Tips and frequently asked questions

Milk teeth begin to erupt around the sixth month of life and finish by age two. At that point the child has 10 teeth in each jaw (20 in total). The first permanent tooth erupts in the sixth year (the famous “sixes”, which have no milk predecessor). Parents should pay attention so that these — like all other teeth — are protected from decay.

Milk teeth should be repaired, since their health is very important for the proper development of the jaws. They are treated just like permanent teeth.

Visits to the dentist should start at age two, and at the latest at two and a half — to check the health of the oral cavity, but also so the child gets used to the doctor and the practice environment. Parents should bring the child along when they go to the dentist themselves and set a personal example for the child's behaviour. A child should not be frightened with injections, extractions and the like.

If the teeth and jaws are not in the correct (optimal) position, we speak of orthodontic anomalies. They most often develop unnoticed by parents, so only a dentist can spot them. Every visit of a child to the practice should also be used for an orthodontic check — anomalies caught in time can be stopped with minor interventions. We monitor hereditary anomalies, diet, the timing and direction of milk-tooth eruption, breathing patterns and bad habits (e.g. thumb sucking).

The first permanent molar. It erupts behind the last milk tooth in the sixth year and has no milk predecessor, so parents often fail to recognise it as a permanent tooth. It is the largest tooth in the row and the key to occlusion (the bite) — essential for the correct relationship of the jaws and the positioning of the other permanent teeth. It erupts during a period of poor hygiene, often surrounded by decayed milk teeth, has deep fissures and still-unmineralised enamel — which is why it is the most vulnerable permanent tooth and usually the first to be extracted due to decay.

The most common cause is dental plaque — deposits on the teeth containing carbohydrates, bacteria and other matter. If teeth are not brushed properly, plaque builds up and, with bacteria (streptococci) present, acidic products form that damage the enamel — this is how caries begins. Caries advances through the enamel into the dentin, where it spreads much faster. Pain on cold and sweet means it has reached close to the pulp (the “tooth nerve”). Without intervention the infection reaches the pulp (pulpitis — death of the nerve with extremely severe pain), then passes into the bone, breaks through it and creates swelling, and finally a fistula whose treatment almost always leaves visible scars.

That is why PREVENTION and health awareness are key: you should visit the dentist at least once a year so caries is caught at an early stage. If everyone did this, no one would lose a single tooth to caries in their lifetime.

White (composite) fillings certainly last more than 5–6 years. The exact lifespan depends on how much tooth tissue was restored, which part of the tooth the filling is on, whether it was correctly placed in layers, the power of the curing light, the adhesive systems used and the patient's oral hygiene.

Old amalgam fillings should be replaced only when necessary: if the filling is failing, if cracks are visible, if the bond with the tooth has weakened, or if caries has appeared next to the filling. Of course, if the patient wants a replacement for aesthetic reasons, we will place composite (white) fillings.

No. While it had its “nerve” (the neurovascular bundle), the tooth was nourished through it. Once the diseased pulp is removed, the tooth still receives nourishment from the blood vessels of the jawbone — reduced, but present. If the tooth were truly dead, the body would reject it as a foreign object. A treated tooth is more brittle than others, often needs reinforcement with a post, and may become darker.

All toothpastes and mouthwashes that contain fluoride are good. There are pastes for smokers that remove deposits better, as well as anti-tartar pastes. Pastes and mouthwashes are a useful complement to the brush and dental floss — but rinsing alone will not remove plaque without a brush.

Tooth decay is prevented by proper brushing. Chewing gum can help, but only sugar-free gum with xylitol — the breakdown products of this artificial sweetener are indigestible to bacteria. Sugar-sweetened gum is extremely bad for the teeth. An added benefit: chewing produces a large amount of saliva and self-cleans the teeth, and if the gum contains fluoride the effect is even better. Use gum after meals for 5–10 minutes so you don't overload the jaw joint and muscles. It is an additional protective measure — never a substitute for the brush.

Tartar forms through the mineralisation of soft deposits on the teeth, incorporating magnesium and other salts from saliva. It is yellowish, but becomes stained by pigments from food and drink (black in smokers). It most often builds up on the tongue side of the lower front teeth and the cheek side of the upper molars. It should be removed regularly — the doctor does this with hand instruments or an ultrasonic device, then rinses the gums.

Fluoride is added where there is not enough of it in drinking water (concentration below 0.7 mg/l). Today the practice is to give it to children from the sixth month of life, when the first teeth erupt — one 0.25 mg tablet every evening before bed. In places with elevated fluoride in the water (over 1 mg/l), endemic fluorosis appears (brownish-stained teeth) and fluoride is not prescribed. Always consult a dentist before giving fluoride to children.

If an X-ray shows that the lower wisdom teeth will not erupt properly, there are advantages to earlier removal — before the roots finish growing (around age 16). The roots are then formed halfway, crowding in the incisor region is smaller, and a child of that age cooperates well during the procedure. If as early as age eight it is established that the wisdom teeth will have no room, a germectomy can be planned — removal of the tooth bud before the crown begins to calcify.

It is better to remove impacted teeth at a younger age, while the patient is in full health and the bone is relatively soft, elastic and well supplied with blood — recovery is good then and complications very rare. Removal is postponed if eruption is expected, if the tooth is needed for prosthetic reasons, or if the impaction is deep, causes no trouble, and removal would be difficult.