By: Camille Hogg | December 20, 2017 | Abu Dhabi World Online
From cavities to consultations, we find out about the main dental issues in Abu Dhabi and how to pick a good dentist.
Your smile says a lot about you, and that’s especially true when it comes to your teeth.
With cavities and gum disease on the rise, we consult the experts on maintaining good hygiene, dealing with dental emergencies and knowing what to look for in a clinician.
The root of the problem
“The two biggest diseases in dentistry are caries – or cavities – and periodontitis,” explains Dr Per Rehnberg, CEO at Snö Clinics.
Caused by factors including poor oral hygiene and diet, cavities are common in children and adults, and occur when your tooth enamel begins to erode due to acids caused by bacteria.
With a particularly high prevalence of decay in the region among children, Dr Per is keen to emphasise that more awareness is needed of the detrimental effects our sugary habits have on our teeth.
“In this region, the caries in kids are so much worse. Kids drink a lot of juice and soda, and the low pH means that the soda is acidic as well as sugary, so we see a lot of eroded teeth,” says Dr Per.
Dr Heba Aboushady, general dentist at the Boston Dental Center, agrees.
“Adults misunderstand the right diet for the teeth and switch from milk to fruit juices; these are actually very high in sugar and acids,” she emphasises. “We need more education on healthy diets and how to follow basic oral hygiene instructions.”
But with pain, sensitivity to cold and, in severe cases, visible holes as key symptoms of caries in children and adults, the solution isn’t always drilling.
“Small caries can be healed without drilling,” Dr Per clarifies. “If you do flossing and fluoride treatments, we can check in three to six months and you may not need a filling, so [the tooth] will have much better longevity.”
Even with larger cavities, there are still options before you need to undergo a root canal, where the infected pulp from inside the tooth is removed and the tooth sealed.
“The root has a function, so once you replace it with a root filling, it shortens the lifespan of the tooth,” Dr Per explains.
“When [the cavity] is middle-big and gets closer to the nerve, you can still do a filling in that case without a root canal treatment.
“If you have a cavity that is close to the pulp, one way of treating it is to have a special kind of dressing and calming filling on top of that in order to save the root,” he adds.
Periodontitis is another common disease in the region, but unlike cavities, pain is not a common symptom until more advanced stages.
“Many people in this region are under-diagnosed with periodontitis,” says Dr Per. “It’s not usually painful for the first ten to 15 years, but then it’s often too late to save the teeth.
“It generally starts with bleeding gums. Bad breath could also be a factor. When you eat, food gets stuck between your teeth and causes inflammation as it rots; this causes tooth loss. We also associate calculus (plaque that has hardened and cannot be removed by brushing) with the disease, which can be removed at the hygienist.”
One key way to slow the disease down is flossing, and Dr Per recommends a once-a-day regimen.
However, whatever your problem, acting early is key, as regular check-ups can prevent problems from escalating.
Things you should look out for include pain or sensation when you consume something cold, as well as bridges, crowns or problematic wisdom teeth – and any jaw joint issues should be dealt with by your dentist, too.
With many of us harbouring a deep fear of the dentist, we often ignore our problems before it becomes an emergency – and that’s not a good idea.
“There’s often a difference in opinion between the dentist and their patient as to what constitutes an emergency,” Dr Heba chuckles wryly.
“When there’s a cosmetic problem, like a tooth has fallen out or a filling has broken, I find that patients come in quite quickly, but with pain or infection, it’s not always the case.
“As a dentist, things like swelling on one side of your face, fever and difficulty swallowing can indicate a life-threatening infection,” Dr Heba states.
“Things like accidents involving knocked-out teeth also need quick intervention, and constant pain might be an abscess or deep cavity. One thing people don’t know too much about is that if you have red patches or ulcers in the mouth, you need to take instant action.”
Dr Per agrees, noting the location of the pain or problem: “Go quickly to the dentist, especially if the infection is in the lower jaw.”
With so many options on the market, it can be hard to know what to look for when picking your dentist.
“That’s the hard thing about being the patient,” agrees Dr Per. “You just don’t know. We have a transitory community here and people don’t tend to get that long bond with their dentist that they might get in their home country.
“One way is to make sure you can audit what the clinic has done,” he adds. “You need to ask to see the documentation, diagnosis, x-rays, printouts and treatment plans so that if needed, you can get a second opinion.”
While many dentists may offer deals for free consultations, Dr Per recommends knowing what you’re getting from the experience.
“It’s very important to have a proper exam,” Dr Per advises. “If you don’t have all the data on the patient’s specific conditions, it’s very hard to suggest the right treatment – it’s like building a house without having a foundation.
“Many dentists might offer a free exam, but these may not be full exams – a proper one would usually take at least 45 minutes and will detail the status today, risk calculation and a prevention plan.
“Patients also need to be informed about problems that might happen,” Dr Per adds. “Many dentists are reactive; they might only treat symptoms like tooth pain, but a good dentist would look at underlying causes.”
For Dr Heba, communication is a huge factor.
“A good dentist will explain everything to the patient, including treatment options, the procedures involved, the expected outcome and, of course, involve the patient in any decision making,” she says.
“Going to the dentist can be scary – I was that child and I had a bad experience,” she laughs. “These days, it’s very different: there are new techniques, technologies and types of anaesthetic.
“We don’t want you to have more pain; we want you to be rid of it, and a good dentist will explain what they’re doing.”
At the end of the day, make sure you feel confident before you put your money where your mouth is, says Dr Per.
“Establishing trust with your dentist is very important, and if you don’t like the clinic or clinician, then close your mouth and get a second opinion.”
Word of mouth
Good oral hygiene takes some effort, so here are our experts’ top tips.
Have regular check-ups: Scheduling a check-up depends on your oral health, says Dr Per. If you have ongoing conditions such as periodontitis or you’re at increased risk of cavities, you’ll need them more frequently, but between six months and one year is common in the UAE.
Get a fresh brush: “You need to change your brush every three months – and use a soft one,” Dr Heba says.
Don’t forget to floss: “Use floss or interdental brushes if you have a brace, crowns or bridges. They have tighter contact than air flossers,” Dr Heba says.
Supplement with fluoride: “Water here has no fluoride,” says Dr Heba. “Fluoride application for children can help reverse early signs of decay.”
By Camille Hogg
December 20, 2017