to move dozens of teeth, orthodontics would be easy and quick.

Teeth move during our lives, they generally move towards the middle. It's called mesial drift. Just fact.

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smee · 24/02/2015 13:48

Thanks MrsM. That's really helpful. The new dentist said she would have done a cap as it would have been easy to do and that the root canal work/ filling looked pretty good to her. So on balance it sounds like I possibly wasn't best advised... You're right of course to say it's matter of opinion though.

smee · 24/02/2015 18:06

MrsM, sorry it's me again! A friend's daughter's been told she needs 4 of her baby teeth removed. She's 11. One's due to decay - not sure what the other reasons are. Do you think that's a lot to do in one go and just with a local anaesthetic? She's been reassured that the teeth are already loose and should come easily but her daughter's already quite nervous of the dentist even though she's never had anything done before. She was given the option of having her daughter referred (not sure where to!), but she said no at the time, but now she's having second thoughts. What d'you think as a dentist. Is it v.traumatic or should it be quite straightforward?

Original poster
Mrsmorton · 24/02/2015 18:12

It should be straightforward. We don't tend to plan stress for ourselves. If it would be difficult/traumatic then they would have referred it.

A few minutes under local is far far preferable to a general anaesthetic. Plus the fact that getting GA extractions done costs in the region of £2000 so doing it under local satisfies all of the basic ethical principles!!

Four at a time depends on lots of things but genuinely, we don't want stress and believe it or not, there isn't much that is more stressful to a dentist than a patient who can feel what you are doing to them.

It's horrible!

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Original poster
Mrsmorton · 24/02/2015 18:25

21/02/2015 21:59 bonzo77

if you have the tooth removed, the consequences are a bit unpredictable but can include:

  1. difficulty eating. Most people adjust very quickly and it shouldn't be a problem unless you have a lot of other teeth missing.
  2. Aesthetic considerations: these are personal and can only really be assessed by you.
  3. Movement of adjacent teeth. This occurs gradually over years. The teeth either side of the gap can tilt and drift making cleaning them awkward. This can make them prone to decay and to gum disease as the bone support may be compromised. It can also make replacing the missing tooth in the future more difficult.
  4. movement of the tooth / teeth that the missing tooth used to bite on. This has the same consequences as above, and can in addition make your bite alter.
  5. Bone loss in the area where the tooth has been lost. This is rapid in the first 3 months and then stabilises, with ongoing gradual bone loss. The main consequence of this is that if you want to have an implant, it is best to do it earlier rather than later to avoid bone grafting.

For the vast majority of people who loose a single back tooth the end result is that they remain comfortable long term and they are largely unaffected by the points above. As a dentist myself I would always consider removal an option if I had a back tooth that was very broken down and was going to need many hours and many more £ to sort out with no guarantee of the outcome.

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Original poster
Mrsmorton · 24/02/2015 18:27

Very comprehensive post from bonzo77 on the pros and cons of tooth removal.

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McKayz · 24/02/2015 18:35

By what age generally do you get all your adult teeth?

DS1 was asking me earlier.