I have loose teeth!

September 8, 2014

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Gum disease is a major reason why people lose teeth as they get older, but this patient is under 40 years of age.  This patient came to me once at Nundah Village Dental complaining that the front teeth had moved creating a gap.  The main complaint was that the smile wasn’t even anymore, and the patient hoped to get Invisalign to straighten the teeth.  Sadly, what has happened is a perfect storm of a smoking history, lack of 6 monthly professional cleans at the dentist for nearly 10 years, and probably a genetic modifier.  Gum Disease, or periodontal disease, occurs when the bacteria growing around the roots of the teeth in scale (tartar or calculus), cause a permanent chronic infection, and eventually this leads to tissue and bone destruction.  Once the jaw bone is lost, the teeth become loose and drift like pylons in soft mud near a jetty.  The gums recede leaving the roots of the teeth sensitive, and people become very disappointed to learn that the loss of bone is mostly irreversible.  Treating the teeth when they are sensitive is another challenge, and in this case I recommended specialist intervention as soon as possible.

Loose teeth therefore can have devastating issues for a patient’s confidence and well being.  I recently saw a 92 year old man with beautiful clean teeth.  He has never missed coming for his check and clean every 6 months, and is healthy and can eat whatever he wants.  How often do you service your car? Why? – People service their car more often than their teeth, spend more buying a car, and expect to often trade it in for little value 5 years later only to spend more to buy another car.  I’m sorry, but prevention wins, and you can’t buy a new mouth.  Any dental replacement will be a poor second to what you started out with in life.  Get your teeth into service and love your mouth again!

 

 

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Tooth Problem? How to avoid dental problems

April 21, 2014

Ok, so I brush twice a day, floss at night, eat well – there is no pain so why should I go to a dentist?

A common misunderstanding about going to the dentist is that we can cure dental disease.   This is only partially true. The reality is that everything wears out, be it your new car, house, computer, fillings or teeth! I have many patients with healthy teeth well into their 80s and some in their 90s, and many people disappointed with their failing teeth and unhappy with the results of years of dentistry under the age of 50. So how can we help you to become one of our long term satisfied patients enjoying the benefits of a healthy mouth for decades?

Dentistry fails—preventistry works!

I had a small filling done on a bottom tooth 30 years ago. It was replaced with a larger but stronger gold filling 8 years later. The tooth cracked around this strong filling on my 40th birthday and I needed a crown. About 5% of teeth that are crowned need a root canal treatment in 5 years. Root canal teeth are weak and it may split and need eventual removal! Sound Familiar?

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So I may eventually lose one tooth but all my other teeth are in excellent shape. Why?

Prevention! Avoid the filling in the first place, or get it done as small as possible. Here’s my guide to healthy happy smiles for life!

Start Early –   Bring children every 6 months to build up their confidence, and get good advice on hygiene and diet. Start from pregnancy and you will avoid the fear cycle and make dental visits fun for your child.

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Seal Fissures– any grooves in your teeth attract bacteria and plaque films that can’t be brushed off. The most at risk are the biting surfaces of the adult 6yr old and 12yr old molars. Simple sealants that release protective minerals and stop bacteria starting decay on these areas are easily placed. Children who have been regularly from the age of 2 find this procedure fun and non-invasive, meaning they trust their dentist for life rather than developing fears.

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I still get my teeth sealed with plastic more durable adult sealants if necessary but some of mine were last sealed nearly 20 years ago!

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Treat Decay Early– If you need a filling, get it done ASAP. Why wait until there is little tooth left or you have a toothache and need a root canal – it just increases the risk!  The teeth below looked fine until you see what was lurking beneath.

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Maintain your engine– regular checks at the dentist also involves regular professional cleans. Over time the build-up on your teeth can result in gum disease. Your teeth become loose and the jawbone is damaged irreversibly. To prevent gum disease requires maintenance. Despite good home care and dental hygiene I still get moderate levels of calculus build-up after 6 months.

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The important thing is that there is no damage to the gums because I haven’t missed a 6 month exam and clean in my life. Having a father and brother as dentists helped me understand the value of preventive care over a lifetime. See below the results of gum disease when you leave it too long.

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Not having a regular clean is like driving a Ferrari around Fraser Island for years without a service and wondering what happened when it stops working!

Protect weak teeth – Old metal fillings creep over the years like lead being hit with a hammer. Eventually, this puts strains on your teeth and they can fracture and split. If you wait too long this split may be catastrophic.   Even replacing metal fillings with white plastic fillings may not be strong enough to resist fracture forces.  This is why dentists recommend a crown, and exactly what happened to me on my 40th birthday. (You can see my gold crown in the photo at the top of this post)  Not what a dentist expects when they look after their teeth—but nothing lasts forever and my filled tooth had been weakened. You can see how teeth can split in the following pictures.

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Below is a cracked tooth protected with a porcelain crown / cap

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Wear a mouthguard – I just put this one in as a no brainer—no mouthgaurd / no play!

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Replace missing teeth –   It may   not   seem important at the time but when you lose a tooth your other teeth have to work harder, and are more likely to break or wear out. This leads to an ever worsening cycle of destruction.   Also your jawbone becomes smaller and   weaker and your remaining teeth move into poor positions.

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Drift X-ray

Many people in later years find their mouth has become a complex and expensive concern to them. Intervention when they were younger would have made all the difference. People with full d entures have continuing jawbone loss because of the lack of bone stimulation dentures provide. As they lose more bone the dentures fit worse and worse in later years leading to great discomfort and lack of chewing power. The jaws also fail to support the face anymore. Many older people that have had dentures for decades complain that their   new dentures are worse than the original ones. We regularly see denture wearers wanting to   have implants to fix and recreate what they have lost.

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Trust your dentist– We are here to help you enjoy your teeth for life. If you have questions, we pride ourselves on taking the time to help you understand your options. We love to talk, educate, and have happy patients!  Does your dentist stand by their work.  Do they help you understand your particular risks.

Find a dentist that wants to be there helping you for life, not someone that is just cheaper, a health fund preferred provider, and that may not be around in 5, 10, 20 years to stand by their commitment to your health.

Oh, and smile!

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More on Wisdom Teeth

June 23, 2011

Wisdom Teeth – Why do we need to remove wisdom teeth?  Often we don’t, but because they are hard to reach, they are harder to clean and more likely to get decay.  Some wisdom teeth may be growing in the wrong direction and get stuck (impacted) and this leads to problems as well.

 

This  young   patient    has  an impacted lower wisdom tooth causing no pain.  It is under the gum and can’t be seen in the mouth.  Sadly, the lower picture  shows the decay highlighted in black – there is decay in the upper and lower wisdom tooth, but also the  second  back  tooth  has decayed almost to the  nerve.  This tooth may now need very expensive root canal therapy or extraction.  The pink line shows that the lower wisdom tooth is touching the nerve in the jaw and will need specialist attention.  This will require time and careful planning but unfortunately the decay has made the  situation urgent. 

Even older patients can  have wisdom teeth problems.  Not long ago  one  of  our dentists removed a wisdom tooth from an 89 year old! 

This picture shows how a cyst is damaging the jaw.

  Many people have wisdom teeth come through perfectly just like any other molar.  Thank goodness we are all different.  If you have any queries see your dentist and get an Xray to check.


Gum Disease

April 5, 2010

Gum disease is painless and progressive in the majority of the population.  Minerals in your saliva are released to neutralise damaging acids in food and bacteria that rot your teeth.  Unfortunately these build-up on your teeth as a hard scale (tartar or calculus) and it can’t be brushed off.  The build-up creates a scaffold for more bacteria to live permanently, resulting in inflammation and infection of your gums.  Over many years this inflammation results in damage – initally bleeding, then peeling away of the gums from the teeth, and eventually bone loss, loose teeth, and lost teeth.  You have heard of the phrase ‘ long in the tooth’.

 

 

 

 

 

 

This process is usually painless, so many people don’t go to the dentist to have their teeth professionally cleaned because they don’t knoe they have a problem.  Once gum disease has caused damage, it can’t be fixed.  Some people don’t go to a dentist for many years and notice no problems, only to find their teeth are suddenly loose and beyond saving, with no bone left.  I would urge everyone to have their teeth cleaned every six months, and in severe cases see a gum specialist (periodontist).  Gum disease is also linked to heart disease and general health.


Basic Resin Filling

March 10, 2010

Just a quick post to show people the general principle of a filling.  Bacteria enter a small entry point but may eat away a significant amount of tooth on the inside.  Your toothbrushing keeps the surface of the tooth looking and feeling solid.  This is a case I did today which is a comparatively small cavity.  See how much tooth can be damaged by a small hole causing no pain or symptoms whatsoever.  That is why we say to have 6 month checks and cleans at the dentist.  This tooth actually has two fillings.  Which of the two do you think will be better for the tooth?

Note the discolouration

Soft dark decay seen after removing surface enamel

 

All softened damaged tissue removed. Residual stain stable.

 

Protective liner placed

Final Restoration

As always, remember dental decay is a progressive disease.  Early damage is reversible, moderate needs a filling, severe needs a crown with or without root canal treatment, and extensive decay means an extraction.  Prevention and early detection rules!


Questions and Answers – Dentistry

December 8, 2009

Well, I have been a bit slack in writing new info.  It takes time to get interesting photos and new ideas, although I see them every single day at work.  I guess this post is to ask people for their dental problems, queries.  I am here for free consultation – obviously I can’t look in your mouth, but I can give advice generally about dental questions you have.  It will give me more info on what are the dental concerns people have that I can help with via the net.  I mostly get wisdom tooth questions but thought this post might stimulate some others.

I’ll have a post coming soon on bleaching and full porcelain crowns for crowded front teeth based on an interesting patient I have just had the opportunity to help.  Come and check it out in the next day or so.

Marc 🙂


Dental X-rays

September 6, 2009

Reducing the exposure of people to radiation is a prime principle governing all medical professionals when we use X-rays for treament or diagnosis.  There is a risk and benefit to all treatments.  The amount of radiation from a standard set of dental X-rays is about equivalent with the exposure someone recieves in a plane trip from Brisbane to Sydney (or about 500 times less than in one mammogram).  We would recommend that general diagnostic dental X-rays for most people every 2 years will significantly reduce the risk of undetected decay causing irreparable damage (see photos).  We would consider the possibility of flying to Sydney every 2 years a low risk for harm from radiation.

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 White areas are fillings

decay2    Dark area is new decay bottom left decay3Red line shows decay extent, Pink area is the tooth nerve outline

Why do we need X-rays in dentistry at all?   Decay usually occurs in areas hard to clean such as the flossing surfaces of the teeth.  The decay in the above photos occured in les than 18 months and could not be detected in the mouth due to its position under the gumline.  If the decay reached the nerve of the tooth there are two options for treatment.  One involves complicated and expensive root canal treatment (which needs several X-rays to complete) or removal of the tooth (which needs an X-ray to assess the risk of permanent nerve damage, breaking the root, damaging the sinuses etc).   If one took the approach of simply removing painful teeth and avoided any X-rays, then apart from the risk of permanent nerve damage or complications, the end result will be a poor ability to eat good healthy food.  The outcome of this is an increased risk of poor health and bowel cancer from poor nutrition.

This is why we try to balance the risks and benefits of treatment.  If you have 6 monthly dental checks, brush twice per day, floss every night, and eat a healthy diet with low processed carbohydrates, then dental X-rays can be taken less often.