Interview with Dr. Aneesha Acharya - Dentist
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Tooth erosion or Dental erosion is the loss of tooth structure, which happens because of an acidic environment in the mouth. While dental cavities occur because of acids made by bacteria in plaque build ups on our teeth, dental erosion happens because of acids contained in our food, beverages or because of medical problems like gastric reflux or anorexia. Dental erosion is more common in people who consume acidic beverages frequently, the most obvious culprits being colas or carbonated drinks and fruit juices, which often have pH, lower than 5, and cause a slow wear of the protective enamel coat on teeth. Signs of erosion include changes in the appearance of teeth due to the loss of enamel, the edges of teeth can look worn, teeth may look yellowish and in areas where enamel is very thin or totally lost, the sensitive dentin will be exposed causing teeth to be sensitive. Erosion is very common in school going children due changing dietary habits. It needs to be managed by detecting and treating the underlying cause, whether dietary or medical, so that further loss of tooth structure can be prevented. Hypersensitive teeth because of erosion can be treated by a number of in–office and home–care measures, which would depend on its severity.
What is a Trench Mouth?
Trench mouth, now known in medical terms as ‘nectrotizing ulcerative gingivitis’, is an acute gum disease. Its symptoms are of a sudden onset and include very painful and sore gums, which makes eating difficult, especially hot or spicy food. The gums can be so sore that they may bleed very easily on just touching, and often a metal like taste and offensive odor can be present. If more severe, it may be accompanied by fever. Often, this condition is preceded by a bout of illness, or triggered by severe stress. While this is an infection caused by bacteria, there is no one known causative factor for this condition, rather, a combination of factors are involved, like, smoking, stress, poor nutrition, illness, poor dental hygiene and a weak immune system such as in HIV affected people. Most people respond very well to treatment. The treatment involves local swabbing, oxygenating and anti–microbial mouthwashes and antibiotics, and with treatment usually the acute symptoms subside in a few days. Later, an ultrasonic cleaning and investigation or management of other risk factors would be required.
What is an Endodontist?
An ‘endodontist’ is a dentist who specializes in the area of endodontics (‘endo’ means within, ‘dont’ means tooth) which basically involves treatment of problems like root canal infections. Endodontists are trained to perform root canal treatment, restorations like composite–fillings, inlays and onlays, laminates and veneers. They are also involved in multi–disciplinary treatment of ‘smile designing’ and treatment of infections or cysts around the roots of infected teeth that need ‘periapical surgery’.
What are Veneers?
Veneers, also known as laminates are dental restorations that are like thin shells covering the front aspect of teeth. Unlike that for caps or crowns, veneers don’t require the entire tooth to be ‘cut’ or ‘prepared’ to reduce its size. Veneers are indicated for front teeth that have some esthetic problems and mar an otherwise good smile, like, stubborn stains which don’t respond to bleaching, chipped or worn teeth, uneven teeth or gaps between teeth that look unsightly or too small. Veneers can be made from composite material or ceramics, and are bonded to teeth that have been very slightly prepared on the front surface. Ceramic veneers can be more long lasting than composite veneers. Modern ceramic technology allows us to custom design very esthetic veneers that resemble the natural sheen and tint of enamel closely. Now, computer aided design or CAD technology can be used to precisely mill ceramic veneers. Veneers are commonly a part of ‘smile designing’ treatment.
Are Silver fillings safe?
Traditionally, silver fillings have been the most commonly used type of dental restoration, because of their strength and durability. These are actually made of a special amalgam of silver with mercury, as pure silver is very soft. Over the last few decades, many concerns have been raised about the safety of mercury contained in silver fillings, as mercury is known to be toxic in high levels, affecting mental status, cancer risk etc. Research showed that the levels of mercury in the blood of those with many silver fillings is higher than those without any. However, the amount of mercury in silver amalgam is extremely small and there are hardly any reports of people with actual effects attributable to mercury in silver fillings. Although, the issue of mercury toxicity from silver fillings has been debated, it seems very unlikely if the small amounts of mercury can actually cause clinical problems. With technological advances, we now have the advances of ‘metal free’ composite fillings that are tooth–colored and mercury free and strong at the same time, and many people are increasingly opting for these.
What is Plaque?
Plaque is a sticky film that forms on the surfaces of teeth. Proteins from saliva settle on tooth surfaces soon after brushing and form a film. Bacteria in the mouth then colonize this plaque film. If the plaque film is not removed frequently by brushing, the bacteria in it multiply and grow and the plaque becomes thicker and more difficult to remove. The plaque bacteria produce acids that cause cavities in teeth. Old plaque allows more gum disease causing bacteria to grow within it, and this causes gum disease. Plaque left un–removed, slowly hardens over weeks to from flakes of tartar or calculus, which lodges still more plaque. Regular and efficient brushing is the most effective way of preventing plaque build–up. Dental floss helps remove plaque from sides of teeth where brushes don’t reach. Some mouthwashes also add to plaque prevention. Regular dental check–ups and professional cleaning are needed to remove any tartar that is accumulating plaque.