Calgary Dental Clinic – Frequently Asked Questions

Frequently Asked Questions

Q1. Why every time I come for a cleaning appointment, my dentist gives me a bunch of other treatments as well?

Answer: Once all your dental treatment has been completed, your dentist will put you on a recall schedule. Basically, you have to come back in a regular basis for oral hygiene (scaling and polishing on your teeth) and an oral examination. The purpose of your recall examination is for the dentist to monitor the condition of your oral health. He/she will check to make sure you don’t have any new cavities, no periodontal problems, and no new pathology such as oral cancer, that are developing, no breaking down of existing restorations etc. Often, during the recall exam, your dentist may need to take some checkup x-rays (called Bitewing x-rays) in order to make the correct diagnosis because cavity or gum problems can develop in some places (especially in the posterior teeth) that clinical examination cannot detect. Sometimes, your dentist will decide to give you topical fluoride treatment as well if you belong to the high risk group of developing cavities. Some people sometimes tell me they don’t want all this, just a “cleaning!” is enough for them. They do not understand every other treatment in a recall appointment is as important as “cleaning!” The oral cavity is an important part of your body that you use all the time. It needs maintenance and care from time to time, just like your car and house.

Q2. I am tired of having cavities every time I see my dentist for a checkup, what can I do?

Answer: Some people are more prone to have cavities than other people, so is the case for periodontal diseases (gum disease). . If you constantly develop new cavities, you must do something in addition to have your teeth filled all the time. You may have to modify your diet (such as decrease snacking, decrease high sugar-content drinks and foods). This is very difficult for many people. Another option is to have daily mouthrinse that contains the mineral fluoride mineral. You can ask the pharmacist in the drug store or your dentist to recommend it to you. I often put my “high-cavity-risk” patients to rinse their mouth 2 times a day with 0.12% chlorhexidine solution (which is an antibacterial mouthrinse) for 2 weeks, and then switch to daily fluoride rinse until the time for next checkup appointment. This group of patients also needs a more frequent recall appointment, say once every 6 months. If new cavity is detected, this fluoride rinse regime will continue until next checkup appointment; this will continue until there are no new cavities detected in a checkup appointment. Then, the patient can stop the fluoride rinse or go to a regime of once every week. Chlorhexidine solution has to be prescribed by your dentist while fluoride rinse is over-the-counter. Chewing gum containing Xylitol has been proven to be very effective at reducing cavities. Xylitol is known to be effective at reducing Strep Mutans, a bacteria species causes oral cavities. So try to chew two pieces of Xylitol gum for 10 minutes 3-4 times a day will help you fight cavities!

Q3. I did not have toothache until I went for a checkup and my dentist told me that I had a cavity and did a filling for me. Pain developed afterwards. He tells me I now need a root canal therapy for this tooth to relieve the pain. Is my dentist causing me all this unnecessary treatment?

Answer: A cavity can develop silently and elusively both to your feeling and even to the dentist’s eyes. Often a cavity is detected only when an x-ray is taken. Sometimes it is difficult to predict whether the cavity just needs a filling or a root canal therapy as well. This often depends on how extensive the cavity has developed or just depends on individual case somehow without any warning signs in advance. Misunderstanding easily arises if prior to restoring the tooth with a filling, the patient is not forewarned by the dentist that the tooth may need a root canal therapy as well.

I often warn my patient that a filling for a tooth can turn into an inflammation of the pulp, especially if the cavity is very close to the pulp chamber before I start any treatment to this tooth. Unfortunately, when it happens, patients often forget what their dentists have told them or that the dentists really did not forewarn them. As a result, patients often hold their dentists guilty for causing problems to their teeth. This is unfair to the dentists. Let’s assume if the tooth with cavity develops silently without the patient knowing about it or without the dentist treating it, what will happen? The cavity will spread into the pulp, then it may cause severe toothache later that it leads to a dental emergency, or the problem can still be going on silently, until the tooth is decayed to the point even root canal therapy and a crown will not be able to save the tooth.

The tooth with a problem still will haunt you one day, it is just a question of when. Therefore, your dentist advised you that you had a cavity and did a filling was out of good will. The only mistake he has done is that he did not explain well to you the situation in advance. I am confident that most dentists are highly conscientious and competent.

Q4. Why my teeth become very sensitive to cold after a hygiene session in a dental office? Should I avoid having my teeth cleaned?

Answer: As I mentioned in the section on periodontal disease, gums can have chronic inflammation because of poor oral hygiene. In this situation, the gum will usually look puffy and red. When the oral hygiene improves, as in the case of after a hygiene session in a dental office, the inflammation of the gum will subside, and the gum will shrink and tighten up. Unfortunately, the side effect is that the roots of the teeth will be exposed as the gum shrinks. Also prior to the hygiene session, these tooth roots had tartar and plaque covering the surface. All these unhealthy stuff were removed during the hygiene appointment. Now what do you get? Bare exposed tooth roots! No wonder you have sensitive teeth!

The worse the condition of your gums and your oral hygiene prior to the cleaning session, the more sensitive teeth will be after the appointment. The sensitivity is especially obvious to people with periodontal disease. Unfortunately, these people are more in need of these hygiene appointments than the average people!

You either will have sensitive teeth or lose your teeth gradually, what do you prefer? What you need to do to avoid or reduce sensitivity after hygiene session are as follows:

  1. Use floss EVERYDAY so that the plaque and bio-film don’t cling to the teeth. In doing so, you don’t have bad periodontal problems or your gum does not have much inflammation at the time of cleaning section; this will reduce post-cleaning sensitivity.
  2. Switch to Sensodyne toothpaste, which you can get over-the-counter after hygiene session.
  3. Have fluoride treatments after hygiene session.
  4. Avoid cold and hot drinks and be patient.

Q5. Should I use electric toothbrush?

Answer: It depends. If you are brushing in a correct way, manual toothbrush is as good as you get. For patients with dexterity problems, for example patients who have had a stroke or patients with mental retardation, electric toothbrush will become very helpful and valuable. For people who develop plaque and tartar easily, the electric toothbrush can help to remove them more thoroughly.

The bottom line is that the correct brushing technique is more important. If you brush correctly, long enough (3-5 minutes to finish the whole mouth) and be gentle, any kind of toothbrush is good enough. Of course, don’t forget to floss as well. One personal experience I had is about my parents. They have had very bad oral hygiene habits and severe periodontal problems. I have been cleaning their teeth once every 3 months since I got into the dental field. However, I still did not find any improvement in their personal oral hygiene habits no matter how I motivated them.

Finally, I bought them an Oral B/Braum electric toothbrush. Ever since then, their oral hygiene has been improved dramatically. After all, if you cannot change someone’s techniques, change the tools! Sonic Complete of Oral B is what I am using now. SonicCare electric toothbrushes from Philips are also very good but they are more expensive. My suggestion to you is to buy the rechargeable ones if you buy any electric toothbrushes, not the one operated with battery!