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 resons for the failure – but the lack of contact between the teeth means more food packing and staying there, and a higher risk of decay.

 

You can see the sticky film of plaque (bacteria) where the 2 teeth are not touching, and the damage to the tooth underneath when I started to remove the old fillings.  The problem with replacing fillings more often is you will run out of tooth as you get older – meaning more complex options and more expense, or less complex options (dentures) and less comfort (i.e. can’t chew and painful ulcers where they rub.

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New fillings placed have the contact between the teeth restored!  Let’s hope the patient doesn’t chew hard foods, eats less sugar and acidic things, brushes well, flosses and has good saliva 🙂

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

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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!


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.

Parafunction cParafunction a

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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.


Should I get my wisdom teeth out? Part 2

December 19, 2011

I have already given a detailed blog about various wisdom teeth and the pros and cons about their removal.  Basically, a wisdom tooth is like any other tooth – if it erupts normally into the mouth it is fine but at risk of decay.  If decay gets into the nerve area it causes pain, swelling and infection.  It is often inaccesable to treat, so the wisdom tooth to be removed.  If this risk appears high, or the teeth are not erupting normally and your dentist suspects future problems – he or she may recommend the tooths removal to reduce the risk to you of a serious infection or complications.  The older you get, the more the wisdom teeth roots can grow towards the nerve in the jaw, and the harder your jawbone can get, increasing the risks of complications of surgery (such as permanent lip numbness or tingling – called paraesthesia).  Your dentist is always trying to wiegh up the best alternative based on the information at hand.

I have taken some random photos of wisdom teeth we have seen in our practice.  Some were fine, others were at risk, some were removed, and some required specilaist intervention.  Don’t let anyone say you should or should not remove wisdom teeth without knowing your specific case – everybody is different.

To the right of each photo I have drawn and approximate line showing the roots of the teeth in black, the nerve in the jaw in blue, any obvious infection in the bone in yellow, and obvious decay in red.


Dark Root Filled Tooth

October 30, 2011

This fellow’s tooth was wacked when he was young. Wear a mouthguard when playing sport please guys! The existing filling was leaking and broken and the tooth had gone dark.  The blood in teeth stains when the nerve dies, and also the medicaments used in root fillings may stain the tooth.  Ideally the tooth would be bleached as a conservative option.  The filling was failing so the next best option would be a crown.  Unfortunately this tooth is on its way out – it is so hollowed an weak it wont hold a crown but we had to do something because the current filling is failing.

We built him a new tooth using a carbon fibre post into the root, and bonding dental composite resin over the top.  It is much cheaper than a crown, and if the tooth fails he is looking at a gap, denture, or implant.  Hopefully we have delayed these options for some time to come and given back a smile.