tooth decay

Extraction

What is it?

A tooth which is very decayed or damaged, or loose because of gum disease, may have to be extracted (taken out of your mouth).

Wisdom teeth sometimes have to be extracted if they have come through at an awkward angle and are causing problems (such as decay in adjacent teeth or, being difficult to clean, causing infections).

Teeth are sometimes taken out from children’s mouths to help other teeth which are crowded to grow straight, usually on the advice of an orthodontist.

What will my dentist do?

Some teeth are easier to take out than others. A local anaesthetic (an injection in your mouth) will be used to numb the tooth before it is extracted; this is the best treatment for most patients.

In some cases, for children or nervous patients, or where a tooth might prove difficult to remove, sedation (something to make you relaxed) with a local anaesthetic may be used. On rare occasions a general anaesthetic may be considered. If a general anaesthetic is needed, you will have to go to a hospital or a specialist treatment centre (you are likely to be able to go home the same day, but not all patients are able to do so).

After working out the best way to take the tooth out, your dentist will discuss with you:

• how to minimise what you feel while the extraction is happening

• whether you should bring someone with you if you are to have sedation or a general anaesthetic

• when it would be convenient for you to have the tooth removed

• you might also discuss other treatment you might need – for example, whether you may require a denture

While the tooth is being taken out…

You may hear some noise and feel some pressure as the tooth is being eased out – but you should not feel pain. Sometimes stitches are put into the gum to minimise any post extraction bleeding, to make the area more comfortable and help it heal quickly.

Afterwards…

You may need a day or so off work to recover, depending on how difficult the extraction was and whether sedation or a general anaesthetic was used. Most people experience very little post-operation discomfort. The dentist will ensure that bleeding has stopped before you leave the practice. You should not smoke or drink for at least 24 hours after an extraction.

The dentist will give you advice on:

• how to look after the space where the tooth was while it is healing

• which painkillers are suitable to use so you are not in any discomfort when the anaesthetic wears off

• how to contact the practice if there are any problems

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.

Why do I need to brush my teeth?

Brushing helps prevent tooth decay

Dental plaque is a soft, sticky substance that builds up on your teeth. It is mostly made up of bacteria, which feed on sugar from food and drink, producing acids as a waste product. The acids attack the teeth by dissolving the minerals in the tooth surface. If this happens too often, tooth decay results. For this reason, you shouldn’t have sugary foods and / or drinks too often during the day.

Minerals in saliva can mend the teeth. If fluoride is present in the mouth, it helps teeth to repair themselves. Fluoride also makes bacteria less able to produce acid.

To remove plaque and help teeth to mend themselves, you need to brush twice a day with a fluoride toothpaste.

Brushing helps prevent gum disease

You also need to brush to stop plaque damaging your gums. If plaque is allowed to build up, the bacteria in it can make your gums sore and infected. Painless gum pockets will start to form around the teeth and bone supporting the teeth will slowly be lost. If left unchecked, gum disease will lead to the loss of teeth.

How should I brush?

  • Brush your teeth thoroughly twice a day with a soft-to-medium brush and fluoride toothpaste. Replace the brush when the bristles get out of shape.
  • Put the bristles at the join between teeth and gums, pointing towards the gums, and brush using short circular movements.
  • Brush all round every tooth, carefully making sure you can feel the brush on your gums.
  • Don’t use too much force – give your teeth and gums a gentle rub.
  • It is recommended that people spend at least two minutes brushing their teeth – why not time yourself?
  • An electric powered toothbrush may be found easier to use and more effective than a manual brush.
  • After brushing you should spit out the toothpaste – but do not rinse, as this lessens the effect of the fluoride.
  • Small children should only use a small, pea-sized amount of fluoride toothpaste. They cannot brush properly until they are at least six or seven, so an adult should help them brush their teeth. One way is to stand behind the child and tilt their head back so all teeth can be seen and reached.

Speak to your local Clear Dental Practice to learn more about brushing your teeth.