Cost of dentistry

February 24, 2008

I read a great quote yesterday.  Dentistry isn’t expensive, neglect is.  You know, I have been a dentist now for 16 years.  In that time I have brushed 2/day, flossed nightly, and had a check and clean every 6 months.  I am not a saint in brushing technique, or my diet – but I don’t drink soft drink unless it is a weekend treat, and I always clean my teeth before going to bed.  I have 2 fillings – the first one was gold becasue it is the longest lasting material a dentist can place.  It was done 15 years ago and looks brand new. 

The cost to me for 2 checks and cleans per year, X-rays every few years, 2 fillings (one gold, one composite tooth coloured) over 16 years would be about $4900 in todays terms – $306 per year.  I get a haircut every month for $30 – $360 per year.  If I neglect my mouth, and get deep decay and a toothache – one tooth could cost up to $2500 to fix properly, and that won’t keep my tooth forever!.  I won’t even discuss the cost people spend on smoking, alcohol, gambling, expensive TVs.

The cost to me in reality is to choose regular care, good dentistry, and to be bothered doing boring things like eating well and flossing.  It is your choice too.

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Toothache

February 18, 2008

I see so many people that have a toothache that could have been easy to fix but they left it until it was too late.  Some teeth can decay all the way to the nerve and not give any sign of pain until BAM – massive toothache needing root canal therapy or extraction.  This decay in some cases has been there for a couple of years slowly eating more tooth away.  Remember that prevention and proactive actions are the best way to keep your teeth for life – everything we do in your mouth has a lifespan – so avoiding it, or getting it early, means buying yourself more options later in life.  A root canal treatment is the last resort to save a tooth.

Don’t be the one who falls off a 60 story building and says as they pass the 30th floor – ‘well, so good so far – nothing is hurting’


Dental Anxiety

February 17, 2008

There are several ways to deal with dental anxiety and phobias.  The first is to recognise what your greatest fear is.  Is it a previous experience?  Is it pain?  Is it the sound?  The cost?

Then you need to find a dentist that you can put your trust in.  A dentist who takes their time to use topical anaesthesia, or can explain the situation and put your mind at ease.  Try using headphones and listen to music if the sound worries you.  Relaxation techniques, good technique, and a friendly fun dental practice and staff can all make a huge difference.  Talk to your dentist about what the biggest hurdles for you are, and they can often make things way more comfortable for you.

I have had some great success for more anxious patients using Nitrous Oxide (laughing gas).  If things are still too concerning then IV sedation or day surgery is an option.  The important thing is to take control of your life.  Dental problems and pain are usually the result of not attending to things early – the sooner you have a dental check-up, find a dentist you can trust, and discuss your options, the sooner you can get on with your life and enjoy youir smile again!

The power is in your hands – go for it!


Deep Bleaching Teeth

February 16, 2008

There are many ways to whiten teeth.  This is what I have been investigating for a long time.  The over the counter options are usually limited due to the strength of the bleach.  Most dentist prescribed whiteners are 10 -20% Carbamide Peroxide, while chemist bought bleaches are usually 1-2%.  Whitening toothpastes are not of sufficient strength and are only in the mouth for a minute or two so there is a negligable effect with these. 

The key is to get a strong enough bleach on the tooth for a long enough time.  We have started using a sopisticated system to make the best fitting home bleach trays EVER!  I imported the technique from The States in December and now have bleaching trays that fit beautifully.  This means the gel stays on the teeth, and saliva can’t dilute it.  The results have been amazing.

The icing on the cake is to try deep bleaching – a specific technique using in surgery bleaching combined with at home bleaching.  I have just started a few cases and have been really impressed to finally get some predictable results. 


Best filling options

February 12, 2008

So you have decay in a tooth – what’s the best filling.  Well it depends on cost, cosmetics, how big the filling is, and how well you look after your teeth.  The longest lasting filling you can have is usually a gold inlay- it doesn’t rust/corrode or chip/break.  It costs more in the short term so if you have a high decay rate, bad diet, poor hygiene or underlying dental disease risk then the cost may not be worth it, but it is still the best.  My father had a couple in his mouth for forty years, and I have one at 15years in my mouth and it looks brand new!  It has a second big drawback – it isn’t white.

Tooth coloured fillings are getting better all the time, but they need great care to be placed well, and many studies have shown an average lifespan of 7-9 years.  Sure, I’ve seen them hold up well, but when placed meticulously, and in mouths where they are well looked after.  Tooth coloured fillings (or composite resins) that I see often have leaking margins, decay underneath, or they are chipped or worn after only a few years.  They work well, just don’t expect not to replace them more frequently.

The other option is old fashioned amalgam fillings.  I don’t do them very often anymore, but I still regularly see patients of my fathers with 15-40 year old fillings.  Amalgam has a couple of big disadvantages – corrosion and swelling leads to cracks and sometimes teeth split apart and are unsavable.  It contains mercury and although studies show this to be a minimal amount and not a health risk people have concerns (nobody asks me what’s in a tooth coloured filling by the way 🙂   Personally, I wouldn’t ever have an amalgam in my mouth – but I wouldn’t have a tooth coloured filling either if it was in between a back tooth.

It is always about risk – brush well 2mins twice per day, floss nightly, see your dentist 6 monthly, eat sensibly and avoid lots of snacking – works for me – 38 yesterday and only 2 fillings – the choice is yours

happy days – Marc


Preventistry

February 6, 2008

Did you know you can reverse decay in your teeth?  Decay forms from bacteria in your mouth producing acids that dissolve the teeth.  Your saliva has minerals in it to neutralise the acid attack and reform the damaged tooth.  Early decay may not always need the drill!  If you can rebalance the acids in your mouth, and the decay is only in its’ early stages, the minerals can reharden small damged areas.  Bacteria live on your teeth and ferment sugar like a little gingerbeer factory, and the fermentation produces acid!

There are four basic rules to stop bacterial acids destroying your teeth:

1/  Clean your teeth often enough – at least 2/day – nighttime is the most important so that your saliva can spend a long time while you sleep repairing the damage.

2/  Clean them well enough – 2mins brush and floss every night – the majority of fillings I do every day are in between the teeth and they are all preventable

3/  Reduce the timing of sugars – chocolate is worse than lettuce, but timing is the big key – let your teeth rest.  If I eat chocolate after dinner, washed down with a hot drink, and then brush/floss then the sugar only fermented for an hour.  If I got the same piece of chocolate and ate a small piece of it every hour all day, the bacteria would ferment like crazy and my teeth would rot – even if I brushed.

4/  Reduce the amount of sugar – more healthy foods, cheese – less sticky sugars, toffees, and 1 can of soft drink has up to 10 teaspoons of sugar and has acid as well.

That’s all for now – I’m off to clean my teeth and go to bed!


Should I get my wisdom teeth out

February 4, 2008

I have a general philosophy on removal of wisdom teeth.  Basically, do it if they have ever given the slightest trouble and you are under 25 and the risks seem minimal.  Reasons for removal are varied:

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Wsidom teeth are the hardest to clean and often decay early- filling them can be virtually impossible due to space and access.  If they can’t be filled or cleaned, they will eventually decay to the point where they cause major pain and problems – this is not the best time to remove wisdom teeth.  Bacteria impacts under the gum causing decay or nasty infections – this can be life threatening, but usually is just a pain.  It also puts the adjacent teeth at risk – see the photo!  The older you get, the harder the bone is and the more difficult to remove the teeth, and the worse result on healing.  If you are likely to keep your wisdom teeth for life then that is fine – but I have had to remove wisdom teeth from a 90 year old and that is a serious risk.  As you age you may be on medications or have health issues that complicate surgery.  Some medications such as bisphosphonates for osteoporosis and bone diseases can be related to post surgery wounds that never heal and are acutely painful (see www.nundahdental.com or http://www.ada.org.au/newsroom/article,documentid,109063.aspx for more info.  If your dentist suggests removal of wisdom teeth it is usually in your best interests in the long run.

What are the risks of wisdom teeth removal? – the nerve supplying sensation to the lower lip and tongue can be damaged resulting in permanent numbness of these areas. This risk is usually very small and your dentist can judge the risk better by looking at your X-ray -(usually an OPG X-ray).  If the risks are great they may advise against removal – but if the tooth is decayed or infected you may have no choice – again, the earlier these teeth are removed, the less the risk of problems.

I am happy to supply more info if anyone is interested.