What causes gum disease?

Plaque and hard deposits of tartar are the main causes of gum disease. The most common reason for gum disease is that people do not clean their teeth and gums as often or as thoroughly, as they should, so it is essential that you maintain a good dental care routine to remove all of the plaque from your teeth. However, there are factors that will mean that some people are more likely to get gum disease, such as: Smoking and drinking excess amounts of alcohol, which are also linked with mouth cancer Drugs and medicine and hormonal changes can affect your gums Some diseases, such as diabetes can weaken gums and bones and therefore, increase the risk of disease.

What is gingivitis?

Gingivitis is a term used to describe the inflammation of gums. It is the first stage of gum disease, where the gums become red and swollen and may bleed when brushing your teeth.

What is periodontitis?

Periodontitis is a deeper form of gum disease that affects the bone supporting the teeth. Left untreated, periodontitis may eventually result in teeth having to be extracted, as some of the bone is lost and teeth become loose. You can prevent periodontal disease from getting worse by maintaining a good dental care routine and making regular visits to your dentist or hygienist.

What should I do if I suspect that I have gum disease?

You should visit your dentist for an examination, so that they can check your teeth and gums and prescribe what treatment is required. Usually the dentist will illustrate how to clean your teeth effectively in order to remove all of the plaque.

What can I do to help prevent gum disease?

Dentists also recommend using a small-headed toothbrush with 'rounded' bristles, so that it doesn't cause any damage to your gums. Brushing alone will not remove all the plaque from in between your teeth. Using dental floss is extremely useful here. Your dentist or hygienist is best placed to advise you on which cleaning methods are best for you.

Some people's teeth are yellower or darker than others, even when they are relatively healthy. In order to rectify this problem, Hydrogen Peroxide (bleach), can be used either on the outside or the inside of the tooth.

What does tooth bleaching involve?

This treatment involves the dentist using a special jelly bleach, which is completely safe, providing that it does not touch your gums and burn them. When bleaching the inside of a tooth, the bleach is put in the root canal temporarily, usually or after the tooth has been root-filled. There are two bleaching techniques that a dentist can use, depending on the strength of bleach that is required. In cases where only a weak bleach is required, the dentist may provide a weak bleach jelly for you to use at home. This will be in a tray, which fits closely round your teeth to ensure that the jelly does not burn your gums. A dental technician will make this tray from an impression of your teeth that your dentist has made. Your dentist will ensure that the tray fits and demonstrate how to put the jelly in the tray at home. In order for this treatment to work effectively, you will need to use the tray for an hour or two a day, for up to six weeks.

The second bleaching technique is used when a stronger bleach is required. Your dentist will paint the bleach onto the teeth, activate it with a light for a few minutes and then wash it off with water. This method is used to ensure that the bleach does not touch your gums, due to strength of the bleach that is being used. Your dentist will note your tooth colour using model teeth in different shades before they treat you. You should look at the colour match yourself before the treatment, so that you can compare it with the colour after bleaching. For a few days after the treatment, your teeth may be sensitive to hot and cold food and drink.

What are the benefits of tooth bleaching?

It improves the appearance of your teeth without removing any of the natural tooth surface. If your teeth are relatively healthy, but you want to lighten the colour, this is a better option than a crown or veneer.

The grooves in the chewing surface of the back teeth are called fissures. They are difficult to clean, which increases the risk of decay. In order to protect them, the fissures can be sealed with a tough plastic, which can either be see-through or tooth-coloured.

Sealants are normally only used on children's teeth and on permanent teeth in particular.

Reasons for having sealants include:

Fissure sealants can last for years and they can usually be replaced if they fall out or wear out, providing that there is no decay underneath They can protect teeth from decay.

The most frequent cause of bad breath is bacteria in the mouth. It is important to remember that bad breath is not a sign of ill health and most adults occasionally suffer from it. Although, gum disease can cause bad breath, people with healthy teeth and gums can still suffer with it. In such cases the smell comes from the back of the tongue and will get stronger, as you mouth becomes drier.

Can my dentist help?

If you are concerned about bad breath, you should discuss this with your dentist. You should ensure that you do not try to hide the smell of your breath in any way, as it will make it difficult for the dentist to distinguish where the problem is coming from. Generally good oral hygiene will resolve bad breath, so your dentist or hygienist will probably give you a scale and polish to make it easier to keep your mouth clean at home. There are also instruments that can be used to measure sulphur compounds in the mouth or swelling around the gums.

How can I help ?

Brush your teeth twice a day and ensure that you use a fluoride toothpaste Your dentist may advise that you use floss. If so, you should smell the floss after you have used it, to check if there is a smell from a particular part of your mouth. This will enable you to take extra care to clean that area If your tongue is heavily coated, you can gently brush it, which should help to get rid of the smell When your mouth becomes dry the smell of your breath will often get stronger. Chewing sugar-free gum will help to reduce this problem, as it increases the flow of saliva around the mouth Smoking can also make your breath smell. Therefore, it is important to try to give up, not only to resolve the problem of bad breath, but to also help you to maintain a healthy mouth and body.

Implants can either be used to replace missing teeth or to support fixed bridges or dentures. You should discuss this treatment with your dentist to see whether it is right for you. Your dentist may carry out this treatment or they may refer you to a specialist. If you and your dentist decide that you should have this treatment, here are the following stages of treatment that you will have to go through.

The implant will be placed into your jaw bone, whilst you are under a local anaesthetic. The implant is then screwed or pushed into the gum. It is then stitched up, so that the gum heals over the implant.

Over a period of several months, the bone underneath the gum will grow around the implant to hold it firmly in place When the post is secure, the second section of the treatment will involve adding an extension. Attaching the extension, will require a small cut in the gum above the implant The implant may be fixed permanently and in such cases, there is sometimes a gap below the tooth, so that the implant can be kept clean. Alternatively, it may be attached in a certain way that will allow you to remove and clean it.

Implants are a good option for improving the appearance of your mouth, as they replace missing teeth and it will not be evident that you have implants in your mouth. However, they are not suitable for everyone.

Please note that implants are a specialist treatment and therefore, are not covered by Denplan Care.

A crown is used to completely cover a weak tooth above the gum line, in order to protect it. They are made of either metal or porcelain, but in cases when the crown has to be made stronger, it will be made out of porcelain with metal inside. Your dentist will normally perform this treatment under a local anaesthetic to numb the area around the tooth.

Your dentist will then shape the tooth to ensure that, with the crown, it will be the same size as a normal tooth. The preparation time will vary according to the extent to which the tooth is damaged and whether it needs to be built up with a filling before the crown is fitted.

The tooth might have to be root-filled first. If there is a lot of tooth missing, the crown is sometimes held in place by a peg in the root canal.

The dentist will then take an exact 'impression' of the tooth that is to be crowned and the surrounding teeth, using a soft, mouldable material. An impression is used to ensure that the crown is the exact height and size required. Your dentist may use a thin cord to hold the gum away from the tooth, to make sure that the impression is accurate round the edges.

A temporary crown will be put over the tooth until the crown is made. This will either be made of plastic or metal. Although, you will be able to chew on a temporary crown, it will not be as strong as the finished crown. Before the crown is glued into place, your dentist will ask you to try it on first. This is to ensure that you can bite comfortably and to identify whether any small adjustments need to be made.

Wisdom teeth appear at the back of the mouth, generally from the late teens onwards. Most people have four wisdom teeth, but it is not unusual to have fewer or even none. As they are the last teeth to form, there sometimes isn't room for them. This can cause them to come through at an angle, pressing against the teeth in front or the bone behind. If you think that you have a problem, you should tell your dentist.

What will my dentist do?

Your dentist can use x-rays to indicate where the wisdom teeth are in the jaw and how much room there is for them to come through. They can also show how simple or difficult it may be to take a wisdom tooth out. Your dentist might refer you to a specialist to have your wisdom teeth removed.

When wisdom teeth come through, the surrounding gum becomes inflamed and sore, which is called 'pericoronitis'. It is usually better to remove a wisdom tooth after you have had pericoronitis, as they often continue to cause trouble. Sometimes it is necessary to remove all wisdom teeth in hospital under general anaesthetic. If so, you may need to take two or three days off work.

Pericoronitis can reoccur and continue to cause problems. Therefore, having your wisdom teeth removed will prevent pain and infection. Also, when there is restricted room for the wisdom tooth to grow in, it can press against the teeth in front. Therefore, removing wisdom teeth can stop any damage to the teeth in front.

Teeth are held in the jaw by their roots, which have nerves inside of them. When there is decay or an injury, it can cause the root to die, which can result in an abscess at the end of the tooth. Root fillings involve removing damaged or dead nerves and filling the space. This allows your dentist to repair the tooth that is left.

What does this treatment involve?

Firstly, your dentist will x-ray the tooth, to identify any signs of infection in the surrounding bone and whether this treatment would be suitable for you, depending upon the shape of the tooth roots. To ensure that this treatment is painless, your dentist will numb the area around the tooth.

Your dentist may apply a sheet of thin rubber around the tooth, which will be attached to a metal or plastic frame outside the mouth. This is to ensure that the root canal is kept dry during the treatment. In order to see the opening of the root canal, your dentist will make a hole in the tooth.

A narrow file will then be used to find the root canals and take out any dead nerves. Your dentist will then fill the roots and apply a paste, so that it will set hard. You may need to take some mild painkillers after the treatment, as the tooth may still feel tender for one or two days.