Single tooth replacement options
Posted by: drkam on: November 10, 2009
by Dr Kamsiah binti Gulam Haider
Introduction
When children loose a tooth, there is celebration and joy. When adults loose a tooth, there is usually concern and dismay. Children replace their own tooth by growing one anew. Adults require assistance from their family dentist. The first job of the dentist is to assist their patient with the decision of how to replace that tooth.
There are many options available to replace teeth. When a front tooth is lost in an accident, such as when playing a sport or in a car, time can be a major concern. Dentists can replace a tooth very quickly by fabricating a single tooth denture . This kind of denture is much like an orthodontic retainer with one or two teeth; it may have a couple of wire clips that hold it onto other teeth. Dentures are easy to wear and care for, and they repair the patient’s appearance. Most people are not happy with their ability to chew with the denture in place, so they remove it when eating. Some have trouble talking with the denture at first, but speech improves with practice. This is the least expensive way to replace a tooth. Some patients will live with a denture for years before replacing it with a more permanent false tooth or another denture.
There are three basic ways to fix a missing tooth or teeth.
- A fixed bridge
- A removable appliance
- A dental implant
A fixed bridge
Having a bridge is like having three crowns. The teeth on either side of the missing tooth are prepared for crowns, an impression is made, and the case is sent to a dental laboratory. The laboratory then makes the crowns and fastens a false tooth between the two crowns – this is a bridge.The advantages of a bridge are that it is fixed, stable, and feels like your own teeth. In most cases it can be made to look just like you never had a tooth missing. The disadvantage is that you have to treat two teeth besides the one that was extracted – these teeth may otherwise be perfectly sound with nothing wrong.
A Maryland bridge is the least expensive type, but has some esthetic and mechanicalproblems.Usually used as an interim treatment during implant treatment in 2 stage implant procedure.
Using the ovate pontic technique with a dental bridge can create the illusion that the false tooth is growing out of the gum.
A Removable Appliance.
Something removable can be used to replace a missing tooth. This can be anything from a budget “denture” (a piece of plastic with a false tooth attached) or a Cobalt Chromium, to a more sturdy metal and acrylic removable partial denture.
The advantages of the removable partial denture appliance are that it is a more economical way to replace missing teeth than a fixed bridge. Also, you can replace multiple teeth with one appliance. If the span of missing teeth is three or more, or if there are not solid teeth on both sides of the missing teeth, a fixed bridge may not work.
The disadvantages are that it may not be as esthetic as a bridge. Clasps will be required to retain the removable partial, and it may not be possible or practical to entirely conceal those (though that problem can be avoided often with a “precision attachment” partial). Also, there may be some discomfort with wearing removable hardware in your mouth, and it is not as stable as a bridge.
A dental implant
A dental implant is an artificial “root” that is implanted in your jaw after a tooth extraction, and then a tooth is placed on it. Biologically, it is like placing an entirely new artificial tooth in your mouth.The advantages of an implant are: No teeth on either side have to be prepared for crowns, so there is no grinding on “good teeth” – you just fix the missing tooth. Implants can also span the space of multiple missing teeth. There is no limit to the span they can cover, as long as the patient’s health is good and there is healthy and adequate bone to support the implant. An implant also is fixed and feels just like your own teeth. Read our more thorough discussion of implants, plus see before-and-after photographs, on our cosmetic dental implant page.
The disadvantages of implants are that they can cost more and be more and time-consuming, and the cost may not be covered by dental insurance. You will likely have to deal with two dentists – the dentist who does the surgery to place the implant, and the dentist who puts the false tooth on top of the implant. There is also a delay in getting the false tooth or teeth – a healing interval of several months may be required before the artificial root can have a tooth placed on it. There is also surgery involved with its attendant discomfort and healing period.
However, if you are missing multiple teeth or all your teeth, there is a strong advantage to dental implants in that they will preserve the jawbone. Sometimes dentists don’t explain the negative long-term consequences of missing teeth, which are that your jaw gradually shrinks until you can’t wear any removable appliance. To read more about this, please see our page about facial collapse. So if you want to still be able to eat when you’re 80, you may want to consider investing in dental implants to replace those missing teeth.
Conclusion
Removable partial dentures have metal clasps that clip onto teeth to hold the device in the mouth. Patients need to take these in and out for cleaning after eating.
Tooth supported bridges rely on the adjacent teeth for support. The teeth next to the missing tooth space are ground down and the bridge is cemented onto them. This bridge does not come in and out and relies on the integrity of the adjacent teeth for support.
Dental implants. The final method of tooth replacement is the dental implant, which is a replacement for the root of a tooth. The implant is placed where the root of the missing tooth used to be. The replacement root is then used to attach a replacement tooth.
There is significant loss of adjacent teeth (ranging from 12%-19%) if the missing tooth is not replaced.Tooth supported bridges improve the survival rate, with abutment tooth loss from 7%-10% at 6.7 and 8.6 years. Removable partial dentures increase abutment tooth failure rate ranging from 17% to 30% at 4.2 to 7 years. There is no significant difference in the statistics of the various studies.When an individual loses a tooth there are important decisions to be made.
Patients who do not replace missing teeth may experience shifting of teeth, spaces opening between teeth (resulting in food impaction), collapse of the bite, alterations in their chewing ability, TMJ pain, and trauma to the remaining teeth. People sometimes don’t replace teeth that are “in the back” of the mouth because no one sees them. The back teeth are needed to support the bite and grind up food. We can all swallow food that is not chewed thoroughly, but this compromises the nutrition we extract from our diet.
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Dental care for those above 6 year old
Posted by: drkam on: November 4, 2009
Dental care for those above 6 year old
Dental Treatments
Filling
If you suffer from dental caries, you have to see a dentist for filling to prevent the caries from getting worse.
Why do we need filling？
*To stop pain caused by decayed tooth.
*To restore the shape and functions of the tooth, such as chewing, articulating, aesthetics, and etc.
*To keep the carious deciduous teeth to prevent alignment problem in permanent teeth due to early loss of deciduous teeth.
*Overview of filling process
-Remove the decayed tooth structure.
-Place the filling material into the cavity.
-Trim off and polish the filling material.
-How many filling materials do you know?
Composite resin fillings
Colour: similar to natural tooth colour
Glass Ionomer Cement
Colour: similar to natural tooth colour
Compomer
Colour: similar to natural tooth colour
Stainless steel crown
Colour: Silver. It has different sizes, and it is often used on deciduous molars.
Feeling uncomfortable after filling?
- It takes a few days to adapt to the newly filled tooth. If situation hasn’t gradually improved, or has even slowly got worse, you need to see the dentist for a detailed examination.
Temporary Denture
If a child loses his/her permanent tooth due to an accident, his/her dentist needs to fabricate a temporary denture for him/her.
Purpose
To improve aesthetics by filling the gap left by the missing tooth. To wait until the child’s jawbones are fully developed (around 18 years old) to insert a permanent denture/bridge/implant.
Material
Plastic and stainless steel wires.
Procedure
Impressions of the teeth are taken, and the occlusion is recorded
The temporary denture is fabricated in the dental laboratory
The temporary denture is fitted
Points to note
After fitting a temporary denture, extra attention should be paid to the oral hygiene in order to prevent dental caries and periodontal disease.
Thoroughly clean the denture and teeth every morning and before bed at night.
When the temporary denture is not worn, it must be soaked in plain water.
If severe discomfort is felt when wearing the temporary denture, you must bring your child to the dentist immediately.
Pulp Treatment (Root Canal Treatment)
What is pulp treatment?
Pulp treatment is necessary if the pulp of a tooth is infected or became necrotic because of trauma or dental caries. The treatment involves partial or complete removal of the pulp and application of filling material to fill up the area.
Knowing more about pulp treatment
Pulp treatment requires a few visits to complete. Remember to revisit on schedule!
If the filling material has fallen off during the treatment period, you must ask the dentist to refill the material in order to avoid infection caused by bacteria in the saliva.
Local anaesthesia may be required during the treatment. Remember not to bite your lips or tongue before the anaesthesia has worn off.
Leong’s Premolar
What is Leong’s Premolar?
Some permanent premolars have a projected portion of the tooth structure which is fragile; this kind of premolar is called ‘Leong’s Premolar’. If the projected portion fractures, the pulp inside the tooth may become necrotic from bacterial infection, or even results in abscess.
If I have a Leong’s Premolar, what should I do?
To avoid the projected portion to fracture, the dentist will use the preventive treatments below according to individual need:
Method 1: Strengthen the projected portion
Method 2: Remove the projected portion and apply filling to the cavity
If you think you have a Leong’s Premolar, you should ask your parents to take you to a dental clinic for a detailed check-up and receive appropriate treatment as soon as possible!
Orthodontic Treatment
What is orthodontic treatment?
Orthodontic treatment is a series of processes to move poorly aligned teeth to a desirable position.
Orthodontic treatment can：
Improve aesthetics
Improve the occlusion and chewing function.
Types of orthodontic appliances
Fixed orthodontic appliance
Procedure
Placement of orthodontic brackets.
The orthodontic wire and orthodontic brackets are connected by elastics and stainless steel wires (ligatures).
Regular dental revisits are needed according to the instructions of the orthodontist.
After the teeth have moved to favourable positions, a retainer is used to hold and stabilize the teeth in these positions.
How long does a fixed orthodontic treatment take?
The overall duration lasts for about one and a half to three years. The actual time needed depends on the complexity of treatment.
Removable orthodontic appliance
It is suitable for simple orthodontic treatments.
Procedure
Impressions of the teeth are taken.
The removable orthodontic appliance is fabricated in the dental laboratory.
The appliance is fitted in the mouth. It is also activated.
Regular dental visits to check the tooth movements and adjust the appliance.
How long does a removable orthodontic treatment take?
The overall duration lasts for about 6 to 12 months. The actual time needed depends on the complexity of treatment.
Points to note on orthodontic treatments
When you are wearing an orthodontic appliance, extra attention towards oral hygiene is needed to prevent dental caries and periodontal disease.
When you are wearing a removable orthodontic appliance, the appliance and teeth must be thoroughly cleaned every morning and evening before wearing it again. Leave the appliance in a cup of water when it is not worn.
If severe discomfort is felt when you are wearing an orthodontic appliance, consult your orthodontist immediately.
Consult the dentist to see whether or not it is necessary for you to undergo orthodontic treatment. Allow him to check your oral situation and explain the treatment to you in detail.
Extraction
Why do we need to extract a tooth？
Caries is found on a tooth where we cannot or do not need to repair it.
For the needs of orthodontic treatment.
Procedure
Apply local anaesthesia to let the teeth and oral tissues to get numb.
Use dental tools to take the tooth out.
Tightly bite on a piece of gauze or cotton roll to help stop bleeding.
Points to note after extraction
For the next 24 hours, you should :
Not rinse your mouth vigorously
Not disturb the wound with your tongue or fingers
Not use alcoholic beverages
Not do heavy exercise
Not smoke
Take pain control medication as recommended
Generally speaking, the wound will gradually heal in 3 to 4 days after the extraction. If discomfort persists even after 4 or 5 days, you should ask your parents to bring you to the dentist for a detailed check-up.
Fissure sealant
Under what circumstances are fissure sealants needed?
Fissure sealant is a composite sealant; it requires a dental professional to apply it for us.
If there are deep fissures on a tooth, dental plaque can easily accumulate in these areas where toothbrush bristles cannot access to and clean these areas.
In order to prevent these teeth from dental caries, we need to apply fissure sealants to seal these fissures.
Procedures for applying fissure sealants
First use diluted acid to etch the surface of the tooth so that the sealant can adhere onto the tooth.
Use water to wash away the acid, blow-dry the tooth, and then apply the fissure sealant onto the fissure.
Use curing light (a dental light source) to harden the fissure sealant in the fissure.
Scaling and Polishing
Why do we need scaling and polishing?
Scaling removes the accumulated dental plaque, calculus, and stain from the surfaces of our teeth, which can prevent periodontal disease.
Treatment procedure
Use dental instruments or ultrasonic scaling machine to remove calculus.
Polish the surfaces of teeth to remove stain and keep the surfaces smooth.
Points to note after scaling
There may be slight discomfort and minor gingival bleeding in the first few days after scaling. Please do not worry. You only need to thoroughly clean your teeth daily, and the discomfort and gingival bleeding will gradually disappear. The gum will become healthy as well.
Prophylaxis is designed to preserve health and prevent the spread of disease. The purpose of polishing tooth surfaces is to make these surfaces smooth which makes it more difficult for plaque and debris to accumulate on your teeth to cause decay or gum disease
Dental polishing or prophy, is rarely done at the first appointment due to restrictions applied by patients dental plans and is only done after completing the clinical exam if there is no presence of gum disease.
It is professionally defined as a procedure that includes scaling and polishing procedures to remove coronal plaque, calculus and stains deposits that are coronal only (which rarely exist) and is a scaling and polishing procedure for patients in a healthy oral state.
Professional polishing removes plaque, tartar, and stain from the teeth. It is a cosmetic procedure that removes surface stains on the crown part of the tooth or above the gumline so they will look and feel cleaner. However, this procedure is not a procedure that cleans infected, diseased gum tissue and root surfaces. This is only a superficial cleaning and will not eliminate disease or get it under control. 
This cleaning may be done by your dentist, dental hygienist, and/or a licensed professional who performs this polishing in the dental office along with education in the proper care of your teeth and gums.
It’s main purpose is to improve the appearance of your teeth by making them look cleaner and brighter.
A Patients Right to Choose
Posted by: drkam on: November 1, 2009
As consumers we all like to have options. In fact, I remember a psychology course in college where we examined a vending machine study. The study, among other things, determined that they would sell more Snickers bars when there were Snickers bars and some other option, than when there was nothing but Snickers bars.
The same hold true for any purchase we decide to make. Often, increasing case acceptance is simply a matter of allowing that patient to feel like they have choices. Especially when it comes to payment plans. Sometimes the anxiety of letting go of that money, or making that commitment today is just too much to stomach. Thoughts of a leaky roof, a broken down car, or the possibility of a losing a job leave a patient wondering if this treatment can wait…because, what if something bad does happen.
Payment plans are nothing new, but patients will frequently reject them because they know what it likely entails:
· Applying for a new credit card
· Having an “introductory/promo rate” with retroactive interest
· Another open line of credit on their credit report (even after it is paid off)
· One more credit card to stick in your wallet
In order to overcome some of these aversions, many practices choose to offer in-house financing. It certainly helps increase case acceptance when the patient knows you’ll offer 90 or 180 days to pay their bill, but how quickly time passes and they soon forget the wonderful treatment they received. Unfortunately, you simply can’t go repo the tooth…not that it would help you pay your bills but might serve as motivation for them to pay theirs. I’m only kidding–it would be quite spiteful indeed.
Accounts receivable balances, however, can become a serious issue for the health of your practice. They can become a small cancer that quickly grows undetected until it is a serious problem. They can be difficult to reduce and hard to manage and the time and money involved in properly managing them can have you feeling more like a collections agency than a dental practice.
Again, I am not recommending the elimination of either, but rather pointing out that by giving your patients options (in addition to the 2 mentioned here), they will say “yes” more often than if they feel they only have the Snickers bar to choose from. Just a simple way to help patients feel comfortable and more in control of their treatment plan. Don’t fall into the trap of thinking that Care Credit and in-house financing are your only options. Dentists like having options other than Snickers too, right?
Tooth Sensitivity
Posted by: drkam on: October 25, 2009
Introduction
Tooth sensitivity is tooth discomfort in one or more teeth, triggered by hot, cold, sweet or sour foods and drinks, or even by breathing cold air. The pain can be sharp, sudden, and shoot deep into the nerve endings of your teeth. For millions of people, sensitive teeth can make life miserable. The pain and discomfort make even favorite hot or cold foods impossible to enjoy. All is not lost. In many cases, sensitive teeth can be successfully treated bringing long sought after relief.
What Causes Tooth Sensitivity?
Tooth sensitivity occurs when the underlying layer of your teeth – the dentin – becomes exposed as a result of receding gum tissue (the protective blanket that covers the tooth roots). The roots, which are not covered by hard enamel, contain thousands of tiny tubules leading to the tooth’s never center (the pulp). These dentinal tubules (or channels) allow the stimuli – for example, the hot, cold, or sweet food – to reach the nerve in your tooth, which results in the pain you feel.
There are many factors that can lead to tooth sensitivity, including.
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Brushing too hard. Over time, brushing too hard or using a hard-bristled toothbrush can wear down enamel and cause the dentin to be exposed. It can also cause recession of the gums (the gum tissue pulls away from the teeth).
- Recession of the gums. As gums move away from a tooth due to conditions such as periodontal disease, the root surface becomes exposed.
- Gum disease (gingivitis). Inflamed and sore gum tissue may cause sensitivity due to the loss of supporting ligaments, which exposes the root surface that leads directly to the nerve of the tooth.
- Cracked teeth. Chipped or broken teeth may fill with bacteria from plaque and enter the pulp causing inflammation.
- Teeth grinding. grinding or clenching your teeth may wear down the enamel and expose underlying dentin.
- Tooth whitening products or toothpaste with baking soda and peroxide. These products are major contributors to teeth sensitivity.
- Your age. Tooth sensitivity is highest between the ages of 25 and 30.
- Plaque build-up. The presence of plaque on the root surfaces can cause sensitivity.
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Mouthwash use. Long-term use of some mouthwashes. Some over-the-counter mouthwashes contain acids that can worsen tooth sensitivity if you have exposed dentin (the middle layer of the tooth). The acids further damage the dentin layer of the tooth. If you have dentin sensitivity, ask your dentist about the use of a neutral fluoride solution.
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Acidic foods. Regular consumption of foods with a high acid content, such as citrus fruits, tomatoes, pickles and tea, can cause enamel erosion.
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Recent routine dental procedures. Sensitivity can occur following teeth cleaning, root planing, crown placement, and tooth restoration. Sensitivity caused by dental procedures is temporary, usually disappearing in 4 to 6 weeks.
What Can I Do to Reduce Tooth Sensitivity?
- Maintain good oral hygiene. Continue to follow proper brushing and flossing techniques to thoroughly clean all parts of your teeth and mouth.
- Use a soft bristled toothbrush. This will result in less toothbrush abrasion to the tooth surface and less irritation to your gums. Brush gently and carefully around the gum line so you do not remove more gum tissue.
- Use desensitizing toothpaste. There are several brands of toothpaste available for sensitive teeth. With regular use you should notice a decrease in sensitivity. You may need to try several different brands to find the product that works best for you. Another tip. spread a thin layer of the toothpaste on the exposed tooth roots with your finger or a Q-tip before you go to bed. Do not use a tartar control toothpaste; rather, use a fluoridated toothpaste.
- Watch what you eat. Frequent consumption of highly acid foods can gradually dissolve tooth enamel and lead to dentin exposure. They may also aggravate the sensitivity and start the pain reaction.
- Use fluoridated dental products. Daily use of a fluoridated mouth rinse can decrease sensitivity. Ask your dentist about available products for home use.
- Avoid teeth grinding. If you grind or clench your teeth, use a mouth guard at night.
- See your dentist at regular intervals. Get professional tooth cleaning, oral hygiene instructions, and fluoride treatments every 6 months (or sooner depending on your condition).
If you still have discomfort, talk to your dentist. There may be some dental procedures that may help reduce sensitivity, including the use of:
- White fillings (bonding) to cover exposed root surfaces
- Fluoride varnishes applied to the exposed root surface
- Dentin sealers applied to the exposed root surface
Conclusion
If you cannot get relief by brushing gently and using sensitivity tooth, your dentist has several options for relief. Your dentist can use “oxalate” compounds that, when applied on the root of the affected tooth, will reduce if not eliminate the sensitivity. Many dentists prescribe high flouride content mouthwashes which help to reduce tooth sensitivity. They may also apply “bonding agents” to close the pores of the tooth root. Always consult your dentist regularly so that you can be proactive in the care and maintenance of your teeth. Protect your smile and feel good about yourself.
Fluorosis can damage your child’s smile
Posted by: drkam on: October 20, 2009
Introduction
drkam
Too much flouride during the early stages of tooth development can cause fluorosis (discolourisation). Children between the ages of 1 and 4 are most susceptible to this problem. Flourosis is not a disease, but it is a cosmetic nuisance, which can be prevented in the young . But if it is allowed to go unattended, flourosis can result in darkened teeth in adults. Fortunately, the damage caused to the physical appearance of the teeth can be corrected by a dentist. Crowns and veeners are usually to cover-up darkened teeth.
As it is always the case, prevention is the best option. By taking your child to the dentist regularly, early signs of flourosis can be detected and early remedial action can be taken. The article is intended to create awareness of fluorosis with some practical steps that you as parents can take to help your kids, especially those between the ages of 1 to 4 when their ‘milk’ teeth are being replaced permanent teeth.
Fluorosis
Fluorosis is a dental problem which happens when a child ingests too much fluoride during the early stages of tooth development. It usually affects children between the ages of one and four years old. It is at this stage when permanent teeth begin to form underneath the ‘milk’ teeth. Children over the age of eight are at almost no risk of developing fluorosis.
Symptoms of Fluorosis
If your child has an excess of fluoride in their diet while their permanent teeth are developing, this can bring about the noticeable signs of fluorosis. The main characteristic of fluorosis is the stains which form on the teeth when yellow and brown spots begin to appear on the enamel of the tooth. The colour changes can range from minor tinges to extensive changes in the enamel’s surface. Stains and discoloured spots can also appear as streaks and in the more severe cases, black and gray spots or pits can develop.
Once your child’s teeth are fully develop, fluorisis no longer poses any risk, this is usually around the age of eight at the latest. Although fluorosis is not a disease in itself, it can be a very noticeable cosmetic condition. In minor cases of fluorosis the discolourations can be so tiny that only your dentist will notice them. The marks that flourorsis leaves on your teeth will be permanent, and as time passes they have a tendency to darken.
Diagnosing Fluorosis
It’s easy for your dentist to spot the signs of fluorosis during one of your regular checkups. You may be asked some questions about your child’s diet such as if they’re using fluoride supplements, a fluoride toothpaste or drinking an excess of fluoridated water. It’s common to be asked about several other medical conditions which could potentially have a similar effect, so that they can be ruled out.
Your dentist will give your child a thorough oral examination and may take some X-ray photographs to scan for any other defects in the teeth. It’s important not to assume your child has fluorosis if they develop stains on their teeth. There’s a range of conditions, some more serious, which can produce symptoms similar in appearance to fluorosis, so make sure you have any discolouration examined by your dentist.
Treating Fluorosis
Fortunately, in most cases, fluorosis is so minor that it doesn’t warrant any treatment. Similarly, the discolouration associated with fluorosis can often occur only on the back of your teeth, where they can’t be spotted. In more severe cases, the front teeth may have to be treated through teeth whitening or another cosmetic treatment. In the most extensive cases of fluorosis, the teeth which have become discoloured can be covered with dental restorations like veneers or crowns.
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Step 1
Look for signs of dental fluorosis. Although mild cases may produce no visible signs on your child’s teeth, moderate to severe fluorosis causes white lines, streaks or spots, as well as pitting of the teeth, misshapen enamel and brown, black or gray spots.
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Step 2
Visit your dentist for a diagnosis. Your dentist will take x-rays and examine your child’s teeth and gums to rule out other dental conditions and defects that may look like fluorosis. Your dentist will need to know your child’s exposure to fluoride, including toothpaste containing fluoride, fluoridated water consumption and fluoride supplements. If your dentist diagnoses your child with fluorosis, he may suggest cosmetic treatments, depending on the severity.
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Step 3
Get teeth-whitening treatments. Although many cases of dental fluorosis are mild enough to not require treatment, tooth whiterning may be an option, to remove stains on the enamel of the front teeth.
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Step 4
Consider tooth restorations for severe cases of fluorosis. Your dentist may recommend bonding, crowns or veneers, if whitening is not enough to correct the affects of fluorosis.
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Step 5
Heed prevention measures. Be aware of your child’s fluoride intake, especially while he is under the age of 6. Make sure your child uses only a pea-sized amount of toothpaste and spits instead of swallowing after brushing his teeth. Have your dentist or local health department check your water for fluoride levels before allowing your child to take fluoride supplements.
What to Consider with Fluorosis
Preventing Fluorosis
You should make sure to only use a pea-sized amount of toothpaste if your child is under the age of six. It’s also important to make them spit after brushing rather than swallowing. As such, you should avoid toothpastes which might encourage swallowing like flavoured toothpastes and to make sure products which contain fluoride aren’t anywhere your children can get at them. There’s a number of soft and fruit drinks which contain fluoride and many brands of bottled water also contains added fluoride. It’s important to make sure your child doesn’t consume a lot of these beverages in order to avoid fluorosis.
Cosmetic Dentistry
Conclusion.
The treatments discussed above have appeared in earlier postings on this blog. In this posting, however, the focus is on fluorosis which can affect children between the ages of 1 and 4 because there is too much fluoride in their diet. Parents and guardians have special responsibility to ensure that kids under their care develop healthy teeth and gums. Special attention must be given to those between the ages of 1 and 4 who are most susceptible to flourosis.
Flourosis is preventable and can be detected early if you make it a point to take your kids to see your dentist regularly. It not just to prevent flourosis, but also to monitor the development of their teeth. Advice of your dentist should be taken seriously. There is also the added benefit of regular dental visits and that is, your child will be able to overcome the fear of dentist syndrome, which is very common in adults.—drKam.
It takes discipline to maintain a great smile
Posted by: drkam on: October 14, 2009
It takes discipline to maintain a great smile.
Introduction
drkam
It takes a lot of effort if you wish to have a good set of teeth. It calls for discipline on your part as you need to observe oral hygiene habits consistently. A good set of clean teeth with healthy gums enhances your personality by boosting your confidence. Therefore, getting a brilliant smile can only come after following good oral hygiene techniques.
People have today become much more conscious of appearance and wellness than ever before. They are living longer, thanks to advances in medical and dental science and in their quest for youthfulness, they invest time, effort and money in dental care in particular, healthy foods, and are doing regular exercises.
Dental Care is essential
Getting a brilliant smile can only come from making sure that you brush your teeth regularly and properly to prevent the build up of tartar and tooth decay and bleeding gums. Obviously one of the steps towards this is making sure that you visit your dentist regularly for check ups, but there are also ways you should look after your teeth in-between visits to ensure good oral health.
Eating a good healthy diet without too many snacks or sugary refined foods also helps. Use dental products which contain Fluoride. Your dentist may also advise you to rinse with a mouthwash containing fluoride and show you the appropriate way of brushing of your teeth and the use of floss. It is important to brush your teeth at least twice each day and after every meal is the ideal. You should also floss at least twice each day to make sure food is not trapped between teeth.
Plaque develops on your teeth every day and taking these measures you can prevent plaque and decay.
Avoid Smoking
Smoking bad for your health and can lead to oral cancer, periodontitis, and tooth decay. It will also stain your teeth. For help on how to stop this unhealthy habit, please contact your dental surgeon.
Conclusion
It pays to have a good set of clean and healthy set of teeth. Observe the above tips and you will earn the distinction of having a brilliant smile as bonus. All it takes is discipline on your part. That smile can do wonders to your personality, confidence and poise. You should give yourself a chance that you richly deserve to have your dental flaws rectified . See your dentist regularly.
Wisdom Teeth: Err on the side of caution
Posted by: drkam on: October 9, 2009
drkam
October 9, 2009
Introduction
No one escapes the agony and pain caused by wisdom teeth. It is not unusual for us to treat this problem as part of our maturing process, hence the word “wisdom” to teeth which pop up in our adult phase. But it is always important that we see our dentist regularly so that problems with wisdom teeth can be dealt with at the first sign of the problem. There are risks associated with the removal impacted wisdom teeth by surgery. This article discusses in reasonable detail how wisdom teeth can cause complications.
Something that is considered elementary or routine for young patients can be serious, especially for 25 year olds and above, especially those who have deeply impacted wisdom teeth. It pays to err on the side of caution, making sure that you see your dentist when you detect early signs of pain due to your wisdom teeth.
What are the risks of an operation to remove impacted wisdom teeth?
All operations have risks, and your oral surgeon should talk to you about things that could go wrong. Anaesthetics can have side effects. These are more likely with a general anaesthetic. You may have an allergic reaction to the anaesthetic, or get breathing or heart problems. These problems are serious. If you have any allergies, you must tell your doctor.
It’s hard to say exactly how often problems happen with surgery to remove wisdom teeth. About 1 in 20 people get problems during or after an operation to take out their wisdom teeth. These problems aren’t always serious or permanent. You may get more serious problems if you’re over 25 and have deeply impacted teeth.
1. Sinus Complications
The upper wisdom teeth roots are very close to the maxillary sinus and some people even have roots that go into the sinus. An opening into the sinus after the removal of wisdom teeth occurs once in a while. If this occurs it is likely that bacteria can prevent healing and get into the sinus. This infection does not respond well to antibiotics and often requires additional surgery to drain the sinus. A material called gelfoam is typically placed in the extraction site to promote clotting and serve as a framework for granulation tissue to accumulate. If this does occur patients are often given antibiotics, decongestants, should avoid certain activities, and should see an Ear, Nose, and Throat (ENT) Doctor.
It is also possible that a fragment of the tooth can end up in the maxillary sinus. Irrigation with saline may allow the tooth fragment to be brought back to the site of the opening through which it entered the sinus, and may be retrievable. At other times a procedure called a caldwell luc must be performed.
2. Numbness/ Nerve Damage
Nerves in your mouth may be damaged during surgery to remove your lower wisdom teeth. Your lower lip, chin or tongue may feel tingly or numb. This happens to between 1 and 8 out of 100 people. For 1 in 100 people, the numbness is permanent, where as others regain feeling after 3 months. The lingual nerve may be permanently damaged in up to 1 in 100 people which is the nerve that helps you sense pain and temperature in your mouth. Dentists and surgeons often use an instrument called a lingual nerve retractor to move the nerve out of the way. But this can actually increase the risk of damage. The inferior alveolar nerve can also be damaged. This nerve supplies sensation to the lower teeth on the right or left half of the dental arch and the sense of touch to the right or left half of the chin and lower lip.
3. Dry Socket (Alveolar Osteitis)
Between 1 in 10 and 1 in 100 people get a throbbing pain after their operation, which is when a blood clot does not form properly in the socket. In some cases, this happens because the patient has disregarded the instructions given by the surgeon. Smoking, spitting or drinking with a straw in disregard to the surgeon’s instructions can cause this, along with other activities that change the pressure inside of the mouth, such as playing a musical instrument. The extraction site will become irritated and pain is due to the bone lining the tooth socket becoming inflamed. The symptoms are made worse when food debris trap in the tooth socket. Dry sockets can heal in a couple of weeks without treatment. Dry socket is not an infection and is inflammation within the bony lining of an empty tooth socket. A dry socket presents as a sharp and sudden increase in pain which usually starts around 2 to 5 days after wisdom teeth removal.
dry-socket, no blood clot
4. Jaw Fracture
In very rare cases, the removal of a wisdom tooth will weaken the jaw bone. This is due to the obligatory removal of bone to obtain access to the impacted tooth. It is very rare of the jaw to fracture after the removal of a wisdom tooth due to weakening and chewing normal foods.
5. Infection
Infection following the surgical removal of wisdom teeth happens to about 1 or 2 out of 100 people. Signs of infection include fever above 100 degrees, abnormal swelling, pain or a salty or prolonged bad taste, with or without evidence of discharge from the surgical site.
6. Injury to Teeth
Damage to fillings and adjacent teeth, to bridgework or to surrounding bone can occur during the removal of impacted wisdom teeth. Even the best surgeon will occasionally have this type of complication. This is rare and happens to less than 1 in 100 people.
7. Root Fragments
This happens to about 5 in 100 people. You might need to have the fragment removed if it causes problems. Usually the fragment is close to a nerve or adjacent sinus. Removal of the root tip could jeopardize adjacent structures. The oral surgeon uses his clinical expertise to determine the benefit to risk ratio of removing a root tip. The fragments can be monitored using x-rays.
8. TMJ pain
TMJ dysfunction following the removal of wisdom teeth is unusual and usually temporary. If treatment is required, it is usually conservative in nature and includes anti-inflammatory medicines, physical therapy and in some cases short term bite splint therapy.
9. Bleeding
Everyone bleeds after surgery, but it should stop by the time you go home. Less than 1 in 100 people have bleeding that is difficult to stop. Small amounts of blood within the first 48 hours after extraction is normal.
10. Air Embolism/ Subcutaneous Emphysema
A gas related embolus can be caused by inadvertent injection of a mixture of air and water under pressure which then passes into the mandible (jaw) to the veins and then to the large vessels leading to the heart. Large amounts of air can cause serious problems including cardiac arrest and death, by traveling to the large veins leading to the heart, and mechanically blocking the flow of blood through the heart. Microbubbles, not detectable by conventional imaging techniques may provoke an inflammatory response and cause tissue damage. Doppler ultrasound may aid in detection and Hyperbaric Oxygen Therapy for treatment.
11. Chronic Headache
Your head can pound 24/7 and cause you severe pain every day.
12. Trigeminal Nerve Damage
Trigeminal neuralgia can develop if there is injury to the trigeminal nerve. This causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, and jaw. Trigeminal neuralgia is considered by many to be among the most painful of conditions and once was labeled the suicide disease because of the significant numbers of people taking their own lives before effective treatments were discovered.
13. Hematoma
A hematoma is a pooling blood in tissues that can happen when a needle moves through blood vessels.
14. Anaphylaxis
A loss of vascular tone indicated by a precipitous fall in blood pressure caused by contact with an allergen (due to anesthesia or another chemical given) can result in bilateral facial manifestations with possible cardiorespiratory symptoms.
15. Angiodema
A massive escape of fluid into the tissue from blood vessels causing large edematous swellings usually appears in the maxilla as a reddened area with well circumscribed rings and a buring sensation.
16. Vertigo/Dizziness
I have found no literature to support this; however, multiple patients have described strange feelings inside the head along with dizziness and vertigo. One such patient complained of these symptoms continuing to persist 12 years after the extractions.
17. Myoclonus
There is some literature suggesting perhiperal nerve damage causes myoclonus and body pounding symptoms/ palpitations.
18. Brain Damage
Anesthetics have been linked both mechanistically and phenomenologically to brain damage in non humans. No human studies have verified this. A few people have noticed cognitive impairment after recieving anesthesia.
19. Death
We can’t exclude the possibility of death during surgical removal of teeth. Multiple people have died as a direct result of having their wisdom teeth removed. Learn about death occuring after wisdom teeth removal.
For some people this third set of molars can grow inside without complication, especially those that NOT been giving any problems such as acute chronic pain or swelling, because a lot of other surgical removal of wisdom teeth is necessary . Your dentist will advise you if it is necessary to remove your wisdom teeth.
Conclusion
As in all matters related to our personal health and well being, it is absolutely essential that we take action at the first sign of a problem brewing with your wisdom. It is best to consult your dentist early so that a proper routine can be established to monitor and manage the problem with your wisdom teeth. With modern X-ray technology and imaging, you can be informed in advance of the severity of your problem. Usually it is easier if you are young and active to deal with it. Your dentist will recommend what steps you need to take. Usually a surgical procedure is required to remove your troubling wisdom teeth. But there are risks associated with surgery which we need to bear in mind.
How To Manage Dental Erosion Caused By Everyday Beverages
Posted by: drkam on: October 6, 2009
drkam
ScienceDaily (Aug. 8, 2009) — Researchers have warned people to beware of the damage that acidic beverages have on teeth. Yet, for some, the damage and problems associated with drinking sodas, citric juices or certain tea may have already begun to take effect. The question remains: What can be done to restore teeth already affected?
dental erosion
In a recent study that appeared in the May/June 2009 issue of General Dentistry, the AGD’s clinical, peer-reviewed journal, its lead author, Mohamed A. Bassiouny, DMD, MSc., PhD, outlined the acidic content of beverages, such as soda; lemon, grapefruit and orange juice; green and black tea. He suggested three steps to rehabilitate teeth which damaged by dental erosion as a result of excessive consumption of these products.
Dr. Bassiouny advises those who are experiencing tooth erosion to first, identify the root cause of erosion, possibly with the help of a dentist or a dental professional. Then, the individual should determine and understand how it affects the tooth in order to control and prevent further damage. Lastly, the person should stop or keep consumption of the beverage to the absolute minimum. He notes that information about the acid content of commonly consumed foods or beverages is usually available online or on the product’s label. It is also recommended to seek professional dental advice in order to possibly restore damaged tissues.
Orange juice can be acidic. For some people, the damage and problems associated with drinking sodas, citric juices or certain tea may have already begun to take effect. The question remains: What can be done to restore teeth already affected? (Credit: iStockphoto)
“Dental erosion,” according to Dr. Bassiouny, “is a demineralization process that affects hard dental tissues (such as enamel and dentin).” This process causes tooth structure to wear away due to the corrosion on teeth, which eventually leads to their breakdown. It can be triggered by consumption of carbonated beverages or citric juices with a low potential of hydrogen (pH), which measures the acidity of a substance. Excessive consumption of the acidic beverages over a prolonged period of time may pose a risk factor for dental health.
“Some may not even realize a problem exists when their teeth are in the early stages of dental erosion,” says Kenton Ross, DDS, FAGD, a spokesperson for the AGD. “Without proper diagnosis by a general dentist, more serious oral health issues could occur.”
“Visiting your general dentist twice a year can help maintain healthy teeth and uncover and prevent future problems,” says Dr. Ross.
Leading your life with an enhanced smile.
Posted by: drkam on: September 27, 2009
Introduction
Having a good set of teeth is important for your self confidence, more so if you have in the process an enhanced smile. Nothing succeeds better than that. In recent years, our society has become much more conscious of appearance and wellness than ever before. People are living longer, thanks to advances in medical and dental science. They are also leading healthier lives and are in constant search for ways to maintain healthy and active lifestyle. They want to look younger and attractive.
Enhance Your Smile
One of the easiest and quickest ways to enhance your appearance is to enhance your smile. A healthy, attractive smile is an important physical attribute and one of the first things people notice about you – it can impact your personal, social, and professional relationships. When you are pleased with your smile you radiate confidence and positive energy.
The treatment involves the upper 2 to 6 front teeth with porcelain restoration such as porcelain veneers and crowns – typically to replace old restorations or to address minor aesthetic concerns such as chipped enamel, spacing, or a missing tooth.
If necessary, braces are first used to straighten the upper and lower teeth to create a stable, healthy bite. Next, the teeth are whitened to the desired color with the 20-80 minute in office whitening system. Finally the upper 4 to 6 teeth are treated with porcelain veneers, crowns, implants or bridges. Aesthetic tooth contouring and laser gum contouring are the finishing touches to create a perfectly symmetrical, balanced, and harmonious smile.
Smile Design
Smile Design is most requested procedure to create a stunning new look in only 2 visits. It is the ultimate option to not only dramatically improve your smile but overall appearance as well.
The treatment involves the upper 8 to 12 teeth with porcelain veneers and/or crowns, as well as laser gum contouring, typically to replace old restorations or address major aesthetic concerns. The number of teeth included in the Smile Design depends on how many teeth show in your smile and what specific aesthetic dilemmas need to be corrected.
In most cases the lower teeth are addressed as well in order to create a completely harmonious look and balanced bite. First, the teeth are straightened with braces to improve aesthetics and function. Next, the teeth are whitened to the desired color with the in office whitening system. Aesthetic tooth contouring adds the finishing touches to a natural looking, symmetrical smile.
Invisalign Clear Braces
Invisalign is the revolutionary way to straighten your teeth without metal braces. Invisalign can correct a variety of aesthetic and bite dilemmas such as crowding, spacing, rotated teeth, overbites, and crossbites.
Invisalign uses a series of clear, comfortable and removable aligners to gradually straighten your teeth without metal braces. Each aligner is worn for approximately 2 weeks, removing them only to eat, brush, and floss. As you replace each aligner with the next in the series, your teeth will move little by little until they have straightened to the final position.
An average case is takes about 10 to 11 months, and in some cases even less. Invisalign straightens teeth which leads to not only a more attractive smile, but also healthier gums, easier cleanings, improved chewing and speech, and decreased risk of tooth trauma and wear.
Dental Implants
Dental implants can be the key to not only enhancing your smile but also your quality of life. They are small cylindrical titanium fixtures that replace missing tooth roots. They provide a stable base for replacement teeth that feel, function, and look like naturally beautiful teeth.
Dental implants are the most predictable tooth replacement option available with over a 95% success rate and over 40 years of practical clinical research. They are designed for a lifetime and the only dental treatment that:
• prevents soft tissue and bone loss
• provides natural tooth hygiene
• eliminates the need to reduce and compromise adjacent teeth
Implants can replace single or multiple teeth, stabilize dentures, or even replace dentures completely. Please refer to previous write ups on this blog by going through the archive, and note why dental implants should be your preferred choice for modern day tooth replacement.
Porcelain Restorations
Inlays , onlays ,veneers and crowns are tooth colored enamel-like porcelain restorations fabricated by a highly skilled dental technician; they are permanently bonded in place. Porcelain inlays and onlays are much stronger and last longer than composite resin fillings; they are highly aesthetic and are the ideal restoration for both strength and longevity.
Porcelain restorations can be completed in two appointments and are indicated for the teeth to:
restore medium to large cavities replace medium to large defective silver fillings
restore the natural anatomy of worn down back teeth strengthen fractured back teeth
Resin fillings and bonding
Resin fillings are a wonderful way to restore small amounts of damage in teeth caused by decay. Because the resin material bonds directly to teeth, they create a long lasting seal. These fillings are able to withstand the continuous biting pressure associated with chewing.
Cosmetic Dental Bonding
If you have close, small gaps between your front teeth, uneven teeth or gum recession, you can benefit from dental bonding. Sometimes when teeth are chipped or worn out, a competent dentist can repair and protect them from further damage. First, he prepares your teeth and applies a conditioning gel before the resin (tooth-colored) material is placed and sculptured to the natural shape of the teeth.
Aesthetic Countouring
For individuals who have chipped, cracked or irregularly shaped teeth, dental contouring and reshaping is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes.
A few millimeters of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.
Conclusion
If you wish to have an enhanced smile, you will be well advised to seek the help of a very competent dentist. That smile can do wonders to your personality, confidence and poise. You should give yourself a chance that you richly deserve to have your dental flaws fixed. State of the art dentistry can help to lead an exciting life.
Alternatives to Braces : Invisalign
Posted by: drkam on: September 25, 2009
drkam
Do you remember the dreaded “head gear” that plagued school playgrounds in the early days of braces? Since then, orthodontics have come a long way. Smaller brackets, clear brackets, no rubber bands, ceramics, Invisalign, and now Minor Tooth Movement.
What are the differences? Which are safe? How do you know which is right for you?
Alternative option to achieving straight teeth and a proper bite
INVISALIGN BRACES
Invisalign straightens your teeth with a series of clear, virtually invisible, customized aligners.
INVISALIGN – The clear alternative to metal braces.
Invisalign clear orthodontics has helped us to transform the way we straighten teeth and improve smiles. Invisalign’s medical imaging technology to manufacture clear aligners that rapidly straighten teeth.
For many adult patients, Invisalign has become the first healthy step to an Incredible Smile. For some, it is the primary solution.
An incredible smile is not only beautiful, it also promotes good health:
Teeth that are straight and properly aligned create a more perfect bite, which can reduce excessive stress, headaches, and strain on your supporting bone and tissue.
Teeth that are straight and evenly spaced are easier to keep clean, leading to better oral health. Better oral health can reduce the incidence of heart disease, gastrointestinal disease, and other health conditions.
Teeth that are properly aligned chew more efficiently, which aids in proper digestion.
Using a precise 3 dimensional analysis of your teeth and adjacent tissue, we will custom craft aligners to fit the unique structure of your mouth and jaw. Each aligner is worn for about two weeks and can be removed to eat, brush, floss, and for brief special occasions. During wear, your teeth are gently moved to their ideal position. The length of the process depends on your specific situation and desired results.
Invisalign aligners are:
Clear – most people won’t even know you’re wearing them.
Comfortable – Invisalign aligners are gentle to your mouth.
Removable – take them out to eat or brush, then put them back in again.
Hygienic – surfaces are easy to keep clean.
Affordable – in most cases, the cost is comparable to metal braces.
Fast - treatment time is comparable and in many cases less than that of traditional braces. An average Invisalign course of treatment takes about one year.
What is Invisalign?
Invisalign is the advanced way to straighten teeth and improve smiles. Using the latest medical imaging technologies, Invisalign manufactures precision polymer aligners that rapidly straighten teeth.
Why are straight teeth important?
Never underestimate the power of an incredible smile. It is not only beautiful, but first and foremost, it promotes optimal health:
Teeth that are straight and evenly spaced are easier to keep clean, leading to better oral health.
Better oral health can reduce the incidence of heart disease, gastrointestinal disease, and other health conditions.
Teeth that are properly aligned chew more efficiently, and that aids in proper digestion
Teeth that are straight and properly aligned create a more perfect bite, and that avoids excessive stress, headaches, and strain on your supporting bone and tissue.
The social benefits of a beautiful smile are also important:
Confidence – in job interviews, public speaking and personal relationships.
Clearer speech – teeth play an important role in your ability to speak.
Why Invisalign?
When it comes to creating beautiful smiles, Invisalign is the clear alternative to metal braces. Invisalign aligners:
Are clear - Invisalign aligners are virtually invisable.
Stay clear - Invisalign aligners do not “cloud” during treatment.
Are hygienic - Invisalign aligners are easy to clean.
Are comfortable - Invisalign’s revolutionary manufacturing process ensures a precise, accurate fit.
Visit your Orthodontist to help get an idea of what you want, how it can possibly be achieved and to allow you to see if you are interested in having it done.
Orthodontists are specialists who have had extensive training in the art and science of occlusion. Occlusion is the relation between the upper and lower teeth when the jaw is closed and their surfaces come in contact.
Orthodontics is not just about creating straight teeth; it is also about establishing a healthy, long-lasting biting position for the teeth. Crooked teeth often result in excessive wear to teeth that can result in a variety of long-term problems.
Orthodontists understand the importance of function and aesthetics.
However not all Orthodontists practise Invisalign.
In addition, many people choose teeth straightening prior to proceeding with cosmetic veneers. The ability to establish proper bite positioning before making the final cosmetic enhancement significantly improves one’s chances of achieving the most natural looking, long lasting results.
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