April 28, 2008
Just a bit of basic dentistry for today. Two teeth with old failing fillings – although you can see the dark shadow next to one of the fillings, the decay is already very deep here. These teeth were causing no pain and people often wait until it is too late.
Decay should be picked up as soon as possible – an X-ray usually shows this much sooner. These teeth have already decayed close to the nerve and under the gum. When these fillings fail (as everything does eventually) then the teeth will need root treatments and crowns or removal. If you get your fillings checked regularly, and any fillings are replaced while they are small, that means you could replace the fillings every 10 years and still not damage the nerve over a lifetime – if you wait till you have pain or deep decay – you may get one more filling and then it is going to be complex work or lose the tooth. Prevention is always better than cure.
But I think these went pretty well 🙂
April 17, 2008
I saw this girl recently and we have been waiting for her eye tooth (canine) to pop through. In the meantime the front teeth have been worn down slightly. It shows how important the eye tooth can be in supporting the overall bite. many people think orthodontics is just for cosmetics – I want straight teeth etc. but your teeth are designed to function for chewing. Note how the eye tooth is a big long butress tooth designed to keep the lower jaw from grinding and damaging the other teeth. Without it you can see the wear and chipping in the photos from grinding of the teeth during sleep (bruxism).
This is the same reason I try to convince older adults not to lose the eye tooth if possible because the remaining teeth start to break down. This high stress area often leads to repeated fracture or failure of any replacement tooth such as a bridge or denture.
April 13, 2008
On rare occasions even unfilled natural teeth break due to the force of chewing, but the larger your fillings get and the more tooth that is drilled away, the more likely that your tooth can break. Dentists often notice small cracks in filled teeth and say,”gee you better watch that tooth because one day it may need a crown”. It is important not to crown a tooth without considering that it is going to cut away even more tooth, but if the tooth is already showing stress, a crown is like a helmet over the tooth and will protect it.
The following tooth presented to me with no pain and the patient hoped it could be just repaired until I showed him the X-ray. Remember no pain doesn’t mean no problems – 30 stories down when falling off a 60 story building causes no pain but you are in deep trouble.
It is quite rare to break a tooth with such a small filling, but if there are obvious cracks in a tooth and you want to reduce the load try replacing the metal filling with a bonded tooth coloured filling, or a full cover crown. My advice always is that a gold onlay or crown is the best alternative because it strengthens the tooth without needing to drill as much as a traditional crown, and gives great protection. The following is a failed tooth with a large tooth coloured filling that I saw in a teenager today – the tooth was unsavable. Also pictured is a gold onlay that has been present over 40years.
Of course if the tooth has so much filling that a crown isn’t going to cause much further tooth loss then tooth coloured porcelain crowns look better like the one I did here –
April 3, 2008
I love the team I work with. A good group of people can make your day special no matter where you work. A beautiful thing happened today when some of our staff were across the road for lunch. A phone call came to the surgery and a woman had seen these happy fun loving people and the uniform name. She had no idea where we were but wanted to come to our dental practice. These staff are so great to work with and it is a huge compliment to them, and a learning excercise for anyone in business, about the response from patients when they see you passionate about a great team, fun work environment, and getting the best out of life.