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Hi everyone! My name is Kuznetsova Marina Vladimirovna, I work as a dentist, with a specialty as a dental-therapist and a dental-orthopedist, and have my own Telegram channel @dentaljedi about my routine dentist life. At work, I often hear many questions from patients and most of them are similar: How do I choose toothpaste correctly? How do I get a bright white smile? How do I fight cavities once and forever?

Especially for Bright Side, I’ll try to give detailed answers to the most common questions and bust popular myths about tooth care. This article doesn’t replace a consultation with a specialist and is not scientifiс — it is of a fact-finding nature.

1. How to fight a fear of dentists?

© dentaljedi / telegram  

“Nice to meet you, I am your dentist Marina.”

Almost everyone is afraid of dentists and that’s the norm because they break your personal space during treatment and all of their actions take place right in your mouth. There are several useful tips for this scenario: The main thing — don’t wait until sharp pain appears! If you have gotten to the point that you have a sharp pain in a tooth, or have had it for an extended time, the anesthesia often won’t work as well. This will likely make you feel nervous and the treatment will take longer. Don’t take strong sedatives, or have coffee or energy drinks before visiting a dentist. They can interact with the anesthetic (and either intensify or inhibit its effect). Try to calm yourself down without the help of any drugs. If you still feel too nervous, try drinking herbal tea before visiting the dentist. This might seem insignificant but it really helps some patients to calm down. And don’t even think of drinking alcohol — it could interfere with the anesthesia, or worse, you could end up having complications. Also, remember to inform your doctor about any medicines that you are currently taking. If you have the opportunity, it’s better to first get acquainted with a dentist, have a consultation, and make a treatment plan together. Next time, you will feel more comfortable and will be less scared. Your treatment plan should go from simple to complex. It’s recommended to start with a cleaning, then treat small cavities, and only after that treat channels and remove teeth or nerves (which is why it’s better to not wait for sharp pain). You’ll have time to get used to the doctor and the environment in the clinic and will gradually be able to overcome more serious interventions. Try to plan a visit to the dentist in the morning. It will help you stay calm because you won’t have much time to worry. Additionally, our ability to feel pain is said to increase in the evening. Try to take time off at work on this day, if possible.

2. Why do cavities appear and how to prevent them?

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Briefly speaking, the mechanism of how a cavity appears goes like this: first, an acid medium is formed (the reasons for it can be the bacteria in plaque producing acids or food with an acidic pH). The acidic environment promotes the washing away of minerals from the tooth’s enamel and the damage to its structure. Gradually a void or a cavity is formed in the enamel, it then starts to become deeper, and the enamel decays little by little. Here is how you can fight it: Conscientiously take care of your teeth and remineralize the enamel. It’s possible to saturate the enamel with minerals with the help of special tools at home too. The most popular ones are — R.O.C.S. Minerals and Tooth Mousse. Don’t let your teeth stay in an acidic environment for a long time. Remember to rinse your mouth with mouthwash or foam after eating candy or drinking a glass of soda. If these items are not available at the moment, drink some water. Don’t drink soda, juice, or other similar drinks before going to sleep or after you have brushed your teeth. Saliva is practically not produced at night, which means that the process of demineralization of enamel will take place in your mouth for about 8 hours. You can only drink water at night before going to sleep and after brushing your teeth.

3. How to take care of teeth properly?

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Brush your teeth with a toothbrush of medium hardness 2 times a day and no less than 3 minutes each time. Soft toothbrushes are good for people with sensitive teeth. It’s important to clean every tooth from all sides with sweeping movements from the top down. The main mistake that almost all people make is brushing with movements from right to left. With this technique, the plaque and bacteria are only pushed deeper under the gum and into the dental spaces. If you are wearing braces, crowns, or implants, it’s recommended to use an irrigator or special small brushes for a more thorough cleaning. It’s necessary to visit a dentist for a check-up once every 6 months and have them conduct a professional cleaning. Even if you brush teeth correctly, there are hard-to-reach places that only a professional can clean. Also, a dentist can spot small issues at the beginning stage and remove them quickly (for example, treat the surface cavities). Remember to change your toothbrush every 2-3 months. Also, replace your old toothbrush with a new one after getting a professional cleaning at the dentist because there are various kinds of microorganisms in your mouth that have now disappeared. Additionally, it’s necessary to change your toothbrush after having a cold or bronchitis. Regarding electric toothbrushes — they can be the perfect motivation for a person to brush their teeth more regularly but an ordinary toothbrush is good at fulfilling its task too; with the only exception being that you’ll have to work a little harder.

4. How to choose a toothpaste?

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The main thing with brushing teeth is that you need to use the correct technique. If you only brush your teeth for 30 seconds, then even the most expensive toothpaste won’t help you. If you don’t have any issues with your teeth like hypersensitivity, bleeding gums, and so on, then you can use any toothpaste except for an abrasive kind. If there is a particular issue you are facing, it’s better to consult a specialist and choose the right toothpaste that will help you solve the issue. When selecting a toothpaste that matches your teeth by yourself, you risk wasting your money. Also, pay attention to the concentration of fluoride in the sources of water supply in your region: the optimal indicator is 0.7-1.2 mg / l. If these numbers are smaller in the region of your residence, then it’s worth using a toothpaste with fluoride. Fluoride is the only substance that can really prevent the appearance of cavities, which has been confirmed by many years of research. At the same time, there are many articles that talk about the dangers of this element. Fluoride can be poisonous but everything depends on its concentration, just like other drugs. Up until now, there hasn’t been a single study confirming the harm of fluoride when using fluoride-containing drugs for preventive purposes.

5. How to make teeth whiter?

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There is a term called RDA — relative dentin abrasivity. It varies from 0 to 220. If the toothpaste is ’whitening,’ it’s likely that its RDA is above 70, which means that there are many abrasive particles in the composition of the paste. It’s like a surface treatment with sandpaper for teeth. That’s why there is a precaution saying that ’this paste shouldn’t be used daily.’ If you don’t have sensitive teeth and if there are no other issues, then you can periodically use a toothpaste with a higher RDA, especially if you love to drink tea or coffee. For sensitive teeth, it’s better to choose a paste with the lowest RDA (about 20-40). Keep in mind that teeth whitening happens due to the removal of plaque from tea, coffee, and tobacco. Using a whitening toothpaste on a regular basis gives you your natural teeth color, which is usually a little bit yellowish. Whitening teeth by several shades is only possible at a dentist. Remember that you should choose the desired shade carefully because an unnaturally white smile doesn’t look beautiful and contrasts too much with the shade of the white part of your eyes.

6. What are fissures all about and why do we need to pressurize them?

Fissures are natural grooves on the chewing surface of the molars, your chewing teeth. Their shape is perfect for getting food particles stuck and for the reproduction of cariogenic bacteria. This is why these areas are usually where cavities start to form. For preventing cavity development in this area, fissure pressurizing is often used in dentistry. This procedure includes cleaning them (if necessary), opening them up, and priming them with a special sealant. As a result, bacteria in this area doesn’t get stuck and doesn’t reproduce. The pressurizing of fissures can be carried out at any age to both children and adults. In some countries, this procedure is included as a part of the routine dental visit.

7. Are veneers safe?

Before and after installing veneers.

Veneers are ceramic plates that replace the outer layer of a tooth (within the enamel) and that help correct its shape and color. Veneers can be compared with false nails to some extent — a thin transparent plate is glued over a tooth and changes its color and shape. If you are visiting a good dentist, then the layer of the enamel removed for installing a veneer won’t exceed 0.5-0.7 mm, which is insignificant and won’t affect the teeth negatively. Veneers can help you: if you have big gaps between teeth; if the color of your teeth is not homogenous and is not easily whitened; if you don’t like the shape of your teeth (for example, you want to have more square-like angles but you have round ones and vice versa). Veneers can break off if the pressure is too strong. That’s why bruxism (the habitual grinding of the teeth, typically during sleep or stress) is a contraindication for their installation. Additionally, it’s better to not install veneers if at least one chewing tooth is missing (excluding the wisdom teeth). The thing is that veneers can’t resist strong pressure and in the absence of a fixed occlusion height, all the pressure goes to the front teeth. The fixed occlusion height is possible when all groups of teeth in the mouth cavity are present. That’s why before installing veneers it’s important to deal with chewing teeth, restore chewing function, and only then engage in aesthetics.

8. What can the lengthy absence of a tooth cause?

If one of your teeth has been removed, I highly recommend not postponing prosthetics. Some patients prefer to not treat a tooth in order to save money, but remove it because ’it won’t be visible anyway, and I won’t install a new artificial tooth because it’s too expensive.’ Doing this can lead to unwanted and unexpected consequences. With time, neighboring teeth move and there will be no space left for a crown or for an implant. One of the neighboring top teeth also replaces the void and moves over. When this happens, a patient will need an expensive orthodontic treatment, the top tooth will also have to be removed, and both removed teeth will need to be prosthetized which will make the cost of the treatment increase by several times. There is another interesting moment connected with the making of a prosthetic appliance. Websites of cosmetologists and plastic surgeons sometimes show examples of work that reduces nasolabial folds and raises the corners of the lips. Very often the appearance of these wrinkles is connected not only with aging but with a decrease in the lower third of the face due to the lack of one or more chewing teeth. Have you ever noticed that the lips of elderly people look as if they are folded inward and make their facial expression gloomy? Usually this is connected with a full or partial absence of teeth. That’s why it’s better to restore your teeth first before visiting a cosmetologist. The absence of even 2 or 3 teeth can drastically change the general appearance of your face.

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If you are facing any problems connected with teeth, don’t use self-treatment. Instead, visit a dentist. It won’t take much time but will help to save you from health problems and expensive procedures in the future. And remember that the reason for most problems in toothcare is a bad hygiene!

Do you have any other questions for the dentist? Please write them in the comments and we will include them in the second part of this article!

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