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General Dentistry

 

1.1 Check ups

 

The dentist uses your check-up to see how healthy your mouth is, whether you might need some work done and, in the case of children, how the teeth are growing and developing. The dentist will have a good look round inside your mouth, checking the teeth, as well as your tongue, the soft palate,the inside of your cheeks and the roof of your mouth. The dentist will also look at your face and neck and feel under your jaw.

 

As well as looking in your mouth, the dentist will ask you some questions, like whether you have had any pain or sensitivity in your teeth or gums recently, what your general health is like, whether you’re on any medication at the moment, what your diet is like and whether you smoke or drink alcohol.

 

Your dentist will tell you how often you need to have a check up.

 

 

1.11 Scaling and polishing

 

When you go for a check-up, your dentist may do a ‘scale and polish’. Essentially, this is a deep clean of your mouth, where the dentist or hygienist will use a special tool to get rid of the hard build up of tartar (calculus)then follow up by giving the teeth a thorough polish. The dentist will probably concentrate on the areas just below the gum line, behind your teeth and in the gaps in between them, as these are the bits that we sometimes miss when we’re brushing our teeth. The scale and polish will help fight against gum disease – although you still need to do your bit by brushing properly twice a day with a fluoride toothpaste.

 

 

1.2 Fillings and Restorations

 

If part of a tooth has been lost through decay or damaged due to an accident, your dentist may put in a filling. A filling will plug the hole and stop any future pain or discomfort. A filling can be made out of a variety of materials. The most common of these are amalgam (silver) or composite (white).

 

Silver fillings are made of a material called amalgam, which is a mixture of mercury, silver, tin, copper, and other metals. Amalgam fillings are very hardwearing which is why they are often put into the back chewing teeth.

 

Some people opt for white fillings, which match the colour of the natural tooth better. White fillings are becoming more popular.

 

 

1.3 Crowns

 

CrownsA crown is like a special sleeve made of metal or porcelain, or both, that goes over a damaged or weak tooth. Your dentist will match it up to the shape – and, in the case of porcelain crowns, colour – of your other teeth so it will look natural. The crown will probably last for many years, depending on the health of the tooth underneath, and depending on how you look after your mouth.

 

The dentist will shape the tooth so that, with the artificial crown, it will be the same size as a normal tooth. Preparation time will depend on how damaged the tooth is and whether it needs to be built up with a filling. The tooth might have to be root-filled first – this is sometimes called ‘removing the nerve’. The crown is sometimes held in place by a peg in the root canal if a lot of the tooth is missing.

 

Your dentist will use a soft mouldable material to make an exact ‘impression’ of the tooth that is to be crowned and the nearby teeth. A dental technician uses the impression to make the crown the exact height and size needed. A thin cord may be used to hold the gum away from the tooth so that the impression is accurate round the edges.

 

A temporary crown made of plastic or metal is put over the tooth until the permanent crown is made. You can chew on a temporary crown but it won’t be as strong as the finished one. When the crown is fitted, your dentist will make small adjustments to make sure you can bite comfortably. The crown is tried on first, and then glued into place.

 

 

1.4 Tooth extraction

 

Having a tooth out is the same as having an operation and, because of this, you must look after the area to speed healing and to reduce the risk of infection. Here are some pointers:

  • For the first 6 hours, try to avoid eating hot food, don’t smoke, don’t drink any alcohol and try not to disturb any blood clot which might have formed.
  • Don’t rinse your mouth for 24 hours after extraction. After that, rinse gently with warm salty water – half a teaspoon of salt in a glass of water is enough.
  • Brush your teeth as normal to keep your mouth as clean as possible.
  • You may feel some small pieces of bone work their way out of the socket – don’t worry, this is perfectly normal.
  • There may be some swelling and a bit of discomfort in the first two to three days. If you need to, take some ordinary painkillers – aspirin, ibuprofen or paracetomol will be fine
  • If you feel pain immediately after the tooth has been removed, it might be where the blood clot has broken down leaving an empty hole in the gum. This is called a ‘dry socket’ and will need to be looked at by your dentist. Simply go back and the dentist will pack the wound to ease your discomfort.

 

Your dentist may have given you some gauze to place onto the area where the tooth has been removed – if not, a clean cloth handkerchief will do just as well (but not a paper tissue).

 

 

  • Roll it into a small firm pad large enough to fit over the gap (probably around 1 cm by 3 cm).
  • Sit up and gently clear away any blood clots around the gap using the gauze or handkerchief.
  • Put a clean pad over the gap (from tongue side to cheek side) and bite down on it firmly for 10 to 15 minutes.
  • Take the pad off and check whether the bleeding has stopped. If not, apply a fresh pad and contact your dentist.

 

 

1.5 Wisdom Teeth Extraction

 

Sometimes there may not be room in your mouth for your wisdom teeth and, as they start to come through, they push against the teeth already there or may start to come through at an angle. When this happens, you might feel some pain or discomfort, so the best thing to do is to visit your dentist.

 

The dentist will probably take an x-ray of your mouth to see how – or if – your wisdom teeth are coming through. From this, they will be able to make a judgement on whether or not to take them out, and how easy or difficult it might be.

 

Often – especially if the teeth are already partway through – your dentist will be able to remove the wisdom at their practice. However, if they think it might be difficult, they will probably refer you to a dental hospital where you can have them removed under general anaesthetic.

 

 

1.6 Root fillings

 

Sometimes, damage or decay gets deep into the tooth and can affect the root. If left unchecked, this could mean that the tooth either falls out or has to be removed by your dentist. Root fillings – also known as root canal work – can ensure that you keep your tooth.

 

Your dentist will take an x-ray of the tooth to check the shape of the root canals and to see whether there is any infection around the root. After putting you under local anaesthetic, the dentist will go through the top of your tooth into the pulp – the bit right in the middle of your tooth that holds the nerves and blood supply. He or she will then remove the dead bits of the pulp and check for any infection. If the infection has spread beyond the tooth, he or she may have to give you a temporary filling and some antibiotics until it clears up.

 

After the pulp has been removed, the dentist fills the gap with a rubbery material and puts a normal filling on top.

 

 

1.6 Treating gum disease

 

In some cases gum disease can be treated easily by a dentist, although more severe cases may require further treatment. Remember the best way to reduce gum disease is by looking after your mouth well, so don’t forget to ask your dentist for tips on how best to brush your teeth.

 

One thing your dentist is likely to do is to scale your teeth. This removes the hardened plaque – known as tartar or calculus – from the tooth, especially behind your teeth and just below the gum line. To find out more about the scale and polish, click here.

 

If you have advanced gum disease, your dentist may advise that you have a longer, more intensive treatment. This is known as root planing or curretage, and is basically an extension of the more usual scale and polish. The dentist – or hygienist – will give your teeth a really deep clean, going below the gum line and clearing any pockets of plaque.