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Frequently asked questions

Frequently asked questions

  1. 1.What is dental caries? Dental caries is defined as an irreversible microbial disease of the calcified tissues of the teeth, characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth which often leads to cavitation. Patients may experience sensitivity, a short and sharp pain, or a prolonged dull and throbbing type depending on the severity of the carious defect.
  2. 2.How is dental caries treated? Dental caries is usually treated by removing decayed tooth material first, and subsequently lost tooth material is then replaced with a restoration. Restorative materials also include composite resins and dental amalgam. However if there is only the presence of a white spot lesion, otherwise known as initial caries or incipient caries resulting from surface demineralization only, restoration is not required. In this instance, conservative management in the manner of topical fluoride application, regular reviews, and oral hygiene instructions will be given to aid in the remineralization of tooth structure.
  3. 3.Why do my gums bleed whenever I brush my teeth or eat? This is due to existing gingivitis which usually occurs as a result of poor oral hygiene with the formation of plaque and calculus which harbours bacteria. The presence of these inflammatory agents will lead to microscopic ulcerations at the epithelial surfaces of the gingival sulcus or periodontal pocket (depending on the severity of the existing condition) as a result of the existing inflammatory processes and any physical contact of the affected area will lead to the bleeding of the gingiva. In some cases, there are other systemic conditions and medications which can lead to spontaneous gingival bleeding; therefore it is highly recommended that a visit to the dentist is required to determine the cause.
  4. 4.When my gums bleed, may I stop brushing? No, you may not stop brushing. When gingival bleeding occurs due to brushing, usually it is an indicator that existing gingivitis is in place. Hence it is paramount that regular disruption of biofilm formed on tooth be done to control the existing inflammatory process. A visit to the dentist is required in order to ascertain the etiology of gingival bleeding and the appropriate treatment plan for the individual.
  5. 5.How often do I need to see the dentist? Generally the recommended number of regular dental check-ups with the dentist is twice a year. However, depending on the condition of the oral health and the type of treatments given, the review intervals may vary. Do consult your dentist regarding your check-up intervals.
  6. 6.What is root canal treatment? Root canal treatment is a treatment modality which enables endodontically compromised dentition to be retained in the oral cavity as an alternative to an extraction which results in the loss of residual bone height and drifting of adjacent teeth into the edentulous space. It comprises of a sequence of steps to remove infected pulpal tissue, cleaning and shaping of root canals with specific instruments, and protection of decontaminated root canals from the oral cavity. Endodontic intervention requires multiple visits to the dentist’s office, and compliance is paramount.
  7. 7.Why are my teeth shaking in the mouth whenever I chew or press them against the tongue? Mobility of existing dentition can be caused by several reasons; poor oral hygiene leading to existing periodontitis which results in the destruction of tooth supporting structures, physical injury to tooth supporting structures leading to dentoalveolar fractures or subluxation of teeth, and existing periapical pathology with or without periodontal involvement. Treatment of mobile teeth is highly dependent on the etiology and the extent of the mobility of tooth/teeth involved, hence a consultation with the dentist is required.
  8. 8.Do I need to extract my remaining teeth to wear new dentures? Extraction of existing teeth to accommodate new dentures is not a golden rule for every single patient. It is usually determined whether dentition should be extracted or retained by its usefulness in retention, path of insertion, function, esthetics, and the overall prognosis of the prosthesis.
  9. 9.Why do my teeth feel sensitive whenever I drink cold water? Tooth sensitivity is most commonly cause by the exposure of dentinal tubules to the oral cavity at which intake of fluids/food will lead to a change in the flow of fluid within those tubules leading to a short and sharp pain. Sensitivity usually occurs due to a variety of reasons; gingival recession, gingivitis and periodontitis, bruxism, systemic disorders like gastroesophageal reflux disorder (GERD), bulimia and anorexia, and brushing of teeth during or shortly after acidic challenges.
  10. 10.What do I avoid doing after an extraction? After an extraction, you are required to bite on a piece of gauze at the site of extraction for at least half an hour. Oozing of blood may occur in the first 6 hours, hence there is nothing to worry about. Gargling or spitting is not recommended to ensure that the blood clot within the extraction site remains intact. Cold drinks/food may help in the reduction of post extraction bleeding. Intake of hot food or liquids is not advisable for 24 hours. Mouthwash usage is not recommended in the same period of time, and brushing at the area of extraction site can be done so gently after 24 hours.
  11. 11.Why is my wisdom tooth growing sideways or not fully erupted? The wisdom tooth (or otherwise known as third molar) grows sideways or becomes impacted as there is insufficient space for the tooth to fully erupt. An impacted tooth usually erupts beyond its normal date of eruption and will not be able to assume a normal and functional relationship within the oral cavity.
  12. 12.What can I do about my impacted third molar? In this instance, there are various ways of management. Prophylactic removal of impacted third molars can be done to avoid pericoronitis, root resorption and or carious defects at the distal proximal aspect of second molars. These problems occur due to the difficulty in maintaining oral hygiene as a result of frequent food impaction which may also lead to periodontal problems. Should pericoronitis occur in third molars which have sufficient space for normal eruption and positioning, removal of the tooth is not necessary, but taking care of your oral hygiene is important to control or reduce the inflammation. Removal of the overlying pericoronal tissues can be done as well. If the decision not to remove the impacted tooth is made, complications mentioned are likely to occur due to the difficulty of maintaining oral hygiene hence the patient should be aware of the possible consequences. To decide which method is best, a visit to the dentist is advised.
  13. 13.Are there any effects that I should be worried about after the removal of my impacted third molar? After the surgical removal of the impacted third molar, the patient can expect some amount of swelling post-operatively at which the size may reduce after 2 or 3 days; at which cold compression with an ice pack is advocated. Mild bleeding from the surgical site also can be expected in the first 6 hours at which post-operatively it is advisable to apply pressure onto the surgical site by biting a piece of gauze for at least half an hour. Trismus may be present also; however this is mitigated by employing jaw exercises. Pain is inevitably present, but usually can be reduced by premedication pre-operatively and is expected to last for approximately 12 to 24 hours, at which can be managed by taking analgesics prescribed. Chances of infection of surgical site are reduced by premedication or post-operative medication. Less common complications include fractures during surgery, damage to adjacent teeth during removal of third molars, periodontal defects and paraesthesia. Paraesthesia is more likely to occur when an impacted mandibular third molar is in close proximity or is contacting the inferior alveolar nerve. Healing of paraesthesia may take a week or a few months to fully recover. Intake of vitamin B complex may help accelerate the healing of an injured peripheral nerve.
  14. 14.What can I do when my tooth is knocked out of its socket? When the tooth is avulsed from its socket, it is imperative that the tooth be located. The tooth should always be held at the crown, NOT the root. A common tendency is for the patient to scrub the surface of the root clean, however doing this will remove existing periodontal ligament fibres which can help in the reimplantation of the tooth into the socket. The surface of the root should be cleaned using slow running water, and stored in a suitable medium, for e.g. HBSS (Hank’s Balanced Salt Solution), pasteurised milk, and saliva. The extra oral time of the tooth will affect the prognosis of the survival of reimplanted tooth: the longer the extra oral time, the reduced chances of tooth survival is noted. Therefore it is imperative that the tooth is brought to the attention of a dentist as soon as possible.

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