Midrand Dental Excellence

Frequently Asked Questions

What about Fluoride?
There is a shift in the way we think fluoride works- formerly the assumption was that the incorporation of fluoride in the enamel apatite lattice during tooth formation and mineralization, resulted in permanent or long lasting resistance to dental decay, was its main mode of action. However it has been found that the fluoride rich surface layer of the enamel, which was a result of the systemic fluoride administration, was gradually lost.

The present view of the mechanism of fluoride in caries prevention is that fluoride has to be present in the plaque fluid during the caries challenge. Slowing down the dissolution of enamel and supporting the precipitation phase.

It has also found that the topical application of fluoride results in the formation of calcium fluoride crystals accumulated on the tooth surface. When pH is lowered during a caries challenge, the crystal is dissolved and provides fluoride that controls the caries attack. Thus, topical application by forming CaF2 crystals constitutes a pH-controlled fluoride slow release system ready to act when needed. This new view has to a great extent changed the practical way of utilizing fluoride.
Is flouride supplementation in the form of tablets or drops still advisable? What protocol?
I don't recommend systemic fluoride (swallowed tablets or drops) even if some well controlled clinical studies of fluoride tablets have resulted in statistically significant reduction of caries. The necessity of extremely good parental cooperation for many years and a potential risk of dental fluorosis have caused the use of this regimen to decrease. In addition it seems as if systemic administration of fluoride pre- eruptively has very little effect in a caries preventive perspective. Much of the effect of systemic application of fluoride has been explained by the simultaneous topical fluoride exposure post eruptively. So if you are using fluoride tablets they must be sucked or chewed. Pre eruptive administration always carries the risk of fluorosis.

Topical fluoride is one of the most important ways of preventing caries. This can be achieved by frequent application of low concentrated fluoride solutions or preparations brushing or rinsing. As a general rule the fluoride should be matched against the caries activity. That is the greater the cariogenic challenge, the more intense the fluoride treatment.
What is root treatment (Endodontics)?
We spend time with you. We do tests. For example, have you ever had an adrenal insufficiency test or had testing for hypoglycemia? We examine your history and then look at genetic, environmental and lifestyle factors that affect your long-term health as well as complex, chronic disease such as autoimmune deficiency, muscle and joint pain, diabetes, acute cholecystitis, hypothyroidism and others. As a result, functional medicine supports your specific health and helps you to discover how to live a happy life, free of problematic conditions such as depression, extreme fatigue, brain fog, sudden hair loss, cold hands and feet, unexplained weight gain and so much more.

Visiting a functional medicine doctor, is not like visiting a traditional MD. We really listen to you. In addition to talking a lot about your history, we ask about your mental and spiritual health and want to know about your social life. We want to see the whole picture. Once, we’re satisfied with test results and feel we have enough background information, we’ll work together on designing a treatment plan just for you.

Often, the news is good. Many health issues can be successfully treated as long as the right causes are identified. Some people are restored to optimum function, others see substantial improvement to their condition and others can take steps to help prevent their disease or condition from worsening.
Why do we root treat teeth?
When the pulp is injured or diseased and unable to repair itself it becomes inflamed and eventually dies. Causes of pulp death are decay, deep fillings, trauma, cracks in teeth, gum disease etc. When the pulp is exposed to bacteria from decay or saliva that has leaked into the pulp system infection can occur. If left untreated infection occurs at the tip of the root forming an abscess. This can lead to swelling, pain and tooth loss.
What is the success rate of root treatment?
Usually 80-95% successful. Those in the failed group can sometimes be re-treated or surgically treated. Although no treatments success can be guaranteed so long as the tooth has a sound restoration and there is good oral hygiene there is every reason for a successful outcome.
Will the root treated tooth discolour?
Discolouration can sometimes occur and if necessary these teeth can be whitened (bleached). They often have large restorations making them vulnerable to fracture and require crowns anyway and then discolouration isn't a problem.
What are the alternatives to root treatment?
Only extraction and this may lead to shifting and crowding of surrounding teeth with loss of chewing efficiency. While root treatment is expensive the long term cost of replacing a tooth or repairing a smile is usually more expensive.
Will the tooth need a crown or cap after treatment ?
It depends on how much sound tooth structure is left. Loss of tooth structure significantly weakens the tooth and makes it more susceptible to fracture. Often a crown is recommended to help protect the tooth from breaking or splitting.
Will the tooth need a crown or cap after treatment ?
It depends on how much sound tooth structure is left. Loss of tooth structure significantly weakens the tooth and makes it more susceptible to fracture. Often a crown is recommended to help protect the tooth from breaking or splitting.
What does root treatment involve?
  1. Local anaesthesia.
  2. The tooth is isolated with a rubber dam (a piece of plastic) to prevent contamination from saliva and to protect the patient.
  3. An opening is made through the top of the tooth to gain access to the root canal system.
  4. The pulp tissue is painlessly removed with special instruments called files.
  5. X-rays are taken every so often and measurements with electronic locators are used to determine and verify the root canal lengths.
  6. The root canal/s are cleaned, enlarged, shaped and rinsed so that it can be filled at the final appointment.
  7. Sometimes medication is placed in the root canals to prevent infection between appointments.
  8. A temporary filling is placed in the tooth opening between appointments.
  9. At the final appointment the canal is sealed with warmed plastic points and sealing cement to safeguard it from further contamination.
  10. Permanent restoration (filling or crown etc) is accomplished after completion of the root canal treatment.
Will it be painful after root treatment ?
In most cases there will be mild discomfort for just a short while which can be treated with over- the- counter anti-inflammatory or analgesic agents such as aspirin (Disprin) or ibuprofen (Nurofen) containing compound.

Prophylactic administration of these drugs will help reduce postoperative discomfort by achieving therapeutic blood levels before the local anaesthetic wear off. If pain is more than mild or prolonged please telephone the practice and we will prescribe stronger agents..