Dentalnews (en)

Aphthous ulcers or canker sores, those painful little things in the mouth – what helps best?

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Anyone who has ever had a small lesion of this kind in the mouth knows how unpleasant aphthea can be. Eating and drinking is severely limited and dental hygiene tends to be neglected.
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Chronic recurring apthe (CRA) is the medical term used,  women generally tend to be affected more often. There are three different types commonly mentioned: minoraphthe, majoraphthe and herpetiform ulcers. This distinction is made based on appearance and location!

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Minoraphthe are the most common: round or oval, flat ulcers of less than 5mm diameter. These usually appear on the flexible part of the gums or mucuous membrane and heal after one or two weeks, without leaving a scar.

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Majoraphthe are less common, and appear on the gums, lips and palatal arches. They usually take several weeks to heal (up to 6 weeks) and can leave scars.
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Herpetiform aphthe are characterized by many hundreds of small lesions, which can appear anywhere in the mouth.
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What causes aphthe?
Aphthe is associated with many different kinds of illnesses, e.g.

• Morbus Behcet
• Sweet Syndrome
• familial neutropeny
• HIV infection
• …

But even healthy persons can develop aphthe, the exact causes are unknown. Various factors such as iron deficiency, vitamin deficiency, glutamate intolerance, food allergies,infections or genetic predisposition have been suggested. Healthy persons often get aphthe after eating nuts, pistachios and/or citrus fruits.
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What can I do against aphthe?
As the exact causes are unknown, only the symptoms of aphthe can be treated:

• Washing out the mouth with astringent solutions such as sage tea
• local cortico-steroids (Volon A ointment)
• Softlaser
• Chlorhexidine mouthwash
• topical analgesics as lozenges

If aphthe seem to appear after eating certain foods, simply refrain from eating those foods!

Natrium fluoride, fluoride water, fluoride for teeth, fluoride toothpaste, flour … the list just goes on, but which claims are true?

First of all – fluorine is a very toxic gas of the halogen group. Fluoride ions, on the other hand, are needed by living beings and classified as trace elements or micronutrients.

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The fluorides most often used are:

• Natriume fluoride (NaF, e.g. in fluoride tablettes or in some brands of toothpaste or mouthwash),
• Potassium fluoride (KF, in fluoridated table salt),
• Stannous(II)-fluoride (SnF2, sometimes used in toothpaste) or
• Amine fluoride (used in toothpaste and gels containing fluoride)

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Only fluorides applied locally to an exposed tooth actually help to prevent cavities

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As people have various sources of fluoride available to them (tablets, table salt, drinking water, toothpaste, fluoride gels,  …) it is important to use these trace elements responsibly. Since there are many factors which affect the incidence of cavities, the use of fluoride alone is not enough to prevent the development and spread of cavities in the general population. Cavities do not indicate a fluoride insufficiency!
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The following recommendations for the use of fluoride only include information which has scientifically proved to be useful!
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Toothpaste
Using toothpaste which contains fluoride is an effective way to prevent cavities, and works even better if the level of fluoride in the toothpaste is high and you brush frequently.
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Fluoride tablets
Fluoride tablets help to prevent cavities. But since this only works locally, they have to be chewed regularly. Only one type of comprehensive (systemic) fluoride intake (tablets or table salt) is recommended – see chart. Even table salt does not yield quite as much precise data as lozenges. Before giving fluoride tablets to children under six years of age, a fluoride anamnesis needs to be performed – a questionnaire is used to determine whether there is increased fluoride intake from other sources, so excessive intake can be avoided. Fluoride tablets are not taken during pregnancy, as they do not affect the incidence of cavities in milk teeth.
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Fluoride finish
Applying a fluoride finish to the teeth helps to prevent cavities. This method can be used for children and adolescents two or more times a year, aside from other methods.
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Fluoride gels
Applying a fluoride gel to the teeth helps to prevent cavities,  aside from other local methods, assuming that the gel is not swallowed. The gel works no matter what method is used to apply it. The method used depends on the compliance of the patient and should be selected individually.
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Mouthwash containing fluoride
If you have a very low incidence of cavities and good dental hygiene using toothpaste containing fluoride, use of mouthwash containing fluoride is not recommended. For persons with a higher risk of developing cavities, moderate use of mouthwash can prevent the spread of cavities and can thus be recommended aside from use of other fluoride products.

I have already had a check-up by a dentist, do I still need to get my teeth professionally cleaned?

Yes, you should still get your teeth cleaned!

Two pairs of eyes are better than one, and it is easier to recognize defects in a clean set of teeth than in teeth covered in plaque.

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How much does it cost to get my teeth professionally cleaned?

The costs can range from 40€ to 120€.

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This not only involves removing plaque, each tooth is examined individually and varnished – which prevents plaque build-up.

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An oral hygienist or prophylactics assistant takes a very good look at your teeth, and sees even more than a dentist, all the more when teeth are thickly covered in plaque.

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Check-ups twice a year and professional cleaning – also known as oral hygiene sessions – ensure the health of your teeth!

Do you want to find out more about this topic?

Visit a dental forum!

Plastic fillings – are they worth the cost?

White fillings are in ever greater demand – but they are not always a good idea! People are sick of silvery mercury fillings (amalgamate), people want to look good, and this includes having a perfect set of teeth. Many people are now getting their amalgamate fillings replaced by plastic fillings – called composite fillings.

Composite fillings do not work that well in side teeth, a fact which many people do not know! Even manufacturers warn that these fillings should only be used to correct surface defects, since teeth do not react well to them. The tooth nerve often dies when this type of filling is used, leading to a root canal treatment.

Patients who get their amalgamate fillings replaced by plastic are in for a bumpy ride. The fillings consist of tiny building blocks called monomers. As soon as a dentist shines a lamp on the filling, these little monomers start to connect – like Lego blocks, a process called polymerisation, which results in polymers – larger building blocks. But these plastic structures are not stable enough to hold up under chewing, so little „Lego blocks“ – monomers – start to separate. These free-floating monomers are very toxic, they invade the tooth nerve, and the nerve dies.

You do not feel the pain right away, it may take years for the   „dead“ tooth to start making trouble, so patients do not always attribute this problem to the plastic filling. Some patients experience problems immediately after the plastic is inserted, such as problems when chewing, pressure, excessive sensitivity to heat or cold.

While some dentists specialize in this type of filling and use a coffer dam, special covers and layering methods to prevent complications, but plastic fillings still end up costing about as much as a ceramic inlay. But ceramic inlays are much better for your teeth than composite fillings – assuming the inlay is inserted correctly.

White teeth may be more trouble than they are worth!

Think about what you’re doing. If you invest in your teeth, then be sure to use goods materials – gold, titanium or ceramics! Or develop a better brushing technique, because if you have poor brushing habits then you will need fillings someday.”

Many doctors still wrongly advise against using an oral irrigator!

Whether you use an oral irrigator made by Braun, Panasonic,  Waterpik, or any other manufacturer – regular use keeps your mouth healthy!

Doctors who are not very knowledgeable about micro-biology argue that an oral irrigator washes bacteria deeper into the gum pockets. While this may sound obvious, this is actually false. First of all, bacteria can move: they have cilia, flagella which help them move around pretty quick! Second,  bacteria are not dangerous in and of themselves!

Parodontitis and also cavities are actually caused by plaque.  Plaque is organized like a little city, there are bacteria which specialize in adhering to the teeth. Other bacteria gnaw at the teeth while others are mainly responsible for transporting nutrients. Mature plaque is organized like an ant heap.

It takes mature plaque 24 hours to form, after which you run the risk of developing parodontitis and/or cavities. The longer you wait before removing the plaque, the harder it gets to remove.

You should make it a habit to remove plaque at least every 24 hours,but using a toothbrush you can only do that above the gums, while the oral irrigator also reaches the areas just below the gums – in the sulcus, and also between the teeth.

Used once a day in combination with regular brushing, the oral irrigator helps to keep your mouth healthy! Do not be afraid if your gums start to bleed a little and hurt at the beginning, this will stop eventually, just keep cleaning!