FAQs in Dentistry

December 11, 2018

Asking questions and getting the right answers is a part of good oral health care.

Over the years, here are some of the questions patients have most often asked me, wanting to know more about their dental health or certain procedures.

• What causes a cavity?

When you wake up in the morning and run your tongue along the surface of your teeth, you will often find a gritty film that disappears after brushing.

That gritty layer is plaque, which is a collection of germs which constantly form on our teeth, and is the main cause for tooth decay (and gum disease too!).

These bacteria produce acid as a by-product of dissolving the sugars we eat which damages the outer structure of the tooth known as the enamel.

To get a clearer understanding of how this happens, visualize pouring concentrated acid on marble. Scary, isn’t it? That’s what happens to your teeth as well, except that it occurs gradually over a period of months and years.

Once the enamel is decayed, the cavity can grow large very quickly, sometimes without a toothache until the cavity grows all the way to the nerve of the tooth.

• Why should I go to the dentist regularly?

Many people do not visit a dentist on a regular basis. They only go when they have a problem like toothache or bleeding gums.

This ‘firefighting treatment’ as opposed to ‘preventive treatment’ ends up being counterproductive to the patient.

While the patient may feel that s/he is saving on treatment costs, it often ends up costing much more in terms of both money and time.

This is because many dental problems do not have symptoms until they reach the advanced stages of the disease process.

An example is tooth decay. It is typical for dentists to have their patients say, "Nothing hurts... I don't have any problems."

Tooth decay often does not hurt until it gets close to the nerve of the tooth. It is not uncommon to see a patient with a huge cavity who has never felt a thing. The dentist can usually detect a cavity 3-4 years before it develops any symptoms. This early detection can help you prevent root canal treatment.

• How can I prevent cavities?

Always spend two to three minutes brushing your teeth with a fluoride toothpaste morning and night. That’s how long it takes to get rid of the bacteria that destroy your teeth.

Do not brush too hard lest you wear out the enamel of your teeth. It takes very little pressure to remove bacteria and plaque.

Floss at least once a day. Flossing is the only way to get bacteria out from between your teeth.

Remember to brush your tongue. By brushing your tongue, you will remove food particles and reduce the amount of plaque-causing bacteria. Tongue brushing also helps keep your breath fresh.

Watch the sugar you eat. There is sugar in foods that are not obviously sweet, like bread, crackers and chips. Be mindful of foods like raisins and chocolates that stick to your teeth-they provide a constant supply for the germs eating into your teeth.

Eat three meals a day with generous helpings of fruits and vegetables, and minimize- or if possible, eliminate - snacking.

Make sure you do not eat or drink anything after brushing at night.

Rinse after you eat or drink something.

Avoid carbonated soft drinks.

Chewing sugarless gum after a meal can also help. Chewing regulates the flow of your saliva which acts as a natural plaque-fighting substance.

Do not forget/neglect your regular dental visit once every six months. Good dental habits will go a long way toward a no-cavity visit.

• How can I get my kids to brush their teeth?

One of the necessary skills every child needs to learn is brushing his or her teeth. Helping your child get in the habit of brushing twice a day for two minutes is an achievement in itself, but a little creativity can go a long way when it comes to his or her long-term dental health.

Start a routine and stick to it. Don’t let the child give in to the temptation of slacking off once they’ve begun.

Reward good brushing behaviour (not with chocolates, though!)

Make up a story to motivate your child to brush.

Go shopping - Let your child pick out his own toothbrush and toothpaste. Choosing a character toothbrush might make brushing more fun, and fluoride toothpastes come in a variety of flavours and colours.

Make it fun! If you are enthusiastic about brushing your teeth, your children will be too. Children watch their parents and want to do what they do. If your children see you brushing your teeth and displaying good dental habits, they will follow.
Getting your children to brush starts with taking them to the dentist at an early age. All children should be seen by a dentist by their first birthday or 6 months after the eruption of the first tooth.

• What type of toothbrush and toothpaste should I use?

Use toothbrushes with soft bristles. Hard and medium ones can damage teeth and gums.

Choose a brush that fits comfortably in your hand, and the head is small enough to effectively reach all corners of your mouth.

Both powered (battery-operated) and manual toothbrushes clean teeth well. Manual brushes with mixed bristle heights or angled bristles clean better than those with all flat, even bristles. Powered toothbrushes may be easier for the elderly, the very young and the physically and mentally challenged.

Replace your toothbrush every 3-4 months. Change sooner if the bristles look bent or “flowered out”. Bent bristles don't clean very well, and they’re also a sign that you may be brushing too hard.

Most toothpastes will clear away bacteria growth and acids from food and drinks. Toothpastes that have fluoride are preferable, because fluoride helps strengthen and protect teeth.

Avoid use tooth powders or brushing with salt since they will abrade the teeth over time, leading to sensitivity

• How can I fix my teeth and smile?

There are a whole host of treatment options available to enable you to smile better.

Tooth-coloured composite restorations hide unsightly cavities in the front teeth as well as are used to correct chipped teeth.

Ceramic crowns cover problem teeth by surrounding them in a ceramic material that looks like a real tooth. They use the root and inside of the tooth as a base to build on, which is then attached to the tooth using a special dental glue.

Veneers and bonding improve your smile by glueing a layer of smoother and whiter material like porcelain or resin to the natural tooth.

Talk to your dentist about which option is the best for you.

• Why is dental treatment so expensive?

There are a number of reasons why dental procedures are so expensive.

First, services are provided by trained professionals.

Dentists are doctors who go through 5-8 years of dental college, practical training and then upgrade their skills and knowledge through ongoing programmes to provide their patients with the best possible care.

The equipment at a dental clinic include highly specialized equipment that is not only pricey to purchase, but also to maintain.

This is apart from the costs of surgical instruments, as well as the medications and materials used in procedures such as root canals, restorations and surgeries.

Additionally, dentists require to use the professional expertise of dental laboratories for treatment options such as crowns and dentures, which can also drive up the costs of certain procedures.

The most effective tools in your fight against exorbitant dental costs are your toothbrush, dental floss and regular professional cleanings.

Brushing and flossing will help prevent plaque build-up and cavities, and other problems that do arise can be nipped in the bud at your 6-monthly dental visit.

• Is there no escape from the dreaded dental drill?

Patients often avoid dental care due to the fear of pain that they perceive they will feel either related to the local anaesthetic injection or during drilling to remove caries.

However, you might be surprised to know that yes, now there is a way to eliminate the drill when getting fillings done!

Dental lasers are used to painlessly drill through the tooth, often without the need of anaesthesia.

The term LASER stands for ‘Light Amplification by the Stimulated Emission of Radiation’.

Lasers act as a cutting instrument or a vaporizer of tissue that it comes in contact with.

Er: YAG (yttrium aluminium garnet) lasers are the lasers of choice for cutting through decayed teeth or removing resin restorations.

A hard tissue laser allows the practitioner to remove carious tooth structure while preserving healthy enamel and dentin for truly minimal invasive dentistry.

The high pitched sound and vibration produced by the dental handpiece is done away with altogether, thereby enhancing patient compliance and comfort.

Despite the learning curve and high costs involved, lasers are slowly but surely becoming an integral part of dental practices, and it is certain that within a few short years they will be ubiquitous, just as happened with the smart phone about a decade ago.

• Will whitening my teeth harm them in any way?

Dental bleaching is recommended for anyone who wants their smile to look brighter, like at their wedding or for a job interview, or even for a social occasion.

Dental bleaching can be done either in-office, which is an hour long, single visit procedure and gives a quick and more visible effect, or at-home bleaching systems which take up to a few days to attain the desired result.

The whitening agents are usually either carbamide peroxide or hydrogen peroxide in different concentrations. Most in-office systems use 15-35% hydrogen peroxide, while at-home systems generally use 10-20% carbamide peroxide.

They work by getting into the tooth enamel and setting off an oxidation reaction that breaks down the bonds holding the staining compounds together.

Dental bleaching when done by a trained dentist using the right protocol and materials is entirely safe.

Some patients may experience transient sensitivity.

Points to note:

1. Bleaching does not whiten restorations and crowns.

2. The effect of bleaching lasts from some months to a couple of years, depending on the patient’s food and drink habits and use of tobacco.


Dr Bennet Anchan Archives:

By Dr Bennet Anchan
Dr Bennet Anchan is a highly-regarded and popular dental surgeon of Mangaluru. After graduating from one of India's most prestigious dental institutions, he has been creating beautiful smiles for the last decade and half. He can be reached at docben2000@gmail.com and +91 9343351611.
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Comment on this article

  • Dev, Mangalore

    Mon, Dec 17 2018

    Good informative article, thank you very much Dr Bennet Anchan.
    As you said keeping abreast with new technology & procedures is never ending learning process for any doctors in any field.
    Despite just like last time I have some reservations like using Fluoride in tooth paste, it too would change in future I hope.
    Please address some issues like using Amalgam as filling, root canal method too is being contested these days.

  • Henry Mascarenhas, Greenville, NC, USA

    Thu, Dec 13 2018

    Dear Dr. Anchan,
    Thank you for your timely article in oral care. If I may add for the benefit of cardiovascular and diabetic patient population and for those who consume excessive alcohol and use tobacco products, evidence from extensive research suggests that there is a link between oral health and heart disease. Gum disease in moderate or advanced stages pose greater risk of heart disease in subjects with cardiovascular problems than in the population with healthy gums. Bacteria and other germs spread from the mouth to other parts of the body through blood circulation. These germs can cause inflammation in the heart leading to illnesses such as endocarditis. Dental care of diabetics is just as important, uncontrolled high glucose levels can create an environment in the mouth for bacteria to grow rapidly leading to severe gum disease.

    Risk factors for oral cancer include betel nut chewing, smoking and chewing tobacco products and excessive consumption of alcohol. Unfortunately, oral cancer is one of the top three cancers in India and one of the highest in the world. The role of dentists in detecting and preventing early oral cancer is paramount just as pap smear, mammogram and prostate exams are important in early detection and prevention of cervical, breast and prostate cancers in primary care clinics.

  • john Monteiro, Bondel Mangaluru

    Wed, Dec 12 2018

    Very down-to-earth, helpful, well-illustrated and comprehensive. Should benefit those who care for their teeth and mouth.

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