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What are my missing tooth options
When a tooth is missing there are usually a number of solutions available.
You could have a false tooth made and fitted to a plate.
Alternatively a Bridge can be fitted to an adjacent tooth.
Or you could have an Implant which doesn’t affect the adjacent teeth.
Instructions following a routine extraction
Q I’ve had my tooth out – what should I do now?
A Take it easy for the rest of the day. Take as little exercise as you can, and rest as much as you can. Keep your head up to avoid any bleeding.
Q What precautions should I take?
A Avoid hot food or drinks until the anaesthetic wears off. This is important as you cannot feel pain properly and may burn or scald your mouth. Also be careful not to chew your cheek. This is quite a common problem, which can happen when there is no feeling.
If you do rest, try to keep your head higher for the first night using an extra pillow if possible. It is also a good idea to use an old pillowcase, or put a towel on the pillow, in case you bleed a little.
Q Should I rinse my mouth out?
A Do not be tempted to rinse the area for the first 24 hours. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.
Q Is there anything else I should avoid?
A Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth.
Q When should I brush?
A It is just as important, if not more so, to keep your mouth clean after an extraction. However, you do need to be careful around the extraction site.
Q What do I do if it bleeds?
A The first thing to remember is that there may be some slight bleeding for the first day or so. Many people are concerned about the amount of bleeding. This is due to the fact that a small amount of blood is mixed with a larger amount of saliva, which looks more dramatic than it is.
If you do notice bleeding, do not rinse out, but apply pressure to the socket. Bite firmly on a folded piece of clean cotton material such as a handkerchief for at least 15 minutes. Make sure this is placed directly over the extraction site and that the pad is replaced if necessary.
If the bleeding has not stopped after an hour or two, contact your dentist.
Q How soon can I have a cigarette?
A It is important not to do anything which will increase your blood pressure, as this can lead to further bleeding. We recommend that you avoid smoking for as long as you can after an extraction, but this should be at least for the rest of the day.
Q Is there anything I can do to help my mouth?
A Different people heal at different speeds after an extraction. It is important to keep your mouth and the extraction site as clean as possible, making sure that the socket is kept clear of all food and debris. Don’t rinse for the first 24 hours, and this will help your mouth to start healing. After this time use a salt-water mouthwash, which helps to heal the socket. A teaspoon of salt in a glass of warm water gently rinsed around the socket twice a day can help to clean and heal the area. Keep this up for at least a week or for as long as your dentist tells you.
It is important to keep to a healthy diet; and take a Vitamin C supplement, which will help your mouth to heal.
Q I am in pain, what should I take?
A There will usually be some tenderness in the area for the first few days, and in most cases some simple pain relief is enough to ease the discomfort. What you would normally take for a headache should be enough. However, always follow the manufacturer’s instructions and if in doubt check with your doctor first. Do not take aspirin, as this will make your mouth bleed.
Q Are there any medicines I should avoid?
A As we have said, it is important not to use anything containing aspirin as this can cause further
bleeding. This happens because aspirin can thin the blood slightly. Asthma sufferers should avoid Ibuprofen-based pain relief. Again check with your chemist or dentist if you are worried or feel you need something stronger.
Q I am still in pain, what could it be?
A Sometimes an infection can get in the socket, which can be very
painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache! In this case, it
is important to see your dentist, who may place a dressing in the socket and prescribe a course of antibiotics to help relieve the infection. You may also feel the sharp edge of the socket with your tongue and sometimes small pieces of bone may work their way to the surface of the socket. This is perfectly normal.
Q Will my dentist need to see me again?
A If it has been a particularly difficult extraction, the dentist will give you a follow-up appointment. This could be to remove any stitches that were needed, or simply to check the area is healing well.
Your dentist will also want to discuss the options available to you for replacing your lost tooth.
Not replacing the lost tooth can result in the teeth on either side of the space tilting into the spaces, resulting in more food and plaque trapping in front and behind these teeth, making them more prone to gum disease and decay and possibly their eventual loss. The tooth above the space is likely to grow down (overeupt) as it no longer has a tooth to bite against making it more prone to being lost as well.
How do you floss your teeth?
A Your teeth vary in shape and size depending on their position within your mouth. These differences allow the teeth to do many different jobs.
Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly.
Finally, teeth help to give our face its shape. A healthy smile can be a great asset and because this is so important, it makes sense to give your teeth the best care possible.
Q How do I clean between teeth?
A One way to clean between your teeth is with dental floss or tape. Flossing removes plaque and food particles from between your teeth and under the gumline, areas a toothbrush can’t reach. Your dentist or hygienist can show you proper flossing techniques.
The following suggestions may help:
Break off about 18 inches of floss, and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the other hand. As you use the floss, you will take up the used section with this finger.
Hold the floss tightly between your thumb and forefingers, with about an inch of floss between them, leaving no slack. Use a gentle ‘rocking’ motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.
When the floss reaches the gumline, curve it into a C-shape against one tooth until you feel resistance.
Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum.
Repeat on the other side of the gap, along the side of the next tooth
Don’t forget the back of your last tooth.
When flossing, keep to a regular pattern. Start at the top and work from left to right, then move to the bottom and again work from the left to right. This way you’re less likely to miss any teeth.
It is also very important to clean around the edges of any crowns, bridges or implants. This can be difficult to do effectively using traditional floss and there are now specialist flosses to do the job thoroughly (such as super floss and specialist floss threaders).
Ask your dentist or hygienist on how to use these properly and which method you should use.
Q Should my gums bleed when I floss?
A Your gums may bleed or be sore for the first five or six days that you floss. This should stop once the plaque is broken up and the bacteria has gone. If the bleeding does not stop, tell your dentist. It may be that you are not flossing correctly or your teeth and gums need a more thorough clean by your dentist or hygienist.
Q What do I do if I have difficulty using floss?
A If you have trouble using floss you can use a floss holder or an interdental cleaning aid. Interdental cleaning aids include wood-sticks or small interdental brushes used to remove plaque from between the teeth. Your dentist or hygienist can explain how to use these properly.
What is dental erosion?
A Erosion is the loss of tooth enamel caused by acid attack. Enamel is the hard, protective coating of the tooth, which protects the sensitive dentine underneath. When the enamel is worn away, the dentine underneath is exposed, which may lead to pain and sensitivity.
This often happens when someone keeps being sick; for instance, in cases of Bulimia, Anorexia Nervosa or long-term ill health.
Q How do I know I have dental erosion?
A Erosion usually shows up as hollows in the teeth and a general wearing away of the tooth surface and biting edges. This can expose the dentine underneath, which is a darker, yellower colour than the enamel. As the dentine exposed is sensitive, teeth can also be more sensitive to hot, cold or sweet foods and drinks.
Q What causes dental erosion?
A Every time you eat or drink anything acidic, the enamel on your teeth becomes softer for a short while, and loses some of its mineral content. Your saliva will slowly neutralise this acidity in your mouth and restore it to its natural balance. However, if this acid attack happens too often, the mouth does not have a chance to repair itself and tiny particles of enamel can be brushed away. Over time, you would start to lose the surface of your teeth.
Q Are there any medical problems which can cause dental erosion?
A Bulimia is a condition where patients make themselves sick so that they lose weight. Because there are high levels of acid in the vomit, this can cause damage to tooth enamel.
Q Do any other acids cause dental erosion?
A There are many medical conditions which could help cause dental erosion. Acids produced by the stomach can come up into the mouth (this is called gastro-oesophageal reflux). Patients suffering from Hiatus hernia and other oesophageal problems, such as drinking too much alcohol, may also find they suffer from dental erosion due to vomiting.
Q What problems can it lead to?
A Dentine is the softer, sensitive part of the tooth. As this becomes exposed, it also becomes more likely to decay, leading to cavities and possible fillings. The dentine is also sensitive, which can cause pain when you have hot, cold or sweet foods and drinks.
The parts of the tooth suffering from erosion can also be unsightly. The dentine is darker and the teeth become shorter and shorter.
Q Can my diet help prevent it?
A Acidic foods and drinks such as fruit and fruit juices, particularly citric ones including lemon and orange, can be particularly harmful to teeth. Fruit juices and fruits contain natural acids, which can be just as harmful to teeth. Fizzy drinks are also a cause of enamel erosion. It is important to remember that even the diet brands are still as harmful. Even flavoured fizzy waters can have an effect if taken in large amounts, as they contain certain acids which can harm the teeth. It is important to have acidic foods and drinks at mealtimes only. Healthy foods such as fruit and fruit juices are not always the best options for teeth if you have too much of them. It is also recommended that you do not brush your teeth for at least one hour after eating or drinking anything acidic, so that your teeth can build up their mineral content again.
Q What about chewing gum?
A After eating, especially acidic foods, plaque acid attacks your teeth. This can lead to enamel erosion and tooth decay. You get the best results by chewing sugar-free gum for twenty minutes after eating or drinking. Chewing sugar-free gum makes your mouth produce more saliva. This neutralises the acid and helps the enamel build up its mineral content, preventing early tooth decay.
Q Are sports drinks safe?
A Many sports drinks contain a lot of acid and can therefore cause dental erosion. However, it is important for athletes to avoid dehydration, and it is essential to drink plenty of fluids during training. Water or sugar – free drinks are ideal to sip during the session, and sports drinks should be drunk more quickly without holding or ‘swishing’ around the mouth.
It is important for everyone training and playing sports to have regular dental check ups and keep to a good standard of oral hygiene and plaque control.
Q How can I help my child prevent erosion?
A Giving your child acidic foods and drinks less often will help prevent erosion. Using a straw with drinks may also help to cut down the erosion. This allows the drink to go straight to the back of the mouth, which avoids long-term contact with the teeth. It is important to remember prevention is better than cure.
Q Should I use a special toothpaste?
A We recommend you use a fluoride toothpaste twice a day. In severe cases fluoride supplements such as rinses and gels may be used once a day. Your dentist or hygienist will tell you the best supplement to use. If you are unsure, look for products that have been accredited by the British Dental Health Foundation. This means the products have been clinically tested and the claims on the packaging are proven to be correct.
Q What about alcoholic drinks?
A Many of the popular ‘alcopops’ drinks have been proven to cause erosion. They usually contain citric fruits and alcoholic spirits, which can be harmful to teeth. It is therefore important not to drink too much of these.
Q How can it be treated?
A Dental erosion does not always need to be treated. With regular check ups your dentist can prevent the problem getting any worse and the erosion going any further. In other cases it is important to protect the tooth and the dentine underneath to prevent tooth decay and sensitivity. In these cases, simply bonding a filling onto the tooth will be enough to repair it. However in more severe cases the dentist may need to fit a veneer. (See our leaflet ‘Tell Me About Veneers’.)
Q How much will treatment cost?
A Costs can vary, depending on the type of treatment necessary. More extensive treatment may only be available privately and can therefore be more expensive. It is important to discuss all the treatment options with your dentist and be sure to get a written estimate before starting treatment.
What is the main cause of tooth decay?
A Tooth decay happens when sugar reacts with the bacteria in plaque – the sticky coating on your teeth. This forms acids that attack the teeth and destroy the enamel. After this happens many times, the tooth enamel may break down forming a hole or ‘cavity’.
Q What about snacks?
A Every time you eat or drink anything sugary, your teeth are under attack for up to one hour. So it is important to keep any sugary foods only to mealtimes and limit the amount of time your mouth is under attack. If you do need to snack between meals, choose foods that do not contain sugar. Savoury snacks such as cheese, raw vegetables or fruit and breadsticks are better.
Q What should I drink?
A Plain, still water or milk are good choices. Soft drinks can increase the risk of dental problems: either the sugar can cause decay or the acid in both normal and diet drinks can dissolve the enamel on the teeth. The risk is higher when you have these drinks between meals.
Sugar-free squashes, if they are completely sugar free, are the safest alternative to water and milk. If you make squash or cordial, be sure that the drink is diluted 1 part cordial to 10 parts water. Some soft drinks contain sweeteners, which are not suitable for young children – ask your dentist or health visitor if you are not sure.
Q Should I brush my teeth after every meal?
A It is important that you brush twice a day. The best times are before breakfast and last thing at night before you go to bed. Eating and drinking naturally weakens the enamel on your teeth, and brushing straight afterwards can cause tiny particles of enamel to be brushed away.
It is best not to brush your teeth until at least 30 minutes after eating. It is especially important to brush before bed. This is because saliva flow, which is the mouth’s own cleaning system, slows down during the night. This leaves the mouth more at risk from decay.
Always use a fluoride toothpaste and look for one carrying our accreditation logo. These products have been clinically and scientifically tested, and a panel of dental experts have decided whether the packaging claims are correct before giving their accreditation badge.
Q Should I stick to fruit and fruit juices?
A Fruit contains acids, but this is only damaging to your teeth if you eat an unusually large amount.
Take fruit juices at meal times; or if you are taking them between meals, try diluting them with water. Or, if you do eat fruit as a snack, try to eat something alkaline such as cheese afterwards. ‘Alkalines’ cancel out the acid effects of fruit.
Q Do other foods have sugar in them?
A Many processed foods have sugar in them. Always read the list of ingredients on the labels when you are food shopping. Sugar can come in many forms, for example: sucrose, fructose and glucose are just three types. Ask your dentist if you are unsure.
These sugars can all damage your teeth, and the higher up it appears in the list of ingredients, the more sugar there is in the product.
When you are reading the labels remember that ‘no added sugar’ does not necessarily mean that the product is sugar free. It simply means that no extra sugar has been added. These products may contain sugars such as those listed above, or they may be listed as ‘carbohydrates’.
Q Does chewing gum help?
A Chewing gum makes your mouth produce more saliva, which helps to cancel out the acid in your mouth after eating or drinking. It has been proven that using sugar-free chewing gum after meals can prevent tooth decay. However it is important to use only sugar-free gum, as ordinary chewing gum contains sugar and therefore damages your teeth.
Q Can I eat sweets?
A The main point to remember, is that it is not the amount of sugar you eat or drink, but how often you do it. Sweet foods are allowed, but it is important to keep them to mealtimes. As far as diet is concerned, snacking between meals is the biggest cause of tooth decay.
Sugary foods can also contribute to a range of health problems including heart disease and obesity.
What is Gum Disease?
A Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.
Q What is gingivitis?
A Gingivitis means inflammation of the gums. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.
Q What is periodontal disease?
A Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out.
Q Am I likely to suffer from gum disease?
A Probably. Most people suffer from some form of gum disease, and it is the major cause of tooth loss in adults. However, the disease develops very slowly in most people, and it can be slowed down to a rate that should allow you to keep most of your teeth for life.
Q What is the cause of gum disease?
A All gum disease is caused by plaque. Plaque is a film of bacteria, which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and flossing.
Q What happens if gum disease is not treated?
A Unfortunately, gum disease progresses painlessly on the whole so that you do notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult.
Q How do I know if I have gum disease?
A The first sign is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.
Q What do I do if I think I have gum disease?
A The first thing to do is visit your dentist for a thorough check-up of your teeth and gums. The dentist can measure the ‘cuff’ of gum around each tooth to see if there is any sign that periodontal disease has started. X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important, so the correct treatment can be prescribed for you.
Q What treatments are needed?
A Your dentist will usually give your teeth a thorough clean. You’ll also be shown how to remove plaque successfully yourself, cleaning all surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dentist or hygienist.
Q What else may be needed?
A Once your teeth are clean, your dentist may decide to carry out further cleaning of the roots of the teeth, to make sure that the last pockets of bacteria are removed. You’ll probably need the treatment area to be numbed before anything is done. Afterwards, you may feel some discomfort for up to 48 hour.
Q Once I have had periodontal disease, can I get it again?
A Periodontal disease is never cured. But as long as you keep up the home care you have been taught, any further loss of bone will be very slow and it may stop altogether. However, you must make sure you remove plaque every day, and go for regular check ups and scale and polishes by the dentist and hygienist.
← Why Use Fluoride? (previous entry)
Why Use Fluoride?
A Fluoride is a natural mineral that is found in water. The amount of fluoride in the water varies from area to area.
Q What are the benefits of fluoride?
A Fluoride has been researched for over 50 years and water fluoridation has been proven to cut dental decay by 40 to 60%. Fluoride is present in many different natural sources, but can also be artificially added to our drinking water. A level of one part in a million has been shown to be most effective. Fluoride can greatly help dental health by strengthening the tooth enamel, making it more resistant to tooth decay. Many toothpastes now contain fluoride, and this is how most people get their fluoride.
Q Are fluoride toothpastes enough?
A If your drinking water does not have fluoride added, fluoride toothpaste is effective. However, some people are more prone to dental decay. If so, the dentist may suggest using fluoride supplements, which can help to reduce dental decay. The amount of fluoride in toothpaste is usually enough to lower the level of decay. In areas where the water supply is fluoridated, fluoride toothpaste provides additional protection. However, in these areas, children under 7 years old should use one of the toothpastes containing lower levels of fluoride.
Q Where can I find fluoride?
A All water contains fluoride. Your local water supplier or health authority should be able to tell you how much fluoride is in the water in your area. One part of fluoride for every million parts of water (1ppm) is considered enough.
Fluoride also comes in specially formulated gels, drops, tablets or mouthwashes which are recommended for those people who need added protection.
Fluoride is also in salt and tea, and some countries artificially add fluoride to their table salt and milk.
Q Is it in my water supply?
A Probably. Unless you are getting water from a private scheme
Q Should children have extra fluoride?
A Many areas have enough fluoride in the water to help fight tooth decay. However, where the level in the water supply is low, it is sometimes necessary for children to take extra fluoride in the form of supplements. It is extremely important that these are only taken on the advice and instruction of a dentist.
Q What are the side effects?
A ‘Dental fluorosis’ can occur when too much fluoride is taken. This can happen for example when the water supply is already fluoridated and supplements are taken, or when children ‘eat’ toothpaste. Campaigners against fluoridation claim that an overdose of fluoride can sometimes cause ‘brittle bone’ disease and digestive disorders, but these suggestions have not been scientifically proven.
Q What is fluorosis?
A Enamel fluorosis is a result of too much fluoride, absorbed while the enamel of the teeth is forming. Severe fluorosis may lead to pitting of the enamel and discolouration. However, severe fluorosis is rare in Ireland.
In its mildest form, fluorosis appears as very fine pearly white lines or flecking on the surface of the teeth. This mild fluorosis is often undetectable except by a dental expert.
Q Is fluoride safe?
A Many reports have been published about the pros and cons of fluoride. After many years the scientific conclusion is that fluoride is of great benefit to dental health and helps to reduce decay, while causing no harmful side effects to general health.
What is root canal treatment?
A Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (known as the pulp) is infected through decay or injury.
Q Why is root canal treatment needed?
A If the pulp becomes infected, the infection may spread through the root canal system of the tooth. This may eventually lead to an abscess. If root canal treatment (RCT) is not carried out, the infection will spread and the tooth may need to be taken out.
Q Does it hurt?
A No. A local anaesthetic is used and it should feel no different to having an ordinary filling done.
Q What does it involve?
A The aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection.
Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist.
At the first appointment, the infected pulp is removed. Any abscesses, which may be present, can also be drained at this time. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in and the tooth is left to settle. The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.
Q What will my tooth look like after treatment?
A In the past, a root filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance.
Root canal treatment is usually very successful. However, if the infection comes back the treatment can be repeated.
Q Is it expensive?
A. Costs of a root canal treatment in this dental practice range from € 350.00 for an anterior tooth to € 550.00 for a molar tooth. The price reflects the time it takes and the skill needed. Occasionally we may need to refer you to a specialist in root treatment. The fees for a molar root treatment by a specialist are around €900- 1000. Your dentist will be pleased to give you an estimate. The revenue give 20% tax back on this treatment.
Q What if I don’t have the treatment?
A The alternative is to have the tooth out. Once the pulp is destroyed, it can’t heal and it is not recommended to leave an infected tooth in the mouth.
Although some people would prefer an extraction, it is usually best to keep as many natural teeth as possible.
Q Will the tooth be safe after treatment?
A Yes. However, it is better to restore the tooth with a crown to provide extra support and strength to the tooth.
Q Where can this treatment be carried out?
A Root canal treatment is a routine dental procedure, which your dentist will be happy to do for you.
Q What about aftercare?
A Root-treated teeth should be treated just the same as any other tooth. Remember to clean your teeth at least once a day, preferably with a fluoride toothpaste. Cut down on sugary snacks, and keep them only to mealtimes if possible. See your dentist for regular check-ups.
What are Wisdom Teeth?
Q Why do we have wisdom teeth?
A Adults can have up to 32 teeth. The wisdom teeth are the last to come through, right at the back. They usually appear when you are between 17 and 25, although sometimes they appear many years later. Nowadays people often have jaws that are too small for all 32 teeth – 28 is often the most we have room for. So if all the other teeth are present and healthy there may not be enough space for the wisdom teeth to come through properly.
Q Do they always cause problems?
A No. If there is enough room they will usually come through into a useful position and cause no more problems than any other tooth. Often there will be some slight discomfort as they come through, but this is only temporary and will disappear once the tooth is fully in position.
Q What is an impacted wisdom tooth?
A If there is not enough room, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. The wisdom tooth will be at an angle, and will be described by the dentist as ‘impacted’.
Q What problems should I be prepared for?
A If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and perhaps swollen. Food particles and bacteria can collect under the gum edge, and it will be difficult to clean the area effectively.
Your dentist will tell you whether this is a temporary problem that can be dealt with by using mouthwashes and special cleaning methods (and possibly antibiotics), or whether it is better to have the tooth removed.
Q What can I do to help myself?
A If your gums are sore and swollen, use a mouthwash of medium hot water with a teaspoonful of salt. (Check that it is not too hot before using it.) Swish the salt water around the tooth, trying to get into the areas your toothbrush cannot reach. An antibacterial mouthwash such as Corsody can also reduce the inflammation. Pain-relieving tablets such as paracetamol or aspirin can also be useful in the short term, but see your dentist if the pain continues.
Q But if it does not help?
A If the pain does not go away or if you find it difficult to open your mouth, you should see a dentist. They will be able to see the cause of the problem, and tell you what to do. It may help to clean around the tooth very thoroughly, and the dentist may give you a prescription for an antibiotic.
Q Are x-rays needed?
A The dentist will usually take x-rays to see the position of the root, and to see whether there is room for the tooth to come through into a useful position.
Q What are the main reasons for taking wisdom teeth out?
A When it is clear that the wisdom teeth will not be able to come through into a useful position because there is not enough room, and they are also causing some pain or discomfort.
If they have only partly come through and are decayed – such teeth will often be more likely to decay as it will be difficult to clean them as thoroughly as your other teeth.
If the wisdom tooth is causing a cleaning problem and has no real use.
If the wisdom tooth starts to ‘over-grow’. This often happens if the lower one has already been removed or is impacted and cannot come through, and the upper one has no tooth to bite against. The upper one will come down too far, looking for a tooth to make contact with.
If they are painful.
Q Are wisdom teeth difficult to take out?
A It all depends on the position and the shape of the roots. Your dentist will tell you how easy or difficult each tooth will be to remove after looking at the x-rays. Upper wisdom teeth are often easier to remove than lower ones, which are more likely to be impacted.
Your dentist will say whether the tooth should be taken out at the dental practice, or whether you should be referred to a specialist (oral surgeon) at a hospital. Very occasionally there is a possibility of some numbness of the lip after the removal of a lower tooth – your dentist will tell you if it is possible in your case.
You will probably have either a local anaesthetic – as you would have for a filling – or sedation. You could also have a general anaesthetic (where you would be asleep), but this will usually be given only in a hospital.
Q Will it make any difference to my face or mouth?
A Taking wisdom teeth out may cause some swelling for a few days. But as soon as the area is healed, there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, especially if the teeth were impacted.
Q What should I expect after a wisdom tooth is taken out?
A The amount of discomfort will depend on how easy it was to take the tooth out. As with any operation there are side-effects and complications.
Q What are the Side-effects?
A These occur after every operation to some degree. Soreness, swelling and stiffness of the jaw with restricted mouth opening usually clear up by about a week, or so, after the operation.
Some bleeding during the operation is inevitable but this is rarely severe or troublesome. It is important to follow any advice you get about mouthwashes and so on, to help with the healing.
Some people also find homoeopathic remedies help to reduce discomfort. Usual painkillers such as paracetamol, or ibuprofen, will usually deal with any pain.
It is best to stay fairly quiet and relaxed for 24 hours afterwards to make sure there are no bleeding problems. There may be some stitches to help the gum heal over.
Your dentist will probably want to see you again about a week later to check on the healing, and to remove any stitches.
Q What are the Complications?
A These are much less common but do occur from time to time. Because the nerve to your lip runs through your jaw and because the nerve to your tongue lies on your jaw near the wisdom tooth these are at risk of being damaged.
This may produce alteration in the feeling in the lip or tongue. This may be felt as numbness (Anaesthesia) or as “pins and needles” (Paraesthesia).
It does not involve any paralysis of the lip or tongue. It can be permanent but this is relatively rare.
Q Does every wisdom tooth removal carry the same risk?
No. It depends on the type and difficulty of the impaction and other factors. The figures below are based on several studies and give some idea of the frequency.
Sensory alteration in the tongue: 1:200(0.5%).
Sensory alteration in the lip: 1:250(0.4%).
The dentist will be happy to discuss this further with you and will try to answer any queries you may have.
Q Have you been shown your x-ray?
A If not, please ask to see it!
Q What does it cost?
A The cost depends on what is involved. If it is a normal extraction it will cost €75.00 plus the cost of an X-ray and examination. If it is a surgical extraction it can cost €250.00.
At an oral surgeon it would probably cost € 500.00. In hospital there would also be a charge for a general anaesthetic etc. It is important that you discuss costs and payment methods with your dentist before starting treatment.
The decision to proceed with removal of your wisdom tooth (or teeth) can only be made by you yourself. You do not have to make up your mind immediately.
What are White Fillings?
Q Why should I consider white fillings?
A Most people have fillings of one sort or another in their mouths. Nowadays fillings are not only functional, but can be natural looking as well. Many people don’t want silver fillings that show when they laugh or smile because they are more conscious about the way they look.
There is a slight chance that some people may be sensitive to the metals used in silver amalgam fillings. If this sensitivity is proven, it may be best to replace the amalgam fillings with another type.
Q Are they expensive?
A Because we use the latest white filling materials and bonding techniques these fillings are more expensive then the silver amalgam fillings.
Costs usually depend on the size and type of white filling used and the time it takes to complete the treatment. Costs may also vary from region to region.
As a guide, white fillings start from around € 80.00 each, but your dentist will be able to give you an idea of the cost before you agree to treatment.
Q Are they as good as silver amalgam fillings?
A White fillings have always been considered less long lasting than silver amalgam fillings. But there are now new materials available with properties comparable to silver amalgam, and these are proving to be very successful.
The life expectancy of a white filling can depend greatly on where it is in your mouth and how heavily your teeth come together when you bite. Your dentist can advise you on the life expectancy of your fillings. However, any fillings provided are automatically guaranteed for one year.
Q Is it worth replacing my amalgam fillings with white ones?
A It is usually best to change fillings only when your dentist decides that an old filling needs replacing. If so you can ask to have it replaced in a tooth-coloured material.
Some dentists prefer not to put white fillings in back teeth, as they are not always successful. One way around this would be to use crowns or inlays, but this can mean removing more of the tooth and can be more expensive.
Q What are tooth – coloured fillings made of?
A This can vary, but they are mainly made of glass particles, synthetic resin and a setting ingredient. Your dentist should be able to give you more information about the particular material that they use.
Q Are there any alternatives to fillings?
A Adhesive dentistry is another form of this treatment. This involves bonding the filling to the tooth. The dentist has to remove less of the tooth, which is obviously better.
As we have already said, there are alternatives such as crowns and inlays although they can cost a lot more. Veneers can be used on front teeth instead of crowns or fillings.
What are Fissure Sealants?
A Sealants are a safe and painless way or protecting your children’s teeth from decay. A sealant is a protective plastic coating, which is applied to the biting surfaces of the back teeth. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay.
Q Which teeth should be sealed?
A Sealants are only applied to the back teeth – the molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. Your dentist will tell you which teeth should be sealed after they have examined them, and checked whether the fissures are deep enough for sealing to help. Some teeth naturally form with deep grooves, which will need to be sealed, others with shallow ones which will not need sealing.
Q Will my child feel it?
A No, it is totally pain free, and the teeth do not feel any different afterwards.
Q How long do they last?
Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes the dentist needs to add or replace some sealant to be sure that no decay can start underneath them.
Q How do they work?
A The sealant forms a smooth, protective barrier, by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves.
Q What is involved?
A The process is usually quick and straightforward taking only a few minutes per tooth. The tooth is thoroughly cleaned, prepared with a special solution, and dried. The liquid sealant is then applied and allowed to set hard – usually by shining an ultraviolet light onto it.
Q When should this be done?
A Sealants are often applied as soon as the permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.
Q How much does it cost?
A Most dentists offer fissure sealing. It is available only privately. The cost is usually €40.00 per tooth but we may offer a discount if doing a few teeth together.
Q Do my children still have to clean their teeth?
A Yes. It is still vital that they do this. The smooth, sealed surface is now much easier to keep clean and healthy with normal tooth-brushing. Using a fluoride toothpaste will also help to protect your children’s teeth. Pit and fissure sealing reduces tooth decay and the number of fillings your child might need.
Q Whom do I ask about the treatment?
A If you would like to know more about the treatment, ask your dentist or hygienist. They will tell you if fissure sealing will help your children’s teeth, and if it is the right time to do it.
The biting surfaces of teeth can be protected by the application of ‘sealants’. These make the tooth surface smoother and easier to clean, and stop decay starting in the difficult to clean areas.
Q When should fissure sealants be applied?
A Sealants are ideally applied as soon as the permanent teeth start to come through. This usually occurs when the child is in Second Class in Primary School, between 6 and 7 years of age. The rest are usually sealed if required as they appear which can be any time between 11 and 14 years of age.
Q How long do pit and fissure sealants last?
A Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes the dentist needs to add or replace some sealant to be sure that no decay can start underneath them.
Q How do pit and fissures work?
A The sealant forms a smooth, protective barrier, by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves.
What are Dental Veneers?
A veneer is a thin layer of porcelain made to fit over the front surface of a tooth, like a false fingernail fits over a nail. Sometimes a natural colour ‘composite’ material is used instead of porcelain.
Q What are the advantages of veneers?
A Veneers make teeth look natural and healthy, and because they are very thin and are held in place by a special strong bond (rather like super-glue) very little preparation of the tooth is needed.
Q When would I need a veneer?
A Veneers can improve the colour, shape and position of teeth. A precise shade of porcelain can be chosen to give the right colour to improve a single discoloured or stained tooth or to lighten front teeth (usually the upper ones) generally. A veneer can make a chipped tooth look intact again. The porcelain covers the whole of the front of the tooth with a thicker section replacing the broken part. Veneers can also be used to close small gaps, when orthodontics (braces) are not suitable. If one tooth is slightly out of position, a veneer can sometimes be fitted to bring it into line with the others.
Q What about alternatives?
A A natural-coloured filling material can be used for minor repairs to front teeth. This is excellent where the tooth supports the filling, but may not work so well for broken tooth corners. There will always be a join between the tooth and the filling material.
Crowns are used for teeth that need to be strengthened – either because they have broken, have been weakened by a very large filling, or have had root canal treatment.
Q How long will a veneer last?
A Veneers should last for many years, but they can chip or break, just as your own teeth can. Your dentist will tell you how long each individual veneer should last. Small chips can be repaired, or a new veneer fitted if necessary.
Q How are teeth prepared for a veneer?
A Some of the shiny outer enamel surface of the tooth may be removed, to make sure that the veneer can be bonded permanently in place later. The amount of enamel removed is tiny and will be the same as the thickness of the veneer to be fitted, so that the tooth stays the same size. A local anaesthetic (injection) may be used to make sure that there is no discomfort, but often this is not necessary. Once the tooth has been prepared, the dentist will take an ‘impression’. This will be given to the dental technician, along with any other information needed to make the veneer. The colour of the surrounding teeth is matched on a shade guide to make sure that the veneer will look entirely natural.
Q How long will it take?
A A veneer takes at least two visits; the first to prepare the tooth and to match the shade, and the second to fit it. Before bonding it in place, your dentist will show you the veneer on your tooth to make sure you are happy with it. Bonding a veneer in place is done with a special adhesive, which holds it firmly on the tooth.
Q Will I need a temporary veneer between visits?
A Because the preparation of the tooth is so slight you will probably not need a temporary veneer. The tooth will look very much the same after preparation, but will feel slightly less smooth.
Q What happens after the veneer is fitted?
A Only minor adjustments can be made to the veneer after it is fitted. It is usually best to wait a little while to get used to it before any changes are made. Your dentist will probably want to check and polish it a week or so after it is fitted, and to make sure that you are happy with it.
Q How much will it cost?
A One veneer costs € 500.00. There may be a discount if having more then one veneer. We use an expensive laboratory to make the veneers as they produce a natural pleasing to the eye and non bulky veneer which we can be proud of.
There is 20% tax refund from the Revenue on veneers
It is important to discuss charges and treatment options with your dentist before starting treatment.
What are Dental Crowns?
A Crowns are an ideal way to rebuild teeth which have been broken, or have been weakened by decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes also known as ‘caps’.
Q Are post crowns different?
A Post crowns may be used when the tooth has been root filled. The weakened crown of the tooth is drilled off at the level of the gum. The dentist makes a double-ended ‘post’ to fit into the root canal. This can be either prefabricated stainless steel or custom made of gold. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.
Q Are there any alternatives to post crowns for root-filled teeth?
A If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This ‘core’ is then prepared in the same way as a natural tooth and the impressions are taken.
Q Why would I need a crown?
A There are a number of reasons. For instance: the tooth may have been weakened by having a very large
Filling you may have discoloured fillings and would like to improve the appearance of the tooth you may have had a root filling which will need a crown to protect it you may have had an accident and damaged the tooth it may help hold a bridge or denture firmly in place.
Q What are crowns made of?
A Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some of the options available at present:
Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and layers of porcelain are then applied over it.
Porcelain: these crowns are not as strong as bonded crowns but they can look very natural and are most often used for front teeth.
Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
Glass: these crowns look very natural and are used on both front and back teeth.
Precious metal (gold and palladium): these crowns are very strong and hard-wearing, but are usually used at the back of the mouth, where they are not visible.
Q How is a tooth prepared for a crown?
A The dentist will prepare the tooth to the ideal shape for the crown. This will mean removing most of the outer surface, and leaving a strong inner ‘core’. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will
take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impressions will be given to the technician, along with any other information they need to make the crown.
Q Who makes the crown?
A The impressions and information about the shade of your teeth will be given to a dental technician who will be skilled in making crowns. They will make models of your mouth and make the crown on these to be sure that the crown fits perfectly.
Q Will the crown be noticeable?
A No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about two weeks.
Q How long does the treatment take?
A You will need to have at least two visits: the first for the preparation, impression, shade taking and fitting the temporary crown, and the second to fit the permanent crown.
Q Does it hurt to have a tooth prepared for a crown?
A No. A local anaesthetic is used and the preparation should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then local anaesthetic may not be needed.
Q How long will a crown last?
A The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay could endanger the crown. Properly cared for crowns will last for many years – your dentist will be able to tell you how long.
Q How are crowns fixed to teeth?
A Once the fit and appearance of the crown has been checked – and approved by you – it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.
Q Will the crown feel different?
A Because the shape of the crown will be slightly different from the shape of you tooth before it was crowned, you may be aware of it to begin with. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if it feels higher than the surrounding teeth. If it is at all uncomfortable ask your dentist to check and adjust it.
What are Dental Bridges?
Q Why should I replace missing teeth?
A Your appearance is one reason. Another is that the gap left by a missing tooth can mean greater strain on the teeth at either side. A gap can also mean your ‘bite’ is affected, because the teeth next to the space can lean into the gap and alter the way the upper and lower teeth bite together. This can then lead to food getting packed into the gap, which causes both decay and gum disease.
Q How are missing teeth replaced?
A This depends on the number of teeth missing and on where they are in the mouth. The condition of the other teeth also affects the decision.
There are two main ways to replace the missing teeth. The first is with a removable false tooth or teeth – a partial denture. The second is with a fixed bridge. A bridge is usually used where there are fewer teeth to replace, or when the missing teeth are only on one side of the mouth.
Q Can I always have a bridge to replace missing teeth?
A Yes, if you have enough strong teeth with good bone support. Your dentist will help you decide the best way of replacing your missing teeth within your budget.
Q What are bridges made of?
A Bridges are usually made of a precious metal base. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base to reduce the cost.
Q Are bridges expensive?
A. Although a bridge may seem expensive it will last many years. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it’s similar to ordering a piece of hand-made jewellery. The materials are also expensive so it’s fair to say a bridge will not be the cheapest treatment you have ever had. The revenue give 20% tax back on this treatment.
Q How do I look after my bridge?
A You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.
Q Are there other methods for fixing false teeth?
A There are other methods, such as using a combination of crowns and partial dentures that can keep the retaining clips out of sight. These are quite specialised dentures, so you should ask your dentist about them. You can also have teeth implanted, ask your dentist for more information.
Remember that it’s as important to care for your remaining teeth as it is to replace the missing ones.
Q Are there different types of bridge?
A Yes, there are different types of bridge which use different fixing methods. Your dentist will choose the most effective and conservative bridge for your personal situation.
What are sensitive teeth?
A Having sensitive teeth can mean anything from getting a mild twinge to having severe discomfort that can continue for several hours. It can also be an early warning sign of more serious dental problems.
Q Who suffers from sensitive teeth?
A Many people suffer from sensitive teeth and it can start at any time. It is more common in people aged between 20 and 40, although it can affect people in their early teens and when they are over 70. Women are more likely to be affected than men.
Q What causes sensitive teeth?
A The part of the tooth we can see is covered by a layer of enamel that protects the softer dentine underneath. If the dentine is exposed, a tooth can become sensitive. This usually happens where the tooth and the gum meet and the enamel layer is much thinner.
Here are some causes of sensitivity. Toothbrush abrasion – brushing too hard, and brushing from side to side, can cause dentine to be worn away, particularly where the teeth meet the gums. The freshly exposed dentine may then become sensitive.
Dental erosion – this is loss of tooth enamel caused by attacks of acid from acidic food and drinks. If enamel is worn away the dentine underneath is exposed, which may lead to sensitivity.
Gum recession – gums may naturally recede (shrink back), and the roots will become exposed and can be more sensitive. Root surfaces do not have an enamel layer to protect them.
Gum disease – a build-up of plaque or tartar can cause the gum to recede down the tooth and even destroy the bony support of the tooth. Pockets can form in the gums around the tooth, making the area difficult to keep clean and the problem worse.
Tooth grinding – this is a habit which involves clenching and grinding the teeth together. This can cause the enamel of the teeth to be worn away, making the teeth sensitive.
Other causes of pain from sensitivity may be: A cracked tooth or filling – a cracked tooth is one that has become broken. A crack can run from the biting surface of a tooth down towards the root. Extreme temperatures, especially cold, may cause discomfort.
Tooth bleaching – some patients have sensitivity for a short time during or after having their teeth bleached. Discuss this with your dentist before having treatment.
Q When are teeth more likely to be sensitive?
A You are more likely to feel the sensitivity when drinking or eating something cold, from cold air catching your teeth, and sometimes with hot foods or drinks. Some people have sensitivity when they have sweet or acidic food and drink. The pain can come and go, with some times being worse than others.
Q Is there anything I can do to treat sensitive teeth at home?
A There are many brands of toothpaste on the market made to help ease the pain of sensitive teeth. The toothpaste should be used twice a day to brush your teeth. It can also be rubbed onto the sensitive areas. These toothpastes can take anything from a few days to several weeks to take effect. Your dentist should be able to advise you on which type of toothpaste would be best for you.
Q Is there anything I should avoid if I have sensitive teeth?
A You may find that hot, cold, sweet or acidic drinks, or foods like ice cream can bring on sensitivity, so you may want to avoid these. If you have sensitivity when brushing your teeth with cold water from the tap, you may need to use warm water instead. It is important you do not avoid brushing your teeth regularly as this could make the problem worse.
Q Do I need to go and see my dentist?
A Yes, if you have tried treating your sensitive teeth for a few weeks and have had no improvement.
Q What treatments can the dentist offer?
A During an examination the dentist will talk to you about your symptoms. They will look at your teeth to find out what is causing the sensitivity and to find the best way of treating it. The dentist may treat the affected teeth with special de-sensitising products to help relieve the symptoms.
Fluoride gels, rinses or varnishes can be applied to sensitive teeth. These can be painted onto the teeth at regular appointments one or two weeks apart, to build up some protection. Sensitivity can take some time to settle, and you may need to have several appointments.
If this still does not help, your dentist may seal or fill around the neck of the tooth, where the tooth and gum meet, to cover exposed dentine.
In very serious cases it may be necessary to root-fill the tooth.
Q How can I prevent sensitive teeth?
A To prevent sensitive teeth follow the principles below:
Brush your teeth twice a day for two minutes with fluoride toothpaste. Use small circular movements with a soft-to medium-bristled brush. Try to avoid brushing your teeth from side to side.
Change your toothbrush every two to three months, or sooner if it becomes worn.
Have sugary foods, and fizzy and acidic drinks less often. Try to have them only at mealtimes.
If you are thinking about having your teeth bleached, discuss sensitivity with your dentist before starting treatment.
What are Sports Mouth Guards?
A mouthguard is a specially made, rubber-like cover which fits exactly over your teeth and gums, cushioning them and protecting them from damage.
When would I need a mouthguard?
It is important to wear a professionally made mouthguard whenever you play sport that involves physical contact or moving objects. This includes: cricket, hockey and football – which can cause broken and damaged teeth; and American football, boxing and rugby – which can all cause broken or dislocated jaws. A mouthguard will help protect against these events.
Where can I get a mouthguard made?
Your dentist will be happy to make you a custom-made mouthguard, which will fit your mouth exactly and protect your teeth and gums properly. Custom-made mouthguards can prevent damage to the jaw, neck and even the brain – helping to prevent the concussion and damage caused by a heavy blow.
How much will a mouthguard cost?
You cannot get mouthguards on the NHS, so costs can vary from dentist to dentist. Ask your dentist about mouthguards and always get an estimate before starting treatment. When you consider the cost of expensive dental work and the risk of missing teeth, it is a small price to pay for peace of mind.
How long do custom-made mouthguards last?
Depending on your age, your mouthguard may need replacing fairly regularly. If you are still growing, new teeth will come through and move into position. So the mouthguard may become too tight or loose, and will need to be remade to fit the new shape of your mouth.
Adults may not need to have their mouthguards replaced quite so often. But they are like any other form of sports equipment and will suffer from wear and tear. It is recommended that you take your mouthguard along to the dentist when you go for your check-up, so it can be checked.
What about home mouthguard kits?
Mouthguards are made by taking an accurate impression of your mouth and making the mouthguard fit your own teeth. The dentist will register the way your jaws bite together to make sure the mouthguard meets properly with your teeth.
There are cheaper kits available. They involve heating the product in hot water and then putting it in your mouth until it sets. Unfortunately, these mouthguards can fit badly and be uncomfortable to wear. They can fall out or even cause choking. Also the material is at its thinnest where it is needed most.
Can I get colored mouthguards?
There are many types of mouthguard including striped, multi-coloured and clear. Many people now have coloured mouthguards made in their favorite team’s colour’s or to match their own sports strip. Your dentist will be able to tell you whether they can provide coloured mouthguards.