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Visiting the dentist: Your questions answered
Anni Seaborne answers some common questions about dental appointments and routine treatments.
Transcript
Who are you and what do you do?
Hi, I'm
Dr. Anni Seabourne and I'm a dentist.
I've been with Bupa for seven years now
and I'm currently the Head of General Dentistry at Bupa.
What would I go to see a dentist for?
Most people come to the dentist for a regular checkup
and sometimes a clean,
but occasionally you'll need to come for specific treatment.
This could be fillings, extractions, root canals, treatment
of gum disease, and replacing missing teeth.
So that could be a denture or an implant.
Will my dentist judge me?
Absolutely not.
There's nothing that we haven't seen before.
We're here to help. So just come in, we'll have a chat, go
through everything, and we'll work together to see
how we can resolve your issues for you.
How often should I come in for a dentist appointment?
For most people, six months is sufficient,
but it really depends on
how at risk you are developing dental problems.
So if you've never had any treatment at all, then it may be
that you only need to come in every two years.
But if you're someone who's prone to getting fillings
or cavities or having an ongoing problem like gum disease,
it may be that you need to come in every three months,
but your dentist will be able to guide you with that.
What if I haven't been to the dentist in a long time?
Please don't stress
if you haven't been in a while,
we are not going to judge you.
We're here to help. So just reach out to one
of our friendly reception team,
give them a call, and they'll be able to guide you on
how we can get you booked in.
What can I expect when I go into a dentist?
So when you arrive at the dentist, head to reception
and they'll be able to check you in
and they'll give you a medical history form to fill out.
When the dentist is ready, they'll call you in
and then they'll do the checkup for you.
So the checkup normally consists of checking
for any holes in the teeth
and also checking your gum health.
They'll also carry out an oral cancer screening,
so they'll be looking at your lips, your tongue,
and your neck, just to make sure there's no
nasty lumps and bumps.
After that, they're most likely going to take some X-rays,
and also they may take some photographs as record keeping.
Why should I brush my teeth?
Over the course of the day,
you naturally get build up a plaque in your mouth.
If this plaque sits on your gum line,
then it'll cause inflammation,
which subsequently can cause gum disease.
The purpose of brushing is
to primarily remove this plaque from your mouth
and keep your gums nice and healthy.
If you use a toothpaste with fluoride in,
this can also strengthen your teeth
and reduce the risk of tooth decay.
How should I brush my teeth?
Depending on whether you have a manual
or an electric toothbrush, the technique will vary slightly.
What we recommend with a manual toothbrush is
to pop it on each tooth, angle it ever
so slightly up into the gum line,
and then use circular motions going systematically across
each tooth and across each surface of the tooth.
If you have an electric toothbrush, we just advise you
to hold it on each tooth,
and once again, go systematically
so you're covering each tooth.
But in this case, you don't need to use a circular motion
because the toothbrush is doing it for you.
What happens if I don't brush my teeth?
Because the plaque accumulates on your gums throughout the day,
if you're not brushing your teeth regularly, this will lead
to inflammation of the gums.
If the gums are inflamed for a prolonged period of time,
you then end up with something called gum disease.
Gum disease in itself can be reversible,
but if it's left for an even longer period of time,
it can cause the bone underneath to start to shrink back,
and then you can eventually run the risk
of losing your teeth.
My diet isn't sugar free, what adjustments can I make to have healthier teeth?
I think realistically, there's not many people
who have a completely sugar-free diet.
So my personal number one tip would be control the frequency
of your sugary snacks as opposed to the total amount.
If we think about how the tooth decay forms, it's
because of the sugar that's feeding the bacteria
that's causing that tooth decay.
If you're constantly feeding the bacteria sugar,
it'll be constantly causing tooth decay
and the tooth themselves can't repair.
So little changes such as having your dessert straight
after your dinner or making sure
that we're not snacking a bag of sweets over a period
of two hours and actually eating it in a short amount
of time will mean that the tooth has then got time
to repair itself.
Why do people need a filling?
People need fillings when they've got a cavity,
which simply put, is basically a hole in your tooth
which is caused by dental decay.
What causes tooth decay?
Tooth decay is caused by the sugar in your diet.
There's naturally occurring bacteria in your mouth,
and when you feed it sugar, it causes it to produce an acid.
And this acid is what weakens the tooth
and causes that tooth decay.
Will getting a filling hurt?
The filling itself shouldn't hurt.
You'll be given local anaesthetic in most cases,
and this process might be a little bit stingy,
but once that's in, after a couple of seconds,
you won't feel a thing.
What is the recovery like after a filling?
The recovery for a filling is pretty straightforward.
Occasionally you might get a little bit of sensitivity
or a little bit of tenderness on
biting, but this is quite rare.
The hardest bit is the fact you'll be numb for a few hours
after the appointment.
This can last three to four hours,
and you might be a little bit dribbly
and you might struggle a little bit when it comes to eating
and drinking.
What happens in a filling appointment?
So normally when you come to a filling appointment,
the first thing that they're most likely going
to do is give you a little bit of local anaesthetic just
so you don't feel anything.
Once that's in, they use a drill
to clear out any decay that there is.
And then once that has been done
and they're happy with how it's looking,
we'll then fill it up.
Normally this is done with a material called composite.
Once this is built up, they'll polish anything off,
check you're biting okay
and then go through any postoperative instructions with you.
How do I stop tooth decay from happening?
Simply put, we need to reduce the amount
of sugar we're taking in.
Sugar feeds the bacteria in the mouth, which subsequently
produces an acid, which causes the tooth decay.
So if we're reducing the amount of sugar
that we're taking in, then we're not feeding that bacteria
to produce the tooth decay.
Having a good oral care regime will help as well.
So there's fluoride in the majority of toothpaste,
and that helps strengthen the teeth,
but ultimately it comes down to how much sugar we're eating.
What are the causes of root canal?
You normally need a root canal
because there's been some sort of trauma
to the nerve of the tooth.
So this can either be by tooth decay, working its way
through the tooth and going all the way into the nerve
and causing it to get irritated.
Or alternatively, if you've had a trauma
to the tooth directly, like a knock to the tooth,
and that impact can irritate the nerve
and essentially cause it to die.
What is a root canal?
So if we imagine the anatomy of a tooth,
we've got the enamel on the outside,
and then we've got the bulk of the tooth,
which is made out of something called dentine.
And then right in the middle we've got where the nerve sits,
which sits essentially in the canals of the tooth.
Okay, so when we're doing a root canal, the reason for it is
because there's been some sort of injury
to the nerve of the tooth.
So this could be from decay coming all the way through
and then irritating the nerve
or it can be from a trauma impact, which has kind
of irritated the nerve and caused it to either flare up
or essentially die off.
The root canal treatment is essentially clearing out any
bacteria or any remaining nerve from the area,
and then we fill up that nerve
or fill up that root canal all the way to the top
so it's blocked off so no bacteria can sit there anymore.
How can I avoid getting a root canal?
The most common reason for needing a root canal is when
you've got extensive tooth decay.
What I would say is make sure you're going
to your dentist regularly so they can take X-rays
and do regular checkups to make sure
that there isn't any decay going on.
And in terms of what you can do from home,
it's just making sure you have a sugar free
or at least reduced sugar diet
and are brushing your teeth twice a day.
What is the recovery for a root canal treatment like?
There's little to no recovery time following
a root canal treatment.
Occasionally it might be a little bit tender afterwards,
but the main thing to be aware of is
that you would've had anaesthetics, so you're going
to be numb for a few hours after,
so it might be a little bit of a struggle when it comes
to eating and drinking.
But in terms of what to expect afterwards,
you should be able to go about your normal tasks,
but you might just be aware that there's been a bit
of poking and prodding around in that tooth.
What happens in a root canal appointment?
So when you arrive to the dentist, if you head
to reception and they'll check you in
and they'll give you a little medical history form
to fill in, and then when the dentist is ready,
they'll call you in. With the root canal,
they're going to numb you up, so they're going
to give you a little bit of local anaesthetic
so you won't feel anything.
The next stage is a bit odd,
they're going to put something called a rubber
dam over your tooth.
What this is, is a sheet of rubber
that essentially will isolate the tooth
to make sure no bacteria can get into the
tooth during the treatment.
At this point, they're going to drill open the tooth
and they're going to access the canals in the tooth
so they can be up to four canals in the tooth.
They're then going to clean it out with some antibacterial
to make sure there's no bacteria left,
and then they will fill the tooth up, each canal, one at a
time, and then they'll put a filling over the top.
Will it hurt to get a root canal?
In the majority of cases with root canals,
you won't feel a thing.
You'll have some anaesthetic just
to make sure everything is nice and comfortable,
but it should be a really
straightforward, painless procedure.
However, there is a certain situation,
in which case it might be a bit uncomfortable,
and this is if the nerve is hyper inflamed.
Normally, you'll be attending the appointment already in
pain, so it's not the treatment itself that's uncomfortable,
but it's the fact that your nerve is so irritated
that it's just being very angry
and not reacting well to the anaesthetic.
In this case, the root canal specialist
or your dentist may decide to
split the treatment over two appointments.
Will a tooth extraction hurt?
So we always use local anaesthetic to ensure
that it'll be a painless procedure.
However, do expect to feel a bit of pressure on the tooth
when they're taking it out.
Why do people need a tooth extraction?
If you need a tooth extraction
or essentially a tooth being taken out, it's
because that the tooth can no longer be saved.
So they could have tried various other options,
and it's in a position that actually it's better off
for your overall health to have the tooth taken out.
There are occasions where we may electively choose
to take a tooth out, and this tends to be
with orthodontic treatment.
How do I stop a tooth extraction happening?
To avoid a tooth extraction,
we just need to make sure we look after our teeth, so we want to make sure that there is no tooth decay
and this is by having a sugar free or reduced sugar diet
and looking after your teeth with a really good oral hygiene routine.
What happens in a tooth extraction appointment?
So when you get to the dentist, if you head to reception
to check in, and they'll give you a medical history form
to fill out, and then when the dentist
is ready, they'll call you in.
The first thing they're going to do is just go over the
risks and make sure you're happy to go ahead.
Then they will use local anaesthetic
to make sure you are nice and numb.
Because the tooth is held in to the gums by ligaments,
what they'll do first is loosen those ligaments up
and then they're able to elevate the tooth out.
Occasionally you may need something called
a surgical extraction.
Don't worry, you'll still won't feel anything
because you'll be under local anaesthetic.
However, what they will do is drill a little channel
around the tooth, and this means that they're able
to pop the tooth out a bit more easily.
What is the tooth extraction recovery like?
We always say take it easy for a couple of days
after a tooth extraction.
You should be able to do your day-to-day
tasks like going to work.
But I'd avoid anything that's going
to get your heart rate up like going to the gym.
We just want to make sure the healing process can occur in a
really nice environment where there's not any excessive
bleeding or anything like that.
What are the causes that can lead to a tooth extraction?
There's a couple of reasons why you might
need a tooth extraction.
It may be that you've had tooth decay that's so extensive
that even root canal can't save it.
It may be that you had the root canal treatment,
but unfortunately it has failed and not worked.
It may be that you are going to have orthodontic treatment
and there's not enough space in your mouth, so they choose
to take a couple of teeth out.
Or it may be that you have a wisdom tooth that has grown
through in an unfavourable position.
What is gum disease?
Simply put, gum disease is a kind of a collective term
for two types of conditions.
One's gingivitis and one's periodontitis.
Gingivitis is essentially just when your
gums are a little bit inflamed.
This could be because you've had a couple of days
where you haven't been brushing as well,
and the plaque has accumulated on the gum line.
The good news is this can be reversed just
by a good few days of really good oral hygiene care.
Periodontitis is when that gingivitis has kind
of taken itself to the next level
and you haven't been looking after your gum health.
That is when the bones then start to shrink
underneath the gums.
How do I stop gum disease from happening?
In order to stop gum disease from happening, we need
to make sure your oral hygiene is optimal.
So incorporating regular brushing in the morning
and the evening and making sure we're removing all
that plaque that builds up from the day
so the gums don't get inflamed.
Why do people get gum disease?
So for the majority of people,
the reason you get gum disease is
because of poor oral hygiene.
If the plaque that accumulates throughout the day is sat on
the gum line, it will cause inflammation of the gums.
In turn, the gums will start to puff up
and essentially swell up and move away from the tooth.
This is what we call gum disease.
Occasionally, there is a small amount of people
that fall into this bracket.
It may be a hereditary thing
or something that you are prone to, in which case,
I would definitely look to seek professional help.
What does it mean if I have gum disease?
First of all, don't worry.
Most people have completely reversible gum disease, so just
with a little bit of TLC
and some active oral hygiene, it should go away.
But if you are concerned, do go visit your dentist
and they'll be able to guide you as to
what the best treatments are.
What is the treatment for gum disease?
So if you do have gum disease,
the primary treatment would be just good cleaning at home
and potentially a hygiene appointment in the dental surgery.
If your gum disease is a little bit more advanced,
you may require a course of treatment,
or you may be required
to see a specialist called a periodontist,
and they will be able to talk you through some other options
to get your gums back to full health.
Why do people need a tooth implant?
When you've had a tooth extracted, for whatever reason,
you may choose to replace the missing tooth.
In this case, an implant may be one of your options.
What is an implant?
An implant is one of the options
you have to restore a space that is from a missing tooth.
Essentially, it's a little screw
that's secured into the jaw,
and then a ceramic fake tooth is placed over the top of it
to give it a nice lifelike tooth appearance.
What is the recovery like after a tooth implant?
We normally say after you're having the main implant
surgery to have a couple of days of downtime,
so you'll still be able to do your day-to-day activities,
but avoid anything that's going
to get your heart rate up such as the gym,
and just take it easy.
That is only after the main implants appointments
where they put the screw in.
After all the other appointments,
you shouldn't have any downtime.
Will a tooth implant hurt?
You'll be under local anaesthetic for the treatment,
so you won't feel anything during the process
of popping the screw into your bone.
However, it will be a little bit tender afterwards,
so do have a couple of days
where you've got a bit more relaxed downtime.
You'll still be able to do your day-to-day activities,
but just take it easy for a couple of days
after you've had that initial implant surgery.
I don't want an implant, what are the other options?
There are many other options when it comes
to restoring a space
because of a missing tooth. As well as the implant,
you can either leave the gap,
although we don't always recommend this as
there can be some implications in terms of how you bite.
You can use a denture, which is essentially a little plate
that you put into your mouth and remove it at nighttime.
Or you can have a bridge, which is a fake tooth,
which is attached to an adjacent tooth.
What is composite bonding?
Composite bonding is essentially a cosmetic procedure
where we place composite,
which is the white filling material, onto the teeth in order
to shape them and make them more aesthetically pleasing.
Why might I need composite bonding?
Composite bonding might've been suggested to you if you've come into the dentist with any particular aesthetic concern.
So, if you want to change the shape of your teeth
or the colour of your teeth, it's a good option,
which is relatively minimally invasive.
Will composite bonding hurt?
Because composite bonding is a minimally invasive procedure,
there's no drilling required to the actual tooth surface.
It shouldn't hurt. However, it can take quite a while,
so your mouth will be open for prolonged period
and sometimes your jaw can get a little bit achy.
What happens during a composite bonding procedure?
Composite bonding is a minimally invasive procedure,
so you shouldn't require any local anaesthetic.
First thing the dentist will do is understand
what you're looking to achieve
and make sure your visions are aligned.
Once that's done, they'll get started.
So the first stage is they pop something called an etchant
on, and this is essentially dries out the tooth.
You then put a bond, which acts like a little bit of a glue
to the tooth, and then they'll layer on the composite,
which is essentially white filling material, onto the tooth
and shape it accordingly. At the end,
they'll then spend quite a long time polishing it down
and shaping it until they're happy,
and most importantly, until you are happy.
What happens in an implant appointment?
Implants tend to be a bit more of a specialist treatment,
so normally your general dentist will refer you onto a
specialist for this. The implant itself takes place across
a series of appointments.
The first one will involve taking X-rays and images,
and this will be used to plan the implant.
The second one is the main appointment in which they will
pop the screw into the bone.
At this point, we then leave it 3 to 6 months
for the screw to kind of integrate with the bone
and make sure it's ready
to have the final fake tooth put on.
If it's a front tooth,
you may be concerned about going round with a gap,
in which case they will provide you with a temporary denture
or little plate that you pop in
and out whilst you are waiting for the screw
to integrate with the bone.
Once the implant surgeon is happy that it's all ready to go,
he'll then take some impressions
and then the final fake tooth known as the crown,
will then be attached onto the screw
and you'll have your implants all done.
What is teeth straightening?
Teeth straightening, also known as orthodontics,
is the process of aligning your teeth
to get them into a favourable position.
This may be functionally, so in terms of chewing,
also and for most people aesthetically,
so in terms of how they look.
This can be achieved with braces:
you can have your traditional wire braces
or you can have something called clear aligner.
Why might I need teeth straightening?
There are a handful of reasons why you might want
to have your teeth straightened.
The most obvious one is aesthetic, so it may be you
want that nice Hollywood straight smile,
in which case teeth straightening will help that.
Another reason might be you're struggling
to clean your teeth because of the crowding in your teeth.
So by straightening it means
that you can get toothbrushes into all the nooks
and crannies and improve your gum health.
The third reason which may be guided
by your dentist is for a functional reason.
Your bites may not be in a favourable position,
and this can have some other effects such as issues chewing
and tooth wear, so the dentist may recommend you having some
orthodontic or teeth straightening treatment.
How long does teeth straightening take?
So depending on the complexity of the treatment,
it can range anything from a couple
of months to a couple of years.
Your dentist or your orthodontist will be able
to guide you on that timeline.
Will teeth straightening hurt?
So for the majority of your teeth straightening
journey, it won't hurt.
However, the first couple
of weeks it can be a little bit sore.
Because we're putting pressure on the teeth in
order to get them to move,
that constant pressure can be a little
bit tender, but it's nothing
a paracetamol won't fix.
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Bupa Dental Care is a trading name of Oasis Dental Care Limited. Registered in England and Wales No: 00478127. Registered office: Bupa Dental Care, Vantage Office Park, Old Gloucester Road, Hambrook, Bristol, United Kingdom BS16 1GW.
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