Your oral health questions answered
What is caries?
Tooth disease is known as decay or caries.
Bacteria, viruses and fungi are the cause of infectious disease in the human body.
Caries, the most common disease in the world, is caused by bacteria in plaque which damages the teeth’s structure and leads to cavities and eventually tooth destruction.
How is tooth decay formed?
The bacteria in plaque uses sugar to produce acid. The acid demineralises the tooth enamel (calcium is taken out) leaving a brittle, porous area which appears grey-white. If the bacteria are not removed with effective brushing methods, the process carries on to penetrate the tooth, leaving a small hole. This is the cavity a dentist can detect. Once the bacteria are inside a cavity, it is impossible to remove them with brushing.
When the dentine is reached, the tooth becomes sensitive to cold or sweet things. At this stage the process can still be relatively easy to arrest by the dentist.
If the process is allowed to run its course, the bacteria will move rapidly through the porous dentine to reach the pulp (chamber inside the tooth with the nerve). Severe pain is usually experienced when the pulp gets inflamed and infected. This can lead to an abscess which is extremely painful. Saving the tooth at this stage, will require removing the nerve. See “root canal therapy”
What is gum disease?
It is an infection that starts in the surface layers of the gum and slowly, over time, works its way down into the bone around the tooth.
Gum disease can be divided into gingivitis and periodontitis.
This happens when plaque collects in the pocket (sulcus) surrounding a tooth. This irritates the gum, causing inflammation, redness, swelling and bleeding when touched. This is the first and reversible stage. Areas left uncleaned for more than 48 hours will develop gingivitis. To cure gingivitis, just remove the cause (plaque) by brushing and floss!
If gingivitis is allowed to continue over a period of time it will result in an infection which spreads into the bone. The supporting bone is destroyed (resorbed) progressively, which results in receding of the gum line, (the) teeth become loose and eventually fall(s) out. The course is usually slow and painless. Surgical treatment stops the process if done timeously, but proper maintenance there after ensures that the disease will not continue.
How does pregnancy influence dental care?
When you plan on getting pregnant, a routine dental check-up must be done to ensure that your teeth are in a good condition during pregnancy.
During pregnancy eating habits change and a high level of oestrogen occurs (which can make gums more susceptible for inflammation). Proper dental hygiene should be meticulously observed.
It remains important to visit the dentist at 4 months after pregnancy, to deal with any problems that might have arisen.
Why do I have sensitive teeth?
A tooth can be sensitive for cold and sweet things when dentine is exposed due to tooth decay or with sensitive tooth necks.
What are sensitive tooth necks?
The point between the tooth crown and root is called the “neck”.
When the gums recede and no longer reach up as far as the enamel of a tooth, then dentine is exposed and causes sensitivity on the tooth neck area.
The main causes are: incorrect brushing techniques, especially harsh brushing with hard tooth brushes, and periodontal disease.
What is the treatment of sensitive tooth necks?
Firstly start using the dental hygiene techniques prescribed by the oral hygienist. The gums won’t grow back over the dentine, but application of fluoride can help remineralization.
In serious cases, a restoration can be placed.
Why are teeth sealed?
The molars can have deep grooves, called fissures where it may be difficult to clean and where bacteria and plaque collects. Caries can form easily in these areas. A sealant is applied to seal fissures tightly. The procedure is and done without local anaesthetic
Primary molars can be sealed at age 3 to 4 and permanent molars as soon as they erupt at age 6.
Note that only the chewing surfaces are sealed. Areas between teeth cannot be sealed.
Why do I have to wear a dentist-made mouth guard?
A mouth guard protects against injury of the lips, cheeks and teeth and absorbs impact of a direct blow as to lessen chances of brain concussion.
- Follow daily effective dental hygiene procedures, as prescribed by your oral hygienist.
- A 6 monthly visit to the oral hygienist for evaluation and prophylaxis.
- A 12 monthly visit to your dentist for a comprehensive examination.
Note that visiting the dentist for a specific problem does not include a comprehensive examination of all the teeth and the total oral status.
Teeth with developmental grooves on the chewing surfaces cannot be properly cleaned by a toothbrush. Thus bacteria collects on the tooth’s surface, despite a correct brushing technique. Tooth decay can then set in.
Preventative treatment involves removal of effected, damaged enamel with micro-abrasion procedure. It is then restored with a tooth coloured resin.
When do teeth erupt?
The first baby teeth can start to appear from 6 months old. At 30 months all teeth should be out. The principle differences with the permanent dentition are that they are smaller, less resistant to caries and have a lower sensitivity.
When do permanent teeth appear?
At about 6 years old, the primary upper and lower incisors (front teeth) are shed, with the permanent incisors erupting between 6 and 8 years. The last permanent teeth to erupt are the wisdom teeth, at 17 to 21 years of age.
What causes caries?
Tooth decay is caused by bacteria which produces acid. All sugars, including natural sugar in fruit and juice, stimulate the growth of plaque. Plaque is the accumulation of bacteria. The acid produced by it, demineralises the tooth’s surface. The enamel becomes chalk-white and softer. If a small lesion is not removed by a dentist, it will continue to grow deeper. At this stage there is still no tooth ache.
In children caries can quickly develop into a tooth abscess, as primary teeth are less resistant to decay.
What is Nursing bottle caries syndrome?
This is the prolonged and frequent exposure to sweetened liquid.
All sugar containing fluids will cause caries, even natural sugar in fruit and juice. Fruit juice and carbonated soft drinks has a higher tendency to cause caries, due to having sugar combined with a higher acidity. These drinks should therefore not be given in a baby’s bottle.
Take note that a baby should not sleep with any bottle in his/her mouth.
How can I prevent caries?
The most important factor is to brush a baby’s teeth from the appearing of the first tooth. All babies will resist it to a degree. If the parents cannot get the child to sit still, or if it is painful to the child, a rubber thimble brush can be used.
Parents should brush their children’s teeth until 8 years of age to ensure that all plaque is removed.
Regular visits to an oral hygienist, from an early age, are recommended. She will be able to assist in technique of brushing and with fluoride treatment for stop early caries from spreading further.
Do antibiotics cause caries?
No, it does not. Tetracyclines can give discolouration of teeth and should be avoided. These teeth are not weakened however.
When should my child have a visit to the dentist?
It is a good idea to start bringing a child to the dentist from about 3 years of age. At this age a moderate amount of cooperation is possible. If the visit is made to be fun, a good grounding for later visits is made.
Children need to be seen every 6 months, since even primary teeth (baby teeth) are very much at risk.With an examination every 6 months, small caries can be identified and stopped. When permanent teeth appear and have deep fissures, it can then be sealed.
A visit to the dentist should be viewed as a routine matter and not be over-dramatised.
Regular dentist visits will help reduce anxiety.
Never use a dentist or doctor as a means to threaten your children.
General anaesthesia or intra-venous sedation
When there is no co-operation from a child or with extended procedures, an anaesthetist will administer sedation in the dentist’s rooms or general anaesthesia in a hospital theatre.
When should I consider orthodontics?
For a baby, an orthodontic pacifier should be used.
Thumb sucking in children older than 4 years, will jeopardise the growth pattern of the teeth.
General orthodontic treatment is started in girls at age 11 and in boys at age 12. Sometimes preliminary treatment may be started at 8 to 9 years.
Bruxism is a chronic habit of grinding teeth, especially while sleeping. Apart from it being irritating for your partner, it also harms your teeth and the jaw’s joints. Up to 50% of people may suffer from bruxism, most of them are unaware of it.
Symptoms may include:
- Morning headaches
- Spasm of neck and shoulder muscles
- Ear ache
- Jaw stiffness
- Feeling tired after a full night’s rest
- Short, broken or chipped teeth
- Migraine without another cause
Dr Beukes presents patients with an apparatus to prevent grinding. It is small, comfortable and effective. Annual follow-up is all that is needed.
This embarrassing condition can be addressed by visiting the oral hygienist.
Tension headaches could be the result of a spasm of the chewing muscles.
It can also be caused by impacted wisdom teeth.
Consult your dentist for a thorough examination.
Mercury is a heavy metal that is toxic to all living cells. It is found in silver amalgam that has traditionally been used for filling teeth. This material is harmful to your general health, as well as to your teeth.
Mercury is neurotoxic which means it damages your nervous system. It has been linked to numerous diseases, eg. Hormone dysfunction, depression, Alzheimer’s’ disease, autism, multiple sclerosis. In time, amalgam fillings fractures teeth, because of the corrosion process. The fracture often presents as teeth breaking for no reason.
If you still have silver fillings, it should be removed. Safe removal of these amalgam fillings are done by Dr Beukes, using the IAOMT protocol. ‘Safe removal’ implies the patient not being exposed to absorption of mercury during the procedure. Therefor strict measurements must be taken and adhered to at all time.