Dr Shawna D'dharan

I had a patient that had a bicycle accident and face-planted on a pole or kerb or something like that. It affected a lot of his front teeth, and it was complex in the sense that there was no more shape of the teeth that were broken. There had to be a lot of root canal treatment done and what made it worse was that the patient had really proclined teeth -- the front teeth were sticking out more. He couldn’t really close his mouth normally. So the process of getting root canal treatment done, rebuilding the teeth.

No. The chances of harm are very low because dental x-rays have limited exposure and we always protect the children or adults before they take an x-ray. They will wear aprons and their neck will be protected as well. There is also a shield for certain x-rays that reduce the remission a person gets. The second thing is that most dental x-rays are digital and the amount of radiation that is required to get a quality image is much less than a traditional x-ray. That’s why dental x-rays are very safe even if we do it for children.

It is a symptom, but there are many reasons for sensitive teeth as well. If you do feel it, especially if it’s just on one tooth and it has suddenly appeared out of nowhere like acute, one of the more likely reasons is a cracked tooth. Like I said, time is of the essence when it comes to dentistry and dental work, and saving your tooth. Don’t delay on all these things. I think another common symptom that people have is when they have sensitive teeth and then it goes away, and then it comes back a month later or a little bit later. And then it goes away.

We need to wear retainers because your teeth have moved and your whole oral environment is a dynamic environment, it’s always changing. And your teeth are moving your whole life. It has the ability to move your whole life. So even for someone who did not do braces, you’d find that over the number of years as you get older, there will be some tooth movement. So all the more someone who has done braces, their original teeth was like that and then it moved straighter and straighter.

I think a question that I get asked quite a lot is “oh you have a permanent or fixed retainer behind” -- I have them as well. And it’s like a wire that’s permanently there, so it’s stuck to your teeth. And people always ask if food gets stuck, isn’t it difficult to clean. Actually, no. It is customised, again, exactly to the shape of your teeth. It is glued precisely in a position where it needs to be. So I honestly do not get any food stuck.

I will assume usually you get loose teeth due to overcrowding in the sense that those teeth are really difficult to clean. So when teeth are not cleaned properly, you have plaque and calculus that goes beneath the gums and it will affect the attachment of the tooth in the bone. That causes loose teeth. That would be a separate problem from the overcrowding. But, over time when you realign the teeth, if you correct the overcrowding and you’re able to clean your teeth properly, then you will have a lower risk of having this loose teeth problem happen again.

A factor would be the aesthetic aspect of it. Some people just refuse to wear something metallic in their mouth. Then you’d have to choose the other option, which is clear aligners. Or there are the ceramic braces as well, ceramic braces is like a good in-between I would say. They function like your metal braces, but they look a bit better because they’re almost tooth-coloured. But of course, it is not as aesthetic compared to clear aligners.

Yes, because the baby teeth essentially allow you to chew and eat. It works as what we call a "space maintainer" for adult teeth. If your baby teeth have been crooked and are taking up more space than the amount of space in your jaw, chances are when your adult teeth grow out, it will be crooked as well. But that being said, just because your baby teeth are very nice and aligned does not mean that your adult teeth will be perfect. It depends on the size of the teeth that will eventually erupt as well as the amount of jaw space the child has.

I agree with what Dr Jaclyn has said, crowning. But if time is a concern and I can’t crown it for you at this moment I think another immediate thing that we could do is to put a band over the tooth to sort of hold it in place. That’s like short-term management, just to get you out of pain. A metal band, it’s like a ring around your tooth. If you had worn braces, some of you may have had it at the back tooth. But then right after that you just really need to come in as soon as possible to get a crowning done. If not the tooth may not be saved.

I think the compliance of the patient is one of the most important. So if you can’t comply with 22 hours of wearing your aligners a day, please just wear braces. I mean there are different types of braces options as well, you don’t have to wear the metal ones, which you see most teenage kids wearing. There are also ceramic ones which are more suitable for adult patients if you want it to be more aesthetically pleasing. Those are fixed in your mouth and compliance of wearing is not going to be an issue.

You should prepare them even before coming to the dentist. Depending on the age of the child, talking to your child about what is going to happen at the dentist and assuring them is a good strategy. Always use positive words. I find other things that help are reading books or watching cartoons such as Peppa pig, where there is an episode on going to the dentist. When they see someone else doing it, especially someone their age, it might help them manage their expectation as well.

I mean you can, of course, do other treatments and then go back to doing your ortho treatment or braces. It can be done, however, that also means you may be paying double because we will need to redo that treatment that you did first once your orthodontic treatment is over. Having this discussion with your dentist in your initial consult is always an important thing. So that you spend the money and time wisely.

Maybe I can share coming from a patient’s perspective. I wore braces for many years, I had teeth that were sticking out, and I had crowded on my lower. When I first went to a dentist, I was like I really want to fix these teeth (that were sticking out) because when I smile -- when I don’t smile, anybody notices it but when I smile everybody sees it.

I would say it really depends. I wore it as an adult so I can speak from that sense. It really depends. Some days when I go in for the tightening of my braces and I come out and everything seems fine. And other days it can be painful. For me it used to be really odd, I don’t get the pain immediately, I get some tightness but I usually get -- the pain peaks on day two to day three. And then after that, it kind of dwindles down. By the one week mark, I’m back to normal and I can eat everything like normal already. So it’s just that first three to four days?

When they have tooth decay, they tend to have food stuck in the cavity and it won’t smell good after a while. Resulting in it being difficult to clean, especially if it's too deep and painful due to severe infection that can come from tooth decay.