Symptoms of gum disease include:
- Bad breath that won’t go away.
- Red or swollen gums.
- Tender or bleeding gums.
- Painful chewing.
- Loose teeth.
- Sensitive teeth.
- Receding gums or longer appearing teeth.
You should book an appointment with your dentist if you think you may have gum disease.
What to do after an extraction
You need to look after yourself carefully after you have had a tooth taken out, as with any operation, to speed up healing and prevent infection. This advice is to help you know what to expect and do, as your mouth recovers.
- For the first 24 hours, don’t drink alcohol, eat hot food or disturb the clot, which will have formed in the space left by the tooth, because this may cause the socket to start bleeding again. Don’t smoke either, and avoid strenuous exercise for the rest of the day.
- Don’t rinse your mouth for six hours after the extraction.
- After six hours, rinse gently with warm salty water to keep the socket clean and continue to do this for up to a week after meals and before bed. Use half a teaspoonful of salt in a glass of comfortably warm water.
- Brush your teeth normally with toothpaste to keep the whole mouth clean but take care in the region where the tooth was extracted.
- If you feel small pieces of bone working their way out of the socket, don’t worry- this is normal.
- Some swelling or discomfort in the first two to three days is also normal.
- Take painkillers if you need them (as you would for a headache). Ask your dentist for advice if you are not sure what sort to take.
If the bleeding does not stop:
- Your dentist may have given you a small supply of gauze in case this happens. If not, clean cotton handkerchiefs will do, but not paper tissues.
- Roll some small firm pads about one centimetre by three centimetres – a size that will fit over the socket.
- Keep sitting up and gently clear away any clots of blood around the socket with the gauze or handkerchief.
- Please a pad across the socket from the tongue side to the cheek and bite firmly on it for 10 to 15 minutes.
- Take off the pad and check whether the bleeding has stopped. If it hasn’t, use a fresh pad. If the socket is still bleeding, contact your dentist.
Occasionally after extraction of a tooth, the blood clot in the socket can break down, leaving a painful empty hole in the gum. This is called ‘dry socket’. If the socket becomes painful a day or two after the extraction, this is usually the reason. If it happens, you should go back to your dentist to have the wound cleaned and packed with a dressing: this will relieve the pain and reduce the risk of infection.
If you follow these instruction, your mouth should heal normally, without becoming infected. But if anything in your mouth worries you, phone the practice for advice.
What are they?
Implants are one way of replacing missing teeth.
Unlike other forms of replacement teeth, dental implants are small metal or ceramic devises not unlike a screw fitting which are inserted into the jaw during surgery. Teeth, in the form of a crown, bridge or denture, are then attached to the implant.
What are the benefits?
Some people have real difficulties with removable dentures. Implants can overcome these difficulties, in particular for eating and speaking properly and they may improve appearance. If a denture is necessary, implants can greatly improve stability. People will not be able to see that your teeth are supported by implants. Implants can be used in place of bridges, for example when adjacent teeth may not be strong enough to support a bridge or if patients have spaced teeth.
Are implants for me?
You should discuss with your dentist whether implants would be right for you.
Patients need to have healthy gums, and enough jawbone to take the implant that supports the replacement teeth although techniques are available to add additional bone if needed. They must also be prepared to maintain good mouth hygiene and visit the dentist regularly.
Implant patients need to be in good general health. Some chronic diseases, such as diabetes, osteoporisis or chronic sinus problems, could interfere with healing and make implants more likely to fail. Make sure that you tell your dentist about medicines that you take regularly, and about your smoking habits. Smoking may well shorten the life of your implant.
Implants involve surgery over a period of several months.
Since they are a complicated form of treatment, implants can be expensive.
This is what will happen:
- Bone is exposed in the jaw where the tooth is missing. Then a hole is drilled and the implant is inserted into the bone. This is usually done under a local anaesthetic, but sometimes sedation is necessary. The gum is then stitched over the implant and it’s left to heal for several months. This allows bone to grow around the implant and to make it secure.
- A second procedure is then planned, in which replacement teeth are mounted onto the implant. This requires a small cut in the gum above the implant. Once the soft tissues have healed, the replacement teeth may be fixed permanently or attached in a way that lets you remove them for cleaning. The replacement teeth might be single or in a group, and possibly as a ‘bridge’, attached to neighbouring natural teeth.
What is it?
Teeth are held in the jaw by their roots.
At the core of each tooth is a soft mass of tissue called the dental pulp. In a healthy tooth, the pulp contains living fibres, cells, nerves and a blood supply, extending into the root(s) through the root canal(s).
Tooth decay or injury can destroy the living pulp. Dead pulp is more prone to infection, leading to an abscess and toothache.
This can usually be dealt with successfully by root canal treatment (also know as root filling or endodontics): sometimes infection can persist at the end of a tooth root, in the surrounding bone. In this case, a dentist can carry out an apicectomy.
What will my dentist do?
- Give you a local anaesthetic to nub the mouth around the infected tooth, so that the procedure is painless
- Make a small cut in the gum, well away from the tooth, so that there won’t be a visible scar afterwards
- Move a small flap of gum to one side, and make a small ‘window’ in the bone, to uncover the infected area
- Clean out the infection and cut off the tip, or ‘apex’ of the root
- Put a small filling at the end of the root canal to stop any more infection
- Stitch the gum back in place
You may feel some pressure and hear instruments being used, but you should not feel any pain during an apicectomy.
After treatment you will need to keep the area clean.
- For the first day, rinse with warm water several times a day, especially after meals. Use half a teaspoon of salt in a glass of warm water, not hotter than is comfortable.
- Brush the teeth normally, but be very careful not to disturb the cut.
- On the next day, continue rinsing and begin to gently brush the teeth next to the cut.
There may be some bruising and swelling for two or three days afterwards. There will also be some slight discomfort – an ice-pack or a packet of frozen peas wrapped in a towel applied to the outside of the face can help. It usually takes about a week for an apicectomy to heal.
Points to remember:
- An apicectomy stops pain,
- An apicectomy saves a tooth that would otherwise have been taken out.
Gingivitis can often be cured simply with good mouth hygiene-brushing twice a day and using other mouth hygiene aids.
The earliest sign of disease is bleeing of the gums. They may also look red or swollen. Gingivitis can often be cured simply with good mouth hygiene. Occasionally, even in healthy mouths, gums may become infected or sore. This is acute gingivitis and you should seek urgent dental treatment.
As the disease progresses the tissues holding them in place start to break down and pockets in the gum form around the teeth which allow even more plaque to gather. This stage os called chronic periodontitis. It is usually painless and can become quite severe if not treated resulting in teeth becoming loose, appearing to move position or to fall out.
Source: BDA Leaflet
Dental plaque is a soft, sticky substance that builds up on your teeth. It is mostly made up of bacteria, whcoh feed on sugar from food and drink, producing acids as a waste product. The acids attack the teeth by dissolving the minerals in the tooth surface. If this happens too often, tooth decay results.
By brushing, this helps prevent tooth decay.
Brushing also helps prevent gum disease.
Source: BDA Leaflet
- Clean the denture over a basin of water so that it does not break if you drop it.
- Brush the denture inside and out every day. Use a soft-to-medium brush so that you do not scratch the denture. Use your normal tooth paste, or soap and water. Then rinse the denture.
- Ask your dentist about denture- soaking soloutions. Soaking a denture will not clean it. You also need to brush it. Rinse the denture before you put in back in your mouth.
- Ideally, dentures should be left out of the mouth for at least 4-6 hours, preferably eight hours, in every twenty-four hours.
- Keep a denture dry or in a denture- soaking solution when you are not wearing it.
Source: BDA Leaflet
Why is cleaning important ?
Just like natural teeth, dentures and bridges collect bits of food, plaque (a sticky deposit, mostly made up of bacteria) and tartar (hardened plaque). By keeping them clean, you can stop decay in any remaining natural teeth and help prevent gum disease. It’s also good for your comfort and appearance to clean dentures, as dirty dentures can make your mouth swollen and sore.
Source: BDA Leaflet
Patients with medical restrictions or other restrictions that may affect the scarring process of the bone or other soft tissues (e.g. connective tissue disorders, therapies using certain medicines, general systemic illnesses, smoking). Such patients should speak to their dentist and carefully assess the potential risks and advantages of using dental implants.
- Esthetic changes caused by the change to facial contours due to the lack of support.
- Occupation of the space left by the missing tooth by the adjacent and opposing teeth, which shift to fill the empty space.
- If the missing tooth is from the front of the mouth, this affects the smile and, potentially, self-confidence.
- Difficulties speaking and chewing and, as a result, possible digestiona and health problems, generally due to incorrect chewing.