Angela Kearney FAQ
Why should I visit my dentist when I don’t have problem?
Attending for regular check-ups will help to maintain good dental health which in turn will help you to maintain your teeth for all of your life. Regular check-ups are essential to detect problems with your soft tissues (the pink bits of your mouth) such as oral cancer or periodontal (gum) disease and problems with your teeth such as tooth decay. A problem such as tooth decay or gum disease will be detected much earlier by your dentist and can be sorted with much less complex treatment if picked up in time. By the time you start to have problems you may well be committed to much more complex treatment.
Options for replacing a missing tooth or teeth
The options to replace missing tooth or teeth can be divided into two broad categories, removable or fixed as follows
Removable options are confined to dentures of which there are two basic types: Acrylic or chrome.
Acrylic is a type of plastic which is used to make dentures to replace a single tooth, to a full mouth of teeth. Acrylic dentures can be:
- Made up quickly which is useful in an emergency situation
- Relatively cheap
- Easily adjusted and added to
- Provide excellent aesthetics
- Have metal attachments such as clasps to improve retention in the mouth
Its disadvantage is that the fit in acrylic dentures tends not to be quite as accurate as other restorations and so may be more difficult to keep in place.
b) Chrome Partial Dentures
A chrome denture has a cast chrome cobalt metal framework onto which acrylic teeth are fitted. It can be used to replace one or several teeth. It does depend on well positioned sound natural teeth or implants for retention. It has many advantages over acrylic and some disadvantages as follows
- The fit is more accurate and so better retained in the mouth
- It covers less of the palate in the upper or tongue space on the lower making for greater patient comfort
- It is strong and can be used to change a patients biting position which can allow for repair or adjustment of the natural teeth
- It can be securely fastened onto implants or crowns to give a very secure fit
- It is more expensive than acrylic
- It takes more planning and takes longer to make than acrylic
- Whilst it is light weight and rigid, if dropped on a hard surface it can bend and become distorted which can be next to impossible to repair.
Fixed options can also be divided into two broad categories i.e. Tooth supported and implant supported
a) Tooth supported/Bridges
Permanent tooth supported replacement teeth are called bridges. A bridge relies on a reasonably sound tooth on at least one side of the space, ideally both sides. Bridges perform best in shorter spaces where the opposite teeth don’t bite too heavy onto the bridge. A bridge can also be built onto implants. Bridges can be divided into two broad categories
- Resin Bonded Bridges (RBB) or Adhesive
- Conventional Bridges
Combinations of the two or hybrids can sometimes be made.
Resin Bonded Bridges (RBB) or Adhesive
These are false teeth that usually have some form of metal wing on either side of the false tooth which is bonded to the backs of the teeth either side of the space RBB depend on sound teeth with preferably no existing fillings or damage to the enamel of the tooth a favourable bite where the opposing teeth will not bite down on the metal wings or retainers. RBBs are suited to:
- younger patients
- Temporary situations
- Good teeth
- Front teeth
A conventional bridge is attached by way of full coverage retainers which involves reducing down the abutment teeth or the teeth to which the bridge is attached by 1.5 to 2 mm all around. The retainer portion of the bridge then resembles a crown or cover over all sides of the tooth. Conventional bridges are suited to a situation whereby the abutment tooth or teeth are heavily filled and perhaps needed a crown. Perfectly good abutment teeth tend to be used less and less today for bridges as we now have a very predictable alternative in implants
What is an implant?
An implant is a piece of titanium that is embedded or implanted into either the upper or lower jaw where the root of a tooth once was. It then enables the secure attachment of a tooth or teeth to the jaws. In its simplest form, a simple implant can be used to replace a single tooth where just one tooth has to be replaced. Where more than one tooth is to be replaced, one or more implants can be used onto which a bridge can be attached, in much the same way as a conventional tooth supported bridge that is if there is just one space.
How often should I visit my dentist?
Six monthly check ups are generally recommended. However if you have gum disease or have difficulty in maintaining good oral hygiene more frequent visits to the hygienist are recommended. If you have a low maintenance mouth and maintain good oral hygiene 12 monthly recalls are sufficient. Your regular dentist or hygienist who is familiar with you, can recommend an interval which best suits your needs.
Why should I visit a hygienist?
A hygienist is a dental professional who is highly trained to diagnose and treat gum problems from gingivitis (inflamed gums) to periodontal (gum) disease. She will examine your gums and recommend a treatment programme from scaling and polishing to deep cleaning under local anesthetic. She will also educate patients on a suitable home care regime and tailor her oral hygiene advice to suit each patient’s specific needs. Her role is in enabling patients of all ages to maintain or re-establish good gum health which is the foundation to good dental health.
Who should visit a hygienist?
We believe every patient should visit a hygienist because you may not be cleaning your teeth correctly. You may not be removing all of the dental plaque from your teeth or indeed so may be cleaning so vigorously as to be damaging your teeth and gums.
How often should I clean my teeth?
We would recommend brushing twice per day every day with fluoride toothpaste and cleaning between the teeth (flossing or interdental brushing) once per day.
Why do I need a filling, I don’t feel any pain?
Your dentist will recommend a filling for a tooth that has been damaged by tooth decay or where an existing filling is itself damaged or has tooth decay underneath it. Tooth decay is the break down or destruction of part of your tooth by the combined action of bacteria and sugar. It will probably go unnoticed by you for some time, as early tooth decay will probably not cause pain. The difficulty with leaving it without treatment until you experience pain is that you may well end up needing significantly more complex and expensive treatment at that point or indeed end up losing your tooth.
Why choose an amalgam (silver) filling?
Amalgam fillings have been with us since 1835, and whilst the quality of the amalgam available to us today has improved significantly it is still very often the material of choice to use.
- It is a very robust and hard wearing material.
- It is relatively quick to place.
- It is cheaper than alternative filling materials.
- It is less likely to be adversely affected by saliva whilst it is being placed in your tooth, especially if the filling extends down to or beyond the gum line in between your teeth.
- It makes an excellent core or foundation material for crowns on back teeth.
Why choose a composite (tooth coloured) filling?
Composite is a compound made up of a resin base and filler particles which sticks or adheres to your tooth surface. Its big attraction is undoubtedly its appearance which can be difficult to distinguish from the actual tooth.
Composite would always be the material of choice for a filling on a front tooth and more and more so for the back teeth especially in areas of the mouth that can be seen when talking or smiling. There is also an argument for placing composites in that they may be less likely to cause cracks in teeth leading to broken teeth at a later stage.
It is ideally suited to the small to medium sized filling.
The material itself requires considerably more time and operator skill to place and where possible a rubber or dental dam should be used to keep the tooth free from saliva when the filling is being placed.
What is a root canal?
Root canal or endodontic treatment involves removing infected or damaged tissue from the central chamber or the root canal of a tooth. This tissue, called the pulp, contains nerves and blood vessels that help nourish the tooth. After the pulp is removed, the pulp chamber and root canals are cleaned, disinfected, filled and sealed. The benefit of endodontic treatment is that it saves teeth that would otherwise need to be extracted. Although the pulp is removed, the treated tooth remains alive, nourished by the surrounding tissues. There is no real substitute for your own tooth in terms of health and investment. Root canal treatment may require one or several visits and is always preformed under rubber or dental dam. With proper care and restoration the tooth may last a lifetime.
What is a crown?
Each one of your teeth is made up of a crown and a root. The crown is the white portion you see in your mouth, the root is the portion hidden in your gum. If the natural crown of your tooth becomes badly damaged through for example tooth decay, whereby it is heavily filled, or through an accident it made need to be replaced with a laboratory made crown. The crown fits over the remaining portion of the natural crown of the tooth and the natural root is retained. It is made of metal, ceramic or a combination of both depending on the requirements for that tooth. Crowns can also be screwed into or cemented onto implants.
Root treated teeth are often crowned because these teeth have usually been extensively damaged by tooth decay and they are also more brittle than non-root treated teeth and so a crown may protect what remains of the tooth from breaking.
Teeth do not necessarily require root treatments prior to crowning.
Can you tell me about bleaching?
Bleaching is a treatment which has become increasingly popular over recent years. It is a cosmetic treatment which will not improve your dental health but the good news is that there is no evidence to suggest that it will damage your teeth either! It will certainly make your teeth look whiter. There are two methods of bleaching the teeth either “at home” or” in office “or so called laser whitening. Both methods use the same basic ingredient, peroxide.
In the at home method you will have “trays” made up to fit your teeth. There are very close fitting plastic covers which you take home together with the bleaching gel. You place the gel into the trays and wear the trays for up to four hours during the day or ideally overnight for several nights until you get the amount of whitening you require.
The “in surgery” bleaching ideally involves having a rubber dam placed on your teeth and much higher strength bleach placed on your teeth. It is then activated by a light or “laser” as it is often referred to. You may require more than one visit to reach your desired whitening or you may wish to carry out at home bleaching as well.
Either method will produce the same end result. The two main disadvantages of bleaching are that your teeth may become sensitive during bleaching, but this is transient. Bleach will only lighten your teeth but not crowns and fillings and so it is advisable to bleach before you have work carried out or be prepared to consider replacing white fillings or crowns on your front teeth after bleaching.
Why do I have pain with my wisdom teeth?
The wisdom teeth or third molar teeth frequently cause pain because the gum around the tooth becomes irritated or infected. This tends to happen because there may not be enough space in your mouth and so these teeth cannot grow properly into your mouth. They then become stuck or impacted having cut partially through your gum. The area is often very difficult if not impossible to clean properly and so discomfort and infection can be the result.
Treatment may simply be a matter of learning how to keep the area clean to avoid problems or they may require extraction.
The lower wisdom teeth tend to be more problematic than the uppers and often require referral to a specialist oral surgeon to remove.
What is a rubber dam?
A rubber dam is a sheet of latex rubber which is fitted around your tooth to enable some dental procedures. It acts as a safety net to trap water and debris from your tooth and will protect you from inadvertently inhaling or swallowing small instruments such as those used for root canal treatment. It also works in the opposite direction keeping saliva off your tooth whilst you are having composite or white fillings bonded to your tooth.
Why is smoking detrimental to our oral health?
There is a lot of evidence in relation to smoking, and the detrimental effects on both oral and general health. We are all aware of the effects it has on our overall health and well being. But are you familiar with the risks smoking has on your dental health?
- Increases the risk of developing gum disease, a leading cause of tooth loss.
- Delays the healing process following tooth extraction, periodontal treatment or oral surgery.
- Increases the risk of developing a dry socket (inflammation of the bone) after an extraction.
- Lowers the success rate of dental implant procedures.
- Increases the risk of developing oral cancer.
Smoking also causes bad breath, tooth dis-colouration and increases the loss of bone within the jaw due to periodontal (gum) disease.
Smokers are at a much higher risk of developing oral cancer than non smokers. Patients rarely seek help for oral cancer at an early stage of the disease due to its painless nature in the early stages and consequently oral cancers are usually well advanced at diagnosis.
With this in mind smokers should visit the dentist regularly as with all patients who visit our surgery, you are screened for early signs of oral cancer as part of your routine examination. Remember that early detection is the key to beating this disease.
If you are a smoker and you want to quit but don’t know how to, help is at hand. We have a trained smoking cessation adviser in our surgery who will give you advice and support throughout the process. As dental professionals we have an obligation to increase the awareness of the effects smoking has on your dental health. So please call Leanne to make an appointment if you feel you are ready to quit. It only takes 10 minutes of your time and we would be delighted to give free advice and information on the help you need to stop smoking.
We request that you give us at least 24 working hours notice, where ever possible, should you need to cancel an appointment. Otherwise, unfortunately, we must apply a fee of €60.
For those that have failed to attend an appointment, we are happy to re-book once a €60 non-refundable deposit has been paid in advance.