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Commonly Asked Questions About Dental Fillings

Commonly Asked Questions About Dental Fillings

Why do I need a filling?

Fillings are treatment for dental decay. When your tooth is decayed, you have a hole inside the tooth which is full of bacteria. This area needs to be cleaned out and filled with a material which stops food from getting in. This in turn stops the decay and restores normal form and function to your tooth.

You may not necessarily have pain to need a filling as early decay are usually painless. Your dentist can detect decay when you attend your regular check-up appointments. If the decay is left until pain starts, you might need more treatment than just a filling.

What types of fillings are available?

The white filling, or composite, is the most common filling material on the market now. It is made of resin and sticks to teeth. It matches the colour of the tooth, and has very good durability and wear resistance, hence is widely used for fillings in most teeth.

A silver filling, or an amalgam, is a mercury based filling and is very popular in the last few decades. It is slowly being replaced as composites rose to the scene.

A temporary filling is offered in some cases, perhaps to wait for an inflamed tooth to settle, or as a temporary measure during ongoing treatment. They are not permanent solutions and typically only last up to 6 months.

Is a composite (white filling) better than an amalgam (silver filling)?

With the advancement in composite technologies, composite has become a very good choice for a filling material. Its main advantage is that it can stick to teeth. This means that the dentist can be minimal with the removal of healthy tooth tissue when placing a composite. Whereas when placing an amalgam that doesn’t adhere to teeth, the tooth has to be altered in a certain way to “lock” the filling in, inevitably sacrificing some healthy tooth tissue.

The composite is also more aesthetically pleasing, being available in different colours to match our natural teeth.

However, amalgam is still available for a reason. Composites do not stick in the presence of water, limiting its use in certain situations. In the mouth where it cannot be completely dried, for example under the gum, or far back, an amalgam filling still works better than a composite.

Your dentist would always recommend the most appropriate material for each situation

I have some amalgam fillings, do I need to replace them?

The main concern people might have about amalgam fillings is that they contain mercury. Rest assured the mercury in the amalgam filling is completely locked away and would not affect your health in any way. In fact, it is during the removal of amalgams that you can be exposed to the vapours which may contain trace amounts of amalgam. The level of mercury in amalgam fillings is tested and safe for use, similar to that of eating one or two pieces of salmon. If your only worry is the mercury, then it is perfectly fine not to replace those amalgam fillings.

However, your dentist may advise you replace your old amalgam fillings if there is decay underneath, or if the tooth has chipped. If the amalgam filling is not very aesthetically pleasing to you, you can also speak to your dentist to get it changed.

Do fillings last forever?

Unfortunately in dentistry, nothing can be promised to last forever. With proper placement and care, a composite filling has a good chance of lasting more than 10 years.

With time, problems can develop which warrant a new filling. You may get decay underneath the current filling, the tooth might chip, or the filling might fall out. These are all circumstances which cannot be foreseen.

But not to worry, given a skilled dentist and good care at home, the chances of these issues happening is low.

Are fillings painful?

Not at all! Like any other treatments, if you dentist anticipate pain, he/she will give you some local anaesthetic to numb up the tooth before starting, which makes it pain-free throughout the procedure.

I’m having pain after my filling, is that normal?

With composite fillings, it is normal to have some sensitivity for 3-5 days after the procedure. You can take some painkillers to help with the sensitive sensation. If the sensitivity doesn’t settle after a week, contact your dentist.

For any filling, if you’re getting a dull, throbbing ache in the area, or pain on biting, it might mean that your nerves are inflamed. This is usually a result from the previous decay in the tooth which warranted the filling. You should contact your dentist and your dentist arrange an appointment at the earliest time to review your tooth for you.

In summary

All in all, fillings are a simple, commonplace procedure which is done on a daily basis by any dentist. The procedure is fairly quick, usually taking not more than half an hour for each. You can return to your daily routine and eat and drink as per normal as soon as you leave the dental surgery.

Regular visits to the dentist for check-ups allows early detection of decay. Treatment of decay with fillings ensures that the tooth is restored to normal form and function before the decay progresses on to warrant more complex treatments.

Need A Filling?

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About the Author

“Positive experiences in the dental setting goes a long way. I aim to provide quality dental care tailored to every patient’s individual needs.”

Dr Li Kexin

Dental Surgeon, NoFrills Dental

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Preventing Dental Caries – The Step By Step Guide

Preventing Dental Caries – The Step By Step Guide

Preventing Tooth Decay

Previously we talked about the formation of dental decay, in this article, let’s look at how we can prevent decay before it even happens.

The first big issue here is the sweeties. Don’t the adults always say “too much sweeties will give you bad teeth”? This is very true. But does that mean I can’t have sweets at all? Let me give you some tips for having those sweeties yet maintaining healthy teeth at the same time.

Let’s start with a simple question: which of the following foods cause caries?

  • Sweets
  • Orange juice
  • Chocolate
  • Ketchup
  • Digestive biscuits
  • Dried fruits (e.g. raisins)

Remember your answer, we’ll come back to this later.

Before we can rationalise the best way to eat, we need to know how decay is formed. When you eat sugars that can be digested by the bacteria on our teeth, the bacteria produce acids which erode away the minerals in the top layer of our teeth. The loss of minerals from our teeth is the process of decay. After you stop eating, it takes half an hour for your saliva to clear the acids and stop the erosion.

Thanks to fluoride, the loss of minerals is not a one way process. When we brush our teeth, fluoride in the toothpaste helps to replace that mineral layer, in turn “healing” our teeth from the day’s damages. But, if you’re nibbling on sugars throughout the day, not giving your teeth a chance to recover, the loss of minerals outbalances the replacement, hence forming caries.

So let’s go back to the question before.
The answer to this question: it is very dependent on how you eat them!

The simple rule of thumb is: Keep all the sweet treats to mealtimes, and no sweet treats in between. The few hours of break in between gives your teeth sufficient time to recover from the sugar attacks. In between meals you can always have savory/salty snacks such as cheese, or natural snacks like salads, fresh fruits, and milk.

Well then what is considered a sweet treat? It is anything with added refined sugar. Here it’s worth pointing out a few interesting options in the question.

Fruit Juice

Fresh fruits doesn’t damage your teeth but when turned into juice, it’s considered a sweet treat. This is because juices usually have added sugar, and even without added sugar, the forms of sugar changes when fruit becomes juice, making it much easier for bacteria to digest, in turn bad for our teeth.

Ketchup & Biscuits

Watch out for those hidden sugars in “savory foods” like biscuits, ketchup. Always read the ingredient label for sugars. It is very common for sugars to be added to savory food to enhance its taste. 

Dried Fruits

Dried fruits like raisins are always considered to be rather healthy, and sometimes frequently offered to children to snack on. This is a time bomb as they are highly concentrated in sugar, making them very cariogenic (causing decay).

In summary

When it comes to teeth, sugar intake is not about the amount, but all about the duration and frequency. 

Now what about fluoride? We mentioned that fluoride helps “heal” (re-mineralize) the teeth, this is why we come into contact with fluoride daily. Fluoride is in our water, toothpaste, mouthwash etc. All these are efforts to help re-mineralize our teeth and tip the balance towards having no decay.

However, the healing capacity of fluoride is only limited to the top layer of the tooth, where it can come into contact with. If decay progresses under the surface, fluoride is unable to penetrate.

This is why it is always important to visit the dentist. The dentist can check your teeth to spot early decay. If early decay is spotted, the dentist can either give you a high dose of fluoride to create a super hard coating outside to protect your teeth, or use early prevention methods (e.g. fissure sealants or preventative resin restorations) to stop the decay from progressing further. The dentist can also discuss your eating habits and help you alter your diet to prevent future decay.

Want to Learn More?

Book an Appointment With Dr Li Kexin Today!

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About the Author

“Positive experiences in the dental setting goes a long way. I aim to provide quality dental care tailored to every patient’s individual needs.”

Dr Li Kexin

Dental Surgeon, NoFrills Dental

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Root Canal Treatment – The Magic Within The Tooth

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Root Canal Treatment – The Magic Within The Tooth

Root Canal Treatment – The Magic Within The Tooth

Root Canal Treatments Explained:

You may have heard about root canal treatment, or nerve treatment. It sounds like a complicated and daunting treatment to have, but is it actually? Root canal treatment may be the most intricate treatment that is almost like working a piece of art inside the tooth, so let’s take a journey into the tooth and explore the magic that happens within.

Before we talk about the treatment, let’s have a look at the structure of the tooth. What you can see is only 1/3 of the whole tooth. The remaining 2/3 is the root that is embedded in bone under the gums. Running throughout the entire tooth is a space in the middle called the pulp, where the nerves and blood vessels are. The enamel and dentine layers on the crown of the tooth offers protection for the pulp.

Time and tooth surface are the two factors that is somewhat out of our control.

The nerves in the pulp supplies sensation to the tooth. Unfortunately, unlike our skin which senses hot and cold, rough and smooth, the tooth only has one sensation: pain. When protected by healthy enamel and dentine, the nerves wouldn’t feel anything, but if outside simulation is allowed to get close to the pulp, we start having toothache.

The most common cause of toothache is dental decay, where bacteria causes loss of minerals in the tooth and forms a hole (cavity). When decay reaches the dentine layer, the tooth starts to get sensitive. This is an early signal of a problem, but at this stage the pulp is still healthy. If decay is not treated and bacteria enters the pulp causing an infection, the pulp dies and the pain changes to a dull, constant, throbbing pain. With the dead and necrotic pulp inside the tooth, the infection would grow and eventually cause an abscess.

This is where root canal treatment comes into play. The dentist will remove the dead pulp, clean out the root canal spaces, and fill them up to completely eliminate the source of infection.

So what about the pain?

Isn’t a treatment in the nerves painful?

Not at all! When you decide to have the root canal, the dentist will give you some local anaesthetic to numb you up. This will stop the toothache that you are currently having. The first stage of the root canal focuses on removing the dead pulp, which is the source of infection. Once this is removed, the pain will be gone too.

However, simply removing the dead nerve only gives you a temporary peace of mind. There is still bacteria left in the root canals, and they can still cause an infection at the tip of the roots, which again, translates to pain. The next stages of disinfecting the root canal, shaping it and filling it up are also essential. Only by finishing the root canal treatment can we ensure that this tooth is infection free and completely pain free in the future.

So why is it like working a piece of art? Each tooth is different and roots are grown in different ways. The dentist cannot see the inside of the tooth, but with the use of guides like x-rays and special instruments, the dentist navigates the root canal spaces which are as fine as a thread. This requires very fine maneuvers within a very small space, similar to producing a tiny art work. Sometimes, one tooth can have up to four root canals! The intricacy of all these means that the root canal will take a few appointments to complete. It is a lot of work, but have a look at the end result on the x-ray, isn’t it beautiful and worth all the effort?

Last but not least

Certain conditions can increase the risk of developing dental decay.

For example, conditions reducing saliva production (e.g. Sjrogen’s syndrome, radiotherapy to the head and neck) increases the risk of decay. Malformed teeth may also be structurally weaker and more susceptible. If you have been brushing your teeth well, following a healthy diet, but are still finding new caries each time you visit the dentist, it might be worth having a more detailed discussion regarding the causes of the decay. If an underlying condition is suspected, your dentist can help treat you or refer you to the right person who would be able to help.

Before Treatment

After Treatment

Are root canal treatments always successful? Well in general, the success rates of root canal treatments are around 90%, but it also depends on the condition of the tooth, and how long the infection has been present. The earlier the treatment, the higher the success rate. Hence don’t leave toothaches alone, always seek treatment early.

For optimum results, your dentist might recommend a crown after the root canal treatment, especially on the back teeth. A crown is a cap that goes over the top of the tooth, it seals up the tooth and ensures no further bacteria can enter. Root treated teeth are also more brittle and the crown will protect the tooth from cracking when you bite on it.

Some may ask, why shouldn’t I just pull the tooth out and place an implant?

Nature designed us teeth that comes in a perfectly matching set, which can last for more than 70 years if properly cared for. No technology today can match that. Implants today are great for replacing teeth, however it also requires more maintenance and cost to upkeep. Therefore, if a tooth can be kept, it’s best not to rush for the quick fix.

All in all, root canal treatments may seem complex, daunting, or even long and tiring. But it is definitely worth all the effort. If you have a toothache, don’t worry about the complexities, simply visit your dentist early, and trust that they’re there to help you return your teeth to a pain-free and healthy state.

Considering Root Canal Treatment?

Book an Appointment With Dr Li Kexin Today!

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About the Author

“Positive experiences in the dental setting goes a long way. I aim to provide quality dental care tailored to every patient’s individual needs.”

Dr Li Kexin

Dental Surgeon, NoFrills Dental

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Causes of Dental Decay

Causes of Dental Decay

Dental Decay Explained:

Dental decay, or caries, is the major cause of toothaches, so what exactly is it? It’s a behavioural condition brought about by bacteria in the presence of sugar. In simpler words, bateria present on our tooth surfaces produce substances damaging to our teeth every time we eat sugars. The damage is minimal each time, but accumulated over months and years, they turn into the cavities (holes) in our teeth.

Early decay is painless and often only detectable by your dentist. During the checkup, your dentist will look at the tooth surfaces, and sometimes take x-rays to help detect caries. Although painless in early stages, if they’re left to propagate, caries can cause pretty nasty toothaches later on. Treating early caries help to prevent such situations from happening.

So what causes decay? There are four major factors which contribute to dental decay: Time, tooth surface, bacteria and sugars.

Time and tooth surface are the two factors that is somewhat out of our control.

As for bacteria and sugars, the bacteria present on our tooth surface feed on sugars and release acids, which slowly breaks down our tooth structure.

Before looking at the types of decay that commonly occur, it is worth noting that dental decay is a normal occurrence and can be easily treated by your dentist. With any other dental condition, it is always best to catch the problem early and nip it in the bud. It is not only easier to treat, but also far less costly than complex treatments at a later stage. Hence you should visit your dentist for regular check-ups, and don’t be afraid to see a dentist for any small issues that you may have. 

Decay in adults most common happen on the biting surfaces, as well as on the surfaces where two teeth meet in between. This is mainly because the spaces in between teeth is most frequently missed during cleaning, which means that there will be an abundance of bacteria residing in that space, releasing substances damaging to our teeth. Flossing or tepe brushing is essential to prevent decay in between teeth. 

Another type of decay is more common in the elderly population: root decay. With age, the gums may recede to expose the roots of the tooth. The roots are softer than the top part of the tooth and more susceptible to decay.

So in summary

How can we control and prevent decay? The answer is easy: brush well and eat well.

Brush your teeth twice a day to remove the bacteria on your teeth, and reduce the frequency that you have those sweet treats.

A more detailed article on decay prevention will be available shortly. This article will elaborate on the sugars in our diet, and how we can tailor our diet to prevent decay. You can also refer to gum article for a more detailed description of the daily tooth-brushing regime.

Last but not least, certain conditions can increase the risk of developing dental decay. For example, conditions reducing saliva production (e.g. Sjrogen’s syndrome, radiotherapy to the head and neck) increases the risk of decay. Malformed teeth may also be structurally weaker and more susceptible. If you have been brushing your teeth well, following a healthy diet, but are still finding new caries each time you visit the dentist, it might be worth having a more detailed discussion regarding the causes of the decay. If an underlying condition is suspected, your dentist can help treat you or refer you to the right person who would be able to help.

For more information regarding decay prevention, please visit this decay prevention article. 

Need Gum Treatment?

Book an Appointment With Dr Li Kexin Today!

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About the Author

“Positive experiences in the dental setting goes a long way. I aim to provide quality dental care tailored to every patient’s individual needs.”

Dr Li Kexin

Dental Surgeon, NoFrills Dental

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Top 10 Commonly Asked Questions About Gum Health

Top 10 Commonly Asked Questions About Gum Health

Why should we pay attention to our gums?

Gums and the structures underneath it are the foundation which hold on to teeth and keep the teeth stable inside our mouths. If gums are not properly cared for, it could give rise to many issues. For example, receding gums can expose the root of the tooth which would give rise to sensitivity. Advanced gum disease can cause teeth to become loose, which not only makes it difficult to eat, but also complicates other dental treatment that you may need.

 

My gums are bleeding, should I be worried?

Bleeding gums are a sign of gum disease, so when should you start paying attention? A one-off event shouldn’t be worrying, but if it happens more than once or twice a week, you might have gum disease.

What is gum disease?

Gum disease is when the gums are inflamed because of bacteria. Tooth-brushing removes plaque which harbours the bacteria that damages our gums. But if tooth-brushing is not done properly, the stagnant bacteria would aggravate the gums, causing it to become red, swollen, and more prone to bleeding. Advanced gum disease can also cause loss of bone support around your teeth, leading to loose teeth.

Gum disease is the leading cause of tooth loss in adults.

When should I suspect I have gum disease?

There are some simple signs which signals to gum disease

– Bleeding gums

– Swollen, red and sore gums

– Bad breath

– Loose teeth

– Receding gums

– Increase in spacing between teeth or teeth shifting away from their original position

I brush my teeth twice everyday, why do I still have gum disease?

Our mouth is a complex space and it is difficult to see where you’re brushing. If some spaces are commonly missed, stagnant bacteria will lead to gum disease in that area. Hence it is important to clean your teeth twice a day, thoroughly and efficiently. This will be further elaborated later on in this article. Even with the most efficient cleaning, calculus (the hard white coating on your teeth) can still develop, which makes cleaning under them virtually impossible. Therefore it is important to visit your dentist for regular check-ups and scaling to remove the calculus, and provide yourself with an easy-to-clean field inside your mouth.

How often should I see my dentist?

For people with healthy teeth and gums, visits to the dentist should be done twice a year for check-up and a scaling (routine cleaning). If you have active gum disease, your dentist may want to see you more frequently, as often as every 3 months, to check on your gums and clean your teeth.

Can gum disease be treated?

Yes and no. The success of gum disease treatment is dependent on two factors: 1. The severity of your gum disease, and 2. How well you are cleaning your teeth at home. Early gum disease, gingivitis, is easy to treat as no permanent damage has been done to the underlying tissues. It will resolve with a routine clean at the dentist, coupled with effective tooth brushing (oral hygiene) regimes at home.

In advanced gum disease, periodontitis, the damage done to underlying structures, such as bone, cannot be reversed. However, your dentist can still help by doing a deep clean underneath the gums to reduce the inflammation and improve the situation. This also requires careful maintenance at home with proper oral hygiene practices.

Is a deep clean painful?

A deep clean underneath the gums may sound scary, but it is actually almost the same as a routine clean. Your dentist will give you some local anaesthetic which numbs up the gums before the cleaning starts, and the entire treatment should be pain-free. You might have a little soreness in the treated area after the treatment, but it will resolve after a few days and you can take simple painkillers to help ease the sore sensation.

What can I do at home to help prevent gum disease?

Practicing a good cleaning regime can reduce your risk of gum disease to the minimum. For tooth-brushing, you should brush twice a day for 2 minutes each time. For optimum results, aim your toothbrush at where the gums meet the teeth, and brush with gentle, circular motions. You should plan your brushing in a systematic manner and ensure all surfaces that can be reached by the toothbrush are brushed. Flossing or using tepe brushes in between teeth is also an important part of the cleaning regime. Your toothbrush can only reach the outside, flat surfaces of teeth and is unable to reach in between teeth. This space tends to accumulate plaque and bacteria and if not cleaned out can lead to gum problems and decay. It is recommended to use floss or tepe brushes to clean in between teeth once a day.

If you have active gum disease, your dentist may prescribe you an antibacterial mouthwash to use at home, make sure to use this according to the instructions given by your dentist.

What else should I know about gum disease?

Smoking increases the risk of gum disease, and it also makes the gums less likely to bleed, which delays detection of gum disease at home. Hence it is worth considering quitting smoking or changing to electronic cigarettes if you have gum disease. Your gums may start to bleed more right after you quit, but your gums should reverse to the state of a non-smoker given sufficient time.

People with diabetes are also more susceptible to gum disease due to the increased risk of infections. In turn, severe gum disease can also negatively affect the blood sugar level. To minimise risk for both conditions, it is important for diabetic patients to keep their diabetes under control and also keep up a good oral hygiene regime.

Need Gum Treatment?

Book an Appointment With Dr Li Kexin Today!

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About the Author
“Positive experiences in the dental setting goes a long way. I aim to provide quality dental care tailored to every patient’s individual needs.”
Dr Li Kexin

Dental Surgeon, NoFrills Dental

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