What is Erosion?
Erosion is the dissolving of tooth enamel by acidic substances.It is often accompanied by abrasion wear caused by brushing too hard and/or using very abrasive toothpastes.
Does it matter?
Although Mild erosion does not cause symptoms, in severe cases the teeth can become very sensitive and cause pain after consuming hot and cold foods.
Often the upper front teeth are affected and can become quite short and disfiguring.
What causes it?
The main culprits are acid-containing fruits, fruit and carbonated drinks taken between meals.
How can it be prevented?
The British Dental Association advises:
- Use a soft or medium toothbrush and avoid brushing teeth straight after consuming acid food or drinks.
- Drink non-acidic drinks (water, milk, tea etc.) and eat alkaline snacks such as cheese between and after meals
- Limit the consumption of acidic foods, fizzy drinks and fruit juices to mealtimes
- Keep drinking times short and avoid sipping
- So not “swish” fizzy drinks or fruit juices around the mouth
- Use a straw to help direct drinks straight to the back of the mouth to reduce contact with the teeth
- Consume acidic drinks chilled
Water and milk are better for teeth but mothers should be aware that milk does contain natural sugar and milky ‘top up’ drinks given during the night can present a risk to baby teeth
Always remember that a clean and healthy mouth heals more rapidly than a neglected one.
Take things easy for a few hours and avoid strenuous exercise for 24 hours
Do not rinse the mouth for at least 6 hours
Avoid HOT fluids, alcohol, hard or chewy foods.Choose cool drinks and soft foods
Should the wound start to bleed, apply a small compress. This can be made from a clean cloth handkerchief rolled up to make a pad about one inch/2.5 cm in thickness and slightly moistened with clean water. Place this on the bleeding point and bite firmly on it for
15-20 minutes, longer if necessary
After 6 hours following extraction, bathe the mouth very GENTLY with a lukewarm saline mouth wash. This should be continued after meals for several days or until healing is complete. A saline mouth wash is made by dissolving a level teaspoon of salt in a glass of warm water. The solution should be held in the mouth for two or three minutes to bathe the wound and then be discarded. Avoid over-vigorous rinsing. The dentist may also advise an antibacterial mouthrinse however you will receive specific instructions is this is the case
Any pain or soreness can be treated by taking a mild pain relieving preparation such as paracetamol. For more
complicated surgery after care adults may be advised to take codeine/paracetamol compound tablets or ibuprofen.You should not take these unless your medical history has been discussed with the dentist
If prolonged bleeding or pain occurs, consult your dentist or, in emergency, attend the local accident and emergency department
If you have required stitches during your treatment then these are usually of the dissolving variety and they will normally fall away after 7 to 14 days.The dentist may require you to attend for review to monitor healing but this is not always necessary.
Did you know that you can get your N.H.S. treatment free while you are expecting and until your baby is one year old?The practice has flexible policy regarding how mothers may prefer to receive their treatment either on the NHS or via their preferred practice plan.
Many mothers have bleeding gums during pregnancy. This seems to be due to changes in your hormone levels which alter the gum response to mouth bacteria and debris(plaque) , this generally returns to normal after baby is born.
It is however, very important to keep the teeth as clean as possible and regular visits to our hygienist may be recommended.
An antibacterial mouthwash may be prescribed to aid plaque control and reduce gum inflammation.
Keep fruit drinks to mealtimes only. NEVER give fruit juices from a bottle – use a feeder cup or spoon. Give cooled boiled water or milk between meals (not mineral water which may not be sterile or contain too much salt)
If your child requires medicine, make sure that it is sugar-free. Always ask your doctor or chemist for sugar-free medicines
It is difficult to cut out sweets altogether, but please try to give them at mealtimes – to save tooth loss and pain later
When baby’s teeth first come through (about 6 months) put a smear of baby toothpaste on your finger and rub the teeth gently. Some babies prefer the fruit flavoured toothpastes over the mint variety.Please ask the dentist for advice.
As more teeth appear, start to use a baby toothbrush with infant toothpaste (only a smear) and brush the teeth and gums. The area where the teeth and gums meet needs special attention.
Children will often need supervision and monitoring of their teeth cleaning until they are about seven years old.
We may advise that your child should be seen every six months for a check – up however, if we are monitoring something this may be more frequent.
Visiting the dentist
Every time you come to the dentist, whilst your children are small, you may bring the children with you.If you are to receive treatment, may wish to bring a helper or relative to help look after your child. Infants can be registered at any age with our practice.
Regular visits accustom children to the sounds and smells of the practice – they get to know where the toys are too!
It may help if you play “Going to the Dentist” at home, and let other members of the family help brush baby’s teeth.
Dentures should always be cleaned over a basin of water to minimise to risk of breakage should they be dropped.
Rinse denture after every meal and remove debris by brushing with a soft brush, soap and cold water
Soak denture in an alkaline hypochlorite soaking solution e.g. baby bottle sterilizing solution, “Milton” or “Dentural” for 20 minutes in the evening
Rinse thoroughly with cold water and soak in cold water overnight
Metal and plastic
Rinse denture after every meal and remove debris by brushing with a soft brush, soap and cold water.
Soak denture in an alkaline peroxide solution (e.g. “Steradent”) for 15 minutes or an alkaline hypochlorite solution (“Dentural” or “Milton”) for 10 minutes in the evening. Rinse denture thoroughly with cold water and soak in cold water overnight. Do not use acid cleansers.
Temporary soft linings
Rinse denture after every meal with cold water.
Soak denture in an alkaline hypochlorite solution (“Dentural” or “Milton”) for 20 minutes
Rinse thoroughly with cold water
Do not use alkaline peroxide cleansers
Permanent soft linings
Rinse denture after every meal and remove debris by brushing with a soft brush, soap and cold water
Soak denture in an alkaline hypochlorite solution (“Dentural” or “Milton”) for 20 minutes in the evening
Rinse denture thoroughly with cold water and soak in cold water overnight
Advice provided by the Britsh Dental Association
Will it be painful?
It is likely to be sore for about 3-5 days each time the brace is adjusted. If necessary, painkillers such as the ones you would normally take for a headache, may help (please read the instructions on the packet). If there is an obvious area of soreness as a result of the brace, ring for an appointment as soon as is reasonably possible (telephone number overleaf). If possible, do not stop wearing the brace or else you will have to go through the 3-5 days of discomfort all over again when you start wearing it once more.
How else might it affect me?
Your speech will be different. Practice speaking with the brace in place e.g. read out aloud at home on your own, and in this way your speech will return to normal within a couple of days.You may also find yourself swallowing a lot to begin with. This is quite normal and will quickly pass.
Can I eat normally?
Yes you should be able to eat normally. It is important you keep the brace in whilst eating unless you are otherwise instructed. Although it may be difficult at first, eating with the brace in place will become easier with time. After each meal remove the brace and rinse it thoroughly. For your orthodontic treatment to work well and in the shortest possible time it is important you take care of your teeth and brace. In order to avoid damage to both, you should try to avoid the following:
Toffees, boiled sweets, sugared chewing gum, chocolate bars, etc.
Fizzy drinks including diet drinks, excessive amounts of fruit juice.
Hard foods which might damage the brace such as crunchy apples, crusty bread rolls, etc.
Hard foods can be eaten with care if you cut them up first.
What about toothbrushing?
It is important you brush well three times per day and use a fluoride toothpaste. If possible carry a brush with you for use after lunch. Take the brace out to clean your teeth. You should also gently brush the brace, taking care not to damage the wires. A daily fluoride mouthrinse should also be used last thing at night, after toothbrushing. Failure to keep your teeth and brace clean will lead to permanent scarring of your teeth.
Can I remove the brace?
Yes but you should only remove it for cleaning. Do not repeatedly click the brace in and out with your tongue as this will break the wires and increase the length of time the treatment will take.
How long will treatment take?
It usually takes 6 – 24 months but will vary according to how severe your case is. Failed and cancelled appointments, or repeated breakages of the brace will increase the length of time the treatment will take.
How often will I need an appointment?
You will need regular appointments during treatment for the brace to be adjusted.
Do I still need to see my regular dentist?
Yes. It will be important you still have check-ups with your regular dentist throughout orthodontic treatment so that your teeth can be checked for decay.
What do I do if I play contact sports?
You should to wear a gumshield instead of your removable appliance when you play contact sports. This will also be the case if you enjoy riding a bicycle, roller-skating or skateboarding. You will be advised about this. When not in your mouth the brace should be in a protective box.
What if I play a musical instrument?
If you play a wind instrument, particularly the flute or a brass instrument, then you may be advised to remove the brace whilst playing. However, when the brace is not in your mouth it should be kept in a sturdy plastic box to prevent breakage.
What do I do if my brace breaks?
Ring up for an appointment as soon as is reasonably possible. Do not wait for your next routine appointment as the breakage may slow your treatment, or may result in damage to your teeth. If you repeatedly break your brace treatment may be stopped.
Your specialist will normally have given you advice about your ‘fixed braces’ however this is some general advice.
Your appliance will feel strange and your speech will be altered for the first few days. It will soon return to normal. During the first few days, a mild pain killer may be necessary as there will be some discomfort.
The appliance is reasonably strong but can be broken by hard or sticky foods. These should be avoided. For example, Mars bars, toffees, chewing gum, crunchy things such as nuts,celery,raw carrot, crusty bread etc. will damage your brace.
Food and drinks containing sugar will cause dental decay. These should be avoided.
The brace will trap more food than usual around your teeth and therefore careful toothbrushing is important.
The appliance and teeth should be cleaned thoroughly after every meal, including snacks. Food left around the teeth will cause dental decay and inflamed gums.
Appliances cannot cause these problems – only food trapped around them will.
Therefore, a toothbrush must be taken to school.
Fluoride containing mouth rinses
Teeth which may be of a higher risk of decay will benefit from fluoride.
Fluoride in the form of a mouthrinse used once a day will strengthen your dental enamel.
Sports,playing wind instruments and the wearing your appliance
Your specialist will have given you advice about the risks attached to contact sports and the wearing of your appliance and also if your play a wind instrument.Please ask at your review appointments if you have any concerns.
Problems and breakages
When first fitted, fixed appliances can rub cheeks and lips causing ulcers. Soft wax may be used to pad out the metal components and you will be provided with a supply.
Should breakages occur you should contact the practice as soon as possible.
Mouth guards are made of a plastic material which must not be exposed to heat other that of normal mouth temperature.
Do not eat or drink hot foods whilst wearing the mouth guard.
The plastic material will have been custom moulded to fit the shape of the patient’s mouth only.
The mouth guard will have been supplied with a storage case and when not being worn, should be kept in the case for safety.
The mouth guard must be cleaned after each use using a toothbrush under cold running water.
A toothpaste may also be utilised to freshen the surface of the mouth guard then finally rinsed.
Keep the mouth guard out of strong sunlight and when dry, replace in the storage box ready for next use.
Providing the mouth has developed fully,mouth guards used properly for sports,only subject to moderate loading and kept clean may last 2 to three seasons.
It is always wise to have the mouth guard checked by your dentist once a year
Here are a few simple rules which anyone can follow:-
If PERMANENT front teeth are accidentally knocked out – but NOT BROKEN while you are playing games or at school – This is what you must do.
If the tooth is clean:-
Pick it up by the crown (the part that you can normally see) and push it gently back into the socket.
Bite on a clean handkerchief (to hold the tooth in place)
Get to a dentist AS QUICKLY AS POSSIBLE
However, if the tooth is dirty:-
Hold the tooth gently by the crown and place it in a cup of milk so that the whole tooth is covered and get to a dentist AS QUICKLY AS POSSIBLE
DO NOT SCRUB the tooth
DO NOT clean it in disinfectant (bleach, savlon etc.)
DO NOT wrap the tooth in a handkerchief
DO NOT waste time
If no one is able to push the tooth back into place:-
Put it in a cup of MILK and get to a dentist AS QUICKLY AS POSSIBLE.
Teeth are most often saved if a dentist is seen within half an hour, the chances of success after one hour are poor.
This sort of injury is best prevented by wearing a custom made mouth guard.
There are many web sites of dental interest and the following are recommended for perusal as they give a considerable amount of general information and both have public as well as professional content.We recommend the following as some of the best.