Frequently Asked Questions of General Dental Questions

Dental procedures are usually short clinic visits. A few visits may be needed for some procedures. To suit your schedule, there are times that multiple short procedures are performed during the same visit to reduce the number of clinic visits. Our clinic always aims at performing predictable procedures in the most time efficient manner.

We have a simple motto in our office: ‘No one leaves our premises without teeth!’ All patients are provided with provisional or definitive replacement teeth before leaving our office. We would like you to go back to your normal daily routine as soon as possible.

Loose teeth may happen at any age even though it is more common in the later part of our life. Loose teeth may be a result of localized dental problems such as gum disease or dental infection. Loose teeth may also be a reflection of general medical problems such as diabetes or drug interaction.

Let us assess the reasons why the teeth are getting mobile. Recent scientific research showed that loose teeth are potential portals for bacteria to enter the blood stream, which may cause or worsen existing medical conditions such as heart conditions and diabetes. Just "hanging on" to loose teeth may not be good for your overall well-being.

The rules are very simple. Think of a tooth like a house. Similar to a house, as long as the foundation (or the root of a tooth) is sound, it can be saved. However, when the foundation (or the root of a tooth) is badly rotten, no amount of work can predictably save it. Saving a tooth with bad roots is usually futile.

Bad breath is a result of a few conditions.

• Do you brush your teeth and tongue at least twice a day?
• Do you have gum problems?
• Do you have decayed teeth?
• Do you have food stuck on your back teeth on a regular basis?
• Do you have impacted wisdom teeth?
• Do you wear your denture(s) at night?
• Do you drink sufficient amount of fluid regularly?
• Do you consume foods with garlic, spices, onion?
• Do you have diabetes?
• Do you have sinus problems?

If you have answered ‘yes’ to any of the question above, it is time to consult your dental professional.

In our clinic, dental cleaning is commonly performed using piezo-electric ultrasonic equipment. Ultrasonic equipment oscillates at over 60,000 cycles per seconds. This ultra-high frequency effectively removes calculus (tartar) deposits on the tooth surface.

At the fraction-of-a-second moment when the tooth surface is re-juvenated, the tooth reacts with a sensation. Basically, the more calculus deposit is on the tooth, the more the tooth reacts with such a sensation.

In general, teeth with no calculus deposits demonstrate little of such sensations. There are times that dental cleaning may be performed under local anesthesia to make it sensation free.

There are a few common causes of mouth ulcers. Ulcers caused by minor trauma (e.g. burn by hot food) usually occur on the roof of the mouth or the tip of the tongue.

Ulcers that are caused by virus (e.g. herpes virus) commonly occur on the lips and sometimes on the inner side of the lip. Before the onset of herpetic ulcers, the individual may experience flu-like symptoms, such as low energy level and a runny nose. The affected area may feel itchy during that time (itchiness is a form of minor pain sensation). The area will form vesicles and then it will become painful and form an ulcerated area. Approximately 90% of the population carries this virus, and most do not have any symptoms.

Some mouth ulcers are of unknown causes (e.g. apthous ulcer) - they can come in single, or multiple form, in small or big clusters. This form of ulcer happens commonly in younger females even though other age groups and genders are not immune to it.

The good news is that most of these oral ulcers heal by themselves without much medical intervention. Topical ointment can be purchased from most pharmacies without prescription to alleviate the pain. Most of these ointments work by forming a protective layer over the ulcer and/or having a local anaesthetic effect.

Oral ulcers that last more than 10 days may be a result of infected teeth, infected gums or even malignancy. If this happens, please see your dentist for a consultation.

If you live in a place where there is fluoride added in the tap water (such as Singapore, most European and North American Cities), you do not need any fluoride supplement. However, many South-East Asian countries do not have a standard practice of water fluoridation. If you are from those countries, you may consider having fluoride supplements. Please ask our friendly staff about this.

We adopt the ‘Universal protocol’ for sterilization. This essentially means that all our equipment is sterilized using the latest internationally accepted methods.

Our autoclave sterilizer is constantly maintained by qualified professionals specializing in the area. Our autoclave is replaced regularly.

All our sealed instruments carry an indicator tab to ensure proper sterilization procedures are carried out before they are used in our clinic. All our instruments and equipment are periodically upgraded and replaced with newer, better models.

More information about this ‘Universal sterilization protocol’ may be found using any major search engine on the internet.

In conventional medicine, doctors are trained to examine the tongue as part of the physical examination for patients. The doctor can detect certain abnormalities in the general functioning of the bodily systems from looking at the tongue. For example, cyanosis or a lack of oxygen in the blood can be detected by inspecting the colour of the tongue. In addition, looking at the coating on the surface of the tongue can also suggest the state of one's oral hygiene, nutrition, recent use of medications and general health status. Examining the tongue is also part of the examination of the mouth and oral cavity so that abnormalities such as tumours and infection can be detected.

The motion of sticking out one´s tongue and saying 'ah' would allow the doctor to have a chance to inspect the condition of the throat and the tonsils. The presence of swelling, plaque, change of colour, or dehydration also indicates diseases of various types. A quick inspection of the oral cavity may also reveal any dental condition that may cause systemic symptoms (e.g. fever due to a dental infection).

In addition, inspection of the tongue can give a quick overview of a person´s general health. Conditions such as diabetes may show up as dryness of the oral cavity and certain forms of bad breath (e.g. ketosis). Nasal sinus infections may also show up as bad breath. Deviation of the colour and contour of the tongue may also reveal certain dietary insufficiencies such as Vitamin B, iron, or folic acid.

Recently scientific evidence also showed that bacteria that stays in the oral cavity is related to other system conditions such as heart disease.

There are generally 2 types of commercially available mouth rinses - alcohol-based and specific chemical based. Different mouth rinses have slightly different functions but they are generally used to maintain oral health and hygiene.

Being fluid-based, mouth rinses would seldom burn the tongue too badly. However, it is not uncommon for some people, after using certain types of mouth rinses for a long period of time, to experience taste changes. This is usually a temporary phenomenon and the person will usually fully recover after discontinuing usage of the mouth rinse, since the mouth rinse only affects the superficial layer of the tongue/taste buds. The taste buds usually recover quickly and the nerve supply (taste sensation) of the taste buds is not affected by the mouth rinse in the long run.

Brushing your teeth after taking any type of food or drinks is a good practice. There is research both for and against brushing immediately after drinking carbonated drinks. The acidity in the mouth increases very quickly when any type of food is consumed and the acidity will begin to neutralize approximately 20 to 30 minutes after eating and drinking.

While prolonged exposure of teeth to carbonated sodas may be harmful to the teeth, some research studies suggest that certain types of toothpaste may actually help in the re-hardening of the enamel when used after drinking these sodas.

Due to the initial softening of the enamel, the key is to prevent the enamel from eroding further and the mineral contents being leached out of the tooth, leading to the formation of cavities. Most toothpastes contain ingredients that may neutralize the acids produced and re-harden the tooth enamel. Ultimately, moderation in consuming carbonated drinks is the best course of action.

Furthermore, there is no strong scientific evidence to support any particular waiting time after the consumption of carbonated drinks before brushing. On the other hand, studies have long shown that without rinsing, it takes close to 45 minutes for the pH in the mouth to return to normal after cessation of food intake. Therefore, it may not be a bad idea to rinse your mouth with plain water as soon as possible after drinking soda to limit its harmful effect.

Acid produced by bacteria from food and drink consumed has been proven to destroy the enamel and leading to the formation of cavities. Rinsing the mouth after eating is a good practice, since there will be dilution of both the sugar and acid produced, thereby reducing the amount and concentration of these cavity causing substances. However, scientific evidence has shown that rinsing alone is not the best option. This needs to be combined with proper brushing and flossing to enhance its effectiveness.

Scientific evidence points to the fact that ethanol-based mouthwashes are not as effective in controlling dental disease when compared with other treatment options. In cases where the use of a mouthwash is indicated, we have other non alcohol-based mouthwashes that are safe and work far more predictably than ethanol-based mouthwashes. Thus our clinic never recommends off-the-shelf ethanol-based mouthwashes to our patients for any therapeutic reason.

Teeth grinding, or bruxism, can occur consciously or subconsciously. We consciously grind our teeth when we are chewing or at times, when we are angry. This type of grinding is rather benign because our conscious self stops the grinding before any damage is done. One of our patients is a professional sportsman and he grinds his teeth hard during training or competition.

The other type of grinding is subconscious. Anaesthesiologist colleagues have mentioned that patients may gnash their teeth when they are entering and/or waking up from general anesthesia. The most common type of teeth grinding by far would be grinding at night during sleep. Some earlier research studies also indicate that newly placed ill-fitting dental fillings may also cause teeth grinding.

Regardless of the type of grinding, the concern is the magnitude of the grinding force.

Research has shown that the force exerted during night time teeth grinding could be a multiple of normal day time maximum bite force as there is minimal inhibition mechanisms in place to prevent grinding with excessive force during this time.

Grinding of teeth over a long period of time may lead to accelerated wear on the teeth, which in turn, causes reduction in the height of the lower face, speech problems, incapacity in chewing, loss of support to the lips and generally, an aged-looking face. It can also lead to jaw, oral and facial pain, and head and neck muscle pain, which is sometime referred to as craniomandibular disorders or temporomandibular joint (TMJ or jaw joint) disorders.

Many times, patient who come to our clinic because of jaw joint problems turn out to be teeth grinders at night.

The most common reason for dental disease is inadequate cleaning and maintenance. Poor dental hygiene results in excessive accumulation of dental plaque, which is full of bacteria. The by-products of the bacterial plaque trigger off destruction of gum tissue and dissolve tooth structures.

Loss of teeth, nowadays, can be predictably replaced by dental implants or dental bridges. However, it is not only a matter of 'dental' diseases. There is scientific evidence using DNA analysis showing that the same bacteria in the dental plaque can migrate to the heart and complicate heart conditions. Also, bacterial dental plaque is related to pre-term birth, low birth weight babies, pancreatic cancer, and other forms of cancers. The hypothesis is that the bacterial plaque sets off the immune system to misbehave and leads to some of the conditions described above.

Regular maintenance and check ups are extremely important. With modern dental imaging techniques, the location and severity of the gum disease could be identified accurately. Treatment such as laser surgery, ultrasonic deep cleaning, localized pharmacotherapy, and localized teeth foundation jaw bone reconstruction are commonly prescribed.

In cases when the teeth are missing, these missing teeth can be predictably replaced by dental implants. Dental implants are artificial dental root foundations which replace the lost tooth and allow life-like teeth to be made. Implant teeth look, function, and feel like your own teeth. The research at conducted by Specialist Dental Group (Henry Lee Dental Surgery) shows that dental implants are 95 to 99% successful regardless of the medical condition of the patient. In other words, out of 100 cases treated, we do not expect more than 5 to develop minor complications.

Traditional dental implant treatments require up to 9 months to complete. Currently, there are computer-based treatment protocols that allows the dental implant process to be completed within hours with no post-treatment pain or discomfort! The person can return to normal life immediately. This is because the use of computer imaging technology and CT scans allows the dentist to plan the implant surgery ahead of time, and utilize a minimally invasive procedure to reduce healing time.

Just like a lot of diseases, prevention is better than cure. The first step is to look at your schedule and block off two 1 hour time slots every year for your teeth and visit a dental clinic with professionals you trust to have a regular dental check up. Routine dental checkups are very economical. Setting aside two hours every year would give you an insurance of better teeth for a long time. This is a sound investment!