Dentistry Concepts

Question 1

What are the most common causes of tooth decay?

Answer 1

1) a diet high in sugars. Sugars interact with the bacteria within plaque to produce acid. The acid is responsible for tooth decay because it slowly dissolve the enamel creating cavities which can lead to tooth abscesses.

2) not brushing teeth properly or often enough. This results in the plaque remaining on the teeth instead of being removed and in turn the bacteria releases acid, breaking down enamel.

3) xerostomia also is a major factor leading to tooth decay. Saliva helps cancel out the acid that attacks your teeth. It also helps fight the bacteria that form dental plaque and cause tooth decay and gum disease.

Question 2

What do you know about dental caries?

Answer 2

My understanding is that dental caries are another word for tooth decay. This is the breakdown of tooth enamel due to the production of acid by bacteria on the teeth. It is one of the most common conditions dentists have to treat, and I saw at my work experience how dentists used fillings or extractions depending on the extent of decay.

Dental caries are preventable by having good oral hygiene practices at home by brushing twice a day, flossing and have regular routine dental checkups. Initiatives like water fluoridation have also been put into place to reduce the occurrence of dental caries.

Question 3

How often should you go for a dental check up?

Answer 3

Generally for adults who maintains good oral health, once a year is the time frame in between appointments. However those with poor oral health, may need check ups more often to prevent their oral health worsening.

Question 4

Why are regular dental check ups important?

Answer 4

Going to the dentists regularly allows the dentist to check for any dental problems and keep the patient’s oral health good. Leaving dental issues untreated makes it more difficult to treat, so catching the issues early allows the dentist to possibly reverse damage and prevent the issues altogether.

Question 5

What are some ways to prevent tooth decay and gum disease?

Answer 5

1) brushing teeth at least twice a day using fluoride toothpaste and to make sure not to rinse after brushing so that the fluoride remains.

2) clean in between the teeth every day using floss or interdental brushes to ensure any food particles that brushing does not remove are removed. This stops the plaque calcifying into calculus.

2) having regular dental check ups ensures that dental issues can be prevented and issues are caught early before they become untreatable.

Question 6

Can tooth aches go away on their own or should you always see a dentist?

Answer 6

Sometimes tooth aches are due to gum irritation and should go away in a day or two. To alleviate the pain, you can take pain killers and have a salt water mouthwash.

However if the toothache exists beyond two days, it is important to book an emergency appointment with your dentist. It is a sign of tooth decay and if left untreated the pulp inside the tooth can be infected and cause irreversible damage.

Question 7

What is a dental abscess + treatment?

Answer 7

A dental abscess is a build up of pus in the teeth or gums caused by infection. It requires urgent treatment by a dentist. Symptoms include intense toothache, sensitivity to temperature and a swollen face/jaw.

To treat an abcess, the individual must visit the dentist and may require a root canal treatment or the tooth may be removed.

Question 8

What are the common causes of bad breath?

Answer 8

1) certain foods such as garlic and onions.

2) poor oral health care such as Insufficient brushing as food may collect on teeth.

3) dentures are not cleaned correctly

4) certain bacteria on the back of the tongue can interact with amino acids in food and make Sulfur compounds that smell.

5) gum disease also leads to an unpleasant taste in the mouth.

6) xerostomia as saliva is not present to remove debris and particles of food.

7) tobacco products such as cigarettes and these also lead to higher risk of gum disease and oral cancer.

Question 9

How to treat/manage tooth sensitivity?

Answer 9

Tooth sensitivity can reduced by using fluoride toothpaste and additionally a fluoride mouthwash. Regular check ups with a dentist is also essential as they also give professional fluoride treatments.

Avoiding acidic foods eg citrus fruits would also help as frequent consumption can reduce tooth enamel and lead to dentin exposure, causing the tooth sensitivity. Using a saltwater rinse may also help temporarily alleviate pain.

Question 10

How to brush and floss to maintain good oral health?

Answer 10

Brush your teeth twice a day with fluoride tooth paste and aim to floss at least once a day.

The correct brushing technique would be to hold the toothbrush at a slight angle and against the teeth and brush with short back and forth motions. Make sure to brush along the gum line and back and tops of teeth.

Question 11

Can gum disease be reversed + complications if left untreated?

Answer 11

Gum disease can be reversed only if it’s in the initial stage when it is considered gingivitis. However once the disease worsens and becomes periodontitis, the condition is no longer completely reversible. This is likely to lead to tooth loss, and dental abscesses.

Question 12

What is periodontitis + what is the treatment?

Answer 12

Periodontitis is a gum disease in which the gums are severely inflamed due to a bacterial infection. It starts with gingivitis, and progresses into periodontitis. If left untreated, it eroded the bone supporting the teeth, leading to tooth loss. This is usually caused by poor oral hygiene.

Treatment such as antibiotics may be given to fight the bacterial infection. Scaling and root planing will also be done to allow the dentist to get rid of bacteria beneath the gum line. Bone and gum grafts may be given to replace the area affected.

Question 13

How does pregnancy affect oral health?

Answer 13

Pregnancy hormones can make women more at risk of gum disease such as gingivitis and periodontitis.

Vomiting can also damage teeth. As most women experience morning sickness, the stromg acid in the stomach can damage the enamel of the tooth increasing likelihood of tooth decay.

Many women also gag while brushing their teeth leading to many avoiding brushing their teeth, leading to tooth decay.

Question 14

What are the symptoms of TMJD + what is the treatment?

Answer 14

Temporomadibular joint disorder is a condition that affects the movement of the jaw. The individual usually has difficulty opening their mouth completely and has pain around. The jaw and temple. It is usually caused by teeth grinding and wear and tear of the joint.

Treatments include stronger painkillers and relaxation techniques to improve stress levels.

Question 15

What is fluorosis?

Answer 15

Fluorosis is when children are overexposed to fluoride leading to white or brown spots on the teeth. People with fluorosis tend to be more resistant to cavities leading to public water supplies now containing fluoride at safe levels.

The white and broken spots aren’t removed from brushing and need proper dental treatments such as teeth whitening and dental veneers.

Question 16

What is dry mouth+ what causes it?

Answer 16

Dry mouth is also called xerostomia and is caused when salivary glands in the mouth don’t make enough saliva. This can be caused by medicines, cancer therapies and ageing. Certain diseases can also lead to dry mouth. My mum has Sjögren’s syndrome which is where parts of the body that produce fluids are affected so she also suffers from dry mouth.

Question 17

What is bruxism + treatment?

Answer 17

Bruxism is when you grind your teeth. It usually happens subconsciously during sleep or during the day. The causes of bruxism are stress, anxiety and certain medications. Dentists can make mouth guards to help protect the teeth. Relaxation techniques and medications can also be given.

Question 18

What is the link between oral health and cardiovascular health?

Answer 18

Gum disease is linked to heart disease. When bacteria from the mouth reaches the heart it can lead to inflammation. Inflammation from dental bacteria can lead to infections of the heart lining, called endocarditis. Oral bacteria can also lead to clogged arteries and heart attacks. Dental disease also increase an adult’s risk of having a stroke.

Question 19

How is oral health linked to respiratory health?

Answer 19

Bacterial infections in the mouth can lead to bacteria spreading to the lungs causing conditions such as bronchitis and pneumonia. It can also worsen conditions such as asthma and COPD, leading to further inflammation in the lungs.

Question 20

What is the difference between a bridge and dentures?

Answer 20

A dental bridge spans the missing teeth or tooth gap. It provided a natural looking and functioning tooth. A bridge is permanently attached in the mouth, by the crowns that are permanently attached to the teeth. Partial Dentures are natural looking restorations and are temporarily attached to natural teeth in the mouth. Dentures are usually used when more teeth are lost and the remaining natural teeth are not strong enough to support a bridge.

Question 21

What do you know about fluoride and it’s uses?

Answer 21

Fluoride is an ion that’s used in many dental products such as toothpastes, varnishes and even water. It works by binding to enamel and altering its structure to make is more acid-resistant than regular enamel. This protects teeth from demineralisation at acidic pHs. Water fluoridation is a controversial topic at the moment. Areas with fluoride in water have shown to have a decrease in the number of dental caries. However it is difficult to obtain consent for whole cities and people have different opinions. Certain people have beliefs that it causes health problems even though there is no supporting evidence.

Question 22

What is a dental implant?

Answer 22

A Dental implant is a titanium screw that’s placed into the jawbone replacing the tooth root. The bone around the implant will gradually fuse to it, holding the implant firmly in place. A crown is then fitted on top of the implant leaving a natural looking tooth look.

Question 23

What is the impact of diet on oral health?

Answer 23

Foods that are heavy in starches and sugars will contribute to high levels of plaque acids which break down tooth enamel. This creates cavities which need fillings to prevent them from turning into a worse problem.

Question 24

What is the difference between a root canal and extraction?

Answer 24

The biggest difference between the two procedures is that the affected tooth is removed during dental extraction whereas root canals are intended to save the damage tooth. Root canals tend to give a more natural look and there is less risks with a root canal.

Question 25

What is a pulp extirpation?

Answer 25

Pulp extirpation is the start of a root canal treatment and where the top part of the nerve is removed. This is usually the most inflamed and painful part as the bacteria reaches the top part of the nerve first. The infected pulp is removed and the tooth is cleaned for the next part of the root canal in which inert material is placed into the tooth.

Question 26

What are the different parts of the teeth?

Answer 26

The outer layer is the enamel which is the protective outer layer of each tooth. Then beneath the enamel is dentin. Then cementum covers the tooth root and helps anchor the tooth into the jaw. The tooth pulp is the inner most layer containing nerves and blood vessels.

Question 27

Why is water fluoridation an ethical debate?

Answer 27

One of the primary ethical concerns is the issue of informed consent. People argue that adding fluoride to public water supplies does not allow individuals to choose whether or not they want to consume fluoride or not. Supporters of water fluoridation point to the idea that fluoride helps reduce the risk of tooth decay but strengthening enamel, whereas those who oppose it, raise concerns about certain health risks such as dental fluorosis. Some also argue that it benefits those from low-income backgrounds proportionally more than high income ones as they have less access to dental care. Those from high income are likely to have access to dental care and receive fluoride treatment from other sources so are more at risk of fluorosis. I would personally say that water fluoridation is beneficial as research has shown it has significantly reduced the number of caries in the last 60 years by around 26% and allows those from low income backgrounds to decrease their likelihood of oral disease.

Question 28

How are dentures made?

Answer 28

Dentists take primary impressions of the patient’s mouth. Impressions are then sent to the dental technician who casts plaster models from the impressions. The dentures are then placed in an ariticulator, where the technician places acrylic teeth and aligns them. They are placed in a way to prevent them from tipping during eating and talking which is called balanced occlusion. The wax is then carved to make it similar to the gums. Then pink acrylic resin is added to the mould until it is cured. Then the plaster is removed and the dentures are polished.

Question 29

What materials are used for dentures and why?

Answer 29

Usually dentures are made from acrylic resin. However there is also the option of getting porcelain dentures. Acrylic dentures tend to be stronger as than porcelain as they hold the teeth in place better. They also do not stain easily and more adjustable and comfortable. However they are still prone to being worn down over time and usually require replacement every 5-8 years. Porcelain is also a hard and durable material uslaly paired with metal framework however it tends to cost more than acrylic resin. Materials such as porcelain and acrylic resin tend to be chemically very stable and the thermal conductivity and thermal expansion tend to be similar to that of dental tissue like enamel and dentine, so with a good marginal seal they are less likely to shift. This makes these two materials the best for things such as dentures and bridges.

Question 30

Advantages and disadvantages of amalgam fillings

Answer 30

Advantages -they are very durable and capable of lasting over a decade with proper care. As they’re very strong, they can fill large cavities. The material tends to be of lower expense compared to composite. Disadvantages-as they are metal they are very noticeable even if at the back of the mouth. Some dentists no longer perform amalgam fillings. Amalgam fillings may expand and contract with temperature resulting in fractures in the tooth. Have big environmental impact.

Question 31

Advantages and disadvantages of composite fillings

Answer 31

Advantages- they look practically invisible as they are made to match the teeth. The resin compound bonds well to the tooth so less likely for filling to pop out. The material isn’t affected by temperature unlike amalgam. Disadvantages-the life span is around 5-7 years which is half that of an amalgam. They often cost more than amalgam. The placement takes longer than amalgam which may be an issue for patients with dental anxiety or special needs.

Question 32

What is the amalgam debate?

Answer 32

Amalgam is a filling material and one of the most widely used filling materials in the uk, especially in the NHS as it is very cost effective, since it is a very strong material and likely to withstand the pressures of biting down and therefore it is less likely to fall out of your mouth. Even before brexit, the EU has been trying to phase down amalgam for a really long time for many reasons, mainly because of its mercury contents, and environmentalists are trying to remove mercury from environmental sources. For example, when a patient dies, the amalgam remains intact so not environmentally friendly, also there is sort of a conspiracy situation in which people believe amalgam can cause mercury poisoning, those fears aren’t really founded though. However the EU have now put into place that they will not be using amalgam after 2025, so countries are given a year to rapidly phase down and switch to alternatives, mostly composite which don’t come close to amalgam in terms of mechanical strength. This has a big effect on the NHS as most amalgam is imported from the EU so if all the countries around the UK stop producing amalgam, we have to import amalgam from countries further away which leads to more expense on the NHS, so the NHS is faced with the dilemma of continuing the use of amalgam or switching to other materials, even though they are not as cost effective as amalgam and will lead to more follow up appointments and longer waiting lists.

Question 33

How has smoking affected dentistry/ should we ban tobacco?

Answer 33

Smoking has had a large impact on dentistry specially by putting strain on NHS resources. This is due to smokers being at higher risk for developing a range of oral health problems such as gum disease, tooth decay and oral cancers. Smokers also tend to experience more complications during and after dental procedures such as longer healing times and higher risk of infections, so they are more likely to need a follow up appointment causing longer waiting lists. Smoking also contributes to oral staining and bad breath so many smokers especially now with the rising use of social media discuss cosmetic procedures such as teeth whitening with their dentists. All these complications has led to greater emphasis on education on the effects of smoking and modifications in post-procedure care. Positives of banning tobacco products- significantly less risk of diseases like bronchitis and oral cancer. Managing conditions like these cost the government lots of money which could be saved if fewer patients developed these illnesses. This money could be spent elsewhere for things such as research to lead to breakthroughs in medicine. Though the priority is the well being of patinets the government has to take into account the monetary value of treatments as well. Negatives of banning tobacco products- this does not necessarily lead to a reduction in use of tobacco products. There will be a rise in tobacco products bought from the black market which are more unsafe and there are not regulations to ensure only adults get the tobacco products. Significant money from selling tobacco products some of which is used for the nhs. Also individuals should have free will and autonomy and so if they wish to smoke despite knowing the risks this is their choice and we should not stop it. Banning tobacco products pits the UK in a nanny state which is basically where the government is too controlling of people’s personal lifestyle and some people use this same logic with the sugar tax. Also if someone needs medical attention due to tobacco products, they are less likely to seek help as they are busy worried about the consequences of owning tobacco products, so this is something that definitely requires more thought before deciding on a definite answer.

Question 34

How does anti-microbial resistance affect dentistry?

Answer 34

1) excessive use of antibiotics for conditions such as dental abscesses leading to development of resistant bacteria. Some individuals also do not complete their treatment worsening this issue. 2) antibiotics may now not work on many individuals so more money is required to come up with new medications to treat dental infections. 3) there needs to be more education on the implications of anti microbial resistance and ways to tackle the issue so that this issue does not worsen in the future.