Dentistry

There are generally 2 types of commercially available mouth rinses – alcohol-based and specific chemical based. Different mouth rinses have slightly different functions but they are generally used to maintain oral health and hygiene.

Being fluid-based, mouth rinses would seldom burn the tongue too badly. However, it is not uncommon for some people, after using certain types of mouth rinses for a long period of time, to experience taste changes. This is usually a temporary phenomenon and the person will usually fully recover after discontinuing usage of the mouth rinse, since the mouth rinse only affects the superficial layer of the tongue/taste buds. The taste buds usually recover quickly and the nerve supply (taste sensation) of the taste buds is not affected by the mouth rinse in the long run.

Contributed by Dr Ansgar Cheng, eMenders Dental Surgeon

Teeth-grinding during sleep is known as nocturnal bruxism. Usually, those that do grind their teeth when sleeping do not remember having done so. In adults, this condition is known to be related to stress and facial pain.

Children usually outgrow their nocturnal bruxism and suffer no short-term or long-term ill-effects. Up to this point, a predictable way to stop nocturnal bruxism has not been identified.

Contributed by Dr Ansgar Cheng, eMenders Dental Surgeon

There are a few common causes of mouth ulcers.

Ulcers caused by minor trauma (e.g. burn by hot food) usually occur on the roof of the mouth or the tip of the tongue.

Ulcers that are caused by virus (e.g. herpes virus) commonly occur on the lips and sometimes on the inner side of the lip. Before the onset of herpetic ulcers, the individual may experience flu-like symptoms, such as low energy level and a runny nose. The affected area may feel itchy during that time (itchiness is a form of minor pain sensation). The area will form vesicles and then it will become painful and form an ulcerated area. Approximately 90% of the population carries this virus, and most do not have any symptoms.

Some mouth ulcers are of unknown causes (e.g. apthous ulcer) – they can come in single, or multiple form, in small or big clusters. This form of ulcer happens commonly in younger females even though other age groups and genders are not immune to it.

The good news is that most of these oral ulcers heal by themselves without much medical intervention. Topical ointment can be purchased from most pharmacies without prescription to alleviate the pain. Most of these ointments work by forming a protective layer over the ulcer and/or having a local anaesthetic effect.

Oral ulcers that last more than 10 days may be a result of infected teeth, infected gums or even malignancy. If this happens, please see your dentist for a consultation.

Contributed by Dr Ansgar Cheng, eMenders Dental Surgeon

In conventional medicine, doctors are trained to examine the tongue as part of the physical examination for patients. The doctor can detect certain abnormalities in the general functioning of the bodily systems from looking at the tongue. For example, cyanosis or a lack of oxygen in the blood can be detected by inspecting the colour of the tongue. In addition, looking at the coating on the surface of the tongue can also suggest the state of ones oral hygiene, nutrition, recent use of medications and general health status. Examining the tongue is also part of the examination of the mouth and oral cavity so that abnormalities such as tumours and infection can be detected.

The motion of sticking out ones tongue and saying ‘ah’ would allow the doctor to have a chance to inspect the condition of the throat and the tonsils. The presence of swelling, plaque, change of colour, or dehydration also indicates diseases of various types. A quick inspection of the oral cavity may also reveal any dental condition that may cause systemic symptoms (e.g. fever due to a dental infection).

In addition, inspection of the tongue can give a quick overview of a persons general health. Conditions such as diabetes may show up as dryness of the oral cavity and certain forms of bad breath (e.g. ketosis). Nasal sinus infections may also show up as bad breath. Deviation of the colour and contour of the tongue may also reveal certain dietary insufficiencies such as Vitamin B, iron, or folic acid.

Recently scientific evidence also showed that bacteria that stays in the oral cavity is related to other system conditions such as heart disease.

Contributed by Dr Ong Kian Chung, Respiratory Physician and Dr Ansgar Cheng, eMenders Dental Surgeon

You are most likely suffering from lip dermatitis. The causes of lip dermatitis are diverse. One of the common causes is habitual licking of the lips and the surrounding skin. This is a type of irritant contact dermatitis caused by saliva. The constant moisture together with certain chemicals in the saliva will break down the skin, causing lip dermatitis.

We have to go through the list of causes to find out which one is causing your problem. If necessary, we may have to do prick or patch test for you. Usually the problem can be solved by taking a more detailed history from you.

Contributed by Dr Lee Chui Tho, Dermatologist

Crowns offer an overall coverage of teeth. Crowns are indicated when there is a need to strengthen teeth that are mechanically weakened (e.g. teeth with large cavities).

Veneers, in general, refer to thin porcelain coverings that are bonded onto the exterior of the tooth. Good quality enamel, preferably intact enamel, is required for successful bonding.

Both crowns and veneers may be used for modifying colors or position of teeth.

Research for crowns has been done for a longer period of time while veneers are a relatively new procedure with less long-term scientific studies about them. The success rate for both is about 85% for the past ten years. This means that out of 100 crowns or veneers procedures done, about 15 of them need to be repaired or done again.

Weak or sensitive gums require gum treatment. Crowns or veneers cannot treat gum problems.

It is advisable to consult a dentist to assess whether crowns or veneers are suitable for you and whether you need to address any existing gum problems.

Contributed by Dr Ansgar Cheng, eMenders Dental Surgeon

1) It is not possible to comment on the financial arrangements of various practices. It is recommended for the patient to discuss directly with his or her dentist.

2) Similar to the above question, it is difficult to answer the question on fees as these are different for various practices (range may be wide) and may be complicated by factors such as degree of difficulty and demand of the individual patient. But a ballpark figure would be $4000 to $6000 per complete impact procedure, assuming the case is straightforward with no additional procedure such as bone or soft tissue augmentation required.

The treatment option for decayed tooth would depend on the extent of the decay. The dentist would first examine the tooth clinically and may order an x-ray to be taken before discussing the treatment option. A small cavity can be filled with amalgam or composite resin, which has the same color as the tooth. Amalgam can be used on back teeth where aesthetics may not be a concern while composite resin can be used on both the front and back teeth.

If the cavity is more extensive, the dentist may prescribe an inlay which may be gold or ceramic. Gold (white or yellow) is the most time-tested material and has been shown clinically to be excellent durable dental material. However, gold may not be aesthetically acceptable to some patient. Ceramic inlay has the advantage of aesthetics and also higher strength compared with composite resin.

A more extensive decay that weakens the strength of a tooth may require an onlay or crown. In the event that the pulp of the tooth is involved, root canal treatment may need to be performed before the crown is fabricated.

In summary, filling is definitely not the only solution for a decayed tooth. The treatment really depends on the extent of the decay. A dentist will conduct a through examination before recommending the best treatment option.

Contributed by Dr Neo Tee Khim, eMenders Dental Surgeon

Braces are custom-made appliances which correct irregularities in teeth, e.g. straightening crooked or overlapping teeth, or protruding teeth.

The cost of braces will depend on a variety of factors such as:

• the complexity of the case;
• the type of braces being used;
• whether braces are used on both upper and lower teeth, or only one row of teeth;
• whether a general dentist or an orthodontist is consulted; and
• whether treatment is provided by a dentist in private practice or at a government institution.

There are two main types of braces: fixed and removable braces. Removable braces cost less but may not be suitable for everyone, and an orthodontist would be able to advise on what is the best option for a patient.

The fees for braces generally vary from $2000 to $7000, depending on the above factors. It is unlikely that there are subsidies for braces as it is generally considered to be an elective procedure unless there are medical grounds for its use. It may be possible to work out a monthly installment plan with your orthodontist.