1. Is it necessary to visit a dentist regularly?

It is important to see a dentist regularly as he/she:

• Is able to identify dental problems early, and take appropriate measures to ensure that they do not progress or worsen.
• Is able to provide corrective treatment for any dental problem before it progresses to a stage whereby the treatment required becomes more complex and less likely to be successful.
• Is able to evaluate oral hygiene measures adopted, and treatment already carried out in the mouth.
• Is able to incorporate a good preventive programme to ensure that your mouth is in a healthy condition.

It is thus important that you co-operate with your dentist in order to satisfactorily maintain your mouth in a good, healthy condition.

2. What is Periodontal Disease and what is it caused by?

Periodontal disease is the inflammation of tissues surrounding the tooth (the gums, the bones supporting the tooth). It is a major cause of tooth loss in adults, apart from tooth decay.

Periodontal disease is caused by bacteria in plaque and tartar. Plaque and tartar accumulation leads to gingivitis (a mild for of periodontal disease), which, if uncontrolled, advances to peridontitis. Periodontal disease is a progressive condition which could proceed to increasingly advanced stages of deterioration if not treated early. Gingivitis, a mild form of Peridontal disease, is prevalent in about 80% of the general population.

3. How can I tell if I have Periodontal Disease?

Signs of periodontal disease are:

• Swelling and bleeding of gums, sometimes with pus formation
• Receding gums
• Mobile teeth/teeth that appear longer

Inadequate or lack of treatment at this stage would result in further infection of the tissues including abscess formation with pus and pain. Further progression would result in greater loss of supporting bone, and the tooth may become increasingly loose, resulting in the possibility of the need for extraction.

4. Why do my gums bleed when I brush my teeth?

Poor maintenance of the teeth, usually inadequate or improper brushing and flossing, result in a thin layer of plaque covering the tooth surface. With time, plaque may harden to form tartar. The bacteria is the chief culprit behind the inflammation. The gums become tender, red, swollen and bleeds easily upon contact, e.g., during brushing.

Bleeding of the gums is often the first indication of the onset of gum disease (periodontal disease). Unfortunately, this sign is seldom taken seriously because there is no pain and the warning is therefore ignored.

Bleeding of the gums is often the first indication of the onset of gum disease (periodontal disease). Unfortunately, this sign is seldom taken seriously because there is no pain, and the warning is therefore ignored.

5. What is a root treatment and why is it done?

Root canal treatment or root treatment is necessary when the pulp of a tooth becomes inflamed or infected. The diseased pulp of the tooth is removed, after which the pulp chamber and root canal are cleaned, filled and then sealed. Pulp is the soft tissue within a tooth that contains nerves, blood vessels and connective tissue.

There are several reasons why the pulp can become inflamed or infected, namely: deep decay, a crack or chip in the tooth, physical trauma to the tooth such as a fall or blow.

In many cases, a crown is necessary to protect the root canal treated tooth from fracturing.

6. What is the best age to start orthodontic treatment?

The best time to start is just before, or immediately after, all the permanent teeth (excluding the wisdom teeth) erupt, as this would coincide with maximum growth activity of the child. Maximum orthodontic response is seen at this stage. This is generally between the ages of 10 and 14 years.

Sometimes treatment is started as early as 7 or 8 years, especially when the child needs what is known as ‘functional therapy’. It is best to seek your dentist’s advice.

7. Can adults undergo orthodontic treatment?

Yes. The biological process involved in tooth movement is the same in both adults and children. The health of your teeth, gums and supporting bone is what's most important in determining the prospects for improving your smile and dental health. Generally orthodontic treatment in adults takes a little longer.

8. How long does orthodontic treatment take?

The length of time for orthodontic treatment depends on:

• The type of problem that exists.
• The age at which treatment is commenced (it generally takes a little longer in adults).
• The type of appliance used (removable appliance therapy would usually take a little longer).

It is also essential that the dentist has full co-operation from the patient. Monthly checkups must be made to ensure that the braces are properly adjusted.

9. What is a bridge?

A bridge is a fixed prosthesis that replaces one or more missing teeth. It makes use of teeth adjacent to the empty space for support. These teeth are crowned, and the crowns are fixed to a false tooth or teeth, which fill the empty space. The bridge cannot be removed from your mouth.

10. What is bonding?

Bonding involves placing a tooth-coloured composite resin material directly onto a tooth defect or cavity. The tooth surface is first treated with a dilute acid solution in a procedure called ‘etching’ to aid in the retention of the filling material when it is applied.
Bonding can be done to:

1. Repair a broken, chipped or worn tooth
2. Cover up discoloration on a tooth
3. Close a small space or gap between two teeth

11. What does ‘bleaching’ a tooth mean?

Bleaching or whitening is a process that lightens teeth discolorations using whitening agents. The active ingredient in most of the whitening agents is carbamide peroxide, also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.

Tooth discolourations are commonly caused by consumption of certain coloured substances (coffee, tea, colas, tobacco, etc), trauma, tetracycline, excessive fluoride, pulp degeneration, and old restorations.

The bleaching techniques have variable results, depending on the case and degree of discolouration, and may need to be redone after a period of time.

12. When do children start losing their first set of teeth? Should they be allowed to drop out on their own?

Deciduous teeth begin shedding around the age of 6 years. The roots are gradually shortened (resolved) as the permanent teeth come up under the primary teeth. Each primary tooth is shed either shortly before, or after, the eruption of the permanent tooth that follows. Most children lose all their primary teeth by the age of 10 to 12 years.

Unless the primary tooth is causing discomfort to the child or is preventing the permanent tooth from coming into its proper position, it is usually advised to let it ‘drop’ out on its own.

13. Is the child’s first set of teeth – the primary teeth – important?

Primary teeth serve as the precursor to the permanent teeth. They are a sort of "blueprint" for the teeth that will come after them. If a child has good primary teeth, he will most likely have good permanent teeth.

They also permit the child to chew food properly, allow for clear enunciation and speech, and provide for a healthy smile that promotes self esteem.

It is very important that primary teeth are kept until they are lost naturally. If primary teeth are lost too early, a "space maintainer" may be necessary to ensure that there is enough space for the permanent teeth when they erupt, otherwise it may cause the problem of crowded permanent teeth.

Thus, it is essential to maintain your child’s mouth in good health to avoid the need for extraction of the deciduous teeth.

14. When should I start taking my child to see the dentist?

A child's first dental visit should occur near their first birthday or 6 months after their first tooth erupts. It is an excellent time to lay the foundation for a lifetime of good dental habits. The child will also familiarise himself/herself with the dentist and the dental setting. Not only can the dentist incorporate preventive dental care, he can also gradually introduce the child to various dental procedures so that he/she will be more receptive to future treatments. The goal is to have your child`s first dental experience be a positive one and to establish a good attitude toward dental care.

15. Is dental implant surgery painful?

No. Local anaesthesia and sedation are used to eliminate any discomfort during the procedure. The mild discomfort you might experience after surgery can be controlled with medications. Following successful implant integration the restorative phase of treatment for the patient is very easy and painless.

16. Are there any age limitations for dental implants?

No. Any person of any age can have dental implants as long as there is enough bone available in which to place the implants. Overall oral health is a more important consideration than age.

17. What advantages do implants have?

Dental implants are stable and can enhance the quality of life of a patient with missing teeth. Implants are more comfortable, stronger, longer lasting and less likely to cause damage to surrounding teeth and bone than dentures or bridges.

For most patients, their appearance, comfort, speech and ability to chew and enjoy food are greatly improved.

18. What is TMD?

TMD, or temporomandibular disorders, are a group of conditions affecting the temporomandibular joint (TMJ) and the muscles involved in chewing. The TMJ is the point at which the jawbone and the skull come together, which is slightly in front the ear canals. The TMJ, along with the teeth and muscles that move the lower jaw, make up the masticatory or chewing system. Imbalances or abrupt changes in any one of these components of the system can adversely affect the other components, and result in facial pain. Other signs of TMD are:

• Limited movement or locking of the jaw
• Pain radiating to the face, neck, or shoulders
• Painful clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth
• Sudden major changes in the way that the upper and lower teeth fit together
• Headaches, earaches, dizziness, and hearing problems may also be related to TMD.

19. What are the causes of TMD?

Severe injury to the jaw or TMJ can cause TMD. Other causes of TMD are less clear. A poor bite (malocclusion) orthodontic treatment, jaw clenching, teeth grinding, as well as physical and mental stress have all been linked to TMD. Unfortunately, their roles as definite causes have not yet been determined.