Archives: Blog

Dental X-rays


What are they?

X-rays pass through your body and make an image on a special type of film or through an electronic detector. The image produced, the X-ray photograph, is called a radiograph.

X-rays allow the dentist to see what is happening deep inside the tooth and its roots. They will show any decay or gum disease, bone loss and, in children, how the jaw is growing too.

The X-rays films are usually placed in special holders to make sure they sit in the right place in relation to your teeth and jaws.

Dentists use these types of X-ray films or images:

• A ‘bitewing’ film is gripped between your teeth. The X-ray then shows the areas in between the teeth, but not the roots.

• A ‘periapical’ film is placed next to the tooth and the image shows the whole of the tooth and its root.

• There are also large X-ray images, which show all of the jaw and teeth. These are called ‘panoramic’ images. The machine that takes them moves around your head, while you stand or sit still.

What happens?

Trained members of the dentist’s team can take X-rays, as well as the dentist. Training makes sure that everyone who takes X-rays takes them safely and so that they are clear to read.

X-rays require tiny amounts of radiation. If you are concerned about safety, it may be helpful to know that:

• The amount of radiation involved in taking a dental X-ray photograph is very low – two dental X-rays expose you to a similar amount of radiation as a flight from London to Bucharest.

• Your dentist will only take X-rays if they are needed and takes courses to remain up-to-date.

• X-ray machines are checked regularly to make sure that they are only using the intended amount of radiation.

• You can still have dental X-rays when you are pregnant – your dentist may still ask you whether you are pregnant, or whether you might be, just to check in case you would rather not have an X-ray taken at that time.

When the X-ray is taken:

• You will need to keep very still for a few seconds to give a clear picture.

• The film is usually developed while you wait and then labelled.

• Sometimes it is useful for the dentist to compare a new picture with one taken some time ago – your dentist will keep old images in your file.

What are the benefits?

• Many forms of dental treatment rely on X-rays. Simply looking in your mouth cannot give the dentist as much information as looking below the surface with X-rays.

• X-rays allow your dentist to check on the state of previous dental work, as well as identify any new problems such as decay or bone loss.

Speak to your local Clear Dental Practice to learn more.

Dental implants

What are they?

Implants are one way of replacing missing teeth.

Unlike other forms of replacement teeth, dental implants are small metal (mostly titanium) devices not unlike a screw fitting which are inserted into the jaw during surgery. Teeth, in the form of a crown or bridge are often then attached to the implant, or the implant can be used to support dentures.

What are the benefits?

Some people have real difficulties with removable dentures. Implants can overcome these difficulties, in particular for eating and speaking properly and they may improve appearance. If a denture is necessary, implants can greatly improve stability. People will not be able to see that your teeth are supported by implants. Implants can be used in place of bridges, for example when adjacent teeth are intact or may not be strong enough to support a bridge.

Are implants for me?

Your dentist should discuss with you whether implants would be right for you, and explain any associated risks.

Patients need to have healthy gums, and enough jawbone to take the implant that supports the replacement teeth although techniques are available to add (graft) additional bone if needed. Patients must also be prepared to maintain very good oral hygiene and visit the dentist regularly. Implants, like teeth, may be lost if mouth hygiene is poor.

Implant patients need to be in good general health. Some chronic diseases, such as diabetes, osteoporosis, or chronic sinus problems, could interfere with healing and make implants more likely to fail.

Make sure that you tell your dentist about any medicines that you take regularly, and about your smoking habits. Smoking may well shorten the life of your implant.

Implants involve treatment over a period of several months. Since they are a complicated form of treatment, implants can be expensive.

What will my dentist do?

Your dentist should tell you about the stages of treatment, who would be carrying out each stage and the timetable for completing treatment. You might be referred to a specialist.

This is what will happen:

  • Bone is exposed in the jaw where the tooth is missing. Then a hole is drilled and the implant is inserted into the bone. This is usually done under a local anaesthetic, but sometimes sedation or a general anaesthetic is necessary. The gum is then stitched over the implant and it’s left to heal for several weeks. This allows bone to grow around the implant and to make it secure.
  • A second procedure is then planned, in which replacement teeth are mounted into the implant. This requires a small cut in the gum above the implant. Once the soft tissues have healed, the replacement teeth may be fixed permanently or attached in a way that lets you remove them for cleaning. The replacement teeth may be single or in a group, and possibly as a ‘bridge’, attached to neighbouring natural teeth.
  • There may be circumstances in which an implant can be placed during the same visit when the tooth is removed.
  • More and more implants are being ‘loaded’ after placement rather than covered by the gum to heal. Please discuss this with your dentist.
  • Maintaining good oral hygiene is important to prevent dental decay and gum disease, which may affect crowned teeth.

Speak to your local Clear Dental Practice to learn more.

Root planning / curettage

What is gum disease?

Gum disease is a complex condition affecting the gums and bone supporting your teeth. Several factors contribute to it, including family history, smoking and chronic diseases such as diabetes.

It begins with plaque, a soft, sticky substance, that builds up on your teeth. Plaque is mostly made up of bacteria, which feed on sugar from food and drink. Tartar, formed by hardened plaque, helps plaque to gather and makes it harder to remove.

If plaque is allowed to build up, the bacteria in it can make your gums sore and infected; they will look red and puffy and hey will probably bleed when you brush your teeth.

The gum will then start to become detached from the tooth, forming ‘pockets’ in which plaque can gather – and bone supporting the tooth will slowly be lost. Because this process is usually painless, it can become very bad without you noticing.

If left unchecked, gum disease will lead to the loss of teeth.

What is root planing / curettage?

Root planing is a way of helping to halt gum disease. It involves ‘deep’ scaling, to clean parts of teeth below the gumline, which cannot be reached with a toothbrush. Root planing cleans out the pockets, and removes plaque and tartar from the tooth roots.

What does the dentist or dental hygienist do?

Dentist and hygienist use two types of instrument for root planing:

  • Hand scalers come in different sizes and shapes to reach different parts of the teeth. This is why you will see the dentist or hygienist changing instruments quite often.
  • Electric scalers use a tip that vibrates very fast in a stream of water. The water is removed from your mouth using a small suction device. A hand scaler is also used along with an electric scaler, to check whether the roots are completely clean.

After a tooth has been root planed, the pocket should shrink, making the gum sit closer to the tooth. You then need to be especially careful about cleaning the teeth above the gumline. Root planing will probably need to be repeated regularly.

Root planing usually takes longer than a normal scale and polish, and is often done under a local anaesthetic. Your mouth might be treated in sections, at more than one visit.

Points to remember:

  • Root planing can help stop gum disease becoming worse and prevent tooth loss
  • Like scaling and polishing, root planing helps you to keep your teeth and gums clean at home.
  • To reduce the risk of your gum disease progressing, do not smoke, and eat a healthy, balanced diet.
  • Dentists and dental hygienists cannot keep your moth healthy by themselves. Your own cleaning is the key.

Speak to your local Clear Dental Practice to learn more.

Keeping a denture or bridge clean

Why is cleaning important?

Just like natural teeth, dentures and bridges collect bits of food, plaque (a sticky deposit, mostly made up of bacteria) and tartar (hardened plaque). By keeping them clean, you can stop decay in any remaining natural teeth and help prevent gum disease (which can lead to tooth-loss). It’s also good for your comfort and appearance to clean dentures, as dirty dentures can make your mouth swollen and sore.

Cleaning a denture is quite easy because, of course, you can take it out of your mouth. Cleaning all round and underneath a fixed bridge is harder. Your dentist or hygienist will show you how to do it.

How do I look after a denture?

  • Clean the denture over a basin of water so that it doesn’t break if you drop it.
  • Brush the denture inside and out every day. Use a soft-to-medium brush so that you do not scratch the denture. Use your normal toothpaste, or soap and water. Then rinse the denture.
  • Ask your dentist about denture-soaking solutions. Soaking a denture will not clean it. You also need to brush it. Rinse the denture before you put it back in your mouth.
  • Ideally, denture should be left out of the mouth for at least four to six hours, preferably eight hours, in every 24. However, if you find this impractical or embarrassing, you should still make sure you clean your dentures by brushing with toothbrush and toothpaste.
  • Keep a denture dry or in a denture-soaking solution when you are not wearing it. These solutions are mild disinfectants available at all chemists’ shops.

How do I clean a bridge?

  • How you clean will depend on where the bridge is in the mouth and its design. As well as normal brushing with a fluoride toothpaste and flossing at each end of the bridge, you need to keep the bridge clean underneath.

You might use:

  • Floss with a threader or a special floss with a stiff end which you can poke underneath the bridge and pull through
  • ‘Bottle brushes’ (your dentist will tell you what size and shape to buy) or
  • Water jets – sending a stream of water under the bridge

What are the benefits?

  • By keeping a denture or bridge clean, you help keep your gums and teeth healthy and avoid bad breath.
  • People who wear dentures sometimes get an infection called oral thrush. Thrush is more likely if you wear the denture all the time.

Good denture hygiene is important for preventing oral thrush.

Speak to your local Clear Dental Practice to learn more.

Bad Breath

What is it?

Bad breath is usually caused by bacteria in the mouth and is not usually a sign of general ill health.

Gum disease can cause bad breath. But you could still have bad breath with good oral hygiene, and healthy teeth and gums. The smell then usually comes from the far back of the tongue. It gets stronger when you talk as your mouth gets drier. To avoid your mouth becoming dry reduce your intake of drinks such as coffee and take sips of water to add moisture.

Most adults occasionally suffer from bad breath; perhaps a quarter have it regularly. If you are worried about bad breath, please talk to your dentist. Your dentist will:

  • Work out whether you really have a bad-breath problem.
  • Find out what sort of problem it is and help you deal with it.

What can my dentist do?

Make sure, before you see your dentist, that you have not done anything to hide the normal smell of your breath. Do not smoke, chew gum or use a mouth rinse, and avoid any sort of perfume; do not clean your teeth immediately before your appointment.

Your dentist might use a plastic spoon to gently scrape the back of your tongue and test the smell. There are also instruments that measure sulphur compounds in the mouth or swelling around the gums.

Good oral hygiene will usually be the answer to a bad-breath problem. A scale and polish from your dentist or hygienist makes it easier for you to keep your mouth clean at home.

What can I do myself?

  • Brush your teeth thoroughly twice a day with a fluoride toothpaste.
  • Use floss or other oral hygiene aids if your dentist or hygienist recommends them. You can check bad breath by smelling the floss after you have used it. If there is a smell from a particular part of the mouth, clean that area with special care.
  • Gently brush your tongue if it is heavily coated. This can be done gently with a toothbrush. Special plastic tongue scrapers can be bought from chemists.

A mouth will smell less if moist. Chewing sugar-free gum can help with bad breath by increasing the flow of saliva. You might have a dry mouth because you breathe with your mouth open or because you are taking certain medicines.

If you smoke, try to give up. As well as making your breath smell better, giving up smoking will keep your mouth and gum healthy, and benefits your general health.

Speak to your local Clear Dental Practice to learn more.

Tooth erosion

What is it?

Acids in the mouth can dissolve away tooth surfaces. Given the chance, teeth with repair themselves, using minerals from saliva. But if acid is in the mouth too often, teeth cannot repair themselves and the hard tooth surface (the enamel) becomes thinner – this is called ‘erosion’.

The teeth can then become extra sensitive to hot and cold food and drink. Eroded teeth can also be likely to suffer decay. The appearance of eroded teeth can also change: they can become discoloured (translucent or yellowish), and their shape can be altered.

The main cause of erosion is too frequent consumption of certain kinds of food and drink. All fizzy drinks (including ‘diet’ brands and fizzy mineral water), all ‘sports’ drinks, all squashes and all fruit juices are acidic to varying degrees. Pickles and citrus fruits are examples of acidic types of food.

Some medicines are acidic and, therefore, erosive.

And people with some illnesses (such as eating disorders) may suffer from erosion because of frequent vomiting, as stomach acids also erode teeth. For this reason, dentists may ask about eating disorders if they see teeth are very badly eroded.

How do I prevent erosion?

Don’t have acidic and/or drink too often during the day. Try to have them only at meal-times and drink acidic drinks quickly – don’t sip them. And don’t swash them around your mouth.

Between meals you should only have ‘safe’ drinks, which are not sugary or acidic. Milk and water are ‘safe’ drinks. So are tea and coffee if you do not add sugar to them (you can use non-sugar sweeteners).

You should try and avoid snacking between meals. If you do snack, only have ‘safe’ snacks, which are not sugary or acidic.  Fruits, vegetables and products such as sandwiches, toast, crumpets and pitta bread are all ‘safe’ snacks. You should try and avoid snacking between meals. Some fruits, especially citrus fruits, are acidic and are known to cause erosion if they are consumed in large quantities. This is not normally a problem for most people; however, you could discuss with your dentist or hygienist the safest way to enjoy these fruits.

Because acids temporarily soften the tooth surface, don’t brush your teeth immediately after eating or drinking something acidic. This will allow time for your salvia to neutralise the acid.

How can my dentist help?

Your dentist can identify erosion, pinpoint the causes and advise how to avoid further damage.

Speak to your local Clear Dental Practice to learn more.