Live webchat with dentist Dr Anthony Zybutz, Monday 8 Sept, 1-2pm

[GeraldineMumsnet]

Hi, we've got Dr Anthony Zybutz coming in on Monday 8 Sept to talk all things teeth. So if you've got any concerns about your kids' oral health or want to know how to stop the rot in your own teeth, come and join in between 1pm and 2pm. Dr Zybutz, who is an experienced dentist with a practice in Harley St, has two children of his own, aged four and six, so is familiar with the challenge of ensuring children clean their teeth properly.

As always, if you can't make it on the day, please post your questions here in advance and we'll try to ensure as many as possible are answered.

[Peachy]

A question please.

My 8 year old fell and snapped his teeth at school, diagonal snaps (about a third of tooth heigt) on both adult front teeth.

We cannot get a dentist (not even taking for waiting lists here now), and the community dentist won't see him as he is not in pain (he is autistic in a mildish fahion, doesn't really do pain).

Is there likely to be any long term damage from the snaps? Or just cosmetic?

[carolt]

Hi. Another question - my 8 year old has overlapping teeth at the front where the new tooth came through but the old one did not fall out - so she just has 2 teeth, one in front of the other, where there should just be one.

It's been like this for 1.5-2 years now. Taken her to 2 dentists, 1 shortly after the second tooth came through and 1 a few months ago, who both said it was OK and the old one would just fall out naturally in due course.

But it's now coming up to 2 years and the old one isn't even properly wobbly! Very concerned about the state of the new tooth, as obviously food must get stuck in between the 2 teeth, and there is no way to clean between them. Surely we should have the old one pulled out! Please advise.

Second question. Same daughter's teeth are v yellow - she hates the taste of her toothpaste so uses it as little as possible or not at all (she hates mint, as do all my kids) - used strawberry flavours etc when she was younger, but can't find anything suitable for her age range. Can you recommend any other non-minty toothpastes?

Thirdly, is there anything you would recommend for kids who don't brush their teeth well enough/use enough toothpaste? eg think I have heard of some sort of painting their teeth with something fluoridey or something? Anything that can be done?

Thank you!

[clontarf]

What do you think about fissure seals?

[ruthhaasbb]

My daughter had a cavity in her molar at the age of 4. I was devostaed as I take oral hygiene very serious.
She grindes teeth during the night, could this have an effect?

[ruthhaasbb]

Why is the general advice in the UK to brush teeth twice a day, wheras in Europe you are told to brush teeth after every meal?
(We learned at school in Switzerland 'everyday after every meal don't forget to brush your teeth')

[petitmaman]

Same as Ruby slippers (dd chewing toothbrush, clamping mouth shut and not letting me brush) but with 18 monyth old. thank you

[WilfSell]

Swedes

1. Do milk teeth molars with decay (DS1 aged 9 has a really bad one: VERY hard to get him to brush his teeth properly, we've had some success with disclosing tablets recently...) need pulling, filling or leaving...? His teeth seem to come through very late and like me he has a very small jaw so they are very crowded. God knows when the molars will be replaced? I don't want him to get an infected jaw etc if it's really bad. Can't get into our NHS dentist until end Sept... any advice welcome.

[WilfSell]

1. I have a private dentist (VERY bad teeth, VERY phobic, need someone who takes lots of time and knows how to deal with my anxiety).

But I worry she tells me I need things I don't just to keep the business ticking over.

What should I do? If I ask for a second opinion it's just gonna cost me more money isn't it. and she's going to be peed off.

We're over a barrel a bit aren't we? Like with builders, plumbers and car mechanics: once they're in, they can charge what they like...

[WilfSell]

1. I'm probably going to have to have a(nother) root canal on my shocking teeth. this time the very back one.

Am heart-stoppingly nervous about this. Because I've had two already, I know how long it takes, how much you have to have your mouth open, the rubber damp and clamps etc and it horrifies me.

My dentist has suggested sedation (assuming she means diazepam?)

I'm almost as terrified of this: isn't it awfully addictive?

Any other advice for very very nervous adult patient?

[MissDipsy]

I was made to feel terrible by the dentist when I took my daughter in for the first time at the age of 5 (we had an absolute nightmare trying to get a dentist due to lack of NHS places, the stupid surgery that we finally got a place with who accused me of lying when THEY had told me the wrong date for our appointment so I left in tears and was too ashamed to go back, plus I have ADHD so I struggle with things like getting a NHS dentist which require a superhuman level of organisation and persistance) and she had very worn enamel and holes in her back teeth. The thing is, I have always been very strict about toothbrushing (they're both rather "dopey" so they take ages and I have to stand over them to make sure they don't just sit and chew their toothbrush for 10 minutes!) and they hardly eat any sweets (and eat generally very healthily), so I know I've done everything reasonable to ensure their teeth were looked after. She lectured me about feeding her lots of fruit & juice, even though she only eats 1 or 2 pieces of fruit a day and only has juice about once a day. My friend's daughter (the same age) brushes her teeth unsupervised for about 30 seconds, eats tons of fruit (she's a fussy eater so fruit is the only way she can get enough vitamins etc) and eats a lot more sweets and other unhealthy food, and yet has no problems at all with her teeth. It's so unfair! And my son doesn't really have trouble with his teeth either. I asked the dentist if it was possible she just had weak enamel but she didn't really give me an answer and just went on about limiting acid attacks to 5 times a day (which we already do - she doesn't really eat lots of between-meals snacks, usually it's just one after school and one at playtime at school).

I seem to just have really bad luck with dentists, I don't like this new dentist but after the hassle I've had trying to get a dentist at all I don't want to leave. I've got lots of anxiety issues with dentists after having lots of work on my overcrowded teeth as a kid (I hate injections, especially in my mouth, and I hate vibrations in my mouth, so dental work is pretty traumatic for me). I haven't even seen the dentist in about 8 years and I'm terrified to go back because I know I'll need fillings. But both of the dentists we've dealt with since then have treated me very unsympathetically and like I'm some kind of terrible parent who doesn't care about my kids' dental health. I'm on income support so I can't afford to go private (I'm aware there are some private surgeries who specialise in work with anxious patients, if I could afford it I'd definately go to them!).

Sorry for the rant, as you can probably tell this is something that really upsets me. I feel so powerless in the face of this ridiculous NHS dentistry fiasco where a child with bad teeth can't get a decent dentist. I just don't get why it can't be like GPs, where you can walk into pretty much any surgery and register on the spot. The current system is horrible and stressful, and I'm sure there are lots of other people out there who are in a similar situation or worse. Anxiety about dentists is so common that there must be other people who've found the whole process twice as traumatic because the whole idea of dentists is anxiety-inducing in itself!

Sorry, rant over.

[hifi]

i have tetracyclene staining and dentists say there is no way of whitening them.Is this true or do you now of a proceedure? tia

[dinny]

My lovely dentist says toothpaste marketed at children is far too low in fluoride and he has seen a great increase in decay in the young. We've switched to small amount of an adult toothpaste for our children. How can this product be marketed without a warning?

Thanks, Dinny

[GreatGooglyMoogly]

Sorry if I'm repeating something someone else has asked but are electric toothbrushes okay for all ages, or should you not use them on young children? If not, why not?

[wilbur]

Oh, please, please [waves hand in air frantically, having only just seen this], I have 2 questions:

1. Ds1 (7) has several hyper-plastic (sp?) baby molars, so they are an unpleasant dull brown colour and the enamel is not in good condition. What is the chance of his big teeth coming through in the same way? And is there any real evidence that antibiotics caused this (both he and I had antibiotics when he was a baby and in pregnancy), or has he just been unlucky?

1. Ds2 (3) has just had his front 2 baby teeth removed after cracking one on the side of a pool. (I am devastated, but that's a whole other thread) Will he need follow-up dental work to make sure his big teeth come through straight? Our dentist said he had not rammed the broken tooth up into the tooth bed, so that at least is good news.

Many, many thanks if you can help with these.

[neighbour]

Fluoride. I can understand that fluoridation of water is extreme and controversial. But why aren't supplements encouraged here as they are in other countries, often to great benefit?

[My2]

my 3.8 year old is grinding her teeth at night - will this cause problems?

also maybe a really silly question but her eye teeth have lost their pointyness - does this mean her teeth are soft and when her big teeth come through they will be soft too?

[hopelesshousewife]

Oh I have one!

My DD (4.5) has recently changed dentist, and she says the enamel on her back teeth is not properly formed, through illness - is this common?

We are using a flouride paste and have has it sealed even though it's a baby tooth, is this a good idea?

Oh and another!!

I recently at great expense had a front tooth capped (£800!) the cap snapped after 6 months, and the dentist replaced it. However as soon as it was replaced (which really hurt) the tooth became really sensitive and pushes forward slightly when I bite, its now settling down. He says either
a) I've started grinding my teeth, and it's my fault, and/or
b) Its now dying and need root canal work.

I'm terrified of him doing the work - he made me cry with pain last time, but don't want to shell out hundreds more for another dentist.

[sphil]

I have a question please.

My 5 year old son, who is autistic, has some spots of decay on his baby teeth, one of which is described as a 'lesion'. Two spots were noticed by the school dentist about five months ago. At that time I wasn't using a fluoride toothpaste on his teeth and he was drinking very watered down pear juice between meals as well as at meal times, and having a number of biscuits between meals. After talking to the dentist I switched to a fluoride toothpaste (Kingfisher) and have limited his juice drinks so that he has them with food only. He has to have watered down juice as he takes a great number of supplements which he can taste in water. I've also started using an electric toothbrush on his teeth. It's difficult to brush them for long, but we do manage twice a day for about a minute each time.

Despite this new regime, three more spots of decay have appeared, two of which are on back molars. Am I still doing something wrong?

[Spink]

ds is 18 months old and reluctant to brush. He'll chew on his toothbrush and allow dh to brush a little (with MUCH persuasion, distraction etc etc.), but we're talking 30? seconds - our dentist said we need to aim towards 2 mins.

Now, our dentist does not yet have children. Is he being unrealistic or do we have to be more forceful with ds? We don't want it to get into a really negative battly type experience..

What do you think is a reasonable guideline for the length of time you should spend brushing at this age.. and (how much) does it go up with age?

[DanJARMouse]

My DD2 is nearly 3. She fell at about 18mnth old and chipped her front top tooth. It has turned yellow and the one next to it is starting to go the same way, despite brushing regularly.

Our own dentist said it was due to weak enamel, and there are signs of the same on her back teeth, but there is nothing that he would or could do for her.

Im terrified of her going to school and having the mick taken for discoloured teeth when we seem to be doing all we can.

Is there any sort of solution?!

[GeraldineMumsnet]

Hiya, we're really pleased to welcome Dr Zybutz to Mumsnet. You've posted loads of questions already, so we'll hand over and hope he can get through as many of your queries as possible in the next hour.

[DrZybutz]

Hi Ladytophamhatt. Thanks for being the first to post a question. I think the most important thing I can recommend is to avoid scare tactics. I find that children just don?t respond to them. It will be much more effective to encourage him with positive reinforcement and find ways to make brushing enjoyable than to threaten him with pictures of rotten teeth. Because he can?t really understand what that would be like, it?s probably not having any effect other than to make him feel negatively about the entire brushing experience.

Because he is getting to an age where his autonomy is important, why not start by allowing him to make some grown up decisions about his oral health. Let him pick out his own themed electric toothbrush and his own toothpaste (make sure it is for children) ? perhaps even introduce a product that makes him feel more grown up, like children?s mouthwash. There is a great new all-in-one product called Smart Rinse from Listerine that is available at all pharmacies.

He needs to feel that he?s cleaning his teeth because he wants to, not because you are coercing him to!

[RTKangaMummy]

Dr Zybutz do you recommend after having fixed train tack braces to have the wire permenantly fitted behind the teeth?

This is for my 13 year old son

Or do you recommend something else?

Thanks

RTKangaMummy {RTKM}

[DrZybutz]

Happychic, children should visit a dentist within a few months of the time their first primary teeth break through. Certainly by the time the child is 12 months old a dentist should have a chance to assess tooth development and advise on proper oral care that is tailored to your child?s needs.

[DrZybutz]

Hi RubySlippers. I find that children like to mimic, so I would suggest that you teach by example. Brush your teeth with your child so he can see how you do it and copy you. This also helps reluctant brushers as it conveys the message that brushing is something fun that ?we? do together, rather than something that the child must succumb to.