X-rays are probably the most valuable diagnostic tool available to the dentist. They enable the dentist to discover problems which a visual examination can not. A few specific examples follow:
Although the safety of dental x-rays has been often questioned, the American Dental Association says that when dental x-rays are made with modern equipment and techniques, the patient has little reason to be concerned about safety.
How many baby and permanent teeth does a person normally get?
The deciduous dentition (baby teeth) is comprised of 20 teeth all of which should be erupted around the age of 3 years old.
The permanent dentition numbers 32 teeth which includes 4 wisdom teeth.
What about tooth coloration?
Generally the deciduous dentition is milk white, and therefore often much lighter in shade than the permanent dentition. As people age, it is often observed that the permanent teeth become darker and more brittle. Stains, both internal and on the surface, along with decay, restorations, nonvital (dead) nerves, etc. can alter the natural shading of teeth {when the nerve of a tooth dies it becomes very dark). This shading is transmitted through the dentin and enamel layers, giving the tooth a characteristic dark appearance.
Will the positioning of the baby teeth give you a clue as to the development of the permanent dentition, and in particular a possible developing malocclusion?
It is usually much better if the baby teeth have spaces between them which will allow adequate room for the larger developing permanent teeth. This is not to say however, that a normally aligned deciduous dentition without spacing will give way to a malocclusion. When a child's baby teeth are crowded, this definitely suggests that there may be a future problem. Such a situation bears close watching.
Types of malocclusions vary greatly from simple (one or more teeth out of alignment or rotated) to complex (i.e., abnormally sized dental arches). There are many situations that may cause a malocclusion such as: abnormally sized or shaped teeth; abnormally sized arches; decay; premature tooth loss; habits; accident; abnormal number of teeth; teeth erupted in an improper position, etc. To be well informed of possible problems, parents should have children's teeth examined routinely while the dentition is developing.
What type of toothbrush should I use?
Most dentists recommend a brush with soft, end-rounded bristles, a flat brushing surface, and a straight handle. Soft bristles are less likely to injure gum tissues, while the head of the brush should be small enough to reach every tooth. Children, of course, need smaller brushes than adults. Ask your dentist to prescribe the toothbrush suited for your needs.
What toothpaste should we use?
A fluoride toothpaste is generally recommended, especially for children, where it may prevent 25 - 30% of a child's decay. Other toothpastes can make brushing pleasant and leave your mouth feeling fresh, but may not give you protection against future decay. Your best protection is to check for the American Dental Association Council on Dental Therapeutics' seal of acceptance.
Do mouthwashes help prevent decay or periodontal (gum) disease?
Most mouthwashes are designed to temporarily freshen your breath or sweeten your mouth. They do not remove plaque and cannot prevent decay or periodontal disease. Recently, however, fluoride mouth rinses have been introduced. These products will reduce the incidence of dental decay when used routinely. Again, one should look for the seal of the American Dental Association's Council on Dental Therapeutics.
What is an Anesthetic?
An anesthetic is an agent used to create a loss of bodily sensation. There are three types used in dentistry:
Topical - sprayedor brushed onto the tissue to numb (freeze) it. This type penetrates only a few millimeters and has short action. Therefore it cannot be used for major restorative procedures. It is generally used to numb the tissue prior to the injection of a local anesthetic.
Local Anesthetic - is injected into the tissue to numb the teeth, bone and surrounding tissues. This type is generally given for most dental procedures.
General Anesthetic - is given in several forms, but renders the recipient unconscious. This is the type one would get in a hospital when having surgery.
Does it mean that you are into the nerve when a tooth that is being drilled on experiences pain?
No. Enamel has very little or no pain response, but the underlying dentin layer when stimulated by thermal changes, drilling, etc., does elicit a sensitive response. Depending on the age and condition of the teeth, the elicited response may vary greatly from tooth to tooth and person to person. Obviously then, one can see that when the drill penetrates the enamel layer and enters the dentin, the patient may feel sensitivity within the tooth, but the work being done may be neither deep nor near the nerve.
Why do my front (white) fillings get darker?
Because of the particular composition of the resin filling materials, which are rather grainy in nature, they tend to take on stain quite easily. To lessen this problem it is suggested to have your dentist polish all white fillings, that you practice good oral hygiene, and try to eliminate substances that stain your teeth. Several of the worst offenders are coffee, tea and tobacco. For permanent stains, ask your dentist about bonding and other procedures.
Why do my gums often bleed, especially when brushing?
Several possible situations may give rise to bleeding gums, but by far the most common cause is periodontal disease. In the early stages of the disease, irritants in the plaque cause the gums to become inflamed, engorged with blood, and bleed easily. Later, calculus (tartar) may form around the necks of the teeth, making cleansing more difficult. If this becomes a noticeable problem, then one should seek dental treatment. Often, regular professional cleanings and a reinforced home oral hygiene program will be enough to substantially contain the disease.
You tell me I have periodontal disease, then why haven't I noticed any discomfort or pain?
Periodontal disease is usually a very slowly progressing disorder that infects the supporting structures of teeth, namely the gum tissue, periodontal ligament, and bone. It may take many years for the disease to completely manifest itself. Ordinarily there is little discomfort until the later stages when the teeth become loose, showing much exposed root surface and the surrounding tissues are severely infected and atrophied. Perhaps the greatest reason for so many people becoming victims of the disease is that they cannot actually see or feel the underlying bone being destroyed.
Is it possible to feel ill from an infected tooth?
Yes. When a tooth becomes severely infected it is possible for this infection to travel throughout the body causing a variety of effects, (i.e., headaches, earaches, elevated temperatures, inflammations generally in the head and neck region, nausea, etc.). If you are inflicted with an ailment that you feel may be initiated by an infected tooth, you should receive dental attention immediately.
Why is it often necessary to remove Impacted wisdom teeth?
Any tooth, not just wisdom teeth, may be impacted if the tooth moves in the wrong direction or is blocked from reaching its normal position in the mouth (see page 24). Although no one can always predict which impacted teeth will cause a problem, most of them eventually need to be removed. Typical reasons for impacted tooth removal include: infection of the surrounding gum tissue that can spread throughout the body; decay; disruption of other teeth's growth and position; cyst formation at the crown of the impacted tooth which may cause damage to the surrounding teeth as well as to the surrounding bone, and "referred pain." That is pain in other areas (i.e., eyes, ears, neck, throat, etc.). Because unexpected complications often occur at the most inconvenient times, and older people generally do not recover as quickly from surgery as a younger person, dentists usually recommend that most impacted teeth be removed at the earliest possible age.
Answers to some commonly asked dental questions: