Dear Dentist, My daughter

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Dear Dentist,

My daughter is 11 years old and we live in Leamington Spa. In her recent dental examination her dentist told us her four adult molar teeth should be extracted. One of those was filed couple of years ago and one has decay. The other two are OK. He advised us removing all four needed as her new teeth will fill the gap. My worry is not just only removal of these teeth including two healthy one but also potential underlying problem. She is strict about sugary drinks and brushes every single night. I am concerned if we remove these four teeth there is no guarantee for other teeth not to have same issues in the future as problem is not diet or hygiene related as far as I am concerned. I would be grateful if you give this concerned dad some advice.

Very many thanks,
Reza Kashtiban

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Asked on 03/11/2016 12:00 am
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Private answer

Usually there IS an underlying sugar-intake issue.
Occasionally teeth erupt with imperfect enamel and are more prone to decay.
You won't really know how well formed the new teeth are until they erupt.
I advise you get an Orthodontic opinion ( try Leamington Spa Orthodontics- Richard Cure) and minimise the extractions as much as possible.
Hope your daughter stays pain-free while
you go through the planning stages.
Meanwhile, continue to focus on sugar control, both quantity and more especially frequency.

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 10/11/2016 12:00 am
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Sugar is indeed the issue. An honest diet sheet of exactly what and when your daughter eats and drinks may give your dentist a clue as to how best to advise. As mentioned by my colleagues it is not as simple as just brushing after meals and reducing sugar intake. Sugar is present in many forms and may be labelled as ‘sucrose’ for example Thetiming and type of snacks is also critical. Diet fizzy drinks may be sugar free but are acidic and cause tooth decay.
A second opinion may help you decide on the appropriate treatment for the decayed tooth
An orthodontic opinion is essential before committing your daughter to the removal of otherwise healthy or restorable teeth which could have implications as she grows and develops

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 10/11/2016 12:00 am
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There are two issues
1 dental decay is related to frequency of consumption of sugar. The bacteria in the mouth digest sugars in food and drink (both natural sugars in fruit and juices and added sugars in sweets cakes biscuits and drinks) The sugar is converted to acid and the saliva takes 40-60minutes to neutralise this acidity Therefore for every sip or bite there will be 40minutes of tooth decay no matter how well cleaned the teeth are before and after
The only way to prevent further decay will be to limit sugary food and drinks to a few set times each day (mealtimes only) and this should reduce the risk of other teeth being as severely decayed as the ones that now need extracting but as you say there are no 100% guarantees as teen consume have access to lots of sugar containing food and drink and often will not follow guidelines
With regard to the proposed extractions the plan is that by taking one tooth from each corner at this time the teeth yet to erupt will do so in a such a way that the chewing forces will be balanced so as to resist the tendency for the front teeth to become misaligned as could happen if teeth were only extracted from one side

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 09/11/2016 12:00 am