Dentistry FAQ

1. What causes hematoma after injection?

Hematoma, which is often caused by excessive and fast injection at the location causes the capillaries to rupture and gather beneath the subcutaneous space. The color could change from purple to red and appear as a bruise. Its only treatment is an immediate cold compress and a hot compress the day after along with comforting the parents and the baby. By one week, the problem will disappear. Always inject calmly during supraperiosteal injections, especially for the D tooth. Convince the child not to make sudden moves so that the injection is not rushed. Always pressure the injection area and the buccal vestibule with a finger or a cotton roll toward the eyes to avoid hematoma and allow the anesthetic to spread.

2.What should be done about the teeth that are in the child’s mouth during infancy?

These teeth will undergo X-ray if they have agomphiasis and a possibility of aspiration.

If the agomphiasis is not severe, doesn’t put the mother’s breasts and the child’s tongue at risk, or causes little irritation, the tooth’s sharp edges can be processed after the tenth day with a composite, or the sharp edges could be spread with a dental turbine.

3.Does scaling damage the tooth?

Plaques gradually gather on teeth due to eating different foods, which put pressure on the gum tissue around the tooth and causes gingivitis and gum disease. Scaling removes the plaques below the gum, heals gingivitis, and guarantees dental and gingival health.

4.What are orthodontic or orthopedic pacifiers?

The harmfulness of pacifiers for children (especially over the long-term) is a matter of fact. Using a pacifier causes maxillary stenosis and vertical deficiency and has a detrimental effect on the jaw, the teeth, and eventually the face, similar to that of finger sucking.
Due to these known harmful effects, some companies have created specially shaped orthodontic or orthopedic pacifiers and claim that they do not have such harmful effects. Unfortunately, scientific evidence has not backed up such claims.
Therefore, it is advisable to minimize the use of any pacifiers by children. The state of the child’s muscles during sucking, especially in the long run, can cause maxillary deficiency and significant problems to the teeth, jaws, and face. Even using a milk bottle has the aforementioned harmful effects. Therefore, orthodontists consider breast milk the best choice for children, because while the infant is being fed from the breast, the contraction of the infant’s muscles for sucking milk differs from the same contraction while having milk from a bottle. Breastfeeding has a positive impact on maxillofacial development, while drinking milk from a bottle will have the same negative effects as sucking a pacifier.

5.What are the side effects of mouth breathing?

Mouth breathing means that the child inhales and exhales most of the air through the mouth.
One can put the face close to the children’s nose and mouth and ask them to exhale to feel the warmth of their breath to detect mouth breath. Placing a mirror in front of the nostrils will reveal which side of the nose has an obstruction.
Factors such as polyps, severe nasal septum deviation, respiratory system problems or adenoid inhibit such people from breathing naturally through their nose. These people sleep and breathe with their mouths open, a condition also known as “adenoid,” where they are often said to have a long face and a long high-arched palate. They also often suffer from crowding due to lack of space, orthodontic problems, and backward mandibular rotation.
Mouth breathing causes the mouth to dry and can increase the decay rate as well as gingivitis.

6. What are fluoride therapy, fluoride, and its functions? How is it utilized? And what function does its anti-decay effect serve?

Fluoride is a natural mineral that exists in the earth’s crust and is found abundantly in nature, and is used in two ways:

1. Systemic

• For example,the fluoride available in drinking water,
• the fluoride in foods and vegetables,
• fluoride as a tablet, which can only be used with a doctor’s prescription

1. and locally,

• fluoride varnish,
• fluoride gel,
• fluoride in mouthwashes,
• and fluoride in toothpastes.

The local application of fluoride (direct contact with teeth) strengthens the dental structure against decay and prevents new decays effectively. At the same time, it can stop or slow down early decays on the teeth. In some cases, the dentist prefers to deliver a high concentration of local fluoride to the child, which takes approximately 10 minutes and doesn’t require local anesthesia.

The procedure is as follows (fluoride gel):

1. First, all dental surfaces are cleaned with a toothbrush.
2. Then all teeth are dried with a sterile gauze.
3. All dental surfaces are smeared with fluoride gel (sometimes one side of both jaws in one stage, and the other half in the next),
4. Fluoride gel remains on the teeth for 1 to 4 minutes.
5. In all stages, the child’s back is vertical and the head is tilted slightly forward to prevent the child swallowing fluoride.
6. After the allotted time, the extraneous gel is removed with a sterile gauze or cotton. At this stage, the child spits out all the saliva.
7. The child should not rinse their mouths after fluoride therapy and should avoid eating or drinking for half an hour. During this time, the saliva in the mouth should be discharged.
8. Fluoride therapy can be done in 6 months-old children who have erupting teeth (for younger ages, it is advisable to use varnish).
9. Fluoride therapy takes place periodically (every 6 months) at the dentist’s discretion and reduces decays by 30 to 60%.
10. Fluoride therapy can be done for both milk and permanent teeth.

7.What side-effects does thumb sucking have on oral and dental health?

Thumb sucking can lead to oral and jaw changes. The level of changes could differ according to the duration, intensity, the habit’s repetition throughout the day and night, and how the thumb is placed in the mouth. The most important changes caused by thumb sucking are as follows:
Anterior Open Bite (no vertical overlap of the anterior teeth): When children press their teeth on top of each other, the anterior teeth don’t reach each other. The child will therefore have issues biting on an apple or a sandwich.

Increased dental overjet and protrusion of maxillary anterior teeth: Increased horizontal distance between maxillary and mandibular anterior teeth and extreme outward sloping of the maxillary teeth
Posterior Crossbite: The narrowing of the maxillary dental arch and incorrect overlap of the maxillary and mandibular incisors
Overall, these changes reduce the effectiveness of teeth in chewing food, aesthetically degrade the child’s teeth and face, and cause diseases and temporomandibular problems over the long-term.8

8.How should thumb sucking be treated?

Before any action, the child and parents should want the treatment to take place at the right time, otherwise any effort will be in vain. Some children break this habit after entering kindergarten or preschool due to peer pressure. Before trying to break this habit, the child’s mental strain should be evaluated by the dentist. It is advisable to delay the treatment of children that have had important changes in their lives, for example, migrating to a new city or country, changing their school, or having divorced parents.

In general, there are four methods to break this habit:
A. Consulting with the patient

Including talking to the child about the side-effects of continuing thumb sucking and especially, its effect on the aesthetic deterioration of their teeth and face. A picture of the undesirable effects of thumb sucking on the teeth and jaw can be shown to children to help them understand. The effect of consulting is seen to be greater on children and those who feel the societal pressure for breaking the habit.

B. Reminding

It is suitable for children who are themselves willing to break the habit but require some help. In this method, the goal of the treatment should be explained to the child. Then, waterproof adhesive bandages and one-finger gloves or socks could be used during bedtime, especially on the child’s finger or hand. There are also bitter solutions (similar to nail polish) available in pharmacies that can be applied to the child’s fingernails as needed during the day or before bedtime. The important thing is that children have to understand that all these methods are intended to remind them not to put their finger in their mouths. If children feel that these methods are punitive, they will not have the required effect.

C. The reward system
In this method, a contract is signed between the child and parents or the dentist. The contract simply declares that the child will leave the habit for a certain period of time and receive a reward in return. For example, a monthly table can be put on the child’s bedroom wardrobe, and for each day that the child leaves the habit, a star will be put on the intended spot on the table. There will be a special reward for every five stars, and in the meantime, the child could be verbally enticed. The reward system will have a better effect in combination with the recollection treatment.

D. Habit-Breaking Appliances:

This treatment can be used if the habit is not broken after applying the recollection and reward methods, but the child is willing to break the habit. In this method, a fixed appliance is placed in the child’s mouth that physically prevents the habit and eliminates the joy of sucking, and also acts as a reminder. To fully break the habit, these appliances should be used for at least six months.

9.From which age should one try to break the child’s habit of thumb sucking?

It is advisable to attempt breaking the child’s habit after two years of age to prevent the side-effects of sucking. Since the aforementioned treatments are more suitable for children above 4, it is suggested to substitute them in 2-4-year old children with a pacifier, since sucking the pacifier has fewer side-effects than thumb sucking and is easier to break as a habit.

10.What is bruxism or gnashing of teeth, and what are its causes?

Gnashing or the non-functional grinding of teeth is called bruxism and is common in 15% of children and teenagers.
It usually occurs at nights and continues for a long time, causing abrasion in milk and permanent teeth.
If the disorder continues until adulthood, it may cause periodontal diseases or temporomandibular joint disorders.
Occlusal interferences (especially if accompanied with nervous stress) can cause bruxism. Therefore, the first step should be occlusal adjustment. In these cases, the palatal bite plane can also be used, which allows the anterior teeth to grow continuously.
is the definitive cause, but the following reasons can also be educated:

A. Local factors:

• Occlusal interferences (mechanical clamp between the cusp of teeth)
• High fillings
• Certain dental stimulant conditions

B. Systemic factors

• Intestinal parasites
• Subclinical nutritional deficiencies
• Allergies
• Endocrine disorders
• They can be treated by visiting a specialist and pharmacotherapy.

C. Psychological factors: Personal disorders or increased stress that are treated by visiting a psychiatrist.

Dental erosion is common in children suffering from neuromuscular disorders and severely mentally-underdeveloped children.

Treatment: The treatment starts with simple methods (identifying occlusal interferences and removing them if necessary)
Using vinyl plastic night guard or bite guard at night to cover the occlusal surface and 2 mm of buccal and lingual surfaces (at less than 2, it will be flexible, and at more than 2, it will be stiff and rigid). The appliance’s masticatory surface should be smooth to prevent occlusal interference.
It’s better to take molds from both jaws, but taking one from the maxilla is sufficient.

11. What are post-tooth extraction (milk and permanent) cares?

Pressure the gauze on the child’s extracted tooth socket for 1 hour.

The child should avoid spitting or sucking the extracted tooth’s socket for up to 12 hours after extraction.

Avoid eating and drinking for 2 hours, then consume liquids and soft and cool foods for 24 hours. Make sure not to use straws when drinking. There are no food restrictions after 24 hours.

Do not rinse your mouth with water or any mouthwash for up to 12 hours after tooth extraction. Older children can toothbrush and rinse with a mouthwash prescribed by the dentist and repeat this 2 to 3 times a day for 1 week.
E. 24 hours after tooth extraction, children above 6 should rinse the area with a syringe (10 or 20 cc) containing lukewarm saline to prevent food buildup after each meal.
F. Some plasma leakage from the extracted tooth is normal for 1-2 days and does not necessitate a visit to the dentist. Place a piece of damp sterile gauze or a wet tea bag on the tooth socket in case of bleeding at home and gently shut the mouth (for at least 2 hours) and use a cold compress (ice bag) externally.
G. If the bleeding is severe and uncontrollable, go to the clinic and avoid placing medicines and other substances on the socket.

H.Medicines

Make sure to give your child the prescribed medicine and contact your clinic or dentist in case of inflammation or infection.
I. Very Important: Make sure not to bite the lips, cheeks, or tongue due to the long period of anesthesia (several hours) of the soft tissue around the tooth. The biting may occur when the child eats.

There is a bitter taste in the mouth for a few days after tooth extraction as well as a bad odor, which is normal and not a symptom of infection.
J. Very Important: See your dentist 3 to 4 days after tooth extraction if your child has pains that are not relieved with sedatives. Taking lots of antibiotics on your own is not beneficial.
K. Very Important: White patches may appear on the extracted tooth’s socket after extraction, which are not necessarily left from the tooth but may actually be the child’s jawbone. In this case, it is advisable to visit a clinic.
L. After extracting a mandibular tooth, if the child suffers from jawbone pain while opening and closing the jaw, the jaw should be repeatedly opened and close fully to be relieved of pain. Tolerating this condition will intensify the pain. If you are unable to open and close your jaw due to severe pain, visit a clinic.
M. Additional physical activity should be avoided for 24 hours of extraction (such as sports and heavy lifting).
N. If the tooth socket is dressed, schedule a visit a week later for its removal.
O. Do not leave town for several days after tooth extraction, and consult with your dentist if you have to.

12.What harmful effects do fast foods have on teeth?

Fast foods have today become a staple of modern life. People are busy and don’t have enough time to make and eat healthy food, and that’s where fast foods comes into play. Fast food not only causes general health problems such as diabetes and obesity, but also gum disease and tooth decay.
One of its causes is their salt and sugar. After having these foods, sticky debris containing sugar and salt sticks to the dental surface and the produced acid causes tooth decay.
Another point is that carbonated beverages are often consumed along with fast foods, such as cheeseburgers, which have high sugar and can damage the enamel.
At the same time, diabetes is a preparatory stage for periodontal disease, and diabetics must maintain their blood glucose levels at the optimum level to avoid its adverse effects on their general and oral health.
Now, if we add poor oral hygiene to all of the above, guess what will befall your teeth and their holding tissues.
Therefore, it is best to talk to your patients and inform them about the side-effects of fast food overconsumption.

13.What are the side effects of chemotherapy and radiography on the teeth and the mouth?

In the United States, one person is diagnosed with cancer every three minutes. The oral side-effects of anticancer therapy (chemotherapy and radiation therapy) clearly affect the illness, tolerance, and the cancer patients’ overall quality of life. Therefore, clinics should be prepared to accept and treat these patients.

The National Institutes of Health’s most important suggestion is that every cancer patient should be thoroughly evaluated before oral chemotherapy and radiotherapy to eradicate any potential source of oral infection.

Dentists are an integral part of the cancer patients’ treatment team and are committed to helping reduce or eliminate the side-effects of cancer treatments. To do this, one should first understand the side-effects and then get acquainted with their treatment.

Side-effects:

In a healthy individual, the mouth’s mucosa cells and the upper esophagus have the fastest cell proliferation, whereas in patients undergoing chemotherapy and radiotherapy, these cells lose their proliferation ability. Therefore, when these cells are pruned and fall by eating and toothbrushing and other natural oral activities, the mucosa becomes thinner and thinner. Mucosa thinning will also create wounds. Mucositis is the first and most common side-effect of anticancer therapy, which usually appears orally 8 to 10 days after treatment and can adversely affect the patient’s ability to chew, swallow, or even speak.

Oral infection is another side-effect of these treatments that occurs due to the severe drop in white blood cells. Fungal infections are more common in this regard, and their symptoms include erythematous mucosa, irritation, and a white layer forming over the tongue.

Xerostomia is the other side-effect that afflicts patients who have undergone radiotherapy in the head and the neck. It is caused by the dysfunction of salivary glands, resulting in little or no saliva secretion. Xerostomia causes sore throat, dysphagia, voice roughness, mouth and lip sores, and irritation in the mouth and throat. Patients suffering from xerostomia are at a higher risk of oral infections and should use saliva stimulants or synthetic saliva.

Treatment:

These patients require an appropriate oral health plan to reduce their level of oral microorganisms such as bacteria, fungi, and viruses in order to reduce the painful inflammation that is an unwanted side-effect of anticancer therapy. They should be evaluated from a dentist’s perspective before the main treatment and undergo full oral cleaning, and the teeth that could become infectious in the future should be treated or extracted if they are unrestorable. The sharp edges of teeth, dentures, partial dentures, and others should be completely corrected. These patients should learn the following points and implement them:

1. Rinse their mouths every 4 hours and before going to bed. If they have multiple mouth sores, they should do this more.
2.  They should use a very soft toothbrush specific for infants, and change it frequently.
3.  Use a mild fluoride toothpaste.
4.  Use soothing mouthwashes more often. These mouthwashes should lack alcohol, strong chemicals, preservatives, and additive colors.
5.  Avoid drinking alcohol or smoking.
6.  Avoid eating spicy foods and drinking acidic drinks, such as orange juice.
7.  Avoid drinking hot beverages so as not to burn the mucous membrane.
8.  Examine their mouth twice a day at morning and night and record the changes.

These patients should be examined every week by the dentist to avoid oral infections and be treated immediately if they find acute symptoms.

14.What are the side-effects of drugs on teeth?

It’s important to consider that some medicines can have unintended consequences on oral health. For example, inhaled medications used by asthma patients have unwanted negative impacts. Australian and Scandinavian researches have indicated that these drugs increase the probability of tooth decay. Inhaled medicines contain powdered essences that are bad for teeth as they deposit on the teeth for some time. Therefore, patients who use inhaled drugs are advised to take special care of their oral health and rinse their mouth after taking such medications.
Some antibiotics also negatively affect the mouth, such as tetracycline, which can cause tooth discoloration. Other drugs of this group can cause oral thrush, and patients who use them should regularly use mouthwashes every day.
Many antihistamines that are used to prevent seasonal allergies and allergic rhinitis have destructive oral effects. An important side effect of these medications is xerostomia, which makes swallowing difficult and causes food and bacteria residues in the mouth, thereby increasing the chance of decay and gum disease.

15.How does tea affect the teeth?

A new research has shown that drinking tea helps prevent gum disease and tooth decay advancement. Drinking three cups of tea a day suppresses the bacteria that cause gum disease and tooth decay.
Normal tea in particular contains compounds that act against Lactobacillus and Streptococcus mutans, which are responsible for tooth decay and gum disease. Researchers suggest drinking three or four cups of tea a day. It’s interesting to know that tea greatly neutralizes the acidic properties of bacterial plaque. These studies proved no differences between normal and green tea, however previous studies had shown green tea to be very effective for weight loss due to being lipotropic.

16.How does smoking affect oral and dental health?

It’s common knowledge that smoking has many detrimental effects on general health, but less is known about the harm that it inflicts upon the mouth and teeth. The 7 most important side-effects of smoking are as follows:

1. Yellow Tooth: Yellow tooth is caused by nicotine and sediments in the tobacco, which cause the teeth to become yellow or even brown in a very short time. This, however, is only the beginning.
2. Gum disease and tooth loss: Smoking cigarettes negatively impacts periodontal connection and the alveolar bone and makes them very susceptible to infection, increasing the tooth loss probability.
3.  Oral Bacterial Growth: Cigarette smoke increases bacterial plaque accumulation around the teeth and intensifies tooth decay and periodontal tissue disease.
4.  Tartar: Also classified as dental calculus or bacterial plaque, it is a permanent bacterial source that creates a very unpleasant appearance for the person’s teeth.
5. Tooth Cancer: The chemicals in the cigarette smoke are all cancerogenic and change the chemical mixture of the saliva in a way that makes it cancerous. Two of the three dental cancers are caused by smoking.
6.  Bad Breath: It is caused by the sedimentation of cigarette smoke particles in the mouth, throat, and lungs.
7. Mucosal patches in the mouth: After some time, white or gray patches appear on the mucosa of the tongue, cheek, or the palate due to the constant stimulation or irritation of the mucosa by smoking. These patches, which are called leukoplakia, are considered suspicious and precancerous in many dentistry resources and should be monitored.