Dry socket – what it is and how to treat it

dry socket

‘Dry socket’ is a dental condition which can occur in adults after they have had a tooth extracted. It is not very common, typically affecting up to just 5% of all cases, but if you are having a tooth extracted for any reason, it is something to be aware of and to be familiar of the symptoms. It is more likely to occur in the lower jaw, but it has been known to occur in the upper jaw as well.

What is dry socket?

During the usual healing process when a tooth has been removed, a blood clot will form in the gap where the tooth has been extracted from. The purpose of the blood clot is to form a protective barrier to look after the gum, the bone and the nerves underneath where the tooth was previously attached. In the case of a dry socket, the blood clot becomes dislodged before it has time to forge a strong enough bond with the gum, which means that the hole is not able to heal effectively.

Recognising and diagnosing dry socket

Unfortunately, if you develop dry socket this is usually very painful and will need to be treated quickly. Although discomfort is expected in the days following a tooth extraction, this should be able to be treated at home with the painkillers prescribed by your dentist, so if you feel that the pain is exceeding a ‘normal’ amount, then speak to your dentist quickly.

Speed is also important as the absence of the blood clot means that there is no barrier protecting the wound, which means that fragments of food can find their way into the hole. Dry socket usually occurs a couple of days after a tooth extraction and patients will usually find they are experiencing a worsening pain at the extraction site, which spreads through the face and causes a lot of discomfort.

On closer inspection, it may be clear to see that there is no blood clot in the place where the tooth used to be, and some patients may even be able to see the exposed bone. Many patients also report an unpleasant taste (and often odour) in their mouth as well, as a result of the infection.

How is dry socket treated?

Dry socket typically requires a return trip to a dentist where the wound is thoroughly cleaned and sometimes a dressing is applied. Once this initial stage is complete, your dentist may also treat dry socket with a course of antibiotics to help cure any infection. They may also prescribe antiseptic cream to be applied around the site of the extracted tooth and could recommend an antibacterial mouthwash.

Here at CK Dental in Bristol, we work with patients who have teeth extracted to ensure that they follow a good hygiene routine after any tooth extraction to mitigate the risk of conditions like dry socket occurring. Although rare, it can happen, but we can help reduce that risk as much as possible.

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Recognising the signs of dental anxiety

dental anxiety

Being nervous about visiting the dentist is not uncommon, it is thought to affect a significant proportion of the adult population in the UK. In the late 1990s, a UK Adult Dental Health survey was conducted, and the results suggested that around one-quarter of adults ‘definitely’ felt anxious about visiting the dentist and a further quarter felt anxiety to ‘some extent’.

Although experiencing nerves in situations where we don’t feel fully in control is quite normal, for some of us we may actually be experiencing ‘dental anxiety’, which is a recognised condition.

How to spot dental anxiety

According to an article published in 2008 by dental experts Banerjee and Fiske, the signs of true dental anxiety can be grouped into three key categories: physiological, behavioural and cognitive.  Physiological means symptoms that you can actually feel, behavioural are outwardly visible symptoms and cognitive describes the way you feel.

This is what you might expect to feel/experience in each of these if you are suffering from the condition:

Physiological signs

  • Looking pale, or alternatively, looking flushed
  • Dry mouth
  • Fast breathing (possibly evening hyperventilating)
  • Tight feeling in stomach
  • Tension in muscles

Behavioural signs

  • Being angry/agitated and directing this at dental staff
  • Cancelling or being very late for appointments
  • Talking a lot on arrival (delaying the onset of the appointment)

Cognitive signs

  • Dreading the appointment
  • Feeling anxious, negative or generally apprehensive about what to expect
  • Focussing on the worse-case scenario when considering different outcomes from the appointment

Does this sound familiar? It doesn’t have to be prohibitive to ensure your teeth are well cared for, you just need to ensure that you find a dental practice that recognises the condition and can help make the experience of visiting the dentist as stress free and calming as possible.

Putting patients at ease

Here at CK Dental, we acknowledge that for patients suffering from dental anxiety – and those who are just not entirely confident about visiting the dentist – booking an appointment to have a routine check-up can be very daunting. Our staff are specially trained to help patients feel at ease, and we believe that this begins with nurturing a caring and calm environment, plus talking openly with patients who have got concerns about their dental care.

Missing appointments, making excuses and generally assuming that your teeth are ok are all risky patterns of behaviour that could lead to longer-term serious dental problems, so if this resonates with your experience then it might be time to try and overcome these concerns and have a think about some of the more positive things associated with overcoming these concerns and getting a clean bill of health for your teeth.

 

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Causes of dental anxiety

 

There are many different reasons why a patient might feel nervous about visiting the dentist, some of which could be rationally justified, others may be based on lack of information or incorrect assumptions about what to expect. Here at CK Dental, we look through some of the most common causes associated with the condition of dental anxiety…

Being in a situation you cannot control

The act of reclining in the dentist’s chair may feel relaxing to some people and nerve-wracking for others. Some people find being asked to recline daunting, but rest assured this is purely to enable to best view inside your mouth at an angle that will cause the least discomfort for the patient.

The other issue for some is the worry that they are unable to communicate with the dentist while the appointment is underway, due to the fact they have their mouth open and dental implements are sometimes used to look and feel inside your mouth. A simple hand motion will be enough to alert your dentist that you wish to communicate with them, and if this is something that you are very worried about then tell your dentist before the appointment begins and they will be able to agree on a hand signal that they will keep an eye out for should you wish to talk to them.

Not knowing what to expect

The fear of the unknown often a factor anxiety and although this is a common symptom of dental anxiety, it is also pretty easy to find a solution for. Firstly, try not to overthink the potential outcomes of the appointment. Remember that all your dentist wants is to check that your teeth and gums are healthy, and then hopefully send you home reassured that you are looking after your teeth sufficiently.

If you need some work done to keep your mouth in tip-top condition, your dentist will explain clearly what they are recommending and what the process will involve. If you tell your dentist about your concerns they will be able to offer dialogue and reassurance throughout the process and work with you to ensure that you are feeling fully informed. Clear, concise information can really help mitigate feelings of anxiety and if your dentist knows this is important to you, they will no doubt love to talk about it in more detail and help you feel reassured.

Learned behaviour

One of the most common reasons that children are nervous about visiting the dentist is because they have witnessed their parents eliciting signs of nerves. From a very young age, children are like sponges, soaking up what they see and hear around them, and they are surprisingly perceptive.

If you are bringing children to the dentist and you are prone to suffering from dental anxiety, try and pretend that you are not phased by the experience. Putting on a brave face for the sake of the kids is a great coping device and will mean that they are less affected by your own fears. Not only that, if you successfully put on a brave face throughout an appointment, focusing your thoughts on your children rather than your fears, you might be pleasantly surprised that the whole experience isn’t nearly as daunting as you were expecting.

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Dental anxiety linked to poor self-confidence and can lead to social isolation

 

Most of us don’t love going to the dentist, but for a surprisingly high number of patients – the Oral Health Foundation estimates that approximately 10 million adults in the UK suffer from dental anxiety to some degree – it can develop into a dental phobia that prevents them from seeking treatment even if they are suffering extreme problems with their teeth.

dental anxiety

Now, a new study published in the International Dental Journal has revealed the true impact that dental anxiety has on sufferers. The issue extends beyond your oral health and, in fact, it can negatively affect social wellbeing such as income and education and will typically extend into the next generation.

Dealing with dental phobia

A few years ago, a study published in the British Dental Journal evaluated the use of cognitive behavioural therapy or CBT. Twenty-one patients with severe dental phobia underwent CBT and twenty of them were able to undergo dental treatment without sedation.  For patients that are unable to undergo this approach, choosing a dental practice that is experienced with treating nervous patients is key.

At CK Dental in Bristol, we are skilled at putting nervous patients at ease. Our approach is as follows:

  • An informed patient is a confident patient: we discuss all aspects of your treatment and what you can expect every step of the way as we find that patients are less nervous if they are fully informed
  • Pain-free dentistry: no dental procedure should be painful and we use pain relief and local anaesthetic injections to ensure the experience is pain-free
  • Conscious sedation is an option: carried out by our consultant anaesthetist, the patient is semi-conscious, so they are completely comfortable and relaxed throughout their procedure.

At CK Dental, we differ from other private dental clinics in the UK as we can also offer patients the option of having dental procedures performed under general anaesthetic. This can only be performed within a hospital environment and CK Dental is located in the Nuffield Health Bristol Hospital, so you have all the assurance of a state-of the-art facility combined with our expert care.

To find out more about our approach to dental phobia, call us on 0117 906 4868 to arrange a consultation.

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UK scientists find a way to regenerate tooth enamel

dental erosion treatment BristolTooth wear is on the rise in the UK with over three-quarters of adults and 50 per cent of children showing some signs or erosion or abrasion. Tooth enamel is the hardest structure in the body, even harder than bone. It coats our teeth, protecting the sensitive dentine layer underneath and it can become eroded gradually as the result of acid attack.

As well as aesthetic changes to the teeth, enamel erosion can lead to increased sensitivity to taste and temperature and also puts sufferers at increased risk of tooth decay. Up till now, it’s not been possible to reverse enamel erosion, but researchers at Queen Mary University of London have recently developed an innovative way to regenerate lost dental enamel.

The scientists found a protein that triggers the growth of crystals similar to the way that dental enamel develops in the body. “This is exciting because the simplicity and versatility of the mineralisation platform opens up opportunities to treat and regenerate dental tissues,” Dr Sherif Elsharkawy, a dentist and part of the team, explains

This discovery could have many applications in regenerative medicine and be of huge importance for modern dentistry. However, in the meantime, preventative measures remain the most effective solution to dental erosion.

How do I prevent dental erosion?

Every time you eat or drink anything acidic, it attacks the enamel on your teeth, causing your teeth to become softer until your saliva restores the natural balance in your mouth. Over time and if this acid attack happens too often then this repair process becomes less effective and enamel becomes eroded. Medical conditions such as alcoholism, bulimia or oesophageal problems which cause vomiting or release of acids into the mouth from the stomach can all increase the risk of enamel erosion.

Here are our tips on how to prevent enamel erosion:

  • Fizzy drinks can be highly acidic and should be limited to mealtimes to reduce the number of acid attacks on the teeth
  • Don’t be fooled by diet or healthy options – even flavoured fizzy water can cause dental erosion over time as they contain weak acids
  • Many sports drinks also contain ingredients that contribute to dental erosion
  • Limit highly acidic foods and drinks such as fruit and fruit juices, particularly citric juices as they contain high levels of natural acids
  • Using a straw can reduce contact on the teeth
  • Certain foods and drinks can help cancel out acid attacks such as cheese and milk
  • Chewing sugar-free gum after your meals can stimulate saliva production
  • Don’t brush teeth immediately after eating or drinking as it gives your teeth a chance to harden
  • A fluoride toothpaste and/or mouthwash should be used

Regular check-ups are also an essential aspect of prevention as erosion can be spotted at an early stage and treatment provided, in the form of a filling or crown, if required. Call Bristol dentist CK Dental on 0117 906 4868 to arrange a check-up today.

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Is juicing good for your teeth?

is juicing good for your teethIn recent years, juicing has exploded in popularity for its many purported health benefits and high concentration of natural vitamins and minerals. However, many juices, particularly those that are heavy on fruit contain a lot of natural sugars (hence their sweet taste) so can be damaging to your teeth and your waistline. Some also contain natural acids which can cause problems with your teeth enamel too.

Sugar levels in blended fruit

When you blend fruit, it is reduced to three simple components – water, natural sugar and flavourings. This essentially means that drinking fruit juices can be similar to drinking sweetened sugary drinks, as your teeth are being exposed to similar things. Sugar, whether added as part of the flavouring process or existing naturally in a drink created from fruit, can be bad for your teeth as it can cause plaque, tooth decay and gum disease.

Guidelines recommend limiting fruit juice intake for children for this very reason: “The American Academy of Pediatric Dentistry even recommends restricting the amount of fruit juice that you give your small children to less than one cup per day.  They have recognized the devastating effects that fruit juice can have on kids’ teeth.” Here at CK Dental we strongly advocate adhering to guidelines such as this, especially in relation to children’s teeth as if damaged is caused when the teeth are developing it can have a knock-on effect onto adult teeth and your on-going oral well-being.

Fruit acidity

There is no evidence to suggest that acidity levels of fruits increase when blended, so it should not make a difference to your teeth whether you eat fruit segments, slices or fruit smoothies. Care should be taken not to eat too many fruits with high acid content, as these can damage the delicate enamel that coats your teeth. Fruits with high natural acid content include oranges, grapefruit and tomatoes (which, yes, do technically class as a fruit, not a vegetable!).

So, what are the problems that can be caused by jumping on the juicing trend:

  • Stubborn surface staining: although juices with a high veg to fruit ratio are probably kinder to our teeth, the chlorophyll in green tea and veggie juices can cause staining. Using a straw will reduce direct contact with your teeth and drink a glass of water afterwards to restore a neutral pH.
  • Enamel erosion: softening of the enamel, as a result of the acids in fruit and vegetables, is often an invisible process until the damage is done and there is long-term enamel loss. Regular check-ups with your dentist or a dental hygienist can ensure your dental health.
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Can teeth whitening damage your teeth?

can teeth whitening damage your teethTeeth whitening has flourished in popularity in recent years, and there is now an expectation for many people that the definition of a ‘good smile’ is synonymous with not just straight, evenly sized teeth, but also perfectly white teeth too.

Gone are the days when stains left from substances such as red wine, coffee and tobacco were seen as ‘just one of those things’ – nowadays there are a plethora of solutions that consumers can use (either professionally or within their own home) to remove staining from teeth.

But just how safe are these products? Can they risk damaging your teeth?

The first thing to note, is that teeth whitening is not a permanent fix – the effects will wear off over time and the speed in which this happens is largely affected by whether or not you consume things that could stain your teeth again.

We have heard teeth whitening likened to the effect of bleaching a tea or coffee cup to remove the tannin staining. No doubt most of us have been told that if we bleach our cups it is making them more susceptible to future staining, therefore we’re making a rod for our own backs – i.e. the more we bleach our cups the faster they will stain again in the future. The cynics amongst us suggest the same is true for if we whiten our teeth, but is there any truth in this?

This very much depends on the type of whitening product you choose to use.  A recent investigation into teeth whitening found that “products using 10% carbamide peroxide showed no effect on the hardness or mineral content of a tooth’s enamel surface”.

DIY teeth whitening can be riskier

If you’re in any doubt, then it is best to leave teeth whitening to the experts. At CK Dental in Bristol, we will only use products that have been stringently tested and are passed as suitable for purpose. Products that can be purchased over the counter vary enormously, and are administered by hand, which always carries an enhanced risk factor (what if you get distracted part way through or don’t read the instructions correctly).

Products that are available to purchase over the internet are even more risky, as many sites are not regulated at all, so you have so real way of knowing what you are purchasing or the strength of the active ingredients.

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Myth busting – why are they called wisdom teeth?

There are many words, phrases and sayings that we all happily recite, but few of us know where they came from and what caused them to be created. Wisdom teeth are a great example of this. We will know that the large teeth that emerge later in life at the back of our mouths are called wisdom teeth, but I expect very few of us know why they were given that name. Well, let CK Dental here is Bristol expand your knowledge in this area (and at the very least, give you a good answer to a pub quiz question).

These teeth are technically our ‘third molars’ and their nickname has been around for centuries. Back in the seventeenth century there are records of them being labelled ‘teeth of wisdom’ and this morphed into ‘wisdom teeth’ at some point during the nineteenth century. And what gave them this name?

“It is generally thought among linguists that they are called wisdom teeth because they appear so late, at an age when a person matures into adulthood and is “wiser” than when other teeth have erupted.”

Throw some science into the equation

The interesting thing is that there is now some science which sits behind this label. Tests carried out on the brain over many years of research have concluded that many people do not research emotional maturity during their adolescence, and that their brain continues developing well into our mid-twenties. This, coincidentally, is when a lot of us will start to see wisdom teeth arriving (although occasionally these can come through as early as the late teens), so maybe it really is true that as we begin to reach a more emotionally stable (and wise…?) time of our lies, this is when our wisdom teeth also join the party.

Wisdom teeth are actually pretty pointless

Despite their colloquial link to wisdom, there are actually few benefits brought by wisdom teeth. Often, they can cause discomfort and overcrowding and do not offer any practical benefits compared with before they arrived. If they do cause pain or problems to existing teeth, it is often recommended that they are removed. But, don’t be scared. At our Bristol dental clinic we are able to offer wisdom teeth removal under sedation or even under general anaesthetic, if required. Call 0117 906 4868 to arrange a consultation.

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Millennial trends in oral care

You’ll have heard of the baby-boomers and probably generation Z, but what about the latest generation labelling… millennials. We are surrounded by millennials, they are the generation who were born between 1980 and the late 1990s, and according to popular culture, are a tech-savvy generation, who value getting a suitable balance between home and work and are not purely driven by career progression.

Millenials have ‘dual lives’ with many having an online presence on a number of social media platforms in addition to making friendships and connections via the more traditional routes, and absorb information in a different way compared with previous generations. Short, punchy information is more likely to cut through, rather than things that are too lengthy or dry and can’t compete successfully for millennials’ attention.

A recent poll of over 2,000 millennials found some interesting insights regarding their approach to oral hygiene and the priorities they place on their dental routine.  Here at CK Dental in Bristol we found some of the findings slightly concerning:

  • Three in ten claims to only brush their teeth once a day
  • Some go two or three days at a time without brushing their teeth at all
  • Just over half suggest they are concerned about losing their teeth as they get older… despite some worrying habits that they are demonstrating now

This is hopefully an isolated set of results and not typical of a whole generation, but even if there are just small number of people who are not taking their oral care seriously enough, it is suggesting that people are lacking awareness of the repercussions of neglecting your teeth and gums.

Brush, brush and brush again

It is recommended that you brush at least twice a day for at least two minutes per brush. This is typically in the morning after you’ve had breakfast (leaving you with minty fresh breath to start the day and a clean set of teeth and gums following your coffee and cereal or whatever breakfast treats have taken your fancy) and once in the evening before bed. B

Brushing your teeth after breakfast is ideal because many breakfasts contain sugars – whether that be natural sugars in fruits or sugars that have been added to cereals or breakfast bars, if you give your teeth a thorough clean once you’ve finished your breakfast it will set you up well for the day.  If you’re really diligent and have an opportunity to do some, brushing your teeth after lunch is also a great idea.

Adopting good dental habits

Flossing is also important as it enables you to remove tiny pieces of food that have found their way into gaps between your teeth that brushing alone wouldn’t struggle to remove. These are regular, important habits to adopt at home, but it is also important to have regular check-ups with your dentist, so that they can check the overall health of your teeth and gums and can also check areas in your mouth that you would struggle to see yourself. Not only that, most people won’t know what to look out for in terms of warning signs.

 

 

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Implications of missing teeth

If you have lost a tooth then, depending on where that tooth was located in your mouth, you may regard it to be a big problem, or you may feel it’s something you can live with.

missing teeth

Here at CK Dental our philosophy is that losing a tooth is not something that you should view lightly – even if you don’t think it is a big problem because it’s not immediately visible to others, you should know what the implications are of not replacing a lost tooth so that you can make an informed decision.

Location

The first thing to consider is where in your mouth the missing tooth was located. If it was at the front and was more visible, then its loss is probably affecting your smile. If that is the case, it is probably affecting your confidence too.

Speech

You may notice that since losing your tooth your speech has become affected – this is very common. Your tongue and teeth are integral to how your words are formed, and when something is unexpectedly changed in your mouth, you can expect that it will affect how your words sound when you try and pronounce certain things.

Trouble chewing

You’ll have to make a concerted effort to find different areas of your mouth to tackle more challenging foods, ones that require more effort to bite, chew or break up.

Moving teeth

If you leave a gap unfilled you may find that other teeth begin to move around once they notice a space has been vacated. This can lead to issues with how your teeth look and feel – you may find that your ‘bite’ feels different as even small changes to where your teeth rest when you close your jaw feel significant.

With this in mind, it is no wonder that most patients choose to fill the gap of a missing tooth with a man-made equivalent. Implants and veneers can be fitted and will be designed to fit with your natural teeth as closely as possible. Not only will solutions such as this restore confidence and make you happier with your smile and how you’re able to annunciate, but they will help ensure that you don’t suffer further oral complications as a result of a missing tooth.

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