Covid19 and dentistry

April 26, 2020

So far in Australia we have been very lucky compared to other countered, but it is timely to realise how important your dental health is in relation to your overall health.
Due to mandatory restrictions, we have only been able to treat acute pain or emergencies for the past 3 weeks, and only using extreme protective equipment.

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Dentistry has been restricted because of aerosols produced, meaning we haven’t had the opportunity to use a drill, or do any fillings or cleans.
We have had many patients calling recently with infections and problems ranging from decay and broken teeth through to dangerously infected wisdom teeth. There are potentially serious risks when things have to be delayed or can’t be treated, and of course there is pain and anxiety being felt by these people. Sadly the risk is even higher in our elderly patients, with other health problems being complicated by dental problems, and higher restrictions on us being able to see them.
A dental infection can have serious outcomes for people with diabetes, heart disease, osteoporosis and many other health conditions. Basically, many dental problems result in inflammation, and this inflammation has an effect on your overall health.
I wanted to assure everyone coming to Nundah Village Dental that we have been going above and beyond in regards to protecting the safety of our patients, staff, and community, and contacting as many patients as we can to reach out and give advice.

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The good news is that restrictions appear to be easing. I congratulate our community for helping slow the spread of this disease that puts all of our lives under stress and strain. We know that prevention and regular dental care is so important, not only to avoid pain, but for many people to avoid serious health outcomes
We are working hard to prioritise our patients and want to let our patients know we are here for you, and we will be in touch as we move forward, to reschedule and see our patients in the most efficient way we can.
Stay safe and keep flattening the curve.

Physical distance


Recurrent Tooth Decay – How long should my fillings last?

September 28, 2018

Nothing lasts forever – but somethings last better than others right?  Various studies put the average life expectancy for a tooth coloured filling between 10 and 15 years.  You can expect variability according to how big the filling is, how strong the tooth is, how heavy you chew and what you eat, how acidic or decay forming your diet and saliva is, and how well the filling was placed.  The reason indirect fillings like gold or ceramic last better is because they are a better fit and are polished smooth so bacteria have a harder time sticking to them.

Here is a routine day for me with some failed old fillings.  Sure there are lots of reasons for the failure – but the lack of contact between the teeth means that more food can pack in the space and stay there.  This then breaks down with bacteria feeding off it and increases the chance of new decay between the teeth around the margin of the existing fillings.

 

You can see the sticky film of plaque (bacteria) sticking to the fillings where the 2 teeth are not touching.  Next you see the damage to the tooth underneath the fillings when I started to remove them.  If you have poorly placed fillings or don’t look after your teeth you have to replace fillings more often.  You may then run out of tooth as you get older – and then need more complex options and more expense to keep things going, or less complex options (like dentures) which means less comfort (i.e. can’t chew and painful ulcers where the denture rubs.

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The new fillings placed have the proper contact between the teeth restored!

Keeping teeth for life is hard, but it is so worth it!


Cerec crown – biocopy

September 27, 2018

This tooth was cracking and had been repaired with resin fillings for 15 years.  Eventually there was no option but to try and support the tooth with a full crown as it was cracking and about to split in half.

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I was worried about the colour and also the shape.  The CEREC allowed me to scan the original tooth and make the exact same shape in ceramic.  the colour came down to some tinting and artwork!

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Overall I was extremely pleased with the result, and the patient had a new strong tooth within one appointment!

 

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Dental Implant Upper Molar

September 15, 2018

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This patient of mine lost the upper molar a few months ago and the area was filled with a bone graft at the same time the tooth was removed.

 

A titanium implant was placed and then a healing cap screwed over the top.  This is then given a few months to allow the bone to grow and lock in the implant.  The wire was placed to prevent the teeth from moving and tipping during this period.

3 monthIO This is how things look after healing when the cap is removed.

 

Finally a crown can be attached to the implant and our patient has a new tooth to chew on!


Cerec same day crowns

September 9, 2018

We added Cerec to our practice in 2017 and I couldn’t be happier.  Crowns are a stronger more permanent way to restore badly damaged teeth.  Traditionally a crown is made over 2 visits by initially preparing the tooth, taking messy impressions of the tooth, and fabricating a temporary crown while the impression is used in the laboratory to make the new crown.  Cerec eliminates this – a digital scan is taken of the tooth, and while the patient sits in the waiting room the scan is used to design a perfectly fitting restoration.  The design is milled out of a solid block of ceramic, fired in a furnace to make it strong, and then it is cemented on the tooth – same day, one injection, no mess!

 

While it is not for every case and there are still requirements for other materials like gold crowns, and the specialised aesthetic work that my laboratory technician does so well, I am loving the opportunity to provide quality restorations with the convenience that Cerec provides.

 


Tooth Grinding – Bruxism

May 10, 2017

Some people can do significant damage to their teeth from grinding them in their sleep.  Sometimes it is a daytime habit.  This can lead to abnormal wear, cracked teeth, pain in the teeth and even tooth loss.

Bruxing

Below are pictures of a person I saw not long ago and you can see how far over they move the jaw.

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Parafunction b

This movement outside the normal range of chewing is called Parafunction.  We know this must be from habitual chewing  (like nail biting) or from bruxing during sleep, because people just don’t chew their food on the front teeth in such an uncomfortable position.

A night splint can help protect the teeth from damage while the patient is asleep.

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Tooth Extraction – What happens next?

May 9, 2017

Overeruption

What happens when you lose tooth?  Well, it’s not the end of the world, but your teeth all have a reason for being and there are consequences when one is lost.

Firstly the bone around the area is lost because there is no stimulation anymore.  In the above photograph you can see the gum has shrunk away.  This can be mild as above, or extreme as in the photograph below:

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The bone progressively wastes away.  Once the bone is lost it is very hard to replace this missing tooth, as the bone needs to be rebuilt before a dental implant can be utilized.   Also the remaining teeth start to move and shift into the space as shown below:

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2cxMolar move

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The extra load can lead to further cracks and splitting of the remaining teeth:

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Eventually the straw on the camels back reaches breaking point and multiple tooth failures occur.  If this also results in bone loss the end result can be catastrophic:

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I am reminded of the old tale – for the want of a nail the shoe was lost, for the want of a shoe the horse was lost, for the want of a horse the battle was lost, for the want of a battle the kingdom was lost.


More White Spots on my Teeth

June 22, 2016

You will see my post from several years ago about teeth and white spots.  Some white spots are due to acid damage and a period of reduced brushing effectiveness or higher sugar diet.  This can be common after braces because it is harder to clean around the wires.

Other white spots are more natural occurring as a hypomineralised layer of the tooth surface that appears frosty.  Some of these are very superficial and and be removed in less than 5 minutes with a mild acid that we use for tooth bonding, followed by a fine mineral particle that helps clog the porosity and allow the tooth to regain it’s transluceny.  Here is another case we did last week.

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Gaps between my teeth!

July 29, 2015

There are three ways to fix gaps between the teeth.

The first is to move the teeth closer together.  This can be done with braces or Invisalign.

The second way is to fill the spaces in with tooth coloured filling material – resin bonding.  This makes the teeth look a little wider so it depends on the size of the gap, and it will also stain and chip over time.  An average for bonding may be around 5 years but may last much longer with care.

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The last option is with porcelain veneers or crowns.  These can look more natural and don’t stain like the bonding can.  I don’t have a picture of veneers used for bonding but go to our website for a picture of before and after porcelain veneers compared to resin bonding veneers HERE


Cracked Teeth – Why?

June 2, 2015

One of the common problems we see as dentists is cracked teeth.  Any tooth can fracture, just like driving a truck over pavement enough times can crack the pavement, but the most commo reason is from the weaknesses caused by drilling and filling teeth.  Large amalgam fillings are like a lump of soft lead in a crystal glass, slowly creeping and expanding over the years until the tooth cracks apart.

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While most cracks are horizontal and a cusp cracks of the tooth, a large number are vertical cracks extending into the nerve of the tooth and splitting the root in half.

Cracked tooth Cracked tooth 2 Root Treatment fracture-web-2 fracture-web-1

It is best to replace any metal fillings if any sign of cracking is evident, but replacement with tooth coloured fillings may not be strong enough.

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The tooth should be supported with a full coverage of porcelain, or the best alternative which is gold.  The porcelain has a higher strength than plastic fillings but can still crack.  The gold will wear at the same rate as your own teeth and will not break but there is a cosmetic compromise.

4Porc Onlay Fracture 3 4Porc Onlay Fracture 5 4Porc Onlay Fracture 7 tamc2 DSC_0125

Talk to your dentist about which option is most suitable for you.