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Visiting the dentist: Your questions answered

Anni Seaborne answers some common questions about dental appointments and routine treatments.

Transcript

Why do people need a filling?

People need fillings when they've got a cavity,

which simply put, is basically a hole in your tooth

which is caused by dental decay.

What would I go to see a dentist for?

Most people come to the dentist for a regular checkup

and sometimes a clean,

but occasionally you'll need to come for specific treatment.

This could be fillings, extractions, root canals, treatment

of gum disease, and replacing missing teeth.

So that could be a denture or an implant.

Will my dentist judge me?

Absolutely not.

There's nothing that we haven't seen before.

We're here to help. So just come in, we'll have a chat, go

through everything, and we'll work together to see

how we can resolve your issues for you.

How often should I come in for a dentist appointment?

For most people, six months is sufficient,

but it really depends on

how at risk you are developing dental problems.

So if you've never had any treatment at all, then it may be

that you only need to come in every two years.

But if you're someone who's prone to getting fillings

or cavities or having an ongoing problem like gum disease,

it may be that you need to come in every three months,

but your dentist will be able to guide you with that.

What if I haven’t been to the dentist in a long time?

Please don't stress

if you haven't been in a while,

we are not going to judge you.

We're here to help. So just reach out to one

of our friendly reception team,

give them a call, and they'll be able to guide you on

how we can get you booked in.

What can I expect when I go into a dentist?

So when you arrive at the dentist, head to reception

and they'll be able to check you in

and they'll give you a medical history form to fill out.

When the dentist is ready, they'll call you in

and then they'll do the checkup for you.

So the checkup normally consists of checking

for any holes in the teeth

and also checking your gum health.

They'll also carry out an oral cancer screening,

so they'll be looking at your lips, your tongue,

and your neck, just to make sure there's no

nasty lumps and bumps.

After that, they're most likely going to take some X-rays,

and also they may take some photographs as record keeping.

What causes tooth decay?

Tooth decay is caused by the sugar in your diet.

There's naturally occurring bacteria in your mouth,

and when you feed it sugar, it causes it to produce an acid.

And this acid is what weakens the tooth

and causes that tooth decay.

What are the causes of root canal?

You normally need a root canal

because there's been some sort of trauma

to the nerve of the tooth.

So this can either be by tooth decay, working its way

through the tooth and going all the way into the nerve

and causing it to get irritated.

Or alternatively, if you've had a trauma

to the tooth directly, like a knock to the tooth,

and that impact can irritate the nerve

and essentially cause it to die.

Will getting a filling hurt?

The filling itself shouldn't hurt.

You'll be given local anaesthetic in most cases,

and this process might be a little bit stingy,

but once that's in, after a couple of seconds,

you won't feel a thing.

What is the recovery like after a filling?

The recovery for a filling is pretty straightforward.

Occasionally you might get a little bit of sensitivity

or a little bit of tenderness on

biting, but this is quite rare.

The hardest bit is the fact you'll be numb for a few hours

after the appointment.

This can last three to four hours,

and you might be a little bit dribbly

and you might struggle a little bit when it comes to eating

and drinking.

What happens in a filling appointment?

So normally when you come to a filling appointment,

the first thing that they're most likely going

to do is give you a little bit of local anaesthetic just

so you don't feel anything.

Once that's in, they use a drill

to clear out any decay that there is.

And then once that has been done

and they're happy with how it's looking,

we'll then fill it up.

Normally this is done with a material called composite.

Once this is built up, they'll polish anything off,

check you're biting okay

and then go through any postoperative instructions with you.

How do I stop tooth decay from happening?

Simply put, we need to reduce the amount

of sugar we're taking in.

Sugar feeds the bacteria in the mouth, which subsequently

produces an acid, which causes the tooth decay.

So if we're reducing the amount of sugar

that we're taking in, then we're not feeding that bacteria

to produce the tooth decay.

Having a good oral care regime will help as well.

So there's fluoride in the majority of toothpaste,

and that helps strengthen the teeth,

but ultimately it comes down to how much sugar we're eating.

How can I avoid getting a root canal?

The most common reason for needing a root canal is when

you've got extensive tooth decay.

What I would say is make sure you're going

to your dentist regularly so they can take X-rays

and do regular checkups to make sure

that there isn't any decay going on.

And in terms of what you can do from home,

it's just making sure you have a sugar free

or at least reduced sugar diet

and are brushing your teeth twice a day.

What is a root canal?

So if we imagine the anatomy of a tooth,

we've got the enamel on the outside,

and then we've got the bulk of the tooth,

which is made out of something called dentine.

And then right in the middle we've got where the nerve sits,

which sits essentially in the canals of the tooth.

Okay, so when we're doing a root canal, the reason for it is

because there's been some sort of injury

to the nerve of the tooth.

So this could be from decay coming all the way through

and then irritating the nerve

or it can be from a trauma impact, which has kind

of irritated the nerve and caused it to either flare up

or essentially die off.

The root canal treatment is essentially clearing out any

bacteria or any remaining nerve from the area,

and then we fill up that nerve

or fill up that root canal all the way to the top

so it's blocked off so no bacteria can sit there anymore.

What is the recovery for a root canal treatment like?

There's little to no recovery time following

a root canal treatment.

Occasionally it might be a little bit tender afterwards,

but the main thing to be aware of is

that you would've had anaesthetics, so you're going

to be numb for a few hours after,

so it might be a little bit of a struggle when it comes

to eating and drinking.

But in terms of what to expect afterwards,

you should be able to go about your normal tasks,

but you might just be aware that there's been a bit

of poking and prodding around in that tooth.

Will a tooth extraction hurt?

So we always use local anaesthetic to ensure

that it'll be a painless procedure.

However, do expect to feel a bit of pressure on the tooth

when they're taking it out.

What happens in a root canal appointment?

So when you arrive to the dentist, if you head

to reception and they'll check you in

and they'll give you a little medical history form

to fill in, and then when the dentist is ready,

they'll call you in. With the root canal,

they're going to numb you up, so they're going

to give you a little bit of local anaesthetic

so you won't feel anything.

The next stage is a bit odd,

they're going to put something called a rubber

dam over your tooth.

What this is, is a sheet of rubber

that essentially will isolate the tooth

to make sure no bacteria can get into the

tooth during the treatment.

At this point, they're going to drill open the tooth

and they're going to access the canals in the tooth

so they can be up to four canals in the tooth.

They're then going to clean it out with some antibacterial

to make sure there's no bacteria left,

and then they will fill the tooth up, each canal, one at a

time, and then they'll put a filling over the top.

Why do people need a tooth extraction?

If you need a tooth extraction

or essentially a tooth being taken out, it's

because that the tooth can no longer be saved.

So they could have tried various other options,

and it's in a position that actually it's better off

for your overall health to have the tooth taken out.

There are occasions where we may electively choose

to take a tooth out, and this tends to be

with orthodontic treatment.

Will it hurt to get a root canal?

In the majority of cases with root canals,

you won't feel a thing.

You'll have some anaesthetic just

to make sure everything is nice and comfortable,

but it should be a really

straightforward, painless procedure.

However, there is a certain situation,

in which case it might be a bit uncomfortable,

and this is if the nerve is hyper inflamed.

Normally, you'll be attending the appointment already in

pain, so it's not the treatment itself that's uncomfortable,

but it's the fact that your nerve is so irritated

that it's just being very angry

and not reacting well to the anaesthetic.

In this case, the root canal specialist

or your dentist may decide to

split the treatment over two appointments.

How do I stop a tooth extraction happening?

To avoid a tooth extraction,

we just need to make sure we look after our teeth, so we want to make sure that there is no tooth decay

and this is by having a sugar free or reduced sugar diet

and looking after your teeth with a really good oral hygiene routine.

What happens in a tooth extraction appointment?

So when you get to the dentist, if you head to reception

to check in, and they'll give you a medical history form

to fill out, and then when the dentist

is ready, they'll call you in.

The first thing they're going to do is just go over the

risks and make sure you're happy to go ahead.

Then they will use local anaesthetic

to make sure you are nice and numb.

Because the tooth is held in to the gums by ligaments,

what they'll do first is loosen those ligaments up

and then they're able to elevate the tooth out.

Occasionally you may need something called

a surgical extraction.

Don't worry, you'll still won't feel anything

because you'll be under local anaesthetic.

However, what they will do is drill a little channel

around the tooth, and this means that they're able

to pop the tooth out a bit more easily.

What is the tooth extraction recovery like?

We always say take it easy for a couple of days

after a tooth extraction.

You should be able to do your day-to-day

tasks like going to work.

But I'd avoid anything that's going

to get your heart rate up like going to the gym.

We just want to make sure the healing process can occur in a

really nice environment where there's not any excessive

bleeding or anything like that.

Why should I brush my teeth?

Over the course of the day,

you naturally get build up a plaque in your mouth.

If this plaque sits on your gum line,

then it'll cause inflammation,

which subsequently can cause gum disease.

The purpose of brushing is

to primarily remove this plaque from your mouth

and keep your gums nice and healthy.

If you use a toothpaste with fluoride in,

this can also strengthen your teeth

and reduce the risk of tooth decay.

How should I brush my teeth?

Depending on whether you have a manual

or an electric toothbrush, the technique will vary slightly.

What we recommend with a manual toothbrush is

to pop it on each tooth, angle it ever

so slightly up into the gum line,

and then use circular motions going systematically across

each tooth and across each surface of the tooth.

If you have an electric toothbrush, we just advise you

to hold it on each tooth,

and once again, go systematically

so you're covering each tooth.

But in this case, you don't need to use a circular motion

because the toothbrush is doing it for you.

What are the causes that can lead to a tooth extraction?

There's a couple of reasons why you might

need a tooth extraction.

It may be that you've had tooth decay that's so extensive

that even root canal can't save it.

It may be that you had the root canal treatment,

but unfortunately it has failed and not worked.

It may be that you are going to have orthodontic treatment

and there's not enough space in your mouth, so they choose

to take a couple of teeth out.

Or it may be that you have a wisdom tooth that has grown

through in an unfavourable position.

How do I stop gum disease from happening?

In order to stop gum disease from happening, we need

to make sure your oral hygiene is optimal.

So incorporating regular brushing in the morning

and the evening and making sure we're removing all

that plaque that builds up from the day

so the gums don't get inflamed.

Why do people get gum disease?

So for the majority of people,

the reason you get gum disease is

because of poor oral hygiene.

If the plaque that accumulates throughout the day is sat on

the gum line, it will cause inflammation of the gums.

In turn, the gums will start to puff up

and essentially swell up and move away from the tooth.

This is what we call gum disease.

Occasionally, there is a small amount of people

that fall into this bracket.

It may be a hereditary thing

or something that you are prone to, in which case,

I would definitely look to seek professional help.

What is gum disease?

Simply put, gum disease is a kind of a collective term

for two types of conditions.

One's gingivitis and one's periodontitis.

Gingivitis is essentially just when your

gums are a little bit inflamed.

This could be because you've had a couple of days

where you haven't been brushing as well,

and the plaque has accumulated on the gum line.

The good news is this can be reversed just

by a good few days of really good oral hygiene care.

Periodontitis is when that gingivitis has kind

of taken itself to the next level

and you haven't been looking after your gum health.

That is when the bones then start to shrink

underneath the gums.

What does it mean if I have gum disease?

First of all, don't worry.

Most people have completely reversible gum disease, so just

with a little bit of TLC

and some active oral hygiene, it should go away.

But if you are concerned, do go visit your dentist

and they'll be able to guide you as to

what the best treatments are.

What happens if I don't brush my teeth?

Because the plaque accumulates on your gums throughout the day,

if you're not brushing your teeth regularly, this will lead

to inflammation of the gums.

If the gums are inflamed for a prolonged period of time,

you then end up with something called gum disease.

Gum disease in itself can be reversible,

but if it's left for an even longer period of time,

it can cause the bone underneath to start to shrink back,

and then you can eventually run the risk

of losing your teeth.

My diet isn't sugar free, what adjustments can I make to have healthier teeth?

I think realistically, there's not many people

who have a completely sugar-free diet.

So my personal number one tip would be control the frequency

of your sugary snacks as opposed to the total amount.

If we think about how the tooth decay forms, it's

because of the sugar that's feeding the bacteria

that's causing that tooth decay.

If you're constantly feeding the bacteria sugar,

it'll be constantly causing tooth decay

and the tooth themselves can't repair.

So little changes such as having your dessert straight

after your dinner or making sure

that we're not snacking a bag of sweets over a period

of two hours and actually eating it in a short amount

of time will mean that the tooth has then got time

to repair itself.

What is the treatment for gum disease?

So if you do have gum disease,

the primary treatment would be just good cleaning at home

and potentially a hygiene appointment in the dental surgery.

If your gum disease is a little bit more advanced,

you may require a course of treatment,

or you may be required

to see a specialist called a periodontist,

and they will be able to talk you through some other options

to get your gums back to full health.

Why do people need a tooth implant?

When you've had a tooth extracted, for whatever reason,

you may choose to replace the missing tooth.

In this case, an implant may be one of your options.

What is an implant?

An implant is one of the options

you have to restore a space that is from a missing tooth.

Essentially, it's a little screw

that's secured into the jaw,

and then a ceramic fake tooth is placed over the top of it

to give it a nice lifelike tooth appearance.

What is the recovery like after a tooth implant?

We normally say after you're having the main implant

surgery to have a couple of days of downtime,

so you'll still be able to do your day-to-day activities,

but avoid anything that's going

to get your heart rate up such as the gym,

and just take it easy.

That is only after the main implants appointments

where they put the screw in.

After all the other appointments,

you shouldn't have any downtime.

Will a tooth implant hurt?

You'll be under local anaesthetic for the treatment,

so you won't feel anything during the process

of popping the screw into your bone.

However, it will be a little bit tender afterwards,

so do have a couple of days

where you've got a bit more relaxed downtime.

You'll still be able to do your day-to-day activities,

but just take it easy for a couple of days

after you've had that initial implant surgery.

What is composite bonding?

Composite bonding is essentially a cosmetic procedure

where we place composite,

which is the white filling material, onto the teeth in order

to shape them and make them more aesthetically pleasing.

I don't want an implant, what are the other options?

There are many other options when it comes

to restoring a space

because of a missing tooth. As well as the implant,

you can either leave the gap,

although we don't always recommend this as

there can be some implications in terms of how you bite.

You can use a denture, which is essentially a little plate

that you put into your mouth and remove it at nighttime.

Or you can have a bridge, which is a fake tooth,

which is attached to an adjacent tooth.

Why might I need composite bonding?

Composite bonding might've been suggested to you if you've come into the dentist with any particular aesthetic concern.

So, if you want to change the shape of your teeth

or the colour of your teeth, it's a good option,

which is relatively minimally invasive.

What happens in an implant appointment?

Implants tend to be a bit more of a specialist treatment,

so normally your general dentist will refer you onto a

specialist for this. The implant itself takes place across

a series of appointments.

The first one will involve taking X-rays and images,

and this will be used to plan the implant.

The second one is the main appointment in which they will

pop the screw into the bone.

At this point, we then leave it 3 to 6 months

for the screw to kind of integrate with the bone

and make sure it's ready

to have the final fake tooth put on.

If it's a front tooth,

you may be concerned about going round with a gap,

in which case they will provide you with a temporary denture

or little plate that you pop in

and out whilst you are waiting for the screw

to integrate with the bone.

Once the implant surgeon is happy that it's all ready to go,

he'll then take some impressions

and then the final fake tooth known as the crown,

will then be attached onto the screw

and you'll have your implants all done.

What is teeth straightening?

Teeth straightening, also known as orthodontics,

is the process of aligning your teeth

to get them into a favourable position.

This may be functionally, so in terms of chewing,

also and for most people aesthetically,

so in terms of how they look.

This can be achieved with braces:

you can have your traditional wire braces

or you can have something called clear aligner.

What happens during a composite bonding procedure?

Composite bonding is a minimally invasive procedure,

so you shouldn't require any local anaesthetic.

First thing the dentist will do is understand

what you're looking to achieve

and make sure your visions are aligned.

Once that's done, they'll get started.

So the first stage is they pop something called an etchant

on, and this is essentially dries out the tooth.

You then put a bond, which acts like a little bit of a glue

to the tooth, and then they'll layer on the composite,

which is essentially white filling material, onto the tooth

and shape it accordingly. At the end,

they'll then spend quite a long time polishing it down

and shaping it until they're happy,

and most importantly, until you are happy.

Why might I need teeth straightening?

There are a handful of reasons why you might want

to have your teeth straightened.

The most obvious one is aesthetic, so it may be you

want that nice Hollywood straight smile,

in which case teeth straightening will help that.

Another reason might be you're struggling

to clean your teeth because of the crowding in your teeth.

So by straightening it means

that you can get toothbrushes into all the nooks

and crannies and improve your gum health.

The third reason which may be guided

by your dentist is for a functional reason.

Your bites may not be in a favourable position,

and this can have some other effects such as issues chewing

and tooth wear, so the dentist may recommend you having some

orthodontic or teeth straightening treatment.

Will composite bonding hurt?

Because composite bonding is a minimally invasive procedure,

there's no drilling required to the actual tooth surface.

It shouldn't hurt. However, it can take quite a while,

so your mouth will be open for prolonged period

and sometimes your jaw can get a little bit achy.

How long does teeth straightening take?

So depending on the complexity of the treatment,

it can range anything from a couple

of months to a couple of years.

Your dentist or your orthodontist will be able

to guide you on that timeline.

Will teeth straightening hurt?

So for the majority of your teeth straightening

journey, it won't hurt.

However, the first couple

of weeks it can be a little bit sore.

Because we're putting pressure on the teeth in

order to get them to move,

that constant pressure can be a little

bit tender, but it's nothing

a paracetamol won't fix.

Who are you and what do you do?

Hi, I'm

Dr. Anni Seabourne and I'm a dentist.

I've been with Bupa for seven years now

and I'm currently the Head of General Dentistry at Bupa.

Why choose Bupa Dental Care?

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Bupa Dental Care is a trading name of Oasis Dental Care Limited. Registered in England and Wales No: 00478127. Registered office: Bupa Dental Care, Vantage Office Park, Old Gloucester Road, Hambrook, Bristol, United Kingdom BS16 1GW.

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