A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.
Periodontists often treat more problematic periodontal cases, such as those with severe gum disease or a complex medical history. Periodontists offer a wide range of treatments, such as scaling and root planing (in which the infected surface of the root is cleaned) or root surface debridement (in which damaged tissue is removed). They can also treat patients with severe gum problems using a range of surgical procedures. In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.
During the first visit, the periodontist usually reviews the patient’s complete medical and dental histories. It is extremely important for the periodontist to know if any medications are being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.
The periodontist examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. The periodontist will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets; this helps the periodontist assess the health of the gums. X-rays may also be taken to observe the health of the bone below the gum line.
Some patients’ periodontal needs can be managed by the general dentist. However, as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases of aging, periodontal treatment may necessitate a greater understanding and increased level of expertise by a trained specialist. Patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, will be best managed by a partnership between the dentist and periodontist.
Dr. John Crotty is a periodontist who attends our clinic once every four weeks to undertake specialist periodontal procedures.
Please see our advice section on the safety of dental amalgam for more info.
Brush your child's teeth for about two minutes twice a day: once just before bedtime and at least one other time during the day.
Encourage them to spit out excess toothpaste, but not to rinse with lots of water. Rinsing with water after tooth brushing will wash away the fluoride and make it less effective.
Supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it. From the age of seven or eight, they should be able to brush their own teeth, but it's still a good idea to watch them now and again to make sure they brush properly and for about two minutes.
Start brushing your baby's teeth with fluoride toothpaste as soon as the first milk tooth breaks through (usually at around six months, but it can be earlier or later). It's important to use a fluoride paste, as this helps to prevent and control tooth decay.
There's no need to buy special "children's toothpaste" brands. In fact, some of them don’t have enough fluoride in them to help prevent tooth decay.
Children from the age of seven can use family toothpaste, as long as it contains 1,350-1,500 parts per million (ppm) fluoride. Check the toothpaste packet if you're not sure, or ask your dentist.
Children up to the age of six who don't have tooth decay can use a lower-strength toothpaste, but make sure it contains at least 1,000ppm fluoride.
Contact your dentist.
Time is a critical factor. Contact your dentist immediately so as to reduce the chance for infection or the need for extensive dental treatment in the future. Rinse the mouth with water and apply a cold compress to reduce swelling. If you can find the broken tooth piece, bring it with you to the dentist.
Contact your dentist. Unlike with a permanent tooth, the baby tooth should not be replanted due to possible damage to the developing permanent tooth. In most cases, no treatment is necessary.
If possible, find the tooth. Handle the tooth by the crown only. DO NOT TOUCH THE ROOT. DO NOT clean with soap, scrub, or handle the tooth unnecessarily. If necessary, give the tooth a quick, gentle rinse with cold milk. Try to reinsert the tooth in the socket as soon as possible. Have the patient hold the tooth in place by biting on gauze or a clean cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva, cold milk, or “save-a-tooth” solution, NOT WATER. The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving a tooth.
Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.
Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.
Unfortunately sometimes fillings for whatever reason may fall out or become chipped or broken.
There are many reasons for this including biting down suddenly on something hard such as a hard boiled sweet. Symptoms can vary from none at all to sensitivity to hot and cold or tenderness on chewing. A lost filling will always feel much bigger to the tongue.
It is important to make an appointment with your dentist as soon as possible. However if you cannot immediately access a dentist here are some helpful tips .
Finally the use of over-the-counter painkillers from a chemist if is constantly painful are also helpful until you contact the dentist.
Don’t place any pain-killing tablets on the site of the tooth or its gum as this can cause burns to the gum.
Tooth whitening is a procedure that should be carried out by a dentist only. There are many reasons for this. Hydrogen peroxide is a substance that should be handled with care and this should only be done by a qualified dentist. Any staining on your teeth may be due to an underlying condition and your dentist may diagnose this. Further information is available here.
Absolutely! Normal brushing doesn't clean in between the teeth fully. The most common and effective way of doing this is by flossing. The dental floss removes the plaque between teeth. It is important flossing is carried out correctly, and regularly, at least once a day. You should get your dentist to demonstrate for you. Some patients may need to use other methods, like small brushes that fit between the teeth, particularly if the spaces between the teeth are bigger than normal. Your dentist will advise you on the method most suitable for you.
Normally it is white (in thick section), almost the colour of the teeth, and thus much harder to see. Plaque is a soft sticky substance, and can be removed with regular, thorough brushing and flossing. Your dentist should be able to show you if there's plaque on your teeth. They will also show you how to brush and floss properly in order to stop plaque accumulating.
The most common reason why gums bleed is due to the teeth and gums not being cleaned thoroughly enough. If you leave bacteria-containing dental plaque sitting on the teeth beside the gums, the bacteria infect the gums themselves.
The picture to the right here shows gums that have been infected. Notice the red colour all along the edge of the gum beside the teeth. Compare this picture with the picture below, and you can see the gums are swollen as well as being red. This gum infection is called gingivitis.
The picture here on the right shows nice healthy gums. The teeth have been kept clean, and the gum has now healed up. It's no longer swollen, and is a healthy pink colour. Healthy gums like this will not bleed when brushed.
If you think there is a chance you might be pregnant, it is always wise to inform your dentist before you begin treatment. Being pregnant will not prevent you from having dental treatment carried out, but most dentists prefer to defer any elective procedures (procedures that are not absolutely necessary) until after the pregnancy is over. This is particularly the case during the first and third trimesters. The taking of dental x-rays is also best avoided, if possible, during pregnancy, but experts agree that x-rays may be taken, where necessary, in the case of an emergency.
The HSE operates the Schools Screening Services which aims to screen children in Second, Fourth and Sixth Class. Unfortunately due to restrictions in the public service, these target classes are not always reached. Children under the age of 16 should be entitled to receive emergency treatment from the HSE public dental service.
Generally, you are entitled to:
Most other treatment has been limited to high risk patients i.e. patients who are suffer from a medical condition or emergency circumstances. Your dentist will apply to the HSE for approval for your treatment.
PRSI payers are entitled to an annual oral examination free of charge.
You should visit your dentist at least once a year, more often if you have difficulties.
Remember under the PRSI and Medical Card dental schemes you are entitled to a free oral examination once a year!