Why Visit a Dentist?

Clues about your Oral Health

Your routine dental check-up reveals more than just the condition of your teeth and gums. It uncovers important clues about your overall health. Dentists and periodontists are concerned about more than saving your teeth - they're looking at how oral health fits into your overall well- being. Here are some of the most common conditions dentists look out for that can affect your oral health.

1. Diabetes : People with type 1 and type 2 diabetes are more likely to develop gum disease. That's because they may have a decreased ability to fight bacterial infections, including those that occur in the mouth. In addition, serious gum disease can make it more difficult for people with diabetes to control their blood sugar. Signs of diabetes are frequent gum abscesses, swelling, a lot of bone loss in a short amount of time and gum disease that doesn't respond to normal treatment. Your dentist or periodontist may recommend that you schedule dental exams more frequently -- for example, every three months -- if you have a history of diabetes and gum disease.
2. Oral Cancer : The first sign of oral cancer is often a small red or white spot or sore in the mouth. It can appear on your lips, gums, tongue, cheek lining or in other parts of your mouth. Often, the patient does not notice it because it starts as a small spot toward the back of the mouth or under the tongue and they don't have any symptoms. Your dentist will typically screen for oral cancer as part of a routine dental exam. By scheduling regular check-ups, you can increase the chances that any potentially cancerous or precancerous lesions will be caught early and successfully treated. Also, be sure to tell your dentist if you've noticed symptoms like a sore in your mouth that doesn't heal, a lump, or pain or numbness anywhere in your mouth or on your lips
3. Stress : If your teeth are worn down or chipped then you've been unconsciously grinding or clenching them. This grinding -- also known as bruxism -- can eventually cause bone loss that your dentist may detect on your X- rays. Bruxism is usually caused by stress but can also occur because the top and bottom teeth aren't aligned properly. You may or may not be aware that you've been grinding your teeth, but your dentist can spot the signs. To prevent damage to your teeth and keep them apart so your jaw muscles can relax, your dentist can fit you with a custom mouth guard to wear while you sleep.
4. Premature and Low-Weight Births : Studies suggest that pregnant women with serious gum disease -- called periodontitis -- are more likely to deliver a premature baby of low birth weight. The bacteria in the mouth of a woman with gum disease can trigger an increase in a chemical compound called prostaglandin and other harmful inflammatory molecules. These chemicals can induce early labor and impair fetal growth. Women who are pregnant or thinking about becoming pregnant should get a dental exam and if necessary, treatment for gum disease as early as they can.
5. Heart Disease : Since gum disease may increase the risk of heart attacks and strokes, you should tell your dentist if you have cardiovascular disease or have a family history of these conditions. Inflammation in the mouth increases inflammation in other parts of the body, including the arteries. This inflammation may play a role in heart attacks or strokes. By treating gum disease and reducing the inflammation in your mouth, you may be able to lower your risk of stroke or heart attack.

   People with weakened immune systems are more likely to get fungal and viral infections in the mouth. The dentist on seeing your oral cavity realizes the presence of the following problems:

   • Deterioration in the dental fillings, crowns and other restorations.
   • Root cavities which is decay on roots of teeth exposed by receding gums.
   • Pockets formed in your gums (periodontal pockets) due to gum diseases.
   • New decay below the gum line
   • Cavities under existing fillings.
   • Hairline tooth fractures.
   • Impacted wisdom tooth.

   Some blood disorders and gastrointestinal disorders such as GERD (Gastro Esophageal Reflux Disease).

   Medicine may cause dry mouth. This increases dental decay, oral yeast infections and other oral infections.

   Vitamin deficiencies can have serious effects on your mouth and teeth.

   Tobacco use and poor dietary practices can affect mouth and face.

   Signs of other problems that can affect your general health.

6. Hypertension : It is important to inform your dentist about any health conditions you have, and the medications you are taking. Your dentist should be aware of the special needs, and potential problems. People with hypertension are generally advised to reduce salt intake, lose weight, and increase aerobic exercise. If these measures are not sufficient, a number of drugs are needed to reduce the blood pressure. As dentists, we are concerned with how well-controlled the hypertension is. Patients with poorly controlled hypertension will often bleed more after routine oral surgery. Patients who take hypertensive drugs may be more sensitive to the small amounts of epinephrine in dental anesthetics as well as need a greater level of assistance when being elevated in a dental chair from a supine (lying on the back) position. Patients whose blood pressures are above target should be monitored at least every 2 months. Follow- up at short intervals improves patient adherence and is required to increase the intensity of treatment.

Dental Specialist

Dentists refer a high percentage of their difficult procedures to dental specialists, electing to do only routine treatment. The main reason for this disparity has to do with the training and experience of the general dentist. In most cases, dentists who have had hospital or other residencies, and have taken many hours of continuing education are more likely to perform procedures that are sometimes referred to specialists. In fact, the recent trend is for the general dentist to do more of these advanced procedures, providing most of their patient's dental needs "under one roof." Even so, in some cases, the dental specialist is the best person to treat a difficult dental problem. The various dental specialities are -

1. Oral Medicine Diagnosis and Radiology [OMDR]:
These specialists are qualified for a better diagnosis and understanding of oral diseases and radiology [X- ray].
2. Conservative Dentistry and Endodontics:
They specialize in the treatment of dental caries and its outcomes, root canal treatment, aesthetic treatment eg. correcting tooth shape and colour using laminates veneers.
3. Periodontics:
The Periodontist specializes in prevention, diagnosis, treatment and structural diseases of the periodontal membrane or gums and related tissues that surround and support the teeth.
4. Pedodontics:
The Pedodontist specializes in the overall health of children up to the age of 12 years.
5. Oral Surgery:
These dental surgeons are skilled in oral surgical procedures and treatment of oral cancer, oral cysts, tumours etc.
6. Orthodontics:
The Orthodontist specializes in braces and deals with straightening crooked teeth and teeth alignment.
7. Prosthodontics:
The Prosthodontist specializes in preparing caps [crowns] and replacement of missing teeth with artificial teeth.
8. Community Dentistry:
There are several dentists that serve the community in providing dental health at the social level.
9. Oral Pathology:
Oral pathologists deal with microscopic details of oral tissues and its diseases.

Selection of dentist

Does the dental office offer you a convenient schedule?

Is the dentist located near your home, office or are you willing to travel to visit the right dentist?

Is the office clean, neat and orderly?

Does the dentist follows sterilization protocol such as wearing gloves, masks and sterilizing instruments?

Does the dentist explain how to control dental problems?

Information about fee to be charges should be told prior to the treatment?

Answering these questions can make your choice easier. Find out if the dentist is a registered practitioner in order to safeguard yourself from quacks and mal- practices.

Visiting a new dentist

1. Visiting a new dentist
The dentist will want to know more about your general health on the following issues.
2. Medical history/current medicines:
Your dentist will want to know if you have been diagnosed with any diseases. Tell the dentist all your health issues, not just those you think relate to your mouth.
3. Current dental health :
Inform the dentist about you oral health problems as this helps to make a prompt diagnosis. Consult the dentist about changes in colour, looseness or position of teeth, teeth sensitivity (heat cold or sweet), changes in gums (colour, tenderness, or bleeding) when you brush or floss, change in the oral skin, you clench or grind teeth, smoke (smoking causes oral cancer), allergies, pregnancy, medicines you are currently taking or disease (medical condition) you suffer from.
4. Dental fears:
If you have any fears about going to the dentist or receiving dental care let your dentist know in order to resolve the problem because today dental treatments have changed and so have pain management options.
5. Clinical examination of teeth :

   The dentist will check for signs of tooth decay using a metal probe and a small mirror with an angled handle. Next, poke your teeth with a dental instrument, called an explorer, to look for cavities. During the cleaning, the dentist will use a scaler (a small metal instrument with a blade like end) to scrape off tartar above and below the gum line. Then use an ultrasonic vibrating device to shake loose plaque and tartar and next rinse it away with a stream of water. The now-smooth tooth surfaces makes it difficult for plaque to accumulate.

   The dentist will also check for gum swelling, redness and measure the depth of the gingival pockets. Your dentist will test how your upper and lower teeth come together and will look for evidence of tooth grinding or problems with the temporomandibular joint (which connects the lower jaw to the skull). Examine the neck, lymph glands, palate and the soft tissues of your mouth (cheeks, tongue, lips, and floor of the mouth) for signs of infections or oral cancer, especially if you are 35 years or older. Your dentist will also check for any problems with fillings, braces, bridges, dentures, crowns, or other restorations.

   In the course of dental work, your dentist may inadvertently touch the soft palate at the back of your throat, evoking your gag reflex. This often happens when your dentist positions X-ray films or takes tooth impressions. Fear often exacerbates the gag mechanism. Needless to say, this causes problems for both the patient and the dentist.

   X-rays: The dentist will take X- rays to look for signs of tooth decay, as well as for gum disease and other oral health problems.

   Conditions that can be diagnosed by a dental X ray are:

   • Cavities between the teeth below the gums and around old fillings.
   • Bone loss caused by gum disease.
   • Teeth that are trapped (or impacted) in the gums, such as wisdom tooth.
   • Infections of the root of the teeth with deep caries.
   • Problems with the bone holding the tooth.

Frequently Asked Questions

What toothbrush and floss are best for me?

Is my brushing and flossing adequate and effective if not, teach me the right way.

Where does plaque accumulate in my mouth?

Are there any areas in my mouth that I am missing during brushing or flossing?

How fast does plaque accumulate in my mouth?

For most people, two checkups per year are sufficient. But if you have special problems or if you're at high risk for conditions such as periodontal disease, your dentist may recommend that you come in as frequently as every three months.

Aids to reduce pain\anxiety

To make your dental visit as comfortable as possible, your dentist may suggest aids to reduce or eliminate any pain or anxiety that may be related to your dental treatment. The type of anaesthesia required for any dental procedure depends on the needs or preferences of the patient. The choice may be to give either local or general anaesthesia when undertaking dental procedures. Analgesics are group of drugs that relieve pain and are given post dental procedures.

Dental anaesthesia : These are important tools to reduce even eliminate discomfort during dental treatment. The choice may either local or general anaesthesia to help alleviate anxiety or pain that may be associated with dental care.

• Local anaesthesia : Are drugs that cause loss of sensibility of peripheral nerves of a particular area. In simple words, they cause numbness of the mouth by injecting anesthetic drug into your gum or inner cheek.
• Topical anaesthetics: Are applied to mouth tissues with a swab to prevent pain on the surface level. A topical anaesthetic numbs an area for administering an injectable local anaesthetic. Topical anaesthetic also may be used to soothe painful mouth sores.
• Injectable local anaesthetics: Prevents pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain and numb mouth tissues. They cause the temporary numbness often referred to as a "fat lip" feeling. Post treatment you may have difficulty in speaking clearly or eating and drinking from a straw. Be careful not to bite your mouth or lip as the area is still numb. Injectable anaesthetic is used in procedures like filling cavities, crowning or treating periodontal (gum) disease and root canal treatment.
• Sedation and general anaesthesia: Anti-anxiety agents, such as nitrous oxide or sedatives may help you relax during dental visits and often may be used along with local anaesthesia. Dentists also can use these agents to induce "minimal or moderate sedation," in which the patient achieves a relaxed state during treatment but responds to speech or touch. Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.

More complex treatments may require drugs that can induce "deep sedation," causing a loss of feeling and reducing consciousness in order to relieve both pain and anxiety. On occasion, patients undergo "general anaesthesia" in which drugs cause a temporary loss of consciousness. Deep sedation and general anaesthesia may be recommended in certain procedures for children or others who have severe anxiety or who have difficulty in controlling their movements.

Analgesics are group of drugs that relieve pain, in simple words painkillers. They are usually 2 types; non-narcotics or NSAID’s and narcotic analgesics. Non-narcotic analgesics are the most commonly used drugs for relief of toothache or pain following dental treatment. This category includes aspirin, acetaminophen and non-steroidal anti- inflammatory drugs such as Ibuprofen. Narcotic analgesics, such as those containing codeine, act on the central nervous system to relieve pain. They are used for more severe pain.

Understanding the range of choices that are available relieve anxiety and discomfort makes you a well informed dental consumer. If you have questions or concerns about your oral health care, don't hesitate to talk to your dentist. If you still have concerns, consider taking a second opinion. Working together, you and your dentist can choose the appropriate steps to make your dental visit as safe and comfortable as possible.

Locate a Dentist

With the huge data base of the Indian Dental Association, you can locate a dentist in your locality to suit your needs.