Anxious to ask my dentist questions

[Jojo3399]

Hi,

It realise it seems so obvious to ask my dentist this but I literally shake when I go in there and just seem to fall to pieces. I just end up wanting to get in and out.

I believe I do a lot of the right things to look after my teeth. Don’t drink alcohol, don’t smoke, I floss every night, don’t drink fizzy drinks etc. I also go for 6 monthly check ups and cleaning.

However in the last 8 weeks I’ve needed 1 root canal treatment and 3 fillings (all separate teeth). I was at my last check up 4 months ago and was given the all clear.

Also pretty much once a year I need a new filling. My mouth is full of fillings even though I know I look after my teeth so much better than friends who are constantly eating and drinking sweet things during the day etc.

Can I ask for some advice?

* How often should I be getting routine x-rays? On the surface I am often told at check ups that my teeth are fine, then pain and issues come along soon after. I am a private patient in the U.K so wondering what the usual X-ray timings would be (every year / every few years?).

* I am a mouth breather all the time due to sinus issues (day time and night time my mouth is always open and very dry). Could this be causing more cavities / issues with my teeth?

* Are some people genuinely more prone to cavities than others? If yes, is there ANYTHING extra I can do myself, or ask my dentist to help with? I really want to do whatever I can to look after my teeth and just feel like there’s something I’m missing as my dental health doesn’t seem to make sense.

Thanks so much.

 

[Gordon]

How often should I be getting routine x-rays? On the surface I am often told at check ups that my teeth are fine, then pain and issues come along soon after. I am a private patient in the U.K so wondering what the usual X-ray timings would be (every year / every few years?).

For somebody with a high decay rate, every year would be likely.

I am a mouth breather all the time due to sinus issues (day time and night time my mouth is always open and very dry). Could this be causing more cavities / issues with my teeth?

Oh yes, very much so.

Are some people genuinely more prone to cavities than others? If yes, is there ANYTHING extra I can do myself, or ask my dentist to help with?

Sort of, due to secondary issues, poor saliva quality/quantity like in your case would be one thing. There is a congenital aspect but it's pretty trivial.

Onto the bigger thing, what you can do about it going forward.
1) Fluoride supplements. Ask your dentist to prescribe you high F toothpaste such as Duraphat. Buy some F tablets from the chemist and suck one every night before bedtime.
2) There are some artificial saliva products which can help dry mouth, ask for a prescription for Saliva Orthana (that's the best one in my experience!). Your dry mouth may be prompting you to drink more, even stuff like milk can cause cavities if you drink it frequently enough.

Finally, before you visit your dentist, type out your questions in advance and send them in... as you're paying privately your dentist should have time to address your concerns with you. Take advantage of this

 

[Jojo3399]

Hi Gordon,

Thank you so much and for such a quick response! I really appreciate it.

I’ve never thought to send some questions in advance. I will do that.

I’ve also never heard of the fluoride tablets so will look into that.

The one thing I don’t use is mouthwash. I always found it to feel like they ‘burn’ for me. However if I should add this to my dental routine then I will.

Would you recommend a mouthwash in the morning or evening before/after brushing teeth?

Thanks again!

 

[Gordon]

The one thing I don’t use is mouthwash. I always found it to feel like they ‘burn’ for me. However if I should add this to my dental routine then I will.

Hell no, I think they're at best a waste of money and at worst positively harmful!

Would you recommend a mouthwash in the morning or evening before/after brushing teeth?

From the above, I would recommend pouring it down the sink instead

 

[Jojo3399]

This is great to hear as I was also told this years ago by a dentist or hygienist (I forget which) and therefore never added it to my daily routine.

However seeing all the adverts for them makes me wonder if I’m doing something wrong!

So thank you for confirming

 

[sudzs]

Hope it's ok to butt in. That's interesting about the saliva Gordon. I was only thinking the other day about why some people don't brush their teeth more than once a day and have no problems at all while others can be flossing and tepe-ing and brushing 3 times a day and still end up with cavities. I was wondering if much research into mouth bacteria has been done. We all have different types and in different numbers throughout the body so might some individuals just have more of the species that can be more damaging to teeth? Would be a great thesis topic if it hasn't been done before. Or maybe post grad. The oral micro-biome!

@Jojo3399 I hate mouthwashes for the same reason as you, they burn! And they do away with teh good bacteria in your mouth. I'm also just the same as you at the dentists. I am always too wrung out to get a question out of my mouth. And if I did I'd never be able to remember the answer. I just want to get out of there and recover in the car for half an hour. But that's a great idea to send them in ahead of time.

 

[Gordon]

I was only thinking the other day about why some people don't brush their teeth more than once a day and have no problems at all while others can be flossing and tepe-ing and brushing 3 times a day and still end up with cavities.

The general public thinks that brushing your teeth prevents decay. It actually does not. It's main job is to prevent gum disease.

(Google The Vipeholm Experiments if you want more, start here: https://en.wikipedia.org/wiki/Vipeholm_experiments, not the most ethical of experiments!).

The main factors for decay are (mainly) diet, fluoride availability, plaque control then saliva quality and quantity and finally there will be some genetic factors in terms of tooth anatomy, enamel quality and so on.

I was wondering if much research into mouth bacteria has been done.

Oh goodness me, yes tons and tons... go have a look on Medline if you want to do some digging. Set aside a few hours!

We all have different types and in different numbers throughout the body so might some individuals just have more of the species that can be more damaging to teeth?

The primary culprit is Streptococcus Mutans, when I was a lad the big idea was to develop a vaccine against this bacteria and thus reduce decay by a large extent... then it was found that S. Mutans shares a lot of its genetic code with... drum roll: cardiac muscle. So that was a bit of a dead end (literally!)
However, other bacteria are able to "take over" from S. Mutans so even dealing with them doesn't completely solve the problem.

Would be a great thesis topic if it hasn't been done before. Or maybe post grad. The oral micro-biome!

It's an interesting subject, especially when you get into the weeds in gum disease.

 

[anonfemale]

@Gordon Is it ok to drink milk and coffee with a straw?. I've heard that doing that stops the drink from doing any damage to your teeth.

 

[Gordon]

It's OK but utterly pointless. Coffee with milk isn't particularly cariogenic (causes decay) and unless you're guzzling it for hours on end will do no real damage at all.

 

[anonfemale]

@Gordon Sorry I meant is drinking a cup or a glass of milk on it's own ok to drink with a straw?

 

[Gordon]

It's OK but utterly pointless.

 

[anonfemale]

@Gordon Thank you for letting me know. I saw your post about milk causing tooth decay so I thought I would ask if having it with a straw prevents tooth decay. I only drink milk on it's own twice a day every day.

 

[sudzs]

The general public thinks that brushing your teeth prevents decay. It actually does not. It's main job is to prevent gum disease.

(Google The Vipeholm Experiments if you want more, start here: https://en.wikipedia.org/wiki/Vipeholm_experiments, not the most ethical of experiments!).

The main factors for decay are (mainly) diet, fluoride availability, plaque control then saliva quality and quantity and finally there will be some genetic factors in terms of tooth anatomy, enamel quality and so on.


Oh goodness me, yes tons and tons... go have a look on Medline if you want to do some digging. Set aside a few hours!



The primary culprit is Streptococcus Mutans, when I was a lad the big idea was to develop a vaccine against this bacteria and thus reduce decay by a large extent... then it was found that S. Mutans shares a lot of its genetic code with... drum roll: cardiac muscle. So that was a bit of a dead end (literally!)
However, other bacteria are able to "take over" from S. Mutans so even dealing with them doesn't completely solve the problem.


It's an interesting subject, especially when you get into the weeds in gum disease.

Thanks Gordon, that's all super interesting especially about the Streptococcus mutans. No I don't fancy being vaccinated against that!