Absolute Dental Centre

This is the last of the best of the International Symposium covering the latest in enamel therapy, sensitivity and allergies.

First, a question you may have asked yourself over the years. When your dentist or hygienist is looking at your teeth, how do they find decay? Some decay or caries as we call it can be seen between teeth on your dental x-rays. Where the tooth surface has been damaged by caries the x rays pass through the weaker part of the tooth giving a dark area on the x-ray. On the smooth surfaces when the decay is in its early stage and active, the tooth will appear as a dull white patch and feels rough to probing. If the decay has stopped, the surface will look shiny and feel smooth. We then need to look at two different aspects of caries, the first is why it occurred in the first place and secondly how we manage and prevent it from progressing. Diet is the key to why most caries occurs and as plaque is present on the tooth surface all the time, we have to look to the foods and drinks we eat and the timing of them. The tooth surface can repair from the minerals in saliva if it has enough time in between eating or drinking as it can take up to 45 minutes for this to occur. Managing the early caries apart from diet, is then down to either applying fluoride at home in the form of toothpastes or mouthrinses or even tooth mousse! In the surgery there have been recent developments in varnishes which can be applied in the surgery and they bind to the tooth surface and can also fill in defects on the enamel. One of the other problems patients encounter is sensitivity. About 75% of patients experience sensitivity and many think that sensitivity is normal. Personally there is nothing more disappointing than facing a very tasty looking ice cream and wondering if the taste will be worth the suffering! We should always investigate the causes of sensitivity as they can be very varied and may indicate either sensitive dentine or caries. When we see patients with sensitivity we need to find out the full history of where and when the sensitivity occurs and this helps to exclude caries. So after elimination of all other causes we can then consider home therapies including toothpastes and mouthwashes and tooth mousse. The latest toothpastes from Colgate and Sensodyne use Pro-Argin technology. This involves arginine, a substance already found in saliva, which mixes in with saliva and enters into the dentine tubules and blocks the open ends of the tubules. The advantage of these toothpastes is that they can be used as a cream and rubbed into the tooth surface but also as a toothpaste to be brushed with on a twice daily basis. Colgate have also brought out a sensitive toothbrush as well. In the surgery, we have a great variety of varnishes and high fluoride pastes we can apply to the tooth surface and Colgate have brought out a pro relief polishing paste which works well as an adjunct to the toothpaste and we can also use it before we commence scaling on patients who find this process uncomfortable. The last lecture of the conference centred on allergies. We have noticed an increase in allergies over the last few years and many of our patients present with a variety of allergies and some can be to food substances, antibiotics or preservatives. Sometimes we can develop an intolerance to a substance and sometimes it may be a full blown allergy and tends to be a very fast reaction. Some of the allergies we have to be particularly careful of in the surgery include latex. Its incredible when we look at the substances we use in the surgery and how they may affect patients. We carry a stock of latex free gloves in the surgeries and its always really helpful for patients to provide us with any details of allergies they may have. Some of the latest research has indicated that there may be a link between allergies and low birth weight and also if there has been a pattern of childhood infection and this may include Hepatitis A.

Toothpastes can also contain substances which patients have allergies to and this includes sodium laurel sulphate (SLS), which provides the foaming capacity in the toothpaste. Fortunately there are toothpastes which don't contain SLS and this includes some of the Sensodyne range.

Research has also been revealing a link with apthous ulcers relating to deficiencies in iron and folic acid and some of the food allergies relate to benzoates particularly E210-E219. All of the lectures I attended at this Symposium were very helpful to gain information and also confirmed many of the treatment regimes we already practice at Absolute Dental!