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Q: When should I bring my child for his first visit to the dentist?
We recommend that children are brought to the dentist at an early age about 3 years old before they need any treatment. We just count their teeth and make friends so that their first visit is fun. Then if they ever do need any dental work it is not such an issue for them. The first dental visit is an important one for a child.
Q: When should I first brush my child's teeth?
It is important to establish the routine of brushing at an early stage even though it may be a useless exercise in terms of effective cleaning. You should let your toddler understand that brushing is a bedtime and morning routine. They can have fun copying your actions. Brush in a rotational circular motion off the teeth and onto the gums. ‘Tickle the teeth and tickle the gums.’ We should all be brushing our teeth and our gums not just our teeth.
Q: My child has lots of cavities but does not eat much sugar. What can I do?
Tooth decay can only happen if there is a sugar source. Sugar is converted to acid in the mouth and it is this acid that causes tooth decay. Today’s diet is impossibly loaded with sugar. Cereals such as Coco Pops, Frosties, Cheerios are sugar coated and best served as a desert or not at all. Baked beans, ketchup, tinned fruits, jams, biscuits, Actimal and children’s yoghurts are very rich in sugar. A child will automatically find the sugar rich foods in the cupboard or fridge if allowed to do so. It is important to break this dependency on sugar. Lunch boxes should not include sweet bars or biscuits. Fizzy drinks should be for special events only. Sweets, if eaten at all should be given with a bottle of water. Interval eating of sweets is the worst. Diet fizzy drinks are not much better as they are still very acidic. Too much natural fruit juices like apple or orange juice are also damaging to the teeth. Moderation is the key as usual! Talk to our dentist or hygienist about your child’s diet. We will be happy to help.
Q: My child sucks his thumb (or uses a dummy) all the time. Should I be concerned?
Thumb sucking is a strong habit and therefore not easy to break. It is not especially damaging up to the age of six but then with the arrival of the adult teeth we need the habit to have stopped. The development of the permanent teeth can be adversely effected by the strong sucking pressures of a digit or dummy. This presents an orthodontic challenge later on. We usually advise the child that it is a baby habit and now they are getting big, and going to school, they will probably stop. Sometimes Santa Claus helps with the problem!
Q: What do I do if a front tooth is knocked out?
- Keep calm but act quickly. Find the tooth. Hold it by the crown (the part we usually see) not by the root. Do not scrub or attempt to clean the tooth! Do not disinfect it!
- If the tooth is clean, hold it by the crown and gently push it back into the socket making sure that the front face is facing out of the mouth. This is usually fairly painless if done immediately after the accident.
- If the tooth is dirty rinse it gently in milk or in the patient’s own saliva before gently pushing it back into place. Warning! There is a risk of swallowing a slippy tooth if you are not extremely careful, so using milk is probably safer.
- Hold the tooth in place. Get the child to bite on a napkin and go to a dentist immediately. Phone ahead to alert him.
- If you can’t put the tooth back in place then put it in a glass of milk. Go to your dentist immediately or go to the nearest hospital casualty department and ask for the dentist on call.
*If the child is under six then the tooth lost is probably a baby tooth. Very little can or needs to be done in this case. These teeth are due to fall out about the age of six and will be replaced by bigger stronger adult incisor teeth. Putting these teeth back is not usually an option.
Q: I have bad breath. What can I do about this?
This may be caused by a stomach complaint, a respiratory condition or more likely by a dental hygiene issue perhaps involving tooth decay or gum disease. The first thing to do is to come and see a dentist. He will do a complete check of your mouth and thoroughly clean all the teeth. He may refer you to see the hygienist. If everything is in order the way to ensure you have good fresh breath is to effectively clean all your teeth and your gums twice daily after flossing. Your tongue and palate should be included in this regime.
Q: I am pregnant and need some treatment. When can I have it done?
Pregnancy is not a contraindication for dental treatment. In some ways it might be a good time to get the work done as you are likely to be busy when the baby arrives! The drugs we use are perfectly safe to use with expectant mums however it is important that you tell the dentist you are pregnant. Intravenous sedation is not possible during pregnancy.
Q: Do I need to use a mouthwash?
Mouthwashes are a bit like perfume, they shouldn’t take the place of soap! Good brushing of teeth and gums twice daily especially if dental floss is used beforehand is the best way to maintain good oral hygiene and ensure fresh breath. Listerene and Corsodyl mouthwashes should be used very sparingly and certainly not daily, as they will stain the teeth a bit like a heavy tea drinker or a smoker.
Q: When I brush or use dental floss my gums bleed. Why is this?
Healthy clean gums do not bleed. Bleeding from the gums tells you where they need attention. Bacteria, acid from broken down sugars, food waste etc. can irritate and inflame the gums if not removed. Inflamed gums bleed and become tender when they are disturbed by brushing. However they need to be brushed to get rid of the irritant causing the inflammation. Bleeding is a cry for help. Bleeding tells us where there is ‘dirt’. As our oral hygiene improves this bleeding will become less until we reach a stage where we can floss and brush all areas of our teeth and gums with no bleeding.
Q: Do I have to take my denture out at night?
Yes it is very important to take your denture out at night, or for at least six hours a day. Your denture is essentially plastic and has absorbent properties. So it will absorb the bacteria rich saliva from your mouth. The denture needs to be steeped for a few hours daily in a mild disinfectant solution (Milton for example) to properly clean it. A quick scrub under the tap is not sufficient and only removes surface debris. In addition the roof of your mouth needs to breathe and to be washed with your cleansing, protective saliva. This cannot happen if it is covered for twenty four hours a day, month after month, year on year. Can you imagine what your hands would look like if you wore gloves constantly, twenty four hours a day. Not very healthy I’m sure! So take your denture out every night for a few hours. It makes good sense.
Q: I get a lot of headaches, could this be related to my teeth?
Headaches and facial pain can be related to teeth and this should be part of any investigation into their cause. Tooth decay is an obvious cause of facial pain. Lower molar teeth can cause earaches on occasion. However a less obvious cause is grinding or clenching of teeth especially in your sleep. This can be exacerbated in times of stress. A protective night guard or bite splint may help to treat this problem. If you suffer from repeated headaches you should visit your dentist as the ‘first port of call’.
Q: I have a problem with my wisdom teeth. Do I need to have them removed?
Not all wisdom teeth need to be removed. In general we leave them alone if they are not causing problems. However they have a poor value in that they do not make us look better, chew better or speak better. Many of us are born without them. Because they are so far back they can be difficult to clean. They can cause crowding and make cavities in the adjacent teeth more likely. They can be partly erupted and trap food waste and bacteria under the gum and cause infection. If they are a disadvantage to your mouth then they should be removed.
Q: Is removal of wisdom teeth a complete nightmare?
With excellent anaesthetics, or I.V Sedation if required any dental procedure can be done quite comfortably. Wisdom teeth are no exception. Their bad reputation is completely undeserved. In fact upper wisdom teeth are usually very easy to remove. Lower wisdom teeth can be more difficult but with good planning they can be extracted in a managed way so that post-operative pain etc. is controlled and minimised. More difficult surgical extractions may need to be referred to an oral surgeon or done under General anaesthetic. Wisdom teeth are usually extracted in pairs on each side. Under sedation or G.A it is usually a good idea to remove all four.
Q: Do I need to use dental floss?
If your teeth are close together then you should use dental floss or tape at least once daily as this is the only effective method of cleaning the tight stagnation areas between the teeth. The bristles of a toothbrush can’t force their way in between these teeth and so bacteria inhabit these areas unless they are cleaned by dental tape or floss. These particular bacteria are the anaerobic or ‘smelly’ bacteria and they thrive in stagnation areas. They also contribute to bad breath. So flossing is a very good idea!
Q: Does it matter what toothpaste I use?
Most toothpastes on the market are excellent and any of the recognised names are fine to use. We do recommend that you use a Flouridated toothpaste and so Euthymol might be one to avoid. If you suffer from sensitive teeth then you might find Sensodyne F or Pronamel toothpaste useful. However sensitive teeth should be seen by a dentist as this can often indicate tooth decay.
Q: Should I use an electric toothbrush?
It really doesn’t matter if you use an electric toothbrush or a manual one. The battery ones usually have the rotational action that we recommend so this is an advantage, however it is perfectly possible to brush our teeth and gums 100% effectively with a normal toothbrush. So it’s a matter of choice. Remember floss before you brush!
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Ratoath Dental & Implant CentreThe Well Road,
Tel: 01 8256983