Health funds and dentistry

March 30, 2008

Over the years things have got more complicated.  Remember when there was one phone company, and everyone new what the special low rate times were to call?  Dentists used to have a health fund guide as to what patients could get back for any treatment but now different patients get different amounts back for the same treatments even when in the same fund.  There is now a push for dentists to affiliate with particular funds and be called ‘preferred providers’ – that means patients have less gap to pay or even no gap for treatment after their health fund rebate if they go to these practicioners.  My concern is this:

Health funds are a business and even non-for-profit ones need to maximise their pool of funds to pay out for large unexpected claims.  Dentists accept these preferred agreements so they can attract more patients, but they treat these patients at a lower fee.  For the dentist to make the same income, they must see more patients.  History has shown that the fees paid by funds increase by a minimum over the years because the fund needs to maximise its profit, so as costs increase from updated materials, new modern equipment, and inflation the dentist must see more and more patients and work faster.

Does a tired fast working dentist sound like the best way to have your mouth treated.  Ok, I can do a filling faster – but you should ask – how long will it last?  is this quality? – and the cost of poor quality dentistry in the long term is far greater.  I would rather just try to do my absolute best, in an appropriate time, for an appropriate fee.  I hope my patients realise that my goal is to keep their mouths as healthy as can be for life. 

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Happy easter

March 25, 2008

Hope everybody had a safe and happy Easter.  You know, chocolate is not bad for teeth.  Sugar can’t harm teeth, but it is fermented into acid by bacteria in your mouth, and the acid eats your tooth away.  If you clean all the bacteria from your mouth by good brushing, nightly flossing, and regular dental check-ups with prophylaxis cleaning, then eating chocolate won’t harm your teeth.  Just eat a bit, not grazing on it all day – that speeds up the grow of bacteria.

Happy eating, and Happy Easter!


Mouthguards

March 15, 2008

A custom fitting mouthguard is one of the wisest decisions you can make for yourself or your children if playing sport.  You have one chance with your adult teeth and trauma can lead to endless expense, pain and heartache.  The minimim damage you may sustain to your teeth would be one tooth getting chipped – and to fix it is the same cost as a custom fitting mouthguard.  Parents say to me that a mouthguard is expensive and they only get one season before kids grow out of it.  It costs less than most sports shoes – and kids grow out of these too!

The second worst scenario is a tooth dying and needing root canal treatment – 3 times cost of a mouthguard

The third is snapped off – root treatment and crown – 11 times cost of a mouthguard – and eventual loss of tooth

The fourth knocked out – root treatment/crown and future implants – 45 times cost of mouthguard

Remember – that is if it is just ONE tooth!   And no replacement will ever look or function as good as the real thing – would you rather a real eye, or a false eye?  We can make pretty good false eye’s – but I wouldn’t want one.  A custom guard fits acurately over the gums and bone around the teeth to distribute any force evenly onto the jaws.  A boil and bite mouthguard transmits force through the guard and onto the teeth leading to a high risk of tooth fracture and limited protection.  Finally a custom guard is laminated and thin meaning comfort and better breathing – many kids lose teeth playing sport because they didn’t wear the guard, stating it was not comfortable.  I try to make the best fitting guard with careful attention to how far it extends into the mouth and under the lips.

And don’t forget they come in some kewl colours 🙂

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Plaque and hygiene

March 10, 2008

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This is a patient that brushes only in the morning every second day.  See how the bacteria have grown onto the tooth, and the infection (that’s what bacteria creates) has caused redness of the gums called gingivitis.  These bacteria will ferment sugar in the diet and release acid onto the tooth causing decay, in years to come the long term infection causes the gums and bone to receed and the teeth fall out, the fermenting process causes bad breath, and there are links between gum disease and heart disease.  Your teeth should look like smooth shiny clean pearls – brush twice a day – at least 2 minutes, and floss – end of problems 🙂

 


Cosmetic fillings, crowns and veneers

March 10, 2008

There are many ways to alter your smile for the better.  Whitening or bleaching is commonplace now.  many people don’t realise some other simple cosmetic options such as bonding tooth coloured fillings to change the shape or colour of teeth.  There are 3 main ways to change a tooth shape dramatically – tooth coloured bonded fillings, porcelain bonded veneers, and porcelain crowns. 

Crowns involve cutting away a lot of tooth structure and are usually best left for repairing heavily broken down teeth, where there is risk of the tooth breaking.  A crown is like a helmet protecting the core of the tooth.

A porcelain veneer is like a thin egg shell thickness covering glued to the front of the tooth like a false fingernail.  Porcelain crowns and veneers are often preferred for their ability to last a long time without losing their colour or shape – much like a porcelain china plate.

Tooth coloured fillings should not be underestimated for their ability to mask defects.  They can be very cosmetic if placed well, which is determined by the skill and artistry of your dentist.  The downside is that, as a plastic resin, overtime they will pick up more stains and chip.  Here are a couple of tooth coloured fillings I did just recently and the patient and I were thrilled.  the cost of these was about $200 per tooth compared to $800 each for veneers and $1300 each for crowns.  I expect them to be in service for 5 to 10 years before we look at replacing them.

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Why should I floss?

March 2, 2008

My father was a dentist, and I had graduated from dental school before I finally got that I needed to floss every night.  Why?  Bacteria live on your teeth and eat sugar.  They ferment the sugar into acid which dissolves teeth!  You get bacteria growing mostly where you can’t clean well – that is, in between the teeth, especially at the back. (look at my photo in the wisdom teeth post – no other holes anywhere but in that crevice is rotten!)

Once you get fillings to repair the damage, you have even more nooks and crannies for the bacteria to live in.  I spend day in, day out drilling in between teeth, or taking old fillings out from in between teeth to put bigger ones in.  It is just like the grouting between the batheroom tiles in the shower – the bacteria and mould grows in the gooves, and down near the plughole – not on the easy wipe tiles

As they say ‘You only need to floss the teeth you want to keep!’