Many of you might not know that by day I hold the title of a feared professional - dentist! That may be because it is my alter ego, and I almost never bring that world together with my writing/blogging world, but on the occasion of World Oral Health Day, I decided to share an article I wrote some time ago so that we can all learn a bit more about those wonderful white choppers that reside in our mouth, that help us eat and speak. Most people don’t give their teeth a second thought until there is a problem with them, and then they often have to meet me in my office. So here is a chance to give some more thought to our oral health, and thank our teeth for keeping us fed, as well as contributing to our best accessory - our smile!

Anyone who has had a toothache would testify that there is no pain like dental pain. It can manifest  itself in many ways and symptoms, ranging from sensitivity to hot and cold, to throbbing pain during the day, to a sleepless night in agony. Dental pain can strike any person of any age who has teeth from a small child to the elderly. But anyone who has had a toothache may also tell you that they don’t like the dentist! Indeed most people have some form of dental fear and some even avoid the dentist at all costs unless they are met with dental pain. I always tell my younger patients that if they don’t like the dentist then the best course is to really pay attention to their dental homecare and look after their teeth. And to come before the trouble starts…

To those who want to take this advice to heart, here are 5 facts that I often find surprise patients when they attend the dental clinic in pain, with tips that you can use to improve your oral health.

1. You don’t have to see it (or feel it) for it to be there.

A large amount of dental decay develops between teeth at the point where they meet, or in the deep fissures of the tooth. It can be invisible to the naked eye, and not even accessible by toothbrush – which is why flossing is considered an essential part of dental care. Early dental decay often goes undetected as it may not cause any pain or sensitivity. The decay starts below the surface and gradually works its way up – and sometimes through – the tooth. This means that often by the time you see a cavity it is quite large, and by the time you feel pain this often indicates it is close to the nerve of the tooth. If you wait until you can see or feel the cavity, it is often large, and might warrant a series of appointments to restore the tooth to full functionality. Depending on its size and depth, treatments such as a temporary filling or even a root canal may be needed, and in some cases the tooth may even need to be removed, as decay may have spread downward into the root of the tooth. In addition, decay weakens the tooth and makes it susceptible to breakage under what may be the ordinary load of chewing. This is why patients occasionally attend the dentist saying that they were “eating something soft and the tooth just broke” while in reality there may have been underlying decay. For these reasons it is important to visit your dentist to have your teeth checked even when you are not experiencing pain, and in addition, to take great care cleaning your teeth at home, with the use of floss to keep between the teeth clean.

2. Decay isn’t the only cause of dental pain

There are other problems which can occur around the teeth causing dental pain. Periodontal disease (or gum disease) is a big problem, and can lead to loss of the supporting structures around the teeth, allowing food and bacteria to remain in the mouth around the teeth and cause infection – pain and swelling being the result of this. In addition by destroying the support of the teeth, teeth are at risk of moving out of position and becoming loose. This process may not be noticeable until it has become quite advanced so it’s also important to catch it early. Other things that may cause pain without being decayed are listed below.

3. Trauma to the teeth can have long lasting effects

Trauma to the teeth – e.g a knock to the jaw or teeth directly – can have wide ranging consequences. The knock may not cause any outward damage, however inside the tooth, the trauma to the nerve can eventually cause it to die off and the tooth can become discoloured, even painful and lead to swelling. This can happen in children in their baby teeth as well as in adult teeth (in children, teens or adults), and the effects of the trauma can take months or even years to be seen. Sometimes, no pain needs to occur and only slight discolouration may be seen however under the surface, the root may deteriorate due to inflammation and the tooth may eventually be lost. Worse trauma can cause a tooth to be moved out of place or knocked out altogether. In these cases it is very important to see the dentist as soon as possible, and if a tooth is knocked out do not rub or clean it, just place it in some milk and attend the dentist as soon as possible. Even when treatment is carried out quickly after trauma, there may need to be prolonged treatment in order to restore the tooth. If a person experiences trauma (child or adult) see your dentist as soon as you can and have them address the problem. It may also be useful for children who play sport such as cricket to consider a mouth guard. 

4. Know your children’s teeth

There are 20 teeth in a set of children’s baby teeth, and 32 in the adult teeth. Although it is not uncommon for there to be extra teeth, or conversely for teeth not to develop, these are the most common numbers of teeth within a set. Adult teeth begin to erupt in children from age 5 (although some children find they erupt even earlier). At the same time that the front baby teeth become shaky, adult molars can start to erupt behind the last baby tooth. Often parents do not realise that these teeth coming up are adult teeth, since they are not replacing any that have been lost. In addition, there may be no discomfort when these teeth erupt and neither the parents nor children may be aware of their presence. I often have parents attending with children who have decay in these teeth, not realising that they are adult teeth and – having assumed that they would fall out – not addressing the problem sooner. Decay should always be addressed – whether in a baby tooth or in an adult tooth – but it is crucial if a parent sees decay to bring the child in to be seen, as decay in any tooth can cause pain and if it happens to be an adult tooth it would be important to address it before it progresses to the nerve of the tooth.

5. Prevention is better than cure

It is best to visit your dentist regularly to have teeth checked and professional cleaning carried out. This saves time and money in the long run, as the dentist can pick up problems before they progress, and can also mean avoiding dental pain. It may not seem appealing to attend the dentist when you are feeling fine, but teeth are important to general health and happiness, and maintenance and prevention is definitely better than cure. It is important to see your dentist regularly as well as do thorough homecare to keep your teeth in good order. You and your dentist can work together to give you a happy smile and a healthy mouth!

And as always I send you big love from a small island.