DENTISTSECRETS Q & A AUGUST 2010

Please note that your questions will be rewritten, not only for brevity in these issues, but to make some questions more easy to understand for other readers .

Thankyou to everyone that has asked us about their dental care. We do apologise that we are unable to answer your questions personally, and we apologise if your qustions have not been answered in this Q&A. Please keep reading fututre editions as we aim to answer all of the important dental queries that you send to us in due course.

Dentistsecrets guarantees strict confidentially for all information received.

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Q. Are fizzy drinks really bad for your teeth?

A. Yes.

Simply put, teeth decay when the bacteria that are in plaque use sugar from the diet to produce an acid (lactic acid) that dissolves away the enamel of the teeth. Saliva counter-acts this acidity to protect your teeth. (How teeth are damaged and how you can alter your diet and eating habits to reduce your chances of decay is covered in Dentistsecrets - Stop Paying For Dental Treatment ).

Many fizzy drinks use citric acid to add flavour. This a very acidic product and creates a ph (a measure of acidity) that cannot be buffered (reduced) by your saliva. This puts your teeth under attack. Teeth decay more rapidly in an acidic environment.

So - even if your fizzy drink is “sugar-free”- be warned, plaque present may not be producing acid but the teeth will still be attacked by the acidity of the drink itself.

Some fizzy drinks - especially the COLA flavoured drinks, use a flavouring called orthophosphoric acid. This is extremely acidic and creates such a high acidity that even the plaque bacteria that cause tooth decay cannot survive. So - although people who drink alot of these types of drinks do not always show alot of decay, instead, the enamel that protects the teeth dissolves away in the acid. This is known as erosion. The teeth become soft and sensitive and can even be worn away by nomal tooth brushing.

Carbonated drinks such as the fizzy waters are less damaging to the teeth than these other drinks, but they are still acidic and will cause an increase in decay if consumed excessively.

One thing that is important to remember is that the frequency of intake of damaging foods/drinks is more important than the quantity (when considering tooth damage).

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Q. My child has been told that they need 5, two surface, composite fillings. they have been brushing well and have had regular dental check-ups. No X-rays were taken and the hygienist did the exam.

A. If a child has had regular check-ups with the Dentist and has had no previous decay/cleans their teeth well and has had no change in medication/habits/diet since their last visit; then to suddenly need 5 fillings - which at 2 surface fillings are quite large fillings - within 6months; does seem to be excessive.

If your child was seen at previous appointments to be at risk of such a high decay rate, then you should have been warned and given appropriate advice on prevention of this decay.

It is hard without discussing this further and seeing previous dental records to give an opinion on whether X-rays are necessary; but if this extensive decay has appeared within 6months, then maybe X-rays would be indicated to check for other early decay not yet visible clinically.

If these fillings are necessary, hopefully you have been given extensive advice on future prevention of dental disease. If not this advice can be found in “Dentistsecrets - A scared Child = A Scared Adult”

The most worrying part of this question, is that you say that your child’s dental exam was carried out by a hygienist.

A dental hygienist is not trained or qualified to:

carry out a dental exam
diagnose dental disease
draw up a treatment plan for a patient.

A dental hygienist is trained and qualified to work under the direct authority and supervision of a dentist. their job is to carry out work prescribed by the dentist.

We recommend, if this is the case, that you get your child’s teeth checked by a dentist before you possibly unnecessarily permanently damage your child’s teeth.

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Q. I was recently diagnosed with diabetes. When I told my Dentist this at my last appointment he told me that I would need to be seeing him more regularly now. When I asked why, he only said that I would need more visits to look after my teeth.

Why?

A. Diabetes is a condition that does has an impact on your oral health:

Because you tend to produce alot of urine, you have more of a tendency to mild dehydration - this reduces your saliva flow which is your natural protection for the teeth against acid attack, so the teeth are more susceptable to decay.
Diabetes can make you more susceptable to gum disease - which is easier to prevent than to stop once it has started to damage the supporting tissues of the teeth.
If you have a tooth removed, you will be more prone to developing the painful dry socket infection.

It may be important that you will need to see your dentist more regularly than you have in the past.

You may have the early warning signs of developing gum disease;
you may have existing gum disease that your dentist is concerned may deteriorate;
you may have teeth that are likely to need removing in the future. There are many reasons why your dentist may feel that you will be better looked after with more regular monitoring.

Our main concern though, is that, although it does seem that your Dentist has your best interests in mind and wants to prevent future complications with your oral health - they have made no attempt to explain to you in detail the potential problems we have touched on here. Good communication is very important to an on-going treatment plan.

We suggest that you contact your Dentist so that YOU are aware of what you can be doing to avoid future problems.

Health issues relating to Dental health are covered in more detail in Dentistsecrets - Is Dentistry Safe?

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Q. My little girls’ front baby teeth fell out ages ago and no other teeth are coming through. How long is it normal to have to wait before teeth are replaced?

A. It is impossible to give a time frame for how long it takes adult teeth to erupt after baby teeth are lost. Some adult teeth are already erupted into the mouth even before baby teeth are loose. If baby teeth are lost early, this can sometimes delay eruption of their replacement teeth.

There is almost cetainly no cause for worry if your daughter’s teeth fell out naturally. Baby teeth become loose and fall out because the adult teeth are erupting from below. If there is no adult tooth present, a healthy baby tooth is not lost. If you are concerned though, mention it to your dentist who will be able to take a small X-Ray to see the position of the unerupted tooth in the bone.

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Q. How many adult teeth should we have?

A. If all adult teeth are present and erupted - 32.

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