Category: Preventive Dental

Do I Need A High Fluoride Toothpaste?

There’s a toothpaste available that is great at preventing tooth decay.  It is anti-bacterial and makes teeth stronger and more resistant to breaking down.  It’s made by leading oral hygiene product brand, Colgate.  However, you’ve probably never heard of it.  It’s called Neutrafluor 5000 Plus.

The name Neutrafluor 5000 Plus is a strange one.  It sounds like a machine or robot name.  It’s not all that enticing coming from a marketing point of view.  However, it’s not meant for marketing.  You cannot find this product on the shelves at your local supermarket or variety store.  It is sold at pharmacies or directly from your dentist only.  It is also more expensive that regular toothpaste.  In fact, it should only be used after assessment and recommendation by your dentist.

The name Neutrafluor 5000 Plus is more for the dentist rather than the patient.  It tells the dentist exactly what is in the product.  Neutrafluor stands for neutral fluoride as opposed to acidulated fluoride.  Fluoride is proven in research to make teeth stronger and more resistant to decay, as well as being anti-bacterial.  Acid roughens tooth structure for the fluoride to absorb better into it.  However, too much acid can wear away the enamel and permanently damage it.  So for products used at home away from your dentist’s direct supervision, a neutral product is much safer than an acidulated one.

The 5000 means 5000 parts per million fluoride or approximately 5 times the amount of fluoride in regular toothpaste.  This higher amount of fluoride is what makes this toothpaste extra good at protecting at risk tooth structure.  However, this higher amount of fluoride also means the toothpaste cannot be used in young children and needs to be recommended by your dentist for your specific needs.  Too much fluoride like too much of anything else can make you sick.  The Plus part of the name is for the other ingredients that make this product into a toothpaste.  These control flavour, consistency, foaming and cleaning properties of the toothpaste.

If you are at higher risk of tooth decay, your dentist may recommend you use Colgate Neutrafluor 5000 Plus toothpaste instead of regular toothpaste.  It may reduce your need for fillings and other dental work.

Do I Have Dry Socket?

A tooth extraction isn’t the nicest procedure at the best of times.  However, it is usually a necessary procedure to get rid of pain, infection or both.  A dry socket after the extraction just makes the bad situation even worse.

After a tooth is removed, a blood clot forms overt the hole where the tooth used to be.  The blood clot protects the exposed underlying tissue and guides tissue healing.  A dry socket occurs when a proper blood clot does not form or more commonly, is dislodged after it is formed.  The jaw bone that was housing the tooth roots is left exposed and this is very painful.

Normally after tooth removal, most of the pain and swelling subside within 2 to 3 days.  If this does not occur, but rather the symptoms increase, there is a possibility you have a dry socket.  The pain is usually quite severe and may radiate from the tooth socket to the eye, ear, temple and neck on the same side as the tooth removal.  There may be a bad taste and smell from the area.  It may be hard for the average patient to tell, but there will be no blood clot, lack of tissue healing and visible bone exposed when the site is examined.

You will need to go back to the dentist to have the socket cleaned and healing started again with the formation of a new blood clot.  The dentist will flush the socket to remove any irritants and debris.  The socket is packed with a medication which kills infection and helps with pain and tissue healing.  More pain medication and antibiotics may be prescribed.  Home care for the socket such as rinsing it with water salt water and a soft diet need to be continued.

Dry sockets tend to occur more in patients who smoke and drink alcohol after getting the extraction.  Not following the dentist’s after care instructions, especially lack of proper socket cleaning, gives you higher risk of a dry socket.  General poor oral hygiene and untreated gum disease and tooth decay in nearby areas of the mouth are also risk factors.  Interestingly, being on oral contraceptives or hormone replacement therapy gives higher likelihood to dry sockets as well as they affect tissue healing.

How To Avoid Teeth Stains

Do you know what is staining your teeth?  Coloured foods and drinks obviously can discolour your teeth.  However, it is not as simple as that.  There may be sticky, acidic and dehydrating compounds at play as well.  Let’s have a look at all 4 of these things and their effect on teeth staining:

  1. Coloured Foods and Drinks

The heavily pigmented compounds in foods and drinks are called chromogens.  Chromogens stain tooth structure with their coloured pigments.  Beetroot, berries, curry, soy sauce, red wine, tea and coffee are classic examples of foods and drinks that contain a lot of chromogens and can stain teeth.

  1. Sticky Foods and Drinks

Some foods and drinks also contain tannins which are plant compounds.  Tannins make it easier for chromogens to stick to tooth structure.  So foods and drinks with both strong chromogens and a lot of tannins tend to cause more staining of your teeth.  The reason why berries, red wine and tea are great at staining teeth is because they contain both chromogens and a lot of tannins.

  1. Acidic Foods and Drinks

Foods and drinks that are acidic soften and roughen tooth structure so chromogens more readily attach to it.  Chromogens embedded into the outer layers of eroded tooth are also more difficult to clean off so the colours stay on your teeth for longer.  Wine is particularly acidic.  Red wine having more chromogens stains teeth itself, while white wine erodes tooth structure, allowing chromogens from other foods and drinks to cause staining.

  1. Dehydrating Foods and Drinks

Foods and drinks that contain dehydrating compounds such as caffeine will dry your mouth.  When your mouth is dry, chromogens are not diluted by saliva and the surfaces of your teeth are exposed to more intense colours.  The lack of saliva also means the chromogens are not washed away from your teeth so colours stay on your teeth longer.  The reason why tea and coffee are particularly good at staining teeth is due to a combination of their chromogens and dehydrating effect.

Dental Implant Procedure

Replacing a single missing tooth with a dental implant and crown involves diagnosis and thorough treatment planning, a surgical phase and prosthetic phase of treatment.

Diagnosis and Treatment Planning

Before a patient can get a dental implant and crown, they must be thoroughly assessed for suitability.  The patient must be medically and dentally fit and healthy.  Medical conditions and medications may affect proper healing of the jawbone around a dental implant.  Tooth decay and gum disease need to be treated first to limit risk of infection after implant surgery.  The patient must maintain good oral hygiene before and after the implant for success.

Besides a thorough dental examination, impressions of the teeth to form study models, photos and x-rays are analyzed.  In most cases a special 3D scan of your mouth called a Cone Beam CT is required for comprehensive planning of where the implant will go.  As this is a special scan, you will need to go to a nearby x-ray clinic for this.

Surgical Phase

Under local anaesthetic and sedation, the sterile dental implant is inserted into the jawbone.  The gum tissue is firstly opened to reveal the underlying jawbone.  A small precision hole is prepared in the jawbone and the dental implant gently threaded into the prepared hole.  A cover is screwed into the implant to protect it and the gum tissue stitched over or around the cover.

After letting the implant integrate with the jawbone for approximately 3 months, healing of the bone and stability of the dental implant in the bone can be checked.  Sometimes a second surgery is needed to uncover the implant if the gum tissue had to be stitched over the top of the implant.  This second surgery is not needed if the gum tissue was able to be stitched around the implant and its protective cover.  If the bone has healed and the implant has integrated with the jawbone and is stable, the restorative phase can commence.

Restorative Phase

The restorative phase is usually done without the need for local anaesthetic or sedation as everything has healed.  Impressions of the dental implant and the surrounding teeth and gums are taken to form models.  On these models, the dental implant crown is made.  At a second appointment, the crown is attached to the dental implant via a special connector.  The crown replaces the original missing tooth.

Do I Have High Risk Of Tooth Decay?

Some people have high risk of tooth decay.  Their tooth structure is more prone to breaking down and forming cavities than the average person.  They can get cavities easily even though they may brush and floss twice daily and go to the dentist every 6 months for a checkup and teeth cleaning.  They may have 1 of 3 problems or a combination of all 3:

  1. Weak Enamel
    Some people are born with thinner or more porous enamel.  There are even conditions where some people are born with little or no enamel at all.Some people damage their enamel significantly after being born with healthy teeth.  They may have suffered an accident which damaged their teeth.  They may have a medical condition or taken medications that damaged their teeth.  Some people may not have looked after their teeth very well for a long period of time and their enamel has been damaged irreversibly.Enamel is the strongest part of the tooth.  Without good enamel, your teeth may be more prone to breaking down and forming cavities.
  2. Low Saliva
    Saliva is very important for protecting our teeth.  It is anti-microbial and washes away food and debris.  It puts mineral back on the teeth to strengthen and repair.  It also buffers acids to limit erosion of tooth structure.Reduced saliva can occur due to salivary gland issues, aging, medical conditions and medications.  With low saliva, the teeth lose their natural protection system and can break down faster and be at risk of decay.
  3. Acidic Mouth
    Some people have a more acidic oral environment than others.  This may be due to saliva issues or reflux from the digestive tract.  Reflux may commonly be due to pregnancy, medical conditions and medications.An acidic oral environment dissolves tooth structure and prevents tooth structure repair.  It allows bacteria that cause decay to thrive so there is high risk of tooth decay.

Dental Fillings Appointment Procedure

What actually happens during an appointment for a dental filling?

Numbing Up

Not every tooth that requires a filling needs to be numbed.  If the problematic part of the tooth is very small or a long distance away from the middle of the tooth where the nerve is, then there is no need for local anaesthetic.  In these cases you won’t feel anything at all besides a few vibrations when your tooth is prepared for a filling.

If you do require local anaesthetic, we will spend a couple of minutes rubbing some numbing paste on your gum where it will go.  The paste numbs the superficial gum a little before the actual injection is given to provide full anaesthesia.  We will wait a few minutes as well as test the area to make sure you are fully numb before we proceed with the preparation of the tooth for the filling.

Preparing The Tooth

If the tooth has decay or some damaged tooth structure that cannot be kept, it must be removed before placing a filling.  The tooth is then usually chemically cleaned and roughened with a special tooth conditioner which allows the filling to better stick to the tooth.

Placing The Filling

These days we use tooth coloured filling material called composite resin and glass ionomer cement or a combination.  A special band may be placed between the tooth that needs the filling and the tooth next to it.  This helps shape the filling and prevents two teeth being glued together so that flossing is still possible.  Filling material is then placed into the prepared tooth, usually in layers if the size of the filling is going to be large.

The material is either set hard or the setting accelerated with a special bright blue light.   Usually you will wear dark glasses to shield your eyes from the blue light.  The dental assistant may cover the area with an orange coloured paddle as well as you cannot see the bright blue through the orange.

Polishing The Filling

Your dentist will shape the filling and trim it to match how you bite together.  You may be asked to bite and grind your teeth on some blue marking paper which helps the dentist check whether the filling is fine in the bite or not.  The filling can then be polished.

Being artificial substitutes, fillings will always feel a little different to tooth structure, but you should get used it a new filling within a few days.  You won’t be able to eat or drink for 2 hours.  This gives the filling more setting time as some parts may be self-setting and requires more time to get to maximum hardness.  This also gives time for the numbness to wear off if you had local anaesthetic.  You don’t want to accidentally bite or burn your lip, cheek or tongue or choke on some food.

Dental Problems Can Trigger Migraines

The precise cause of migraines has been puzzling for the medical profession.  It is believed that there is some connection with how the brain stem and the trigeminal nerve interact.  Neurotransmitters such as serotonin may play a role.  An increase in the number of certain oral bacteria in some people is now thought to make them more prone to getting migraines.