Frequently asked questions

The literature describes 50–60 different causes of bad breath, and most of them relate to the gums. Common causes include gum inflammation (gingivitis, periodontitis), impacted wisdom teeth, poorly fitting crowns and bridges, or faulty fillings. There can also be causes outside the mouth, such as throat infections, chronic sinusitis, reflux, digestive problems or diet. That is why an accurate diagnosis should come first, with treatment planned accordingly.

The main cause of gum disease is microbial dental plaque, and the make-up of your saliva plays a role in how it forms. Saliva composition is inherited, which is why tartar builds up faster in some people than in others. It cannot be changed, but preventive measures such as regular cleaning and check-ups can be stepped up. Tartar that is left in place advances down towards the root inside the gum pocket, dissolving bone and leading to gum recession, sensitivity, loose teeth and eventually tooth loss.

If you run your hand over smooth glass, nothing happens; run it over a rough surface and it becomes irritated and may bleed. Your gums should likewise rest against a smooth tooth surface. Any roughness beneath the gum line, most often tartar, overhanging fillings or poorly fitting crowns and bridges, keeps irritating the gum and causes bleeding. The cause should be identified at an examination and removed.

Not necessarily. Because saliva composition is inherited, you may have a similar predisposition. However, gum disease is largely preventable with measures taken early in life and regular check-ups.

Scaling (tartar removal) and whitening are not the same thing. Scaling is necessary for your health and should be done regularly. On the other hand, having tea, coffee or smoking stains polished off every month or every two to three months can wear down the enamel and may do harm. The real way to reduce staining is to cut back on these habits; whether whitening is suitable for you is assessed at an examination.

Scientific research recommends using a fluoride toothpaste twice a day. As with any substance, it is the dose that matters. Even when fluoride is taken systemically (tablets, drinking water) the risk is very low, and using it topically in toothpaste poses no concern.

In recent years, misinformation about fluoride has led more people to switch to fluoride-free herbal toothpastes, and sensitivity complaints have increased along with it. Brushing too often or too hard can also wear the enamel and cause sensitivity. Because sensitivity can also stem from decay, a crack or gum recession, the cause should be established at an examination.

Today many foods contain far more carbohydrate (sugar), and unprocessed, natural food is harder to come by. That makes dental care much more important than it used to be. Regular brushing, cleaning between the teeth and check-ups are the foundation for preventing decay and gum disease.

Some people are simply born with thicker, whiter enamel. The colour of a tooth mainly comes from the inner layer, the dentine, which is always darker than enamel; the thicker the enamel, the whiter the tooth looks. In people who have brushed hard for many years, the enamel becomes thinner and teeth can look more yellow over time.

There may be more than one reason. Visiting the dentist only for the teeth that are visible or painful, and leaving other cavities for later, simply postpones the problem. At the first examination all teeth should be checked and, where needed, a panoramic X-ray taken so that hidden cavities between the teeth can be found and treated. Regular preventive care and oral hygiene follow-up are essential afterwards.

According to World Health Organization data as of 2020, no complications or side effects linked to amalgam had been identified. Amalgam is a durable filling material that can last many years in the mouth; it is used less today mainly for aesthetic reasons. Correctly placed composite fillings can be similarly durable, so composite or ceramic fillings are generally preferred today. A known drawback of amalgam is that very large fillings may cause the tooth to crack after many years.

When decay is treated late, it reaches close to the nerve (pulp), and the filling ends up sitting close to it as well. The deeper the decay, the deeper the filling, and in such cases a protective procedure called pulp capping is carried out. Its aim is to keep the tooth alive without the need for root canal treatment. Sensitivity to cold, heat or biting can be normal for up to 4–6 months after pulp capping; if it gets worse, contact your dentist.

There can be several reasons. The most common are errors while placing the composite filling, an initial misdiagnosis (for example, a composite filling where a crown or ceramic inlay was needed) and habits such as cracking hard-shelled nuts with your teeth. Identifying the cause at an examination makes it possible to choose the right type of restoration.

After root canal treatment it is normal to feel temporary tenderness when touching or biting on the tooth for one week to fifteen days. This is due to swelling in the surrounding tissues and settles with time. If it lasts longer than this, the root canal treatment should be re-evaluated.

This is a very common situation. With an accurate diagnosis and careful planning, and provided appointments go ahead as scheduled, treatment time can be shortened considerably. In suitable cases, completing root canal treatment in a single day, making crowns and ceramic inlays in the same session with CAD/CAM, and placing implants with X-Guide all help. While one side of the jaw is anaesthetised, treatments in that area such as fillings, deep cleaning, root canal treatment, implants and extractions can also be done in the same session.

The cost of a filling depends on its size and the condition of the tooth. Even during treatment it may become clear that the tooth needs root canal treatment, a ceramic inlay or a crown. For this reason we cannot give accurate information over the phone; the soundest approach is to plan after the initial examination (oral diagnosis).

If the cause is bone loss, the problem can only be managed with floss or interdental brushes. If the cause is a very large filling that doesn't make good contact with the neighbouring tooth, a ceramic inlay or onlay made with CAD/CAM may be a solution. Which applies to you is determined by an examination and X-rays.

During pregnancy, X-rays and strong antibiotics are avoided; otherwise, necessary treatment can be carried out. Local anaesthetic poses no concern, although situations that require antibiotics afterwards can be a problem. Hormonal changes in pregnancy make the gums prone to swelling. For this reason, issues such as tartar or an impacted wisdom tooth are best treated before pregnancy.

Sterilisation and disinfection are an essential part of dentistry. To prevent cross-contamination, instruments are sterilised in an autoclave inside single-use sterilisation pouches. Having two autoclaves matters, so that sterilisation continues without interruption in the event of a technical fault. A dedicated rapid-sterilisation device is also used for handpieces that go into the mouth.

This fear is usually seen in people who have had a bad experience in the past. Decay and gum disease need more demanding treatment as they progress, so seeking care early matters; an abscessed tooth, for example, may not respond fully to anaesthetic. Once the anaesthetic has taken effect, treatment is usually carried out without pain; if sensitivity remains, more anaesthetic is given and treatment does not continue while you still feel it. Where appropriate, treatment can also be carried out under conscious sedation with nitrous oxide.

Looseness is common with lower full dentures. In patients who lost their teeth many years ago, bone loss is greater, so even a new denture may not stay in place well. In such cases, placing at least two implants in the lower jaw and anchoring the denture to them is usually the most suitable solution. Suitability is determined by your medical history and a CBCT assessment.

There is no scientifically proven evidence that implants cause cancer. Inflammation around an implant (peri-implantitis) can develop because of misdiagnosis, incorrect placement or inadequate oral hygiene. That is why careful planning and regular maintenance matter.

Implant treatment may seem more costly than other options, but in suitable cases it can offer a healthier, longer-lasting solution. What patients mention most is often not the cost but the waiting time between placing the implant and fitting the final teeth. With newer systems, this time can be shortened in suitable cases. Your treatment plan and its scope are determined individually after an examination and a CBCT scan.

Implant treatment can be carried out for anyone whose jaw bone has finished growing and who meets the necessary conditions. The main conditions are sufficient bone volume and suitable general health. Suitability is assessed through an examination and a CBCT scan.

The first step is to identify the actual problem and build the treatment plan around it. If the issue is colour alone and conditions are suitable, it can be addressed with whitening (bleaching). If the issue is shape, several options can be considered as part of smile design, such as veneers, ceramic crowns or bonding.

There are differences between zirconia and glass-ceramic (E-Max) restorations. Where conditions allow, glass-ceramic tends to give a more aesthetic result. Which material suits you is decided by assessing the position of the tooth, the biting load and the remaining tooth structure.

One of the main jobs of baby teeth is to hold space for the permanent teeth coming through beneath them. If a baby tooth has to be removed too early, the neighbouring teeth can drift into the gap. The permanent tooth then has no room and crowding can result. That is why decayed baby teeth should be filled or, if needed, given root canal treatment.