Deep pits and grooves can be found on the chewing surfaces of the back teeth.
Such pits and grooves are termed ‘fissures’ and are usually so narrow that toothbrush bristles and streams of water are not able to clean them effectively. These form a favourable environment for bacteria to flourish, often resulting in tooth decay.
WHAT CAN BE DONE?
Fissure sealants can be applied to the teeth. Fissure sealants are special materials used by dentists to seal off pits and fissures from the oral environment. Sealing the tooth surface protects fissures from bacteria and fermentable foods like sugar and starches to prevent decay from starting deep within the fissures. Any tooth with pits and fissures can be treated, provided the surface to be filled is sound and has not been previously filled. The most commonly treated teeth are the molars and premolars.
WHEN SHOULD SEALANTS BE PUT ON THE TEETH?
Sealants are most effective when applied after the eruption of the tooth. Early application ensures pits and fissures are sealed before the decay process begins.
HOW ARE SEALANTS APPLIED?
Sealants are applied easily and painlessly. No drilling is required. The tooth is properly cleaned, treated, dried, and the sealant applied. It then hardens to form a protective coating over the tooth.
HOW EFFECTIVE ARE SEALANTS AND HOW LONG CAN THEY LAST?
Many studies show sealants to be very effective in preventing decay in fissures. They do, however, require regular maintenance by your dentist. This can be performed with your six- monthly check-up. Recent studies show that a properly placed sealant will last as long as a typical amalgam filling. Even if a sealant is damaged or lost, it is easily repaired and replaced. Regular maintenance by your dentist will help them last.
WHAT IS A DENTAL HYGIENIST?
Dental Hygienists are registered dental professionals whose main role is promoting good oral health through prevention and education.
By educating and motivating patients in the necessity of good oral hygiene and diet advice, they help patients prevent gum disease by scaling and polishing the teeth and carefully monitoring patients.
WHAT IS GUM DISEASE?
Gum disease develops when plaque bacteria, a sticky, colourless membrane that develops in the mouth, is allowed to build up along and under the gum line.
Plaque that is not removed can harden and form tartar that can only be removed professionally by a dentist or hygienist.
It is estimated that half of all adults in the UK experience some degree of gum disease.
If you have gum disease, your gums may bleed when you clean your teeth and you may experience bad breath. This stage is known as Gingivitis. If Gingivitis is left untreated it can progress to Periodontitis, which affects the tissues that supports the teeth and hold them in place.
In the UK up to 15% of adults are estimated to have severe periodontitis, with many more effected less severely. If periodontitis is left untreated it can eventually result in tooth loss and may also increase the risk of stroke, heart attack and other health problems.
As well as poor oral hygiene, a number of things can increase your risk of developing gum disease:-
Smoking
Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.
Genetics
Research has indicated that some people may be genetically susceptible to gum disease. Despite excellent oral care habits, these people maybe more likely to develop periodontal disease.
Stress
Stress is linked to many serious health conditions. Research has shown that stress can make it more difficult for the body to fight infection, including periodontal disease.
Medication
Some drugs can affect your oral health. Just as you notify other care providers of all your medicines and any other changes in your overall health, you should also inform your dental care provider.
Other systemic diseases
Other systemic diseases that interfere with the body’s inflammatory system may worsen the condition of the gums. These include cardio vascular disease, diabetes and rheumatoid arthritis.
PREVENTION OF GUM DISEASE AND TOOTH DECAY
Good oral hygiene will help keep your plaque levels down and help prevent gum disease and tooth decay.
You can maintain good oral hygiene by:-
brushing your teeth for 2 minutes twice a day with a fluoride toothpaste. Studies show that powered brushes with a oscillating action such as the Braun Oral B remove more plaque than a manual toothbrush.
cleaning between your teeth removes plaque bacteria from areas where your toothbrush doesn’t reach.
cut down on how often you have sugary foods and drinks.
visit your dentist and hygienist regularly.
There are many oral care products now available to patients. Your dentist or hygienist will recommend those that are best for you.
With regular professional cleaning by a hygienist, combined with a good oral hygiene regime at home, you will help to keep your mouth healthy, which in turn will improve the appearance, function and longevity of your teeth.
DIAGNOSING GUM DISEASE
The dentist or hygienist will examine your gums using a periodontal (gum) probe. The probe is inserted next to the tooth and around the gum line. If the gum is healthy the probe should not slide below the gum line. In cases of periodontitis the probe will reach deeper under the gum line. X-rays may also be taken to detect any bone loss.
Preventive dentistry is the modern approach to reducing the amount of dental treatment required to maintain a healthy mouth and help keep your teeth for life.
Tooth loss primarily results from gum disease and decay. A proactive approach to the management of these causes therefore increases the opportunity for prevention.
Whilst it is the ideal way to manage the oral healthcare of children and young adults, it is the recommended approach for everyone – including people with false teeth who can benefit through the early identification of conditions like mouth cancer and denture stomatitis.
Through recommended treatment, a maintenance plan, and the combined efforts of the dentist, hygienist and patient, the need for treatment can be prevented. The historical pattern of fillings and extractions can also be avoided.
WHAT ARE DENTURES?
A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, a denture is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function, and often improves a person’s appearance.
WHAT TO EXPECT?
New dentures always feel strange when first placed in the mouth. Several days or weeks will be required before you get accustomed to them. Adaptation varies depending on the individual and often time and experience are essential before dentures can be worn comfortably and function effectively.
HOW LONG DOES IT TAKE TO MAKE DENTURES?
Depending on the complexity of each case, the duration of the treatment will vary. After the initial visit of examination and diagnosis, the subsequent visits will include taking impressions of the mouth, bite registration, try-in of the denture, fitting and review.
USEFUL SUGGESTIONS TO HELP YOU TO ADAPT TO THE NEW DENTURES:
Eating
Eating will take a little practice. Start with soft foods and foods cut into small pieces will help. Chew slowly using both sides of your mouth at the same time to prevent dentures from tipping. Once you become accustomed to chewing, include other foods until you return to your normal diet.
Increased salivary flow
You may experience an increase in salivary flow when the dentures are first inserted. This is a natural response of the salivary glands that will return to normal after a few weeks. You can improve the situation by swallowing more often.
Speech
New dentures may alter your speech initially. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will speed up the adaptation process. This problem rarely persists beyond two weeks.
Sore spots
Minor irritation caused by surface irregularities or pressure spots on the denture-bearing areas are quite common. Your dentist will relieve the discomfort by adjusting the denture surface. Stop wearing the denture if the irritation is very painful. Consult your dentist immediately.
WHAT IS A CROWN?
A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.
Crowns are used for several reasons:
as a protective cover for badly decayed teeth or fractured teeth
as a permanent restoration for teeth with large fillings
to correct minor problems in natural teeth, e.g spacing and irregular shape or severe discolouration
WHAT ARE CROWNS MADE FROM?
Crowns can be made from a variety of materials. They can be made from plastic, ceramic or metal alloys. A combination of metal and ceramic is also possible to maximise strength and simulate the appearance of natural teeth.
HOW ARE CROWNS MADE?
Firstly, a thorough clinical examination is conducted with radiographs, by the dentist. The suitability for crowns is assessed and any preparatory work is carried out. Your dentist will also be able to advise on material choices, treatment sequence and any other concerns you may have.
At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted.
The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.
At the third appointment, the temporary crown is removed and the tooth surfaces cleaned. The completed crown is tried on the tooth for fit, harmony with the bite, and appearance. Finally, the crown is cemented onto the prepared tooth with dental cement.
HOW LONG DO CROWNS LAST AND HOW DO I CARE FOR THEM?
Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.
Ceramic on the surface may chip or fracture. Avoid chewing excessively-hard substances like ice or bones. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.
Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.
A dental bridge literally bridges that gap created by one or more missing teeth. They are made up of two or more crowns either side of the gap, with a false tooth in between. Bridges are supported by natural teeth or implants.
WHAT ARE BRIDGES MADE OF?
Bridges are usually made of a precious metal. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base for strength.
HOW DO I LOOK AFTER MY BRIDGE?
You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.
ARE BRIDGES EXPENSIVE?
Although a bridge may seem costly they can be a wise investment that will give many years of good service. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it’s similar to ordering a piece of hand-made jewellery.
Most people have fillings of one sort or another, but today, because we are much more conscious of our smile, we can choose a natural looking alternative – the composite or tooth-coloured filling.
A composite resin is a tooth-coloured plastic mixture filled with glass (silicon dioxide). The composite filling was first introduced in the 1960s and originally only used for front teeth because of its softer nature. However, with modern improvements to its composition, the treatment is generically suitable today.C
Composite fillings are more difficult to place than silver fillings, so may take your dentist 15-20 minutes longer to complete. Because they are considered to be a cosmetic treatment, they are not available on the NHS and must be paid for.
The main advantage of composite fillings is their aesthetic appeal. The main disadvantage is their life expectancy as white fillings have always been considered less long lasting than silver amalgam fillings. Despite this, there are now new materials available with properties comparable to silver amalgam and these are proving to be very successful.
The life expectancy of your composite filling can depend on the depth of cavity and its position in the mouth.
Your dentist is best positioned to advise you.
Clove House Dental Practice
48 Pickwick Road
Corsham
Wiltshire
SN13 9BX
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