Dr Mouthcare Q&A advice

Subjects covered in these FAQs

click on the subject of your choice to find Dr Mouthcare's response.

Fuller answers are also covered in Dr Mouthcare's information service.

Baking Soda

I see that there has been a lot of information about on the wonders of baking soda toothpaste. A number of companies are producing tooth pastes that contain baking soda, and I wonder if anyone knows if these tooth pastes are any good, or if this is only media hype?

Baking Soda is well known as a cleaning, polishing and deodorising product. It's great for all sorts of cleaning purposes and it has been used around the house for this purpose for many years. Some years ago it became popular to use it in various mixtures for whitening and cleaning teeth, and helping gum conditions. A number of toothpaste manufacturers have now made up tooth pastes using baking soda and other ingredients. Yes, it should be good, but you can make up your own mixture that is more effective, and a fraction of the cost. A mixture of this type is described in the subscriber section under the heading "How to take extra care of my teeth " Why not purchase a copy now?

Talking during treatment

My dentist seems to take pleasure in filling my mouth with his instruments, and his hands as well, and then asking me a question! I mean, is this some kind of a dental joke! I have enough trouble keeping my mouth open and putting up with his treatment without having to attempt to talk at the same time. Surely he knows that it is impossible to do that. It really annoys me!

Getting patients to try and talk during treatment, while there are all sorts of instruments in their mouths is an old trick that some dentists use to try and distract your mind while you are having treatment done. In other words, it helps to take your mind off things and gives you something else to concentrate on.

Tooth pastes and babies teething questions!

What kind of toothpaste do dentists recommend. I have been using a salt toothpaste for some years and really like it, but is it good for my mouth?
Our baby is teething now. Is there anything we can do to make life easier for him?
Generally dentists do not recommend tooth pastes specifically. There are many different types for very different needs. The salt toothpaste that you are using is probably fine for you. People who collect lots of plaque, tartar, or want fresh breath, may find a toothpaste specifically for their needs. However, what is important is not the toothpaste that you use, but how carefully you clean your teeth. The mechanical brushing action and the use of inter dental cleaning aids to physically clean the teeth is more important than the type of toothpaste that you use. There is a leaflet on this site where you can get detailed advice on how to keep your mouth clean, and extra clean. Why not buy a the leaflet and have access to the details!

Teething problems are very distressing to babies (and parents as well!!). The best thing you can do is to get a teething gel (Which is topical anaesthetic) to rub onto the gums to numb them and make the baby more comfortable. If the problem gets worse, it may be necessary to contact your dentist or doctor to get some medication to help the baby. A leaflet on mums and babies is being planned for later in the year, so do keep in touch, and you can purchase it when you see the leaflet.

Increasing frequency of filling replacement with age?

I am 38 years old and have several fillings (most of which are deep). In the past, I have had the fillings replaced periodically as more decay developed and some were apparently just getting old and soft. But in the past two to three years, I have been going to a dentist (whom I trust as far as his character goes) and have spent close to $1000 on replacing these fillings. Every time I go for my semi-annual check-up, he finds at least 2-4 fillings that seem to need to be replaced. Is it just coincidence that they are all falling apart in a narrow time span? I do not know if any of the teeth he is filling now are teeth in which he has done the previous dental work; I did not keep records. But if they are they can't be more than 3 or 4 years old, and I only have 14 teeth with fillings in them. Is it possible that what he uses to fill my teeth (silver fillings) is poor quality, or is his technique poor? I do know that he has worked on one tooth on my 21-year old daughter 3 or 4 times in the past 2 years, and has said it needs to be replaced again... he admitted that it wasn't staying in the last time, but I'm not sure if he's taking the responsibility for this next replacement or not. I do take good care of my teeth, so neglect is not the problem. What other possibilities are there for these constant filling replacements? Could it have something to do with my age?

If you are looking after your teeth and gums properly (see our leaflets on this subject), you should not have to have your fillings replaced for years on end. Every now and again a tooth or filling may break because there is something hard in your food, or for possibly other reasons. With this exception, your fillings should last for years. If you are having so many fillings replaced, I would see at least 2 other dentists for 2nd (and 3rd) opinions, and then make up my own mind. At your age you should also be having very thorough scaling, especially if your gums bleed at all, because after about 20, tooth decay reduces and gum disease is by far the biggest problem (See our leaflet on bleeding gums if this is appropriate to you). Oh, one thing that does cause softening of the teeth is fizzy drinks. If you drink a lot of these, even if they are the diet variety, they do a lot of damage, so cut down on them, or even cut them out.

Should I get my teeth straightened?

I am embarrassed by my teeth which have never been straight. My dentist says they are strong and best left as they are. Am I risking my teeth if I get them straightened?

If it is important to you, get them straightened!!! Some dentists seem to believe that how you feel about your teeth doesn't matter, all that matters is that they are healthy. If that is what your dentist feels, that's OK, but it doesn't help you. Either insist that you get a referral to an orthodontist for an opinion on your teeth, or find another dentist who is prepared to help you with this problem

Chronic bad breath

Constant dry mouth, sticky feeling on the tongue, chronic bad taste & breath even five minutes after brushing & scraping, what are these a symptom of? Is there an effective cure, and what type of Doctor specialises in this problem?

This is a complex subject and the causes of it are closely related to burning mouth syndrome (see our leaflet on this subject). As many things can cause this, if you place the question in the "ask the Doctor" section, you will receive a detailed reply, telling you why you have this problem. The best type of dentist to see about this problem is a Periodontist, because, although they specialise in gum problems, these are often related to other conditions in the mouth so they will often be able to treat the problem, or advise you as to what to do if they can't.

Dental sensitivity: Nerves in certain teeth give pain when eating certain foods

I'm 27 years old and have a good set of ivory teeth, I have no fillings and I have never had any problems with my teeth before, but recently I have been experiencing nerve pain when eating (mostly chocolate or compact foods), my dentist said that I have no decay in my teeth but yet I am frequently in pain when eating .... could you tell me what my problem is? Thank you.

I don't know what is wrong with your teeth, and I cannot tell you what is wrong with them unless I am able to see you. This is not possible, so I can only give you some guidelines. Sensitive teeth are usually caused by tooth decay, but if your dentist says you don't have this, this is probably not the cause (Some people might seek a second opinion just to make sure, but this is your decision.) Other causes include gum recession, that leads to exposure of the roots of the teeth and makes them sensitive. If you can identify which spot is sensitive, you may rub on some desensitising toothpaste before going to bed, after brushing your teeth with the same toothpaste. These tooth pastes are freely available at your local chemist or drugstore. Sometimes people brush their teeth too aggressively, and this leads to trauma, which causes sensitivity. If you want more information on how to look after your teeth, you can get this information by purchasing our leaflet on the subject.

Coatings on the tongue: tongue health

I have a strange white coating on my tongue. most of it comes off when I brush my tongue during my regular brushes, but I can only get the brush so far back before my gag reflex kicks in. It's a little uncomfortable, as it feels as though there is something on my tongue. Some of the places where I brushed it off are a bit sore as well. Could this be a problem? an infection? a normal occurrence? thanks.

It is difficult for me to tell you what is wrong with your tongue, without examining you, as all sorts of things can cause this coating. In the vast majority of cases, this is a normal occurrence, and you cannot brush it off without hurting yourself. The whiteness is from filiform papillae which contain your taste buds. It has become popular to brush the tongue to remove any trapped food debris or bacteria that may have lodged in these papillae, and that's fine, but don't try and brush them off. It is not necessary. If you can't get far enough back, you can try using a baby toothbrush, and in some places you can actually get a tongue scraper that may help. Use it carefully though! All sorts of things do cause white coverings, and it is always a good idea to see your dentist to make sure that there is nothing abnormal there.

Bleeding Gums, bleeding mouth?

Every morning when I wake up, I find that my mouth has blood in it. I have never seen any during the day though? I just am not sure where it comes from

If you purchase the leaflet on gum problems, you will find that you have access to information on bleeding gums, what causes them to bleed, and how this can lead to tooth loss if not treated. You will also find a great deal of information on how to treat this condition yourself, How to look after your teeth and prevent the condition from returning, and how to keep your mouth extra clean. You can get most of your answers from the leaflets. WARNING: If you purchase the relevant leaflets, and you follow the instructions that you receive in them on cleaning your teeth and how to keep your mouth extra clean, and the condition does not improve, you must see a dentist for advice and possibly some treatment.

Receding gums: gum line

Lately, I've been looking at my gums and it looks like there is less gum covering my teeth than there should be. They are pink and healthy, and they have never bleed, but they just seem as though they should be covering more. Are these signs of a receding gum line and what should I do if it is?

If your gums do not bleed, it may not mean that they are healthy. One of the problems with periodontal diseases is that often people have gums that look superficially healthy, but plaque bacteria have gotten in underneath the margins and are eroding them away from under the foundations. The best thing that you can do is to ask your dentist to check to see that you don't have any pockets of infection under your gums and to advise you if you need to have any treatment done. If you are not happy with his examination or recommendations, ask him to refer you to a periodontist who is a dentist that specialises in fixing gum problems.

Do it Yourself Dentistry

I am an engineer and have not had the time to take care of my teeth. Scared shitless of a Dentist, but I am looking for a home remedy for a chipped tooth, ceramics, or porcelain touch-ups with epoxy to get me through my fear. Any ideas, would help.

No, I'm afraid that you will have to see a dentist to have your teeth sorted out. If you are scared, that is often not a problem, because some practices actually specialise in helping terrified patients. So if you find the right dentist, you really have nothing to fear. More specifically, there is not a suitable glue that you can use to repair your own teeth. You suggested Epoxy. Epoxy is no good in a wet environment, and any moisture during curing wrecks it before you even start. Other problems include problems with thermal contraction/expansion with temperature changes, and chemical destruction due to rapid cycling of pH changes during function. Also, abrasion and compressive strength are inadequate for use in the mouth. There are very good reasons why dentists have to use precious metals like Gold, and cast ceramics in the mouth. Other materials simply will not take the strain.

Black gums

There are many individuals that I have seen with black gums... Spanish, Indian and blacks etc... is this normal I'm Spanish and have pink gums.. I Have cousins with black gums this doesn't seem normal please explain. I'm only 15 yrs old and concerned.

First and most important, your message says that you are concerned about this. Please don't be, because it is absolutely normal. The dark colour, or black patches that some people have on their gums is due to the deposition of melanin in the tissues. This is the same pigment that causes people to have a dark skin, or freckles. Because the lining of the mouth is pink, these areas of melanin deposition appear to be dark blue or black instead of brown as they are in the skin. Different people have different amount of this deposition so they have different amounts of darkening of their gums. Anglo-Saxon people originating from the north of Europe have virtually no pigment in their gums, so their gums are pale pink. From there, you can get all of the different shades up to dark black patches.

Worried about symptoms

I went to dentist for first time in six and a half years in Feb 1998. The dentist told me I needed a couple scale and polishes and one filling. She also said because I had not seen a dentist for such a long time that my gums were in poor conditions and that she was more concerned with getting my gums healthy then the filling since it was only a very small filling. It took me until November 1998 to get the filling done because I am so phobic about the dentist. I had the filling done in November 1998 with the help of gas and air. I also had my first scale and polish on 17 Dec 98 and was due to have the second one on Feb 18 1999. In the middle of January 99 I started getting a bit of discomfort while brushing my teeth down the left hand side of my mouth. The discomfort was coming from the lower teeth. I went to the doctors who prescribed me flagyl antibiotics 200mg but suggested I go and see my dentist. I saw my dentist on 19 Jan 1999. She examined my mouth with the mirror and said everything looked fine. In her opinion it was not a gum infection but could have been an ulcer. I had the second scale and polish done on that visit and the dentist said she wanted to see me in four months time so an appointment was made for 24 May at 2pm. I later realised we are on holiday then so my appointment is now 5 July at 2pm. A few days after I had the second scale and polish it became a bit sensitive while brushing near the front teeth on the bottom set of teeth. It was just one tooth and it was the gum area which was sensitive not the tooth. The dental clinic phoned on 28 Jan 99 to rearrange my wife's appointment has the dentist was on annual leave. A new appointment was made for my wife on March 4. On Feb 9 I phoned the dentist again has I was still getting a bit of discomfort. So she agreed to see me after my wife's appointment. We have since had to cancel the March 4 appointments as my wife is ill and she will not be well enough to attend. The discomfort I was getting when brushing that tooth at the front of my mouth has now stopped but I have now started to worry that my teeth are becoming loose as when I rub my finger down the side of the tooth onto the enamel there's like a squeaky sound and the tooth seems to move slightly. I am not in any pain. Do you think I am just panicking? I don't want to keep ringing the dental clinic so far they have been excellent. I just need some good advice.

It is very difficult to tell whether or not you should be panicking about the symptoms that you describe. If you have a gum condition and you have had the sort of extensive deep scaling that you have described, the symptoms that you are describing sound pretty normal to me. The loose sensation sometimes is part of the healing process, and sometimes it indicates that the condition is ongoing. I can't say which it is without a full examination. If you are worried do discuss this with your dentist, or if you are still not happy, why not ask to be referred to the periodontal department of a local dental school, and let them have a look for you. If you want any further information from me, you'll have to pay to "ask the Doctor" and I'll arrange for one of our team to give you lots of information on diagnosing and assessing gum problems yourself.

Toothcare

I'm doing a project on teeth care. Can you tell me any thing?

This is a huge subject, so I can't give you any information really. There is a leaflet on this subject in the subscription section, but you have to pay for it. You will find lots of information in your local library, or if you go to some local dentists you may be able to get some free leaflets from them produced by the toothpaste and toothbrush manufacturers. Not only do they have lots of good information, but they often also have good pictures that you may be able to use in your project.

Sensitive teeth

Recently I have noticed that one of my teeth has become more sensitive to cold than the others. Also, if I press my fingernail against the tooth at the gum line I get a pain definitely caused by nerve irritation. The tooth doesn't ache, but the temperature sensitivity has increased. Is the nerve dying or is the gum line, for some reason, too low so that the nerve is affected by the cold or by touch?

There are many reasons why teeth become sensitive. Obviously it is impossible to make a diagnosis over the net, but it seems likely that your diagnosis is correct. The symptoms that you are getting are not from the nerve dying, but because the gum line is receding. This is an annoying problem, that is likely to get worse with time. There are many causes of gum recession, but one of the most common is that you are brushing your teeth traumatically with a horizontal scrub technique. This often exposes the root of the tooth as you have described it. If you want advice on the correct way of brushing your teeth, you will find a leaflet on this subject on this site. If you use the technique described there, you will lessen the trauma, and prevent it getting any worse. Also, a visit to your dentist or hygienist will be helpful to show you how to brush your teeth properly, and also to treat the sensitivity.

Food for your teeth

What foods do you recommend eating to prevent tooth decay?

Yes, we all know what not to eat, because we've been told over and over again------ no sugar, or sugar containing sweets, biscuits, candies, cakes etc., but what can we do to help our teeth along? The problem is that once our teeth are formed, there is little that we can do to alter them. We can use fluoride toothpaste to strengthen the enamel, but that's about it. Or is it...... Well, two things are important here. First, it is important to realise that the frequency of intake is most important. When you eat, you should try to keep it to fixed periods like meal times. People who nibble at food and snack all day feed the bacteria all day, so they develop a more severe problem of plaque management than those who don't nibble all day. Therefore avoid snacking!!! Also, it has been shown that some cheeses like cheddar have anti-plaque substances in them. If you finish a meal with a little cheese, or substitute sugar containing snacks for cheese, this helps to kill off plaque. Give it a try and see for yourself if it works.

Braces

I have got a brace and I feel very conscious about it and I would just like to know does anyone else feel like this.

Braces are a pain!!!! They are uncomfortable, and embarrassing, but it is one of those things that we have to put up with in life. I know many people who have braces fitted and have been so embarrassed that they start to walk around with their hands over their mouths to cover their teeth when they talk. Please try not to worry about it too much.... you are definitely not alone, most people feel embarrassed about it, but just think of how good you're going to look after it's finished!

Why your teeth may be aching

I see the dentist regularly, but recently my two front bottom teeth are aching and they are starting to get discoloured (very light) lines in them. Can you tell me what it might be, and should I go see a dentist now. Thank You!

Without seeing you, it is impossible to say what the problem might be, but if there are little vertical cracks appearing, it may me that your teeth are meeting unevenly in the front of your mouth. This causes the enamel to crack, and these cracks can take up stain from the food that you eat. If this is the case, the question is why are your teeth cracking? One of the most common causes may be that you clench or grind your teeth. When you do this, tremendous force and stresses are placed on the teeth, and this causes pain, tenderness, cracking, and even breakages. I don't know if this is your problem, as I can't examine your mouth, but your dentist can. Why not give him a call, and see what he says?

White gums

Can someone please help me with my problems, for the past few weeks I have just discovered that the gums just beneath my teeth has become white. Does anyone know what that is and if there is any way I could get rid of it. Please someone give me any advice you know I want to get rid of it as soon as possible.

It really is impossible to say on this one. White patches can be caused by so many things that without seeing you and assessing the situation, it really is impossible to say. Only a full examination by your dentist can really solve this problem for you

Black teeth

I see questions about black gums and margins, but what about black teeth. One of my back teeth turned black & my dentist said not to worry. Now it is turning even darker & the tooth beside it is turning dark too. The original tooth has an old gold half crown on it and the other an old filling. What causes this & should I be concerned?

Teeth darken for a number of reasons, but the most common are due to decay, or old fillings that need to be replaced. As you have been to the dentist, and you have been told that you should not worry about it, it is probably not from either of these causes. The other common cause of teeth darkening is that the nerve of the tooth dies. This causes the tooth to go grey, or brown/black. This does in fact get worse with time. Usually you would have root canal treatment to get rid of the infection in your tooth, but the darkness remains. Yes, your dentist is right that if this is the cause, it is harmless, and you needn't worry about it. If you are embarrassed by it, you can have some white filling material glued over the visible surface, or you can have a porcelain veneer made to mask it so that it looks OK in public. Ask your dentist for advice if you want to have this done

Growing teeth!! Lower front tooth that seems to keep growing

I have a lot of crowding in my lower front tooth area, after having braces that gave me a beautiful set of teeth 30 years ago! Now, I have excessive gum recession, and one of the lower front teeth is getting pushed back, and is getting longer and longer. X-rays show that the roots of this tooth are just as long as the roots of adjacent teeth. I will need to have gum grafts before the orthodontist attempts to move these teeth again-- but I am wondering if it might be best just to have that one tooth extracted, since it will need a lot of filing once it is straight to bring it to the level of the other teeth. Also, I am 42 years old, and the periodontist suggested that I begin oestrogen therapy, in order to enhance the gum tissue (he indicated that my gums are basically thin membranes stretched over bone, with no cushion). Could it be that I have had lower than normal levels of oestrogen all of my life? My gum problems began in my late 20's. I would like to save my teeth!

This requires a detailed reply as all sorts of factors are present in these sorts of problems. Essentially, there are many reasons why teeth move, and start to get crowded. All sorts of treatments are possible, most of them unnecessary! If you want detailed information on this subject, you will have to ask the question in the fee paying section of this site under the "Ask the Doctor" section. You will need to give details of what treatment you have had for orthodontic straightening of your teeth, previous periodontal treatment, and any other information that you think may be relevant. If you can scan a colour picture of your teeth and gums into the computer and send that over, that would be helpful. You may find that you don't get an answer immediately, but the Doctor has a few more questions that he would like to put to you first before you get e detailed reply to this question.

Enlarged Gums

I have big gums and am embarrassed to smile. I heard somewhere that there is a procedure done where they actually shave off part of your gums. Is this true? If so, is it safe and how much would it cost to get done?

There are lots of reasons why people have large gums. All sorts of medications, Orthodontic problems, and inherited large gums, with small teeth. Without actually seeing you, its impossible to tell what the best solution to your problem actually is. You can get detailed information, if you "Ask the Doctor" in the paid section, and one of our team will contact you for more details, and give you some more specific information and advice on how to get you problem sorted out. Without further information, I can't be more helpful I'm afraid. The procedure that you may be after is called a "crown lengthening procedure", but please bear in mind that this might not actually be appropriate for you, so do contact the paid section of this site as suggested above, or seek advice from your dentist.

Crowning teeth

I have been told I need my front incisors to be removed an replaced with crowns. When the teeth are removed, will I get the crowns the same day, or is there likely to be a delay in having the crowns made? or do they make the crowns before the remove the teeth? Please explain the process. Thanks.

If you really want details on the procedures and what is involved in doing crowns, you will have to submit you question to the "Ask the Doctor" section, as this is quite a long story. Your teeth are not removed when you have crowns, but shaved down and the impressions are taken to make models of your teeth in a dental laboratory. The crowns are fitted about 2 weeks later, but your dentist will make temporary crowns for you to use while the permanent ones are being made.

Wart on Gums: lump on gums

My 7 year old son has a strange lump on the lower right side of his gums. It looks like a large wart. He says it doesn't hurt, but it looks very strange. Any idea on what it may be???

Your son is only 7 years old. The most likely cause of this swelling is a permanent tooth erupting underneath his baby tooth, forming a swelling that can sometimes look quite alarming. There are other things that can cause this sort of problem, and it is impossible to diagnose what it actually is. If you are concerned, do see a dentist who will be able to make a full diagnosis for you. If you could photograph it, and send the photograph, with the appropriate fee to the "ask the Doctor " section, we may be able to help you a bit more.

Killer Drinks

What drinks are killing our teeth? What drinks are safe on our teeth?

This is a very good question. Dentists have always told their patients that they must avoid sugar and sugar containing products. This is correct, but it isn't the whole story. Drinks that contain sugar are obviously going to damage the teeth, but most fizzy drinks (i.e. sodas) use Carbon Dioxide to make them fizzy. This forms carbonic acid in the drink. As a result, most fizzy drinks are quite acidic. The acid combines with the calcium in the teeth and causes them to erode. So even if you are drinking a sugar free drink, the acid from the gas still causes damage. Interestingly, most fruit drinks and juices are acidic as well, so they can have the same effect. What to do, is also an interesting question. Firstly do not sip the drink slowly, swilling it around your mouth to give the acid time to work. Drink it and let it go straight down. Also, if you are thirsty drink plain (not fizzy) water more often to reduce your exposure to acid. Oh and one other thing, Do not brush your teeth immediately after exposing them to acidic substances, because if you do, you brush away all the calcium that is remaining on the surface, hastening the erosion process. Have a washout with plain water, or have something alkaline (like a little cheese) to counteract the acid, before brushing your teeth.

Mouth ulcers

I have got a mouth ulcer, and I have these following problems:

teeth sensitive
tooth sore inside lip where ulcer is

There are many things that cause ulcers, dental sensitivity, and loosening of the teeth separately, let alone all together. Its therefore impossible to advise you as to what your problems may be caused by. Our advice is to see a dentist and get a full diagnosis. If you can get someone to take a few photographs of your mouth, and you can send them to the "Ask the Doctor" section with the appropriate fee, maybe we can help a bit more.

Chewing Gum: Is chewing gum after meals a good idea?

I have always been told that if you chew gum after every meal that it will keep your teeth healthy is this true?

Yes, it's great to chew gum after meals or snacks. It has been shown that chewing gum increases the flow of saliva. This flushes out the food debris and helps to counteract the effects of sugar and other carbohydrates on the teeth. It also brings high levels of natural antibodies to the tissues of the mouth so it helps to fight off plaque. Chewing gum also "exercises" the gums and this helps to keep them healthy. Yes chew gum, but please, please, please make sure it's SUGAR FREE!!!

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