This is one of the most common questions I hear — and the honest answer is that most of us are doing it wrong, not in terms of frequency, but in terms of when and how.

The American Dental Association (ADA) recommends brushing twice a day for two minutes each time, with a soft-bristled toothbrush and fluoride toothpaste. This is echoed by the FDI World Dental Federation, which sets the standards used in dental colleges globally.

Morning brushing removes the bacterial film that builds up overnight. While you sleep, saliva flow drops and your mouth's natural defences weaken. Brushing in the morning clears that build-up and freshens your breath for the day.

Bedtime brushing is the critical one. After a full day of eating and drinking, food particles and acid residues sit on your teeth. If not removed, bacteria feed on them all night, producing acids that erode enamel — that is how cavities form. Research in the Journal of the American Dental Association (JADA) consistently shows that people who skip their night brush have significantly higher cavity rates over time.

A few things I always tell my patients:

• Use a soft-bristled brush. Hard bristles feel more thorough but they gradually wear down enamel and irritate gums. Both the NHS and ADA say soft only.
• Wait 30 minutes after eating before brushing — especially after acidic foods or coffee. Acids temporarily soften enamel, and brushing too soon causes micro-abrasion.
• Brushing more than twice is unnecessary and can wear enamel over time. More is not always better.
• Replace your toothbrush every 3 months or after illness. Worn bristles clean far less effectively — this is in the WHO oral health guidelines.

One more thing — brushing alone is not enough. Cochrane review studies show that combining brushing with daily interdental cleaning measurably reduces plaque and gum disease. If flossing feels difficult, ask me about interdental brushes — many of my patients find them easier and equally effective.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I know what many parents think — "It's just a baby tooth, it will fall out anyway." But baby teeth are not temporary tenants. They hold space in the jaw for permanent teeth. When a milk tooth decays and falls out too early, neighbouring teeth shift inward and block the path for the adult tooth. That is often how children end up needing braces — not always genetics, sometimes just an untreated milk tooth cavity.

Think of it like this: you would not skip cleaning a rental flat just because it is not yours permanently. Same logic applies here.

The American Academy of Pediatric Dentistry recommends oral care before the first tooth even appears — wiping gums with a soft damp cloth after feeds clears milk residue that bacteria love. Once the first tooth comes in (around 6 months), use a grain-of-rice-sized smear of fluoride toothpaste on a soft infant brush, twice a day.

• Make it a game, not a chore. Let them brush your teeth while you brush theirs. Children copy adults — if you take it seriously, they will too.
• Night milk feeds are a hidden risk. Milk pooling around teeth overnight causes what dentists call "nursing bottle caries" — rapid decay in very young children. Wipe gums and teeth after a night feed, even if they are half asleep.
• No sharing spoons or blowing on food. Cavity-causing bacteria (Streptococcus mutans) transfer through saliva. A JADA study found children of parents with high cavity rates had significantly higher rates themselves — often from shared utensils.

Children can brush independently when they can tie their own shoelaces — that is the general rule. Until then, a parent should finish the job. Most children cannot brush effectively on their own until around age 7 or 8.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

When a patient tells me their gums bleed, I always say: "They are not bleeding because you brush too hard. They are bleeding because there is inflammation — and inflammation means bacteria have been sitting there too long."

Imagine the gap between your teeth and gums like the gap between a window frame and a wall. If you never clean that gap, build-up happens silently. In your mouth, that build-up is plaque. When plaque is not removed daily, it hardens into tartar within 24 to 72 hours. Tartar is like cement — brushing alone cannot remove it. That is when gums start to swell and bleed.

This is called gingivitis. A Cochrane systematic review confirms it is almost entirely reversible with consistent daily cleaning.

• Morning: Brush for 2 full minutes. Move slowly — one section at a time. Most people rush and finish in 40 seconds, leaving entire areas untouched.
• After meals: Rinse well with plain water. No fancy mouthwash needed — vigorous rinsing dislodges food from between teeth.
• Night: Brush again, then clean between teeth. An interdental brush (Apollo Pharmacy or 1mg, around ₹130–170 for a pack of 5–6) used 3–4 times a week makes a visible difference.
• Short-term help: A chlorhexidine rinse like Hexidine or Rexidine (any pharmacy) can support brushing — but it does not replace it.

The most common mistake: stopping brushing because it hurts or bleeds. That makes it worse. The bleeding reduces only when you keep cleaning and the inflammation comes down.

If gums still bleed after 2 weeks of consistent care, come and see me. A professional scaling removes hardened tartar that home care cannot reach. The British Dental Association considers untreated gum disease one of the leading preventable causes of adult tooth loss worldwide.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Think of your tongue as a thick carpet. Now imagine not vacuuming that carpet for weeks. Bacteria, dead cells, and food particles settle deep into it. That is exactly what happens — especially on the back of your tongue, which most people never clean. Those bacteria release sulphur compounds, and sulphur is what smells.

The most common causes in the order I see them in my patients:

• Not cleaning the tongue. Use a metal U-shaped tongue scraper — the ones at any medical shop or pharmacy for ₹15–50 are more effective than the plastic ones on toothbrushes. Scrape from back to front, 5–7 times, every morning.
• Dry mouth. Saliva is your mouth's natural cleaning system. People who breathe through their mouth or drink little water have less saliva and more odour. Eight glasses of water daily directly affects oral bacteria levels.
• Food trapped between teeth. If food gets stuck regularly, it decomposes there. This usually means a gap, loose filling, or early gum recession that needs attention.
• Gum disease. Infected gums produce a specific unpleasant smell. If your gums bleed, that is likely contributing.
• Strong foods. Garlic, onion, fenugreek, and certain dals have sulphur compounds absorbed into the bloodstream and exhaled through the lungs. No brushing removes this — it clears only as the food digests (24–48 hours). Green cardamom (elaichi) and parsley genuinely work as natural fresheners for this.

If bad breath persists with excellent oral hygiene and also comes with acid reflux, sinus issues, or an unexplained cough — discuss those symptoms with a physician. But rule out oral causes first.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Let me split this into two situations — a tooth that fell out naturally, and one that was knocked out by accident.

When a milk tooth falls out naturally (age 5 to 12):

• A little bleeding is normal. Have the child bite gently on a clean piece of cloth for 5–10 minutes.
• Gentle gum massage is fine and soothing. Use a clean finger and rub in circular motions — light pressure, like kneading soft dough. This improves circulation and helps the new tooth push through faster.
• Warm salt water rinse after meals (half teaspoon of salt in a glass of warm water) keeps the socket clean. The NHS recommends this even for adult dental wounds.
• The permanent tooth usually appears within 3–6 months. If it does not, come and see me.

When a permanent tooth is knocked out — this is urgent:

• Pick it up by the crown (white part), never the root.
• If dirty, rinse gently with milk or clean water. Do not scrub.
• Try to place it back in the socket immediately, hold it by biting on a clean cloth.
• If you cannot reinsert it, keep it in milk or the child's own saliva — not water, not dry.
• Come to any dentist within 30 minutes. IADT research shows teeth replanted within 15 minutes have significantly higher survival rates.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Tooth pain does not go away on its own. If your tooth is hurting significantly, something is happening inside — a cavity reaching the nerve, an infection, a crack, or a failing filling. Home remedies buy you time. They do not buy you a cure.

• Salt water rinse. Half a teaspoon of salt in a glass of warm water, rinse gently for 30 seconds, every few hours. Reduces inflammation. Endorsed by the National Institutes of Health as an effective anti-inflammatory rinse.
• Clove / Lavang. Cloves contain eugenol — a natural anaesthetic used in dental clinics worldwide. Place a whole clove next to the painful tooth and bite gently. A tiny drop of clove oil on cotton held near the tooth also works. JADA research has confirmed eugenol's effectiveness for dental pain.
• Cold compress from outside. Hold a cloth-wrapped ice pack against your cheek for 15–20 minutes. Do not apply ice directly on the tooth.
• Paracetamol or ibuprofen. Dolo 650 or Crocin with food will manage the pain through the night. Do not hold aspirin against the tooth — it can chemically burn gum tissue.
• Sleep with your head elevated. Lying flat increases blood pressure in the head and intensifies throbbing. An extra pillow makes a real difference.

Do not apply garlic, raw onion, or tobacco directly on the tooth. I have seen patients come in with gum burns from these — they cause more harm than relief.

Please come and see me within 24–48 hours. A tooth that hurts is asking to be saved — and the sooner I see it, the more options we have.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

When I look inside someone's mouth, I am running through six checkpoints. Think of it like a cricket scorecard — each area has its own score, and the total gives me the picture.

1. Teeth — Cavities and Cracks (2 points)
Any visible dark spots, holes, or roughness? Does any tooth hurt with sweet or cold? A sharp pain that goes away quickly suggests early decay. A lingering ache means the nerve may be affected. Run your tongue slowly over every tooth — a rough or sharp edge that was not there before is a sign.

2. Gums — Colour and Bleeding (2 points)
Healthy gums are firm and pale pink — like the inside of a guava. If yours are red, swollen, or bleed when touched, they are inflamed. Press gently with a clean finger. No blood is good. Blood means work to do. The American Academy of Periodontology uses gum bleeding as the primary early indicator of disease.

3. Plaque and Tartar (2 points)
Run your tongue along the inside surface of your lower front teeth. Feel anything rough, chalky, or ridged? That is tartar — hardened plaque you cannot remove at home. Clean teeth feel smooth like a polished plate. Textured means a professional scaling is overdue.

4. Tongue — Coating (1 point)
Stick out your tongue and look in a mirror. Healthy is pink with a very thin white coating. Thick white or yellow means bacteria build-up — often causing bad breath. A very red tongue with no coating can indicate nutritional deficiencies (B12, iron) worth mentioning to a physician.

5. Bite and Jaw (1 point)
Do teeth meet comfortably? Any jaw clicking? Do you wake up with headaches or sore jaw muscles? These are signs of grinding (bruxism) — common and underdiagnosed. NIH research shows bruxism affects 8–31% of adults and often goes unnoticed until significant wear has occurred.

6. Soft Tissues — Cheeks, Lips, Tongue Edges (2 points)
This is the one most people never think about. Look at the inside of your cheeks, roof of mouth, and tongue edges for white patches that do not wipe off, persistent ulcers not healing in 2 weeks, or unusual lumps. This screens for early oral cancer. India has among the highest oral cancer rates in the world. Early detection — at the patch stage — is almost always treatable. The WHO identifies this as critical in South Asian populations.

A 9 or 10 is rare. Most patients come in around 5–7, which is fixable. A 3 or 4 means we sit down and make a plan together. The score is not to judge you — it is a starting point and a roadmap.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I know parents are often anxious after a child's dental procedure. Think of a new filling like wet cement — it needs a little time to fully set and settle into place. Even with modern tooth-coloured fillings (composites) that harden instantly under a special light, the tooth and gums might be a bit sensitive for a day.

• The best foods: Soft comfort foods are ideal. Think curd rice, mashed idli with mild chutney, or a banana smoothie. These do not require heavy chewing.
• Temperature matters: Avoid very hot milk or very cold ice cream for the first few hours. The nerve inside the tooth is a bit "awake" after a filling, and extreme temperatures can cause a sharp zing.
• The sticky danger: Avoid sticky candies, dairy milk chocolates, or peanut chikki. These can act like glue and put unnecessary pressure on the filling edges.
• Wait for the numbness to wear off: If we used a local anaesthetic, ensure your child does not bite their lip or cheek. Wait until they can feel their lip again before giving them a full meal.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Imagine washing your hands but never cleaning between your fingers. Eventually, dirt builds up in those hidden spots. Your teeth are the same. A toothbrush is great for the front and back, but it cannot reach the narrow lanes where two teeth touch.

• Why it matters: Food particles trapped in these gaps rot and produce acid, leading to cavities I can often only see on an X-ray. It also prevents gum disease (gingivitis).
• How to do it: Take about 45 cm of floss (available at any medical shop or pharmacy for around ₹150–₹250). Wrap it around your middle fingers and gently C-shape it around the base of each tooth, sliding it just under the gum line.
• The bleeding fear: If you have not flossed in a while, your gums might bleed a little. Do not stop — this is a sign the gums are inflamed from trapped bacteria. With regular flossing, the bleeding usually stops in about 10 days.
• Alternative: If thread floss feels too fiddly, try floss picks — they have a small handle that makes it much easier to reach the back teeth.

The Cochrane review found that flossing plus brushing significantly reduces gum bleeding and plaque compared to brushing alone.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Think of it like cleaning a house — you sweep the dust out of the corners into the middle of the floor before you mop.

• Floss first: This clears the debris from between the teeth. Now when you brush, the fluoride in your toothpaste can actually enter those gaps instead of being blocked by food.
• Brush second: Spend a full 2 minutes using a soft brush. Spit the foam out, but do not rinse your mouth with water immediately. Let that little bit of toothpaste stay on your teeth to strengthen them.
• Tongue clean third: Use a gentle U-shaped scraper (available at pharmacies for ₹15–₹50). This removes the bacteria that cause bad breath.
• Mouthwash last: If you use mouthwash, wait at least 15 minutes after brushing. If you use it immediately, you wash away the concentrated fluoride from your toothpaste.

A study in the Journal of Periodontology confirmed that flossing before brushing leads to significantly more fluoride retention between teeth.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

When we eat — especially things like citrus fruits, soda, or a heavy meal with pickles and curds — the acid in the food temporarily softens the outer layer of our teeth (the enamel).

Think of your enamel like a wall. Acid makes the paint on the wall soft for a while. If you scrub it immediately with a toothbrush, you are scrubbing away your own enamel. It takes about 30 to 60 minutes for your saliva to naturally neutralise the acid and re-harden the tooth surface.

• What to do immediately after dinner: Rinse your mouth vigorously with plain water. This dislodges food without the abrasive action of a brush.
• Then wait: Finish your chores, and brush right before you go to bed — well after the 30–60 minute window.

Research from NIH consistently supports waiting after acidic meals before brushing.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I understand the nostalgia for tooth powders, but as a dentist, I see the damage they can do. Imagine cleaning a glass window — you would use a soft cloth and a gentle spray, not a handful of sand.

• The abrasive factor: Many tooth powders (especially traditional or charcoal-based ones) have large, rough particles. Over years of use, they act like sandpaper, wearing away the white enamel and exposing the yellow layer underneath (dentine). This leads to severe sensitivity.
• The fluoride benefit: Almost all toothpastes (like Colgate, Pepsodent, or Sensodyne, usually ₹50–₹150) contain fluoride. Fluoride is like vitamins for your teeth — it repairs early decay and makes the surface acid-resistant. Most powders do not have this.

The WHO and every major dental body consider fluoride toothpaste the cornerstone of cavity prevention.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Think of an electric toothbrush like a washing machine, while a manual brush is like hand-washing your clothes. Both can get the job done, but the machine is more consistent and does the hard work for you.

• Built-in safety: Many modern electric brushes (starting around ₹1,200–₹2,500 at pharmacies) have pressure sensors. If you press too hard, the brush slows down or alerts you — preventing gum damage.
• Better cleaning: The vibration or rotation movements remove significantly more plaque than the 200–300 strokes we manage by hand.
• The 2-minute timer: Most models have a built-in timer. Most people think they brush for 2 minutes but actually stop after 45 seconds.
• Who needs it most: Children who find brushing boring, seniors with joint pain or arthritis, and anyone with braces.

A large Cochrane review found electric brushes reduce plaque and gum disease more than manual brushing.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

In India, our love for tea, coffee, and turmeric-rich food means our teeth pick up stains easily. Also, as we age, the white enamel thins, showing the naturally yellowish dentine underneath.

• The safe fix: Start with a professional scaling and polishing at our clinic (typically ₹1,500–₹2,500). This removes hard tartar and external stains that no amount of brushing can touch.
• Professional whitening: If you want them even whiter, in-office bleaching uses safe, tested gels to brighten the tooth colour from within.
• The danger of home hacks: Please do not use lemon juice or charcoal powder. They are either too acidic or too abrasive. They might look white for a day, but they are dissolving your enamel. Once enamel is gone, it never grows back.
• Maintenance: Drink your tea or coffee quickly rather than sipping for hours, and rinse with water immediately after meals.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I hear this almost every week. A patient drinks a glass of chilled water or bites into a kulfi and gets a sharp, shooting pain that disappears within a few seconds. They have often been living with it for months, thinking it is normal. It is not normal — but it is very fixable.

Inside every tooth, below the hard enamel, there is a layer called dentine. Dentine has thousands of tiny tubes running through it, all leading toward the nerve. When enamel wears down or gums recede, these tubes become exposed to the outside world. Hot, cold, sweet, or acidic things trigger fluid movement in those tubes, and that movement is what you feel as a sharp pain.

The most common causes in my patients:

• Brushing too hard. This is the number one cause I see. A hard toothbrush used with vigorous scrubbing wears away enamel over years. The damage is slow and invisible until sensitivity appears. Switch to a soft brush and use gentle circular strokes.
• Acidic food and drinks. Tamarind, raw mango, lime juice, aerated drinks — all of these are highly acidic. Acid dissolves enamel slowly but surely. If you drink a lot of these, your enamel is taking a beating. Rinsing with plain water after acidic food helps neutralise the acid quickly.
• Gum recession. When gums pull back — usually from gum disease or aggressive brushing — the root surface of the tooth becomes exposed. Root surfaces have no enamel at all, making them extremely sensitive.
• Teeth grinding (bruxism). Many people grind their teeth at night without knowing it. Over time, this flattens the chewing surfaces and wears enamel down significantly.
• A cracked or chipped tooth. Even a hairline crack can cause sensitivity, as it opens a pathway to the nerve.

What you can do at home: Use a desensitising toothpaste like Sensodyne or Colgate Sensitive (widely available, ₹80–₹150). These contain compounds like potassium nitrate or stannous fluoride that block the dentine tubes over time. Use it consistently for at least 4 weeks before judging the result — it does not work overnight. Apply a small amount to the sensitive area with your finger and leave it on after brushing rather than rinsing it away.

According to the NHS and ADA MouthHealthy, desensitising toothpaste is the first-line recommendation for mild to moderate sensitivity, with professional fluoride varnish being the next step for more persistent cases.

If sensitivity is severe, affects just one tooth, or has appeared suddenly — please come and see me. It could indicate a deeper cavity, a cracked tooth, or a failing filling that needs attention beyond toothpaste.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

When patients ask me why they have cavities despite brushing regularly, the answer is almost always diet. Brushing is important, but it cannot undo the damage that a steady stream of acid does to enamel throughout the day.

Think of your enamel like a freshly plastered wall. Every time you eat or drink something acidic or sugary, the acid weakens the surface a little — like splashing water on wet plaster. Saliva slowly repairs this between meals. But if you are eating or sipping frequently throughout the day, the repair process cannot keep up.

The main culprits — some will surprise you:

• Aerated drinks (Pepsi, Coke, Sprite, even soda water). These are highly acidic — pH 2.5 to 3.5. Even the sugar-free versions are just as acidic and equally damaging to enamel. A study published in NIH found that regular soft drink consumption was strongly associated with enamel erosion even in teenagers.
• Packaged fruit juices. A glass of fresh orange juice has a pH around 3.5. Packaged versions are often more acidic and have added sugar. The acidity is the bigger problem — not just the sugar.
• Nimbu paani and tamarind. Lemon is pH 2 — more acidic than vinegar. Tamarind-based dishes and chutneys are similarly acidic. These are staples in Tamil Nadu cooking. This does not mean you stop eating them, but rinsing your mouth with water immediately after helps significantly.
• Pickles. Indian pickles — mango, lime, mixed — are preserved in oil and salt but also highly acidic. Regular pickle consumption is a hidden contributor to enamel erosion I see frequently.
• Sticky sweets — jaggery (vellam), toffees, dried fruits. These stick to the tooth surface for long periods, giving bacteria a sustained source of sugar to produce acid.
• Tea and coffee with sugar. It is not the tea itself that causes damage — it is the sugar stirred into it, combined with the fact that most people sip slowly over 30–45 minutes, bathing their teeth in sugar for extended periods.
• Sports and energy drinks. Products like Glucon-D, Electral, and branded sports drinks are highly acidic. They are meant to be consumed quickly — not sipped slowly during workouts.

Simple habits that make a real difference:

• Drink acidic or sugary drinks quickly rather than sipping slowly
• Use a straw where possible — it bypasses teeth
• Rinse with plain water immediately after acidic food
• Wait 30–60 minutes before brushing after acidic meals
• Finish meals with a piece of cheese or plain milk — both neutralise acid and contain calcium

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

The body is remarkable at healing many things — skin, bone, muscle. But teeth are different. Enamel has no living cells in it. Once it is damaged, it cannot repair itself. A cracked tooth will not close up, seal over, or become stronger with time. In fact, without treatment, most cracks gradually get worse.

Think of it like a crack in a ceramic plate. If you keep using the plate normally, the crack slowly spreads until the plate splits. Same principle with a tooth.

What you might feel with a cracked tooth:

• Pain when biting down — especially when releasing the bite (this is classic for cracks)
• Sensitivity to hot, cold, or sweet
• Intermittent pain that is hard to pinpoint
• Sometimes, no pain at all — which makes cracks easy to ignore

What can be done, depending on how deep the crack is:

• Surface crack (craze line): Very shallow cracks in the enamel surface only. These are cosmetic, do not cause pain, and often do not need treatment beyond monitoring.
• Cracked cusp: A piece of the tooth's biting surface has broken off or cracked. This usually needs a crown to protect the remaining tooth.
• Crack extending toward the root: This is more serious. If the crack has reached the nerve, a root canal followed by a crown is needed. If the crack has reached below the gum line, extraction may be the only option.

The ADA MouthHealthy guide on cracked teeth is clear: early treatment almost always results in a better outcome. A crack caught early might need just a crown. Left untreated, the same crack may eventually need a root canal or extraction — both more expensive and more uncomfortable.

If your tooth feels different after biting something hard — even if it is not painful — come and see me within a few days. I can often identify a crack with a special dye or by asking you to bite on a small stick that isolates individual cusps.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Wisdom teeth — the four large molars at the very back of your mouth — usually appear between age 17 and 25. In many people, the jaw simply does not have enough space for them. This leads to them getting stuck, growing at an angle, or partially emerging — all of which cause problems.

Why wisdom teeth hurt:

• Pericoronitis — the most common cause. When a wisdom tooth only partially erupts, a flap of gum tissue sits over part of it. Food and bacteria get trapped under this flap and cause infection and swelling. You may notice pain, bad taste, and difficulty opening your mouth fully. This can recur every few months.
• Cavity in the wisdom tooth. Because wisdom teeth are so far back, they are nearly impossible to clean properly. Cavities develop frequently, and by the time they cause pain, the decay is often quite advanced.
• Pressure from an impacted tooth. A wisdom tooth growing sideways puts pressure on the neighbouring molar, causing a deep aching pain that can feel like an earache.
• Gum disease around the wisdom tooth. The same difficulty in cleaning makes gum disease more likely at the back.

Does it have to come out? Not always. A wisdom tooth that has fully erupted, is in good alignment, is easy to clean, and is not causing decay or gum problems can stay. But if it is impacted, causing recurrent infection, affecting the tooth in front of it, or has a cavity that cannot be properly filled — removal is almost always the right call.

The ADA's guidance on wisdom teeth recommends that the decision be based on a clinical examination and X-ray rather than a blanket rule. An OPG X-ray (panoramic dental X-ray) gives me a complete picture of all four wisdom teeth and their relationship to the nerves and adjacent teeth — this is usually the first thing I order when a patient comes in with wisdom tooth concerns.

If you have recurring pain at the back of your mouth, please come in early. A wisdom tooth problem caught before it becomes an infection is much easier and less uncomfortable to manage.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Most of my patients come to see me in pain. This is completely understandable — nobody wants to sit in a dental chair unless they have to. But from a clinical standpoint, pain is almost always a late signal. By the time a tooth hurts, whatever is happening inside it has usually been developing for months or years.

Think of it like a car. You do not wait for the engine to stop working before you service it. You follow a maintenance schedule — because catching a small problem early is always cheaper, faster, and less uncomfortable than dealing with a breakdown.

What happens at a routine check-up:

• I examine every tooth surface for early decay — spots I can see on examination or X-ray long before they cause pain
• I check gum health — pocket depths, bleeding points, early bone loss
• I look at soft tissues for any unusual patches (oral cancer screening)
• I check old fillings, crowns, and any existing dental work for wear or failure
• I often do a scaling and polishing — removing hardened tartar that your brush cannot reach

Why every 6 months? Tartar (hardened plaque) typically takes 3–6 months to build up to a level where it starts causing gum inflammation. Cavities, if caught in the early enamel stage, can sometimes be reversed with fluoride — no drilling needed. But left another 6 months, they progress into dentine and need a filling. Left another year, they may need a root canal.

The WHO and ADA both recommend at least one dental visit per year, with every 6 months being ideal for most adults. Children and people with higher cavity risk (diabetics, people on certain medications, heavy smokers) should come more frequently.

A check-up at our clinic is ₹200 — the same as a consultation. It takes about 20 minutes. Compare that with the cost and time of a root canal. Regular visits are genuinely one of the best investments you can make in your health.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I want to start by saying — I understand. Dental fear is not weakness or irrational. For many people it comes from a childhood experience, a story someone told them, or simply the unfamiliar sounds and sensations of a dental clinic. It is one of the most common specific fears in the world.

But here is the unfortunate reality: avoiding the dentist because of fear almost always makes the actual dental problem worse. A small cavity that causes mild discomfort becomes a painful abscess that needs a much more involved procedure. The fear of a small treatment leads to a big treatment — which then reinforces the fear. It is a cycle, and the only way out is to break it early.

What I do for anxious patients:

• Tell me before we start. If you are nervous, say so. I will adjust my pace, explain every step before I do it, and check in with you throughout. The single biggest source of dental anxiety is the feeling of loss of control — knowing what is happening restores that control.
• We go at your pace. For very anxious patients, sometimes the first visit is just a conversation and a look. No instruments, no treatment. Just getting comfortable with the environment.
• Numbing is very effective now. Modern local anaesthetics are fast and very effective. Most patients are surprised by how little they feel once an area is numb. If injections themselves are a concern, topical anaesthetic gel applied before the injection significantly reduces the sensation.
• Agree on a signal. I always offer my patients a hand signal — usually a raised hand — that means "stop immediately." Knowing you can stop at any moment gives most people enough confidence to proceed.

Research published in the NIH on dental anxiety consistently shows that communication and patient-centred approaches dramatically reduce anxiety levels — often enough to make treatment entirely manageable without medication.

If you have been avoiding the dentist — please come in. Tell me about your fear. We will start small, go slow, and work together. You will leave wondering why you waited so long.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I have this conversation almost every week. A patient needs a root canal, and before I can finish explaining the procedure, they tell me what they have heard from a neighbour or relative. The stories are always dramatic. Almost always, they are based on experiences from a different era of dentistry — or from second-hand accounts of second-hand accounts.

Let me explain what a root canal actually is. Inside every tooth there is a soft tissue called the pulp — it contains the nerve and blood vessels. When decay reaches this pulp, or when a tooth gets infected, the pulp becomes inflamed and painful. That inflammation is what causes the severe toothache you feel before treatment. A root canal removes that infected pulp, cleans the canals inside the tooth, and seals everything up. After that, the tooth has no nerve — it cannot feel pain anymore.

What the procedure actually feels like:

• A local anaesthetic injection is given first — the same kind used for a filling. Once the area is numb, you feel pressure and vibration but no sharp pain.
• The procedure typically takes 45 minutes to an hour for a front tooth, slightly longer for a back molar. It may take 2 sittings.
• After the anaesthetic wears off, there may be mild soreness for 2–3 days, easily managed with a paracetamol.
• Most patients tell me it was far less than they feared.

A survey published in the Journal of Endodontics (NIH) found that patients who had experienced root canal treatment rated it as no more uncomfortable than having a routine filling — and significantly less uncomfortable than their expectations beforehand.

The alternative to a root canal on an infected tooth is extraction. An extraction solves the immediate problem but leaves a gap that affects chewing, causes neighbouring teeth to shift, and often requires an implant or bridge later — at considerably more cost. A root canal saves the natural tooth, which is almost always the better outcome.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Implants have transformed what we can offer patients who have lost teeth. Before implants became reliable and accessible, the only options were removable dentures (which move around and feel unnatural) or fixed bridges (which require grinding down healthy neighbouring teeth). An implant does neither of those things.

Here is how it works, simply: A small titanium screw is placed into the jawbone where the missing tooth was. Over 3–6 months, the bone grows around the screw in a process called osseointegration — the implant essentially becomes part of your jaw. A ceramic crown is then placed on top. From the outside, it looks and functions exactly like a natural tooth.

How long does it last?

• The implant (titanium root): With good oral hygiene and no medical complications, implants have a 95–98% success rate at 10 years and many last 25+ years or a lifetime. Research from the NIH on implant longevity consistently shows excellent long-term outcomes.
• The crown on top: Crowns are subject to the same wear as natural teeth. Most last 15–25 years before needing replacement — but the implant beneath stays.

What affects how long an implant lasts:

• Oral hygiene — implants can develop gum disease (peri-implantitis) just like natural teeth
• Smoking — significantly reduces success rates and healing
• Uncontrolled diabetes — affects healing and osseointegration
• Teeth grinding — puts excessive force on the crown

In terms of cost in India, implants typically range from ₹25,000 to ₹60,000 per tooth depending on the brand and the clinic. This sounds significant, but when you spread it over 20+ years of function — compared to the recurring costs and inconvenience of dentures — the value is clear.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Your mother-in-law is not entirely wrong — but she is also not entirely right, and the timing and intensity of the habit matter enormously. Let me give you the full picture.

Thumb sucking is a natural self-soothing behaviour. Most children do it, especially when tired, anxious, or bored. The vast majority stop on their own between ages 2 and 4. When children stop by this age, even if they were heavy thumb-suckers, the teeth and jaw typically correct themselves because the jawbone is still very malleable at this stage.

When does it become a problem? After age 4–5, if the habit continues with significant intensity and frequency — especially during the day, not just at bedtime — it can cause:

• An open bite — where the front teeth do not meet when the back teeth are closed
• A narrowing of the upper jaw
• The upper front teeth tilting outward (protruding)
• Speech issues in some cases

The American Academy of Pediatric Dentistry advises that most children will stop on their own, and intervention should be gentle and positive. Scolding, bitter nail polish, or physical restraints are not recommended — they often create anxiety and can make the habit worse or create other emotional behaviours.

What actually works: Positive reinforcement — praising and noticing when the child is not thumb-sucking. Identifying triggers — if it happens when bored or anxious, address those. For older children (5+) who have not stopped on their own, a custom mouth appliance made by the dentist can gently discourage the habit without any discomfort.

If your child is under 4, I would say: do not worry. If they are 5 or older and still sucking intensely, bring them in — I can assess whether there is any impact on development and advise on timing for any intervention needed.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I want to first clear up a misconception I hear often: "I brush twice a day, so why do I have tartar?" Brushing removes soft plaque — the sticky film of bacteria that forms daily. But once plaque is not removed within 24–72 hours, it mineralises (hardens) using calcium from your saliva and becomes tartar. Tartar has the consistency of stone — it bonds to the tooth surface and no brush, no matter how good, can remove it.

Think of it like lime scale in a water pipe. Daily wiping keeps the surface clean, but the deposits that have hardened onto the pipe walls can only be removed with a descaling treatment.

What scaling involves: An ultrasonic scaler — a small instrument that vibrates at very high frequency — is used to break up and dislodge the tartar from the tooth surface and below the gum line. It is accompanied by a water spray that flushes the debris away. The procedure takes 20–40 minutes depending on how much build-up there is.

Does it hurt? For most patients with healthy or mildly inflamed gums — no. You feel vibration, water, and some pressure but no sharp pain. For patients with significant gum disease and very sensitive gums, there may be some discomfort — in which case I apply a topical anaesthetic gel first.

Why it is necessary even if you brush:

• Tartar below the gumline causes chronic inflammation — the primary driver of gum disease
• Gum disease is the leading cause of tooth loss in adults
• It cannot reverse on its own — the bacteria causing the inflammation are protected inside the hardened tartar

A Cochrane review on scaling and root planing found significant improvement in gum health outcomes compared to no treatment. The NHS recommends scaling as the standard first-line treatment for gum disease. After scaling, most patients notice their gums bleed less within 2–3 weeks as the inflammation settles.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

This is a fair question. Walk into any pharmacy and there are dozens of mouthwash options — each claiming to do something remarkable. The truth is more nuanced.

A mouthwash reaches areas that a brush and floss miss — the soft tissues of the cheeks, the back of the throat, the tongue. It also briefly reduces bacteria count across the entire mouth. For these reasons it is genuinely useful — but only as an addition to brushing and flossing, never a substitute. A 2016 Cochrane review confirmed that antiseptic mouthwash reduces plaque and gingivitis when added to regular oral hygiene, but the benefit is modest when brushing is already good.

Which type to use:

• Fluoride mouthwash (like Colgate Plax Fluoride or Listerine Total Care) — strengthens enamel, good for people prone to cavities. Use at a separate time from brushing — not right after, as it washes away the fluoride from your toothpaste.
• Antiseptic mouthwash (chlorhexidine-based — Hexidine, Rexidine, available at pharmacies for ₹80–₹150) — kills bacteria effectively. Best used short-term during a gum infection or after dental procedures. Not for daily long-term use — it can stain teeth brown and alter taste over time.
• Cosmetic mouthwash (Listerine Cool Mint, most supermarket options) — freshens breath temporarily. No therapeutic benefit beyond the rinse itself. Fine to use daily if you enjoy it.

When not to use mouthwash: Do not give alcohol-based mouthwash to children under 6. Do not use it immediately after brushing — wait 30 minutes. And never use it instead of brushing when you are short on time — it is not a shortcut.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Most people think of the mouth and the rest of the body as separate. They are not. Your mouth is an entry point into your bloodstream, and whatever lives in your mouth has access to the rest of your body.

When gum disease is active, the inflamed gum tissue acts like an open wound — and the bacteria living there can enter the bloodstream directly. These bacteria can travel to the heart and arteries, contributing to the build-up of arterial plaques. This is why multiple large studies, including one published in the NIH, have found that people with moderate to severe gum disease have a 2–3 times higher risk of heart attack and stroke compared to those with healthy gums.

Other connections that are well established:

• Diabetes: Gum disease makes blood sugar harder to control — and uncontrolled blood sugar makes gum disease worse. It is a two-way relationship. The WHO recognises this bidirectional link explicitly.
• Pregnancy: Severe gum disease in pregnant women is associated with preterm birth and low birth weight. Hormonal changes during pregnancy also make gums more susceptible to inflammation — which is why I always recommend pregnant patients come in for a check-up and cleaning.
• Respiratory disease: Bacteria from infected gums can be inhaled into the lungs, contributing to pneumonia and worsening existing lung conditions.

I am not saying that treating your gums will guarantee a healthy heart. But I am saying that your mouth is not isolated from your body. Gum disease is a chronic infection — and chronic infections have consequences beyond just the mouth.

If you have been told you have gum disease and have not had it treated — please consider it not just a dental matter but a whole-body health matter.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

The common belief is that you wait until all the adult teeth have come in — usually around age 12–14 — before doing anything about crooked teeth. For many children this is true. But for some, waiting that long means missing a window when the jaw is still growing and problems can be intercepted easily.

The American Academy of Pediatric Dentistry recommends that all children have an orthodontic screening by age 7. Not because they will all need braces at 7 — but because certain conditions are far easier to correct while the jaw is still developing:

• Crossbite — where upper teeth bite inside lower teeth on one side. Correcting this early with a simple palate expander prevents more complex problems later.
• Overcrowding — if the jaw is too small for the teeth coming in, early guidance can sometimes create enough space without extractions later.
• Habits like thumb-sucking or mouth-breathing — these affect jaw development and are far more manageable if caught early.
• Severe protrusion — children with significantly protruding front teeth are more likely to injure them. Early correction reduces that risk.

For most children, the assessment at age 7–8 will simply confirm that we monitor and wait — and that is perfectly fine. But for those where early intervention helps, the difference can be significant. A problem that needs a simple expander at age 8 might need jaw surgery at age 18.

Bring her in. At the very least I can tell you what we are looking at and when to expect the next step. There is no cost to looking.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

The tricky thing about bruxism is that most people have no idea they are doing it — it happens during sleep. The first sign is often a partner complaining about a grinding sound, or waking up with a sore jaw and dull headache. By the time these symptoms appear, some wear has already occurred.

When I look inside a grinder's mouth, I can see the signs immediately: flattened chewing surfaces, worn-down front teeth that look shorter than they should, sometimes small chips or cracks. Over years of grinding, enamel loss is significant — and enamel, once gone, cannot be restored by the body.

What causes it: Stress and anxiety are the primary drivers — which is why bruxism is extremely common in urban populations with demanding work schedules. Sleep apnoea, certain medications, and caffeine consumption also contribute. According to NIH research, bruxism affects 8–31% of adults, though many are unaware.

What can be done:

• Custom night guard — a thin, hard acrylic appliance made from an impression of your teeth that you wear during sleep. It does not stop the grinding but protects your teeth from the force. This is the most effective intervention. Cost in India: approximately ₹3,000–₹8,000 depending on the type.
• Stress management — yoga, regular exercise, and improving sleep quality genuinely reduce bruxism frequency for many patients.
• Avoid evening caffeine — tea, coffee, and cola in the hours before bed increase teeth grinding frequency.
• Warm compress on the jaw — for morning soreness, a warm cloth held against the jaw for 10 minutes relaxes the muscles.

If you are waking with headaches or jaw soreness, come and see me. I can assess the wear, check for any cracks that may be developing, and take an impression for a night guard before the damage progresses further.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I want to be clear first: most white patches inside the mouth are benign. A canker sore (aphthous ulcer), a small bite injury, or a patch of inflamed tissue from a rough tooth edge are all very common and resolve on their own within 1–2 weeks. If it healed — do not worry.

But if a white or red patch inside the mouth has been there for more than 2 weeks without healing, it needs to be examined. The condition is called leukoplakia (white patch) or erythroplakia (red patch) — both of which can be precancerous changes in the mouth lining.

India has one of the highest rates of oral cancer in the world — largely because of tobacco use, betel nut (paan), areca nut, and gutka, all of which are widely consumed across Tamil Nadu. The WHO identifies oral cancer as a significant public health concern in South Asia specifically.

Warning signs to watch for:

• A white or red patch that does not wipe off and has lasted more than 2 weeks
• A sore or ulcer that does not heal
• A lump or thickening inside the cheek, lip, or tongue
• Difficulty swallowing or persistent hoarseness
• Numbness in the mouth or lip

At your next check-up, I examine all soft tissues inside the mouth as a routine part of every visit — this is a quick oral cancer screening that takes under 2 minutes. When something suspicious is found early at the patch stage, treatment is straightforward. When it is found late, it is a very different situation.

Please do not wait. Come in this week. Most likely it is nothing — but if it is something, you want to know now.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Clear aligners have become very popular, and patients ask about them constantly. Instagram and social media have made them seem like a magic invisible solution — which is partly true and partly marketing. Let me give you an honest picture.

Clear aligners are a series of custom-made, transparent plastic trays that fit over your teeth. Each tray moves your teeth a tiny amount, and you change to the next tray every 1–2 weeks. They are nearly invisible when worn, removable for eating and brushing, and far more comfortable than metal brackets and wires.

Where they work well:

• Mild to moderate crowding or spacing
• Minor bite issues
• Adults and older teenagers who will wear them consistently (they must be worn 20–22 hours a day)
• People with certain professions or social situations where visible braces are a concern

Where traditional braces are better:

• Severe crowding or complex bite problems
• Significant rotation of teeth
• Cases requiring precise control of tooth movement in three dimensions
• Children and teenagers who may not comply with the discipline of wearing removable aligners

In terms of cost in India, clear aligners typically range from ₹60,000 to ₹1,50,000 depending on the brand and complexity. Metal braces range from ₹25,000 to ₹60,000. The Cochrane review on clear aligners vs braces found that both achieve comparable results for mild-moderate cases, but that clear aligners require higher patient compliance to be effective.

Come in for a consultation and I can tell you which option makes clinical sense for your specific situation — without any obligation.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Oil pulling — swishing a tablespoon of coconut or sesame oil around your mouth for 10–15 minutes — is actually one of the older Ayurvedic oral hygiene practices, called kavala or gandusha. It is not a modern social media trend. What is new is that researchers have started studying it properly.

A study published in the NIH journal on complementary medicine found that oil pulling with coconut oil for 30 days significantly reduced Streptococcus mutans (the main cavity-causing bacteria) in saliva and plaque, with effects comparable to chlorhexidine mouthwash. Another study found it reduced bad breath scores similarly to antiseptic mouthwash.

What the evidence supports:

• Modest reduction in bacteria that cause cavities and gum disease
• Some benefit for bad breath
• Possible mild anti-inflammatory effect on gums

What the evidence does not support: Claims that it detoxifies the body, whitens teeth dramatically, cures systemic diseases, or replaces any conventional dental care. These are exaggerated.

How to do it correctly: Use 1 tablespoon of cold-pressed coconut or sesame oil. Swish for 10–15 minutes (start with 5 if it feels too long). Spit it out into a bin — not the sink, as it solidifies and blocks drains. Rinse with warm water. Do this before brushing in the morning.

If you already have good brushing and flossing habits and want to add oil pulling — go ahead. It is safe, inexpensive, and the evidence suggests a modest benefit. Just do not use it as a replacement for the basics.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Gum recession is one of those things patients notice gradually — one day they realise their teeth look longer than they used to. Sometimes the roots become visible as a yellowish area at the base of the tooth, and there may be sensitivity when the exposed root surface touches hot or cold.

The most common causes I see:

• Brushing too hard or with a hard toothbrush. This is the number one cause in my patients. Years of aggressive brushing wears away the gum tissue. The damage is gradual and painless until it has progressed significantly.
• Gum disease (periodontitis). As gum disease destroys the bone and tissue supporting the tooth, the gum level drops. This is why treating gum disease early matters so much.
• Tooth grinding. The force of grinding puts stress on the gum tissues and contributes to recession over time.
• Genetics. Some people simply have thinner gum tissue that is more prone to recession regardless of how well they care for their teeth.
• Misaligned teeth or bite. Teeth that are out of position can experience uneven force that pushes the gum down in that area.

What can be done: First, remove the cause. Switch to a soft brush and gentle technique. Treat any active gum disease. For mild recession, this is often enough to stop progression. For significant recession where root exposure is causing sensitivity or there is a risk of tooth loss, a gum graft (connective tissue graft) can restore the gum level. This is a minor surgical procedure done under local anaesthesia with a good success rate — reviewed favourably in Cochrane systematic reviews.

If you have noticed recession, come in for an assessment. Early intervention is always simpler than late intervention.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

After a tooth is extracted, a blood clot forms in the empty socket — this clot is essentially a natural bandage that protects the underlying bone and nerve while healing takes place. When this clot is lost or does not form properly, the bone and nerve endings are exposed directly to air, food, and fluids. This is dry socket, and it is extremely painful — often described as a deep, radiating ache that extends up into the ear or down the jaw.

Typically, post-extraction pain improves steadily day by day. Dry socket is the opposite — pain that gets significantly worse 2–3 days after the extraction, not better.

What increases the risk:

• Smoking — the suction action dislodges the clot, and nicotine impairs healing
• Drinking through a straw in the first 24 hours
• Vigorous rinsing or spitting in the first 24 hours
• Wisdom tooth extractions (higher risk than other teeth)
• Certain medications like oral contraceptives

What the treatment involves: I gently irrigate the socket to clean out food and debris, then place a medicated dressing — usually containing eugenol (clove oil) — which provides almost immediate pain relief. This dressing needs to be changed every few days until the socket begins to heal normally. According to the NIH, properly placed dressings resolve dry socket in 7–10 days in most cases.

If you have significant worsening pain 2–3 days after an extraction — anywhere you had it done — please call the clinic immediately. This is something that needs professional care the same day.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Diabetes is one of the most common conditions I see in patients in Chennai, and its impact on oral health is significant and underappreciated. I always ask new patients whether they have diabetes — not as a formality, but because it changes how I approach their treatment.

How diabetes affects the mouth:

• Increased gum disease risk. High blood sugar reduces the ability of white blood cells to fight infection. The gums become more susceptible to bacterial attack and inflammation is harder to resolve. People with poorly controlled diabetes are 3 times more likely to develop severe gum disease, according to NIH research.
• Slower healing. After any dental procedure — from a simple extraction to a scaling — healing takes longer and there is higher infection risk. I always inform my diabetic patients about this and schedule closer follow-up.
• Dry mouth. Diabetes reduces saliva flow in many patients. Less saliva means more bacteria, more acid, and higher cavity risk.
• Thrush (oral candidiasis). High sugar in saliva encourages fungal growth. White patches or soreness on the tongue or cheeks may be thrush, which is more common in diabetic patients.

The reverse link: Active gum disease produces inflammatory chemicals that interfere with insulin action. Treating gum disease has been shown in multiple studies to improve HbA1c levels — the 3-month average blood sugar marker — by a modest but meaningful amount. The WHO explicitly recognises this bidirectional relationship.

What this means practically: If you have diabetes, I recommend dental check-ups every 3–4 months rather than every 6 months. Control your blood sugar as well as possible before any planned dental procedure. Tell me your current HbA1c — it helps me plan safe treatment. And if your gums are inflamed, treating them is not just about your teeth — it may help your diabetes management too.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Your friend is right that it sounds like an overbite — but that word covers a wide range. An overbite simply means the upper front teeth overlap the lower ones. Ideally, the upper teeth overlap the lower by about 2–4mm vertically. This is considered normal and functional.

Problems begin when the overlap is larger. A deep overbite — where the upper teeth cover more than half of the lower teeth — can cause several issues over time:

• Wear on the lower front teeth: When the upper teeth bite too far down, they grind against the lower front teeth or the gum behind the upper teeth, wearing both down significantly over the years.
• Jaw joint (TMJ) problems: A deep overbite can force the lower jaw back into an unnatural position, contributing to jaw pain, clicking, or headaches.
• Gum damage: In severe cases, the lower teeth bite into the palate behind the upper teeth, causing gum injury.
• Appearance: A significant overbite can make the chin appear recessed and the face shorter in proportion.

What causes it: Overbites are largely genetic — the size and position of your jaws is inherited. However, childhood habits like prolonged thumb sucking, dummy (pacifier) use beyond age 3, and mouth breathing can worsen a tendency toward deep overbite.

Treatment options: In children and teenagers, braces or clear aligners are highly effective because the jaw is still growing and more responsive. In adults, treatment is still possible but may take longer. Severe skeletal overbites in adults sometimes require a combination of orthodontics and jaw surgery for the best result — though most cases can be managed with braces alone.

The ADA MouthHealthy guide on malocclusion recommends an orthodontic assessment for anyone concerned about their bite. Come in for a check-up — I can measure the overbite precisely and tell you whether it needs any attention.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

This is a very perceptive question and I am glad you asked it. Sensitivity and cavities are different conditions, but they are related in an important way — both become more likely when enamel is compromised.

Sensitivity occurs when the dentine layer underneath the enamel becomes exposed or when enamel thins. Dentine is porous — it has tiny tubes running through it — and temperature, sweetness, or acidity can travel through those tubes to the nerve. Cavities occur when bacteria in plaque produce acid that dissolves enamel and eventually dentine.

The connection: When enamel is thin or worn (which is what causes sensitivity), there is simply less protective barrier between the outside world and your dentine and nerve. The same thinning that allows temperature to cause pain also allows bacteria to penetrate more easily. So yes — sensitive teeth are at higher risk of developing cavities, particularly on the exposed root surfaces.

The good news: Enamel that is thinning but not yet cavitated can be remineralised. Fluoride — both in toothpaste and in professional fluoride varnish applied at the clinic — actively helps enamel absorb minerals and become stronger. A Cochrane review on fluoride varnish found significant reduction in cavity incidence in patients with sensitivity and early enamel loss.

What you can do:

• Use a fluoride toothpaste daily — do not rinse immediately after brushing, let it sit
• Reduce acidic food and drink frequency
• Come in for professional fluoride varnish application every 6 months
• Ask me about fissure sealants if specific teeth are at high risk

Sensitivity is your teeth asking for help before a cavity develops. Act on it now and the protection is simple and inexpensive.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I hear this concern often, and I understand it. Radiation is a word that sounds alarming. Let me give you some perspective with real numbers.

A standard set of dental X-rays (4 bitewing films) exposes you to approximately 0.005 millisieverts (mSv) of radiation. To put that in context:

• Natural background radiation from the environment: approximately 3 mSv per year — just from living on Earth
• A single dental X-ray: roughly equivalent to one hour of background radiation
• A flight from Chennai to Delhi: approximately 0.01 mSv — twice a dental X-ray
• A chest X-ray: 0.1 mSv — 20 times a dental X-ray

The WHO's guidance on radiation and health is clear that dental X-ray doses are in the lowest-risk category possible. Modern digital X-ray systems (which we use) reduce the dose even further compared to older film-based systems — by up to 80%.

Why they matter: About 40% of the tooth surface — the areas between teeth — is completely invisible to a clinical exam. Cavities between teeth are only detectable on X-ray. By the time such a cavity causes pain, it has typically already reached the nerve and requires a root canal rather than a simple filling. An X-ray that catches it early means a filling instead.

I do not take X-rays unnecessarily. For adults with healthy teeth, I typically recommend bitewing X-rays every 12–24 months. For patients with active decay or gum disease, more frequent imaging helps me track changes. If you have recent X-rays from another dentist, bring them — I will use them rather than repeat the exposure.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

The whitening market is enormous and the claims on packaging can be confusing. Let me break down what actually works and what to be cautious about.

Whitening toothpastes: These work by two mechanisms — mild abrasives that physically scrub surface stains, and sometimes low concentrations of hydrogen peroxide or blue covarine (an optical agent that makes teeth look whiter). The abrasive action is effective for removing tea, coffee, and tobacco stains from the enamel surface. However, they cannot change the intrinsic colour of the tooth. If your teeth are naturally more yellow or greyish, toothpaste will not make a meaningful difference. Look for the ADA Seal of Acceptance on the packaging — it confirms safety and efficacy claims have been verified.

Over-the-counter home kits (strips, gels, trays): These typically contain 3–6% hydrogen peroxide. They can produce a noticeable result over 2–4 weeks, but the trays are not custom-fitted, which means the gel can seep onto gums and cause irritation. Results are variable and often uneven.

Professional whitening at the clinic: I use higher concentration peroxide gels (15–40%) with custom-fitted trays made from impressions of your teeth. This gives faster, more even, and more predictable results — typically 2–8 shades lighter in 1–2 sessions. The custom tray also protects your gums from gel contact.

Important caveats: Whitening only works on natural tooth enamel — it has no effect on crowns, veneers, or composite fillings. If you have restorations on visible teeth, whitening the surrounding natural teeth can create a mismatch. Always let me check before you start any whitening — I can advise on realistic expectations for your specific teeth.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Gingivitis literally means inflammation of the gingiva — your gums. It is extremely common. Studies suggest that some degree of gingivitis is present in the majority of adults at any given time, though most people are unaware of it because it is painless in its early stages.

What causes it: Plaque — the soft, sticky film of bacteria that forms on teeth daily — is the primary cause. When plaque is not removed by brushing and flossing, it irritates the gum tissue, causing it to become red, swollen, and prone to bleeding. When plaque hardens into tartar (calculus), the irritation becomes more persistent because tartar cannot be removed by brushing alone.

Signs to watch for:

• Gums that bleed when you brush or floss — even a little
• Gums that look redder or darker than usual (healthy gums are pale pink)
• Gums that appear puffy or swollen along the edge of the tooth
• Persistent bad breath despite brushing

Why it matters: Gingivitis affects only the soft tissue — the bone and deeper structures are not yet involved. This is why it is fully reversible. A professional scaling to remove tartar, combined with improved brushing and flossing at home, typically resolves gingivitis within 2–4 weeks. The Cochrane review on scaling confirms this is the most effective first-line treatment.

If gingivitis is not treated, it progresses to periodontitis — where the inflammation spreads to the bone supporting the teeth. Bone loss is permanent. Teeth become loose. This is the leading cause of tooth loss in adults over 40. Catching it at the gingivitis stage means none of that needs to happen.

If your gums bleed when you brush — even occasionally — please come in. It is not normal and it is easy to treat at this stage.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

I see baby bottle tooth decay frequently in very young children, and it is heartbreaking because it is always preventable. Understanding why it happens makes it easier to avoid.

When a baby or toddler falls asleep with a bottle of milk, formula, or juice, the liquid pools around the teeth. Saliva production almost stops during sleep — saliva is what normally washes and neutralises acid in the mouth. So the sugars from the milk sit undisturbed on the teeth all night, feeding the bacteria that produce acid, which dissolves the enamel of baby teeth.

Baby teeth have thinner enamel than adult teeth, which makes them more vulnerable. The decay can progress from mild discolouration to complete destruction of the front teeth within months. Severely decayed baby teeth need extraction under general anaesthesia in very young children — a procedure that is stressful for the child and family.

Why baby teeth matter: I hear parents say "they will fall out anyway." Baby teeth hold the space for adult teeth. When they are lost too early due to decay, neighbouring teeth drift into the gap and the adult tooth has no space to come in properly, requiring orthodontic treatment later.

The American Academy of Pediatric Dentistry recommends that bottles should not be used as a sleep aid after the age of 12 months, and that any bottle feeding should be followed by wiping the gums and teeth with a clean damp cloth.

What to do: Transition the bottle to a cup by 12 months. If the bedtime bottle is a comfort habit, try replacing it with water in the bottle rather than milk. Wipe her gums and teeth gently with a damp cloth after the last feed. Once teeth are present, a soft baby toothbrush with a smear of fluoride toothpaste (rice grain size under age 3) is recommended.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Implants are often the best long-term solution for missing teeth, but cost is a real barrier for many patients. A dental bridge is an excellent alternative that has been used successfully for decades.

How a bridge works: A bridge uses the teeth on either side of the gap as anchors (called abutment teeth). Crowns are placed over those anchor teeth, and between them is a false tooth (or teeth) called a pontic, which fills the gap. The whole structure is cemented permanently in place. From the outside it looks like your own teeth.

Advantages of a bridge:

• Fixed — does not come out like a partial denture
• Looks and functions like natural teeth
• Significantly less expensive than implants — a 3-unit bridge in India typically costs ₹15,000–₹40,000 depending on material
• Treatment is completed in 2–3 visits over 1–2 weeks
• No surgery required

The key trade-off: The anchor teeth need to be prepared (shaped down) to accommodate the crowns. This is irreversible. If those anchor teeth are healthy and cavity-free, grinding them down is a real sacrifice. This is why, when the adjacent teeth are healthy, implants are preferred — a bridge compromises two good teeth to replace one or two missing ones.

Materials available: Porcelain-fused-to-metal (PFM) bridges are the most common and affordable. All-ceramic (zirconia) bridges are stronger, more natural-looking, and metal-free — they cost more but are excellent for visible areas.

According to the ADA MouthHealthy guide on bridges, with proper care a well-made bridge lasts 10–15 years or more. Come in for a consultation — I can assess your specific situation and give you a clear picture of what makes sense clinically and financially.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Pregnancy gingivitis is one of the most common oral health conditions I see, and it affects up to 70% of pregnant women to some degree. You are not doing anything wrong — your hormones are the primary driver.

During pregnancy, elevated levels of progesterone and oestrogen cause the blood vessels in the gums to become more permeable and reactive. Gum tissue that was previously tolerating a normal level of plaque now responds with inflammation even to relatively small amounts. The result is swollen, red, easily bleeding gums — often worse in the second trimester, which is exactly where you are.

Why it matters beyond the gums: A large body of research, including guidance from the WHO, has found a significant association between severe gum disease during pregnancy and preterm birth and low birth weight. The inflammatory chemicals produced by gum infection can affect the uterus. This is not meant to alarm you — it is meant to explain why we take pregnancy gingivitis seriously.

Is dental treatment safe during pregnancy? Yes — and it is actively recommended. The second trimester (weeks 14–28) is the safest and most comfortable time for routine dental work. Local anaesthesia at the doses used in dentistry is safe. Scaling and cleaning is safe and important. Elective cosmetic work should wait until after delivery, but necessary treatment should not be delayed.

What you can do:

• Brush twice daily with a soft brush — do not avoid brushing because it bleeds
• Floss gently once a day — bleeding gums improve with cleaning, not by leaving them alone
• Come in for a professional scaling and cleaning — this is the most effective treatment
• Inform your obstetrician about any dental treatment you receive

Please do not put this off. Come in — it is safe, straightforward, and important for both you and your baby.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai

Root canal treatment has a success rate of about 85–95% over 10 years — which means a small but real percentage of cases do experience problems down the line. Pain returning after a previously treated tooth is worth taking seriously, but it does not automatically mean the tooth is lost.

Why root canals can fail:

• Complex anatomy: Some teeth have curved, narrow, or extra canals that are difficult to clean completely. Bacteria can persist in areas that were not fully treated.
• Recontamination: If the crown or filling placed after the root canal has cracked, leaked, or was delayed, bacteria can re-enter the cleaned canals and cause reinfection.
• Missed canals: Upper back molars often have 3–4 canals. If one was missed during the original treatment, infection can persist there.
• Fracture: If the tooth has since cracked — which is more likely in teeth without crowns — bacteria can travel down the crack regardless of the root canal.

What happens next: I will take an X-ray to assess what is happening at the root tip. If there is a shadow (indicating infection) that was not there before, or has grown, that confirms failure. The options are:

• Root canal retreatment — the old filling material is removed, the canals are re-cleaned more thoroughly, and re-filled. Success rate for retreatment is approximately 75–85% according to NIH research.
• Apicoectomy — a minor surgical procedure where the very tip of the root is removed along with the infected tissue. Used when retreatment is not accessible.
• Extraction — the last resort if the tooth cannot be saved, followed by implant or bridge planning.

Do not wait — infections at the root tip can spread to the jawbone if left untreated. Come in soon and we will assess what is happening.

— Dr. Sandhya B.M.  |  Infinity Dental Care, Anna Nagar, Chennai