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Dental Tips

At Dental Hygiene Care, we've done our best to create a Web site that anticipates and satisfies our customers' needs. With that goal in mind, we've compiled a list of frequently asked questions. If you do not find an answer to your question here, contact us at 905-868-8110 or info@dentalclean.ca.

 

Dental Anatomy

1. Does everyone have wisdom teeth?

No, not everyone has wisdom teeth. Wisdom teeth are also known as third permanent molars. (see diagram)  Some people will get all 4 (one in each corner, at the back of the mouth), some will have any combination of 1 to 4.  They are the most common teeth to be missing. These teeth also have the most variation in size and shape from person to person. Scientists believe that it is a sign of evolution,

When wisdom teeth are missing. Our ancestors needed all 3 permanent molars to chew and digest their food, based on a diet of nuts and berries.  Today our diets vary greatly and it is not necessary to have all permanent molars.  Often wisdom teeth do erupt all of the way or not at all and can cause pain and infection.  These teeth are most likely to be extracted, usually by an Oral Surgeon.(see picture)

2. Does everyone have the same amount of teeth?

No, not everyone has the same amount of teeth. Wisdom teeth can be missing (see above), cuspids and premolars can also be missing. 32 teeth would be considered a full permanent dentition. There are a few possible causes for this development.  Genetic factors are the most common, cleft palate and other syndromes that cause interruption of development of certain teeth.  20 teeth would be considered a full primary dentition.(see picture)

3. Do people get extra teeth?

Yes, some people do have extra teeth.  They are called supernumerary teeth.  They are most common in the front, but can be seen in other areas. An example would be extra wisdom teeth in one quadrant or all quadrants. Sometimes teeth can be fused together or sometimes they can have twins.

4. Do we have a permanent molar for every baby molar?

No, permanent molars do not replace baby molars. When the baby molars are exfolliated they are replaced by premolars. Permanent molars develop behind the premolar/baby molar area of the arch.(see picture)

5. Do all teeth serve the same function?

No, not all teeth serve the same function. A) Incisors are for biting food. B)Cuspids are for tearing into food. C) Molars are for chewing food. D) Premolars are used for a combination of tearing and chewing food.

 

Periodontics and Pathologies

6. Periodontal disease and tooth decay is painless (until too late).

7. Periodontal disease is equally prevalent in both males and females.(graph)

8. The average age of referral to a periodontal specialist is 35 years old.(chart)

9. Periodontal disease is not a sign of age. Some of my healthiest clients have been over 65. Let’s suppose you had periodontal disease as a young adult, if left untreated, it will persist.

10. Tissues in the mouth can heal within 24 hours. The less keratin in the tissues the faster the healing.

11. Is it normal to have loose secondary teeth?

No, it is not normal to have loose teeth in the permanent dentition. The most common causes would be bone loss or trauma.

12. Bacteria can be contagious.  Bacteria can be passed from one person to another.  The new bacteria can become resident bacteria in the new mouth.  This can predispose or increase the likelihood of periodontal concerns in the future.

13. Why does my gum-line look high?

This is called recession, when half moon shaped pieces of tissue are missing.  The most likely causes for this trauma are brushing too hard and or using a tooth brush that had bristle that were too hard.  This is not normal but it is very common.

14. Why do my gums bleed?

The #1 sign of gingivitis is bleeding. The bacteria in plaque cause swelling and bleeding of the gingival tissues.  This is known as a gum infection.

15. What is gingivitis?

Gingivitis is an infection of the gingival tissues.  This is the area around the neck of the tooth.  Bacteria in plaque that is left behind after brushing and flossing can cause this infection. Luckily gingivitis is reversible, if treated before the progression of the disease.

16. What is Periodontal Disease?

When Gingivitis is left untreated new types of bacteria can form.  These new strains of bacteria are generally stronger (more virulent), there are higher numbers of concentration (more of them).  The bacteria tend to migrate down the root of the tooth (beyond the gum-line), creating a periodontal pocket.  This is what causes destruction of the bone and other soft tissues below the gum-line.  This can occur localized (specific areas) or generalized (more than 50% of the teeth).  Periodontal Disease is diagnosed by a Dentist, using radiographs and certain measurements from a Periodontal Assessment.  Periodontal Disease causes permanent damage.  The goal is to slow or arrest (stop) the disease.

17. What is Plaque?

Plaque is a sticky film of build-up on your teeth. This film forms within minutes of brushing your teeth. The first layer is a protein layer, then bacteria, food debris and dead skin cells attach to it. Plaque is teaming with bacteria. The longer any piece of plaque remains on the teeth the more mature it becomes. The bacteria in plaque causes Gingivitis and Periodontal Disease.  Therefore plaque must be removed daily.  If it is left long enough the plaque will harden or calcify.  This will happen in areas that you have not touched or properly cleansed.

18. What is Calculus (tartar)?

Tartar and calculus are the same thing, mineralized (hardened) plaque. These mineral deposits must be removed from teeth and roots by scaling.  Calculus will build-up in areas that have plaque.  New layers of plaque will form on top of the calculus and they will harden the same as the first layer. Other debris can also attach to these layers and harbor bacteria and stain.

19. What is Scaling?

Scaling is the act of removing calculus, plaque and stain from the teeth.  You may recognize this procedure from your last routine maintenance appointment with your Dentist or Dental Hygienist.  Calculus must be removed to promote the healing of the tissues, and reattachment of any damaged tissues. After a thorough scaling you can expect some regeneration of the gingival tissues. It is very important to remove any new plaque daily. Please note, damage from Periodontal Disease cannot be reversed, it can be slowed or arrested (stopped).

20. What is Root Planing?

Root Planing is scaling the roots of the teeth.  Removing calculus from the cementum (roots) of the teeth.(see Anatomy for picture)

21. Why do I need routine maintenance appointments?

All calculus and plaque should be removed from the teeth.  This may be required 2 to 4 times per year. Twice a year for preventive scaling and 3 or 4 times per year for theraputic scaling.  If you have Gingivitis or Periodontal disease you may require theraputic scaling. Dental exams for caries (decay) and soft tissue exams for oral pathologies.       

22. What can happen if I wait too long between appointments?

Calculus and plaque build-up in layers.  The longer the time between scaling appointments, the more layers there are, the more debris there is to remove. The longer the calculus is present the mineral content increases, therefore creating a harder build-up. Often it can take several appointments to remove all the debris if there is a long gap between appointments. In a case where it has been years between good thorough cleanings or someone has never had their teeth cleaned the procedure could be different than a routine maintenance appointment.

The cleaning is often split into halves or quadrants.  Scalings are often preformed with local and or topical anaesthetics. Caries can spread quickly if not caught when it is small.  Bacteria can begin to multiply at a high rate and new bacteria begin to form that are more virulent (destructive).

TIP-along with calculus, dead skin cells, necrotic tissues bacteria, blood and superation (puss) and other debris can be found in the sulcular space and in all other exposed areas of the mouth.

Theory-complete removal of all debris

Reality-reduce as much debris as possible.

23. Can restorations contribute to periodontal problems?

Yes. Older fillings with rough margins can trap bacteria leading to micro-leakage and recurrent decay of the restoration and infection of the surrounding tissues.  Could be localized or generalized.

24. How does the health of an individual affect their oral/dental health?

Host response can be different for everyone. The stronger the immune system the easier it is for the body to fight bacteria in the mouth(24-7-365)

25. How can host response affect periodontal disease and bacteria?

A person with a weak immune system can have a delayed or weak reaction to the bacteria.  Tissue regeneration may be slowed.  Therefore increased gingivitis and increased periodontal disease. Examples of  immuno-compromising diseases are HIV, AIDS, cancer, diabetes, heart and many others.

26. ANTIBACTERIALS BEWARE

Should I be concerned about using antibacterial products?

Antibacterials change the natural micro-flora of the mouth and the rest of the body. This can make you susceptible to many organisms.  Here are some general rules you should consider when using them.  Use only for two week periods of time, not long term. Try to localize  areas that need treatment. Eg. use in areas that bleed when you brush or floss, swollen or inflamed areas cuts or abrasions, areas that have periodontal pockets. Use a syringe or cotton swab to apply ‘medicine’ to the effected area. Cuts and abrasions anywhere on the body can be cleaned with antibacterial soap.  Also good in the kitchen when cooking.  Be careful when handling  raw meats and eggs.  Hands, chopping boards and anything touched with dirty hands should be cleaned with antibacterials to prevent infection.

Antibacterials can be found in many products such as: tooth paste, mouthwash, dental floss, soap, detergent, lotion, bandages and countless other products.

NOTE: Mouthwash can have both antibacterials  and alcohol added.  High alcohol content should also be avoided unless an infection is present. Can cause chronic irritation, could also change micro-flora and other problems related to chronic alcohol abuse.

27. What is occlusal trauma?

Occlusal trauma can be caused by a high filling or other restoration, bruxing (clenching and or grinding teeth), psychosematic (stress related) or TMJ(joint that connects the jaw and temperal bones) disorders.  Often evidence, signs and symptoms can be seen like sensitivity to cold, sore jaw, could feel like an ear ache, slight to severe tooth ache. Sometimes wear patterns can be seen on the teeth and in moderate to severe cases could be seen on an x-ray.

28. Does you jaw ache, pop or grind when you eat, yawn or talk?

Could be from  occlusal grinding, stress, high restorations or mal-aligned teeth.  Many of the pressures on the dentition can be removed by placing a night guard, generally made from plastic, in between the upper and lower jaws. An impression is taken at the dental office and sent to the lab, about a week later the guard can be fitted. Adjustments to the height of the guard should be made before you leave.   Orthodontics could be ideal to re-align teeth in a more functional relationship.

29.  What is an abscess?

Have you ever noticed a pimple or bump (fluid filled) on your gums? It could be an infection at the root of the tooth (Periapical abscess) or side of the tooth (Periodontal Abscess). Infection causes swelling of the tissues and pus, this creates pressure and the infection forces its way out of the confined area by following the path of least resistance.  Therefore you might notice a bump on the gum where the infection goes out to the side of the tooth to escape the confines of the bone space.  Could be localized or generalized, chronic or acute.  You must see a dentist as soon as possible for treatment. An abscess could be caused by a deep cavity or other infection within the tooth or debris trapped inside of the sulcular space, like a popcorn kernel.

29. Do not rinse with Hydrogen Peroxide.

Can change the micro-flora of the mouth, can leave a yellow stain and could cause yeast or other infection. Should be used for specific periodontal infection called ANUG(Acute Necrotizing Ulcerating Gingivitis).

30. This type of infection is known to destroy the papilla and is caused by stress.

31. Some people can be more susceptible to either tooth decay or periodontal problems.

An increase in the acidity of the saliva can cause more decay and less periodontal problems.

32. Can stress cause dental problems?

Yes, stress can cause the immune system to be more vulnerable. When someone is immuno-compromised they are more susceptible to viral and bacterial infection. This can mean an increase in gingivitis, periodontal disease, warts, bruxing (clenching or grinding of teeth) and many other concerns.

33. A wart is a wart is a wart!

Warts are caused by a virus (Humane Papilloma Virus).  They are contagious and must be completely removed to avoid spreading. Host response may determine if a person will get a wart after being exposed to the virus.  This virus can incubate for 6months.  It is the same virus regardless of the location of the wart (oral, genital or planters warts).

34. Anything that does appear to heal within 14 days should be examined by a doctor or dentist.

35. Initial or early signs and symptoms of many diseases can be seen orally.

Chicken Pox , oral lesions can precede skin lesions, they look the same, but erupt faster and are very contagious.

German Measles(Rubella), spots can be seen on the soft palate and rash on face neck or body.

Red Measles(Rubeola),  spots can be seen on the mucosa of the cheeks near molars.

AIDS/HIV, yeast infections are common

36. Growths can be malignant or benign.  Most growths should be removed. The jaw is a common 2nd site for cancer.

37. Periodontal Disease is more common after the age of 20.  Cavities are more common before the age of 20. 50% of all extractions are caused by Periodontal Disease.  38% of all extractions are due to decay.

Dental Prevention and Diagnosis

40.How can I reduce tartar?

 Brush twice a day and floss everyday. Try toothpaste with pyrophosphates in it.  The less plaque on the teeth the less debris there is to harden.  Drink a lot of water to help dilute your saliva.

41. Do I really need to floss?

30% of all tooth surfaces cannot be reached with a brush.  Therefore even if your brushing was 100% perfect you are only 66% complete.  Another tip, Starting to floss even once a week from never flossing, is increasing your production 100%.  Floss provides stimulation to the gum tissues, increasing oxygen flow to the area, and increasing regeneration of the tissues. Contact points between the teeth need to be cleaned with floss to reduce decay.  Bacteria between the teeth will increase gingivitis and periodontal disease.

42. The softer the bristle the better.

Pressure from a hard brush or pressing too hard on the teeth can remove the fluoride rich layer of the teeth. You can etch, abrade or damage the enamel and root surfaces, weakening them. This can increase decay, sensitivity to cold and will cause recession of the gum line.

43 .Pyrophosphates in toothpaste can reduce tartar, by inhibiting the mineralization of the plaque.

44. Bacteria must be mechanically removed.

Plaque must be removed with a brush or floss or other tool.  It will not rinse away with water once it is attached to the tooth surface. Just touching bacteria will kill it.

45. Most popular location for tartar build-up are 1)bottom teeth inside next to the tongue 2)upper teeth outside surfaces next to the cheeks.

46. Tooth Brushing Techniques

Gently sweep towards the chewing surfaces. Always Rolling,  Never saw back and forth. Brush only a few teeth at a time to ensure coverage of the bristles. Don’t forget to brush all sides of each tooth and use floss to cover the ones you cannot reach. Remember, DO NOT SCRUB BACK AND FORTH.  Brushing too hard can lead to sensitive teeth and can damage the tooth structures.

47. Flossing technique.

Floss should always disappear below the gum line, give a shoe shine motion, rocking back and forth ensure that you cover as much tooth as possible. Try to adhere, the floss against the tooth surface, but apply the pressure, against the tooth, on the up or out stroke to avoid tissue damage on the way down. We want to disturb and disrupt whatever bacteria are growing there, not necessarily to remove everything.  Think of the bacteria growing in colonies, the more there are, the more surface they cover. When you disturb and disrupt them, they are spread further apart.  This will slow down the destruction the bacteria might cause.  The idea is to do this as often as possible to slow or destroy the bacterial population.

48. What are sealants?

Sealants are clear or opaque plastic coatings, hardened on the teeth on the chewing surfaces to protect them from decay. This procedure is most often preformed on newly erupted teeth (6-12 years old).  The sealants will protect pits and grooves. They can last from a few years to 10 years.  As small pieces of sealant fall off, the child has become more proficient at oral health care, but tags of material will often remain in the smallest of grooves giving added protection. This protection can give children the added benefit of a barrier from acids and bacteria in the mouth.

49. Different kinds of bacteria cause decay in certain locations.

The bacteria that cause cavities on the smooth surfaces (facing tongue or lips) are different than the ones that cause cavities in pits and grooves on the chewing surfaces.

50. Why are my teeth sensitive to cold?

Brushing too hard is the usual suspect.  This can remove the fluoride rich layer of tooth structure, from the root or enamel surfaces,

Exposing the tooth to acids and temperature changes in the mouth.  The amount of pressure and the length of time that you scrub your teeth will determine the damage.  The most common sign of damage is recession of the gum line. Abrasions on the tooth surface are also commonly seen. Small tubes on the on the surface of the roots become exposed and transit the temperature change to the nerve of the tooth, causing pain.  Intact gingival tissues will help to insulate the tooth from temperature changes bacteria and acids in the mouth.  Damaged areas of the tooth can be more vulnerable to decay.

51. What can I do to relieve sensitive teeth?

Assuming that there is no decay there are several ways to decrease sensitivty. Fluoride gels or rinses are available at your pharmacy. They are found in daily and weekly doses.  Fluoride will reduce sensitivty by reinforcing weak areas of the tooth and root structure. Tooth structures will pick up the amount of fluoride needed, often based on the areas that have lost minerals. Enamel, dentin and root have different amounts of minerals in them but a predetermined amount. Don’t worry about getting too much topical fluoride, because any one spot will only take as much fluoride as it needs.  Do not swallow fluoride, do not drink or eat for 30 minutes after a fluoride treatment. The chemical process actually takes 30 minutes to convert the fluoride into a useable form, by the body. If you should ever swallow the dose of fluoride, DRINK MILK. The calcium in the milk will bind with the fluoride and it will pass through the system inert.

If more than a dose is swallowed call poison control.  Too much of anything is not a good thing.

Desensitizing toothpaste with 5% potassium nitrate will help relieve symptoms.  Read directions carefully, must be used daily for 6 weeks to benefit from a barrier of protection. This works almost the same as fluoride.  Week areas will take as much minerals as they need. Don’t brush too hard or you will remove your new layer of protection as you did the old or original layer.  The final tip to reduce sensitivty is to not brush hard and never use a hard or medium toothbrush, only soft or extra soft.

52. Why do we get cavities?

There are many possible causes that will lead to decay.  High acids in the mouth will eventually lead to decay if a tooth is vulnerable.  There are certain things that can leave a tooth susceptible to decay like, defects in the enamel, deep pits and grooves, or decalcified or de-mineralized teeth. High acids in the mouth are often attributed by frequent snacking and drinking liquids that are not water.   Old fillings can break or leak, causing recurrent decay, under or near margins of existing fillings.

53. What are de-calcifications?

De-calcifications can be seen as brown to yellow to white spots on the teeth.  They are caused by insufficient or excess amounts of minerals.  Most of these conditions happen at the time of formation of the teeth.  A high fever, a trauma to the head or mouth or even genetics can play a role in de-calcifications. It can also happen in weak areas like around orthodontic appliances or in areas of bad oral hygiene, too much fluoride could be ingested at the wrong time during the formation process, and it could be seen in an area were a cavity is starting or has stopped forming.  Minerals can be lost from the tooth structure, caused by any of the things listed above.  These areas can be compromised causing weakness and susceptibility to acids, leading to decay.

54. Can a cavity be stopped or reversed?

Once a cavity has started it can be stopped or reversed if it is still small.  When a cavity is this small, still within the enamel layer we call it incipient decay. A cavity will start slowly, after decay has broken through the enamel layer, which is the strongest layer it will move very quickly to destroy the tooth structures.  If you can catch decay before it breaks through the enamel than it could potentially be stopped or even reversed. The area must be kept very clean and treated with fluoride.  A topical gel or liquid could be applied directly to the surface or rinsed throughout the mouth. Sometimes evidence can be seen on a radiograph.  If any incipient decay is found between the teeth, you must floss as often as possible to remove debris, bacteria and acids from the area.     

55. USE ONLY A PEA-SIZED AMOUNT OF TOOTHPASTE FOR CHILDREN UNDER 6 YEARS OLD.

Do not allow child to swallow the toothpaste. If under 3 use no paste or buy a non-fluoridated paste. Swallowing too much toothpaste could cause de-calcifications.

56. Newly erupted teeth use more fluoride.

Fluoride is most important during childhood and adolescence. Both systemic and topical fluoride are necessary for development.

57. Can I use too much topical fluoride?

No, a tooth will only take as much topical fluoride as it needs. For example, a weak area, exposed roots, incipient caries or areas that are decalcified or have lost minerals for some reason.

58.DO NOT EAT OR DRINK ANYTHING FOR 30 MINUTES AFTER BRUSHING YOUR TEETH.

Sodium Fluoride is the most common form of fluoride in toothpaste. It will take 30 minutes for the fluoride to become usable by the body.

59. 95% of systemic fluoride goes to the bones, only 5% to the teeth.

60. What is systemic fluoride and where do I find it?

Systemic fluoride is fluoride that is ingested by the body.  The most common place that you will find it is in tap water. All juice and soda pop will have fluoride in it. Swallowing toothpaste or fluoride rinses or gels, is common in children and becomes systemic when swallowed.  It fortifies the tooth from the inside. Ingesting too much fluoride can cause de-calcifications on permanent teeth while they are still forming.  Too much fluoride could cause a toxic dose or fatal dose. NEVER LEAVE CHILDREN UNATTENDED WITH FLUORIDE. It would take many doses to cause a toxic dose.  Call poison control if this happens, know how much the child would have ingested.

61. How much fluoride should be in our drinking water?

Most fluoride is found at a level of 1 part per million. Most water has fluoride content naturally, some areas will add or take away fluoride to bring it to a safe level. Some areas do not add fluoride to the water, some city water supplies will need extra fluoride to compensate for evaporation in warm climates.

62. What is topical fluoride?

Topical fluoride is when you apply or put the fluoride directly on the surfaces of the teeth.  Gel, foam or rinses can be used professionally or at home.  Apply to tooth with brush or cotton tip.  Can zero in on weak areas reversing or arresting decay.

63. What can I do about stains on my teeth?

There are 2 types of stains, extrinsic and intrinsic.  Intrinsic stain is an internal discoloration of the tooth that may be caused by exposure to certain medications during tooth development.  Tetracycline or systemic fluoride would most likely cause intrinsic stain. This type of stain cannot be removed and must be treated cosmetically, by restoring the tooth with a veneer or composite bonding materials. There has been success with bleaching tetracycline stains from the tooth, but results vary from person to person. Extrinsic stain is an external discoloration of the tooth that may be caused by certain foods (coffee, cola, berries, spices etc.), tobacco, bacteria, metals or drug therapy.  Usually these stains can be removed with a varying degree of difficulty.  Mechanical removal of these stains is necessary. Bleaching will not remove these stains.  Always have your teeth professionally scaled and polished before bleaching. Mechanical removal could include a scaling and polish by your Hygienist or Dentist, or at home with store bought toothpaste or adding baking soda to your toothpaste (only 1-2 times per week). ABRASIVES BEWARE.  You want to remove only the stain layer, beware not to damage the enamel or root surfaces.  Brushing too hard with an abrasive or using it too often or using a medium or hard brush could damage the tooth.

The last thing that you want to do is remove the fluoride rich layer of the tooth. Try over the counter stain removing products after researching them and call the customer service department to get accurate details. Do not buy bleaching products, over the counter.

64. Water can help reduce bacteria in the mouth.

Rinsing with water can be a very effective way to remove free floating bacteria from the mouth.  Bacteria that is already attached to the tooth must be mechanically removed (brush, floss or polish). Rinsing with water can be 80% as effective as prescription strength antibacterial rinses (water pik). Water can be used for more than just rinsing.  Water or water and ‘medicine’ can be placed under or below the gumline into the sulcular space between the tooth and the gum. This will remove or disturb and disrupt any bacteria that is growing but, will not remove debris that is already attached to the tooth. This will reduce the amount of bacteria below the gumline that can attach to the tooth in order to form plaque. We call this oral irrigation, it can be done at home with a store bought machine or professionally. It is very important that great care is taken not to damage the papilla or pointed areas of the gum.  Directing too much pressure towards the papilla could blunt the tissues changing the shape.  Avoid rinses that contain alcohol.

65. Should I perform a self-exam?

Yes, a self-exam could be the most part of your daily or weekly routine. Always use a good light source, use one or two mirrors.  Look for colour (pink or pink-red), texture, bumps or growths.  Anything that does not heal within 7-14 days should be checked by a doctor or dentist. Check by looking and feeling with finger tips the following areas: Palate, floor of mouth under tongue, insides of cheeks, borders and back of tongue, gums and teeth (look for brown spots or grey or opaque areas, broken or loose restorations or chipped teeth).  Look for changes in colour or consistency    (the way it feels, hard or soft). Bone growths are common on the midline of the palate or under the tongue.   

66. Avoid chewable vitamins.

Chewable vitamins can de-mineralize or decalcify the teeth.  Newly erupted teeth are more vulnerable, they are not as strong as adults teeth.  Try to introduce tablets or liquids.

67. Snacking and eating should be grouped together to avoid high acids in the mouth. Drink only water between meals. Do not sip drinks like coffee or juice or anything but water throughout the day. Acids in the mouth can take 15-20 after eating to return to normal.

68. Certain foods are more cariogenic (cavity causing) than others.

All foods that have equal amounts of sugar are not equally cariogenic. Consistency and solubility, the ability to break down the food will determine how cariogenic it is.  Wait to eat at meal times, when more saliva is present. Less food more often is not better.  The type of acid is also important, not necessarily how much.  Soluble carbohydrates like sugars are not healthy but clear the mouth faster than cereal, a healthy carbohydrate.  Carmels clear the mouth and breakdown faster than chips or crackers. Bananas are very cariogenic. Cheese helps neutralize acids. Carmels, wafers and cookies clear the mouth faster then croissants, chips and cornflakes. 

69. Are vitamins important for proper growth and maintenance of oral health?

Yes, vitamins are extremely important for proper growth and regeneration of damaged tissues and maintenance of tissues.  Basic vitamins and minerals are all important but some have a direct affect on the mouth. Vitamin C helps to maintain skin, teeth, blood vessels, gum tissues and helps maintain the rate of regeneration (healing) of tissues.  Vitamins B1, B2, B3, B6, B12 are also important and perform varying functions; including fatigue, nerve changes, swellings, heart failure, cheilosis (cracks at corners of the mouth), skin lesions, irritability, convulsions, muscle spasms, kidney stones, anemia and neurological disorders.  Vitamin A plays an important role in bone growth and remodeling, maintenance of epithelial tissues (tissues in the mouth and body), level of saliva flow, can also have an affect on eye-sight and respiratory infections. Vitamin D is very important, it promotes growth and mineralization of bones and teeth, and it increases the absorption of calcium in the intestine.  Other important vitamins include Pantothenic acid, Folacin, Biotin, Iron, Zinc, Protein, Calcium, Fluoride and Vitamins E and K 

70. Can eating disorders effect oral health?

Yes, Anorexia Nervosa and Bulimia have oral manifestations.  Anorexia can cause enlargement of the parotid glands, diminished taste, dehydration, enamel erosion, self induced lip and cheek trauma, and an increase in dental caries.  Bulimic clients will have similar signs and symptoms and also lesions on the lips, dry chapped lips, dry mouth, trauma to the palate, ulcerations and could have a callus on the knuckle.  The problem of obvious nutritional deficiencies will cause poor growth, strength and regeneration of the tissues in the body.  Less resistance to bacteria and viral infections causing disease when the immune system is low (immunocompromised).    Acids from the stomach can thin and erode away the enamel surface on the tongue side of the teeth (lingual), creating a see-through, transparent or translucent appearance. Teeth are likely to chip and break and have carious lesions. 

71. Can oral health be affected if you are a vegetarian?

Of course, if you are a vegetarian see above #69.  The above nutrients are essential, and easy to find if you know where to look.  Protein can be found in Soya and the Vitamin B complex can be found in peas, beans, vegetables, fish, poultry, grains and dairy sources. B12 is important because it is not found in plant sources. 

72. What factors affect tooth decay?

There are three factors that will affect tooth decay the tooth, bacteria and diet.

Saliva is one of the most important things affecting teeth, the amount, content and consistency. The age of the tooth is important, the younger the tooth the more porous or vulnerable and the arrangement of the teeth (misalignment). Hereditary factors, nutritional deficiencies and lack of fluoride.  If a child had 1ppm of fluoride from birth, in their diet, compared to a child of the same age without Fluoride, it would take 20 years to equal the strength of the teeth.

The type, quantity and location of the bacteria will determine how the tooth is affected.

The last factor is diet, the easiest to change.  Acids are highest in the mouth 5-20 minutes after eating and it takes up to 2 hours after eating to return to normal.  6.2-7 are neutral ph levels.  At 5.5 a tooth begins to decalcify.  Carbohydrates breakdown into simple sugars, sugars convert to acids. Acids create the breakdown of the tooth, therefore causing the cavity. As you can see, depending on the strength of the tooth, the bacteria involved and diet are the factors that affect tooth decay. Bacteria and carbohydrates must come in contact with the teeth.  Eg: Tube fed rats had calculus or tartar but no cavities. 

73. Can chewing gum affect teeth?

Yes, chewing gum can affect the teeth. When chewing gum the saliva flow increases, increasing the alkalinity of the saliva.  This helps to neutralize acids and wash away food debris. Within 1 minute there is 12 times more saliva.  Please note that sugar-free gum is better for your teeth, but there is some new evidence that suggests sugar substitutes may lead to more hunger and a craving for food or insatiability.

74. What do I need to know about radiographs?

Background Information on X-Rays

Radiography is the art and science of applying X radiation to sensitized films to produce shadow images.  Radiology is a specialized branch of dental and medical science that uses radiant energy for diagnosis and treatment of disease.  Radiation is the emission and propagation of energy through space or objects and travels in different wavelengths. X-rays are radiant energy with short wavelengths and high penetrating power that can penetrate most substances except lead. Radiographic film (radiographs) is photosensitive film that produces a negative after exposure to X-rays.  Radiation is all around us, natural and man-made.

Different forms of radiation do not have the same wavelength.  All pass through space in a wavelike motion and travel at the speed of light.  Listed is a comparison of the electromagnetic spectrum.

The Electromagnetic Spectrum

Radio

Television   least penetrating and longer wavelengths

Radar

Microwave

Infrared

Ultraviolet

X-Rays   highest penetrating power and shorter  

Gamma Rays   wavelengths

Cosmic Rays

Background radiation originates from both man-made and naturally occurring phenomenon. The amount of background radiation received depends on altitude and latitude.  It can be inhaled or ingested.  The following are examples of background radiation sources: earth, cosmic rays, radioactive materials (uranium, radium, thorium, etc), water, luminous dial watches, houses and buildings, televisions, subways, microwave ovens, etc.

The Benefits and Uses of Dental Radiographs

The primary benefit for the patient, is the detection of disease.  When radiographs are properly exposed, prescribed and processed, the benefits far exceed the risks of small doses of exposure. Radiographs can be used for the following:

· to detect or confirm disease, lesions or other conditions

· detect decay and periodontal disease

· evaluate growth and development

· to provide information during certain procedures (root canal)

· orthodontics (braces)

· oral surgery (wisdom teeth removal)

· extractions

· bone loss

· infection

· abscess

· bone density

· cyst or other growth

How often should I have radiographs taken?

The decision to use radiographs is the decision of the Dentist.  As a professional the Dentist’s judgement is used concerning quantity, type and frequency of dental radiographs. There is no set timel

 

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