Things I've Learnt

Good Evening!

Now I’m WELL aware that I wanted this out by NYE 2021. But look around. It’s been stress. So better late than never.

Before we begin, if you’re not with an NHS practice (akin to a lot of the British Public), or simply don’t live in the UK, some of this unfortunately will not apply. But please, take what you can out of it. Equally, this blog post is more of a “PWIP” (Perpetual Work In Progress) because I’m within my first year of training and like any profession, Dentisty changes and developes with time and technique. So if there’s anything you specifically want me to delve into further, or want advice on, please let me know and I’ll either add it on or post an update.

Likewise, normal disclaimer. I’m not a / your dentist. Check with them. Saying that, Here’s some things I’ve learnt since becoming an NHS Dental Nurse.

Things to Remember

1. A prevailing thought process throughout all of this. Something will ALWAYS be better than nothing. Whether you brush three times a day or miss a day here and there when you’ve in a funky mentality, something is always better than nothing.

2. Your dentists are out to help you, but if you don’t get along with your dentist, request another with your practice. It’s okay! It’s not personal, and your healthcare and comfort is more important than anything.

3. If there is anything you prefer, let your dentist know. If you have sensory issues and need headphones in during a filling, tell them. If you’re nervous as a patient, or need more anaesthetic, or have a strong gag reflex, or struggle with water getting on your face, you can tell them. Your dentists are here to help, and if not, see point 2

4. Adjacent to point 3, some things can not be accommodated for. Handpieces spray water to stop them over heating, so there’s not many ways to do some treatments without using it. However, if you can’t deal with the feeling of water, you can advise that you’d want a longer appointment time for more frequent breaks.

5. Listing recreational drug use on medical forms is not to catch you out or get you in trouble. Smoking weed does still count as smoking and affects your teeth, and eating habits change when under influence, meaning you may consume a higher amount of sugary snacks or grind/clench your jaw.

6. You can always refuse treatment. I’m not saying that’s advised, or that your dentist will always be okay with it, but patient wishes take priority. If you want to just monitor the situation, you can.

7. Understanding the NHS band (aka pricing) system helps. Band 1 is for ALL emergency treatment and basic routine things such as exams, xrays, and cleans. Band 2 is for second tier work, including Fillings or root canals (restorative work), and Deeper cleans under the gums. Band 3 is for anything that includes an external laboratory such as a crown or denture. So, for example, say you need a root canal. That, plus the exam and any xrays, comes under the band 2, which is currently £66 (rounded up). However, root canals make teeth brittle, so your dentist may advise a crown on top to prevent fracturing, which is a band 3 (£283). This jump sounds big, but this includes paying for the custom-made labwork, plus the root canal, and the exams you had up until that point. I am happy to explain this more if needed!

8. If you are not registered to an NHS dentist but are suffering from a bad toothache, you can call 111. They will book you in at an emergency slot where possible with a local dental hospital.

Cleaning and Lifestyle

1. Interdental (between teeth) cleaning is equally as important as brushing. Whether that’s floss, brushes, waterflossers, or something else.

2. The brushes should be the biggest size you can fit snuggly in the gap between the teeth against the gum. It’s the little black triangle between teeth you’re aiming for. You can get multisized packets from basically anywhere they sell toothpaste, and it doesn’t have to be branded. The main company are Tepes but any brand of interdental brushes is good

3. This one is more for information than use; when looking for an interdental brush, the colour responds to the diameter of the wire, not the diameter of brushes. Different companies have different sizing charts to may not directly transfer. If you have bigger gaps, they may be less likely to be sold on shelves, so you’ll find bigger sizes online.

4. Electric toothbrush will always be best because they aren’t technique specific, but if you can’t for financial or sensory reasons, that’s okay. Just know you may need to put in a bit more work. You’re also more likely to over-brush and apply too much pressure, which will cause gum recession or sensitivity.

5. For wisdom teeth, get yourself a single tufted brush. It’s a manual brush with a small amount of bristles, so you can really get around and under the gums. It’ll stop them from flaring up as much and will prevent them from getting infected due to bacteria from food trapping.

6. This advise is usually given to parents of kids with learning difficulties, but this may be of use to you! If you struggle with electric toothbrushes bushes and focusing on spending the right amount of time brushing, there is a manual toothbrush called a Three Headed manual toothbrush. It’s like a normal toothbrush, except it has 2 additional heads angled inwards so the tooth gets coated from all sides. like the brush rollers on a car in an automatic carwash.

7. Check your mouthwash and toothpaste for flouride. If it has no flouride, it’s got less than optimal uses for the prevention of tooth decay.

8. Whitening toothpastes have abrasive material in them to scrub staining off; they don’t actually whiten your teeth. Yellowing is not staining, so the yellowing won’t go away with a whitening toothpaste. Staining is the brown marks left behind from tea, coffee, red wine, curries, and other foods like that.

9. Good technique is: interdental cleaning once a day before brushing, then brushing twice a day and getting along the gumline. Mouthwash is an optional extra but not after brushing because it’s a lower, more diluted concentration of flouride than toothpaste. Get a tongue scraper to take extra bits of bacteria off your tongue and keep your breath fresher for longer.

10. This bit, you probably know: diet is really important. Sugar is the tooth killer. it’s worse to sip fizzy or snack on sugary things throughout the day than just to have it at meal times. But sugar can be addictive and hard to shake, so do what you can. Remember: something is better than nothing.

11. Your medication, diagnoses, genetic factors, or health conditions may affect your teeth and gums more than you realise. Especially diabetic or pregnant folks. Folks who don’t have a drink or rinse after using their inhalers are more likely to get oral thrush.

12. Repeat: Do the best you can. It’s no secret that my mental health is pretty patchy sometimes and the FIRST thing that gets pushed by the wayside in a slump is my oral hygeine. So I chew a lot of gum, Floss my upper teeth one day and my lower teeth another, then make a concerted effort to try and brush my teeth on the loo before bed. The evening one is more important because it protects your teeth overnight and removes most food debris from the day. Maybe a mouthwash in the morning if I just don’t have the capacity. Do what you can, when you can.

This isn’t perfect. Speak to your dentist before making any changes, and you may find something which works better for you and that’s perfect! Whatever you think is best, this is just for those who maybe need a little helping hand. Don’t be afraid to ask for help

For now,

Rhyana

Edit: Hello, so this has been posted publicly for 4 days so far and I have to thank those reading this, or who have read this. It’s been really positively recieved and I appreciate those who not only shared it, but have told me how they’ve either learnt something or it’s reminded them to continue a more established Oral Hygiene routine. So thank you, thank you, thank you! I already have additions so they’ll be added below.

13. Charcoal Toothpastes aren’t particularly proven to do anything differently to whitening toothpastes that are already available. They’re mostly just abrasive so won’t change the tooth colour.

14. If you are interested in realigning your teeth to straighten them, or whitening your teeth, go to a dentist supported system AKA one that you do in partnership with a Dentist/Hygienist. There’s a current trend of “order online aligners”, “home whitening systems”, and even “at home tooth cleaners” (the latter of which is a “replacement” of a scale/hygiene appointment”). The thing with these is that they have no wider support. Doing an aligner process without a dentist can work, but if you have unknown factors affecting your teeth, you can do more damage than good. Likewise, with home whitening, there’s only so much medical support you’ll have and there’s nobody to support you with your additional questions or to help if your treatment doesn’t go as you planned. At home scalers, which clean around your gums, can be dangerous. You could scratch your gums, the soft tissues which connect yout teeth and gums, scratch and create weakpoints in your enamel, or worse.

    Long one here: how Dentist supported aligners work is by using Xrays to show your sub-gumline health, create a targeted plan, then add removable “handles” to your teeth so that the aligners have something to put force on, and the dentist removes harmless milimetres from the sides of the tooth so that there is actual room for your teeth to move into. Without these steps, your realignment is less likely to work long term or hold at all. Short one here: any changes you’re making towards the structure or aesthetics of your teeth should have support from the required professional. You wouldn’t forcibly change your body shape without a doctor, right?

15. UV doesn’t lighten your teeth. Bleaches do. If it says “bleach free tooth whitening”, it’s horse.