More White Spots on my Teeth

June 22, 2016

You will see my post from several years ago about teeth and white spots.  Some white spots are due to acid damage and a period of reduced brushing effectiveness or higher sugar diet.  This can be common after braces because it is harder to clean around the wires.

Other white spots are more natural occurring as a hypomineralised layer of the tooth surface that appears frosty.  Some of these are very superficial and and be removed in less than 5 minutes with a mild acid that we use for tooth bonding, followed by a fine mineral particle that helps clog the porosity and allow the tooth to regain it’s transluceny.  Here is another case we did last week.

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Gaps between my teeth!

July 29, 2015

There are three ways to fix gaps between the teeth.

The first is to move the teeth closer together.  This can be done with braces or Invisalign.

The second way is to fill the spaces in with tooth coloured filling material – resin bonding.  This makes the teeth look a little wider so it depends on the size of the gap, and it will also stain and chip over time.  An average for bonding may be around 5 years but may last much longer with care.

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The last option is with porcelain veneers or crowns.  These can look more natural and don’t stain like the bonding can.  I don’t have a picture of veneers used for bonding but go to our website for a picture of before and after porcelain veneers compared to resin bonding veneers HERE


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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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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Cracked Tooth Syndrome fixed with eMax Crown

July 22, 2013

This patient started getting sharp pain every time they bit on this tooth.  It had never been filled but it started to split  This can happen from grinding (bruxing) at night, clenching, eating hard foods, or often old fillings have weakenbed the tooth.  In this case the patient admitted a very stressful period over the previous 6 months and an awareness of heavy clenching.

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You can see natural grooves and small enamel cracks in both teeth.  The pain was localised to the second premolar by biting on a hard object.

4Porc Onlay Fracture 3After removing the enamel a verticle crack can be seen extending into the tooth.  Without support this will continue down through the nerve and root of the tooth and the tooth will need to be removed.  Below is an image of a tooth where this has already occured.

1Fracturetooth1A porcelain shell like a helmet is made that can fit over the tooth and protect it.  We use only Australian laboratories and don’t source crowns from overseas.

4Porc Onlay Fracture 5Thanks to Jade Dental Laboratory in Buderim ,Queensland, for this artistic creation.

4Porc Onlay Fracture 7The crown is glued onto the remaining tooth to seal the crack and reinforce the tooth.

4Porc Onlay Fracture 6I have used eMax for this crown.  As it is cosmetic and translucent, I don’t have to agressively remove tooth structure all the way to the gumline like a traditional crown.  This leaves the tooth much stronger in the long term.

4Porc Onlay Fracture 4You can see where the tooth was reduced on the side.  Traditional crowns would mean removal of tooth all the way to the gumline.


Porcelain Bridges – missing lateral incisors and cosmetic dentistry

February 17, 2013

What a difference a smile makes!  This patient was missing her lateral incisors – a common genetic occurence.  Her options were a denture, bridges, or implants.  I would prefer inplants but there was no room in the bone to fit them.  She had worn the denture since a teenager and hated it – why wouldn’t she.  That only left us with bridges.  A bridge is a false tooth that is attached to the exisitng teeth on either side or both sides.  Traditionally this meant cutting the tooth significantly.  Newer techniques give us more options.  These bridges have been made with Zirconia, a very hard and strong porcelain, with a wing wrapping around the back of the front teeth.  By use of a new spray on porcelain bond, we were able to bond the Zirconia wing onto the back of the front incisors without any prepping or danage to the existing teeth.  The porcelain bride cantilevers out over the space.  I have also closed the dark triangle between the front teeth with tooth coloured composite resin bonding as the patient found it unattractive.  I think we have ended up with a lovely result.

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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.