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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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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My gums are receeding

October 19, 2010

This 21 year old came to see me today complaining of pain and receeding gums.  The tissue is very thin and fragile on some people and the gum can receed from brushing too hard, or leaving bacteria on the gumline from brushing too soft.

We cleaned the hard calculus and build up off the teeth and prescribed a toothpaste for sensitive teeth.  Rubbing with salt and gentle brushing with a soft brush will help maintain the area – an electric toothbrush can be of benefit here.

Unfortunately the gum won’t repair (it may do slightly as the patient is very young).  What we want to do is be very diligent and stop it getting worse.  If it gets into the soft part of the lip it can speed up and long term the tooth could then be at risk of getting loose and falling out!  Sometimes a specialist can do a graft to cover the sensitive root.  If it is well maintained then receeding gums can be stabalised with regular check-ups.


Work in progress

July 10, 2010

I’ve shown this young guy before.  We are just picking away at it a bit at a time.  The most rewarding thing is this patient has listened to everything about home care and prevention and is looking after things beautifully. See how the gums are pink and healthy and the remaining decay is so clearly visible.  Without good home care, nothing will last.

This was the first day we met.

The front 2 right teeth we managed to avoid exposing the nerve in the centre of the tooth despite severe decay.  They have temporary fillings to keep things stable until we sort out the remaining teeth.  The 2 teeth further back have permanent composite resin restorations placed.

This was today before we started to tackle the upper eye tooth and tooth behind.  So far this has been four visits at about $300 a trip.  We are just going at a rate our patient can afford.  I’ll keep future updates as I get time.

Here is the latest.


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.


General Dentistry

February 28, 2009

Prevention, prevention, prevention!

Bacteria grow on your teeth, eat sugar, and ferment it into acid – acid rots teeth.  More bacteria (i.e. high sugars and low brushing) = more decay

This is a young patient I saw recently after we used a dye to show the bacteria (plaque) growing on the teeth. 

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As you can see, the bacteria are covering the teeth in a thick layer.  The following picture is a more common amount of plaque but still too much if you want to keep your teeth for life.

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The important thing is to remember to brush the gumline, and floss to clean the bits left in between the teeth.  Dental disease is one of the most preventable diseases on the planet yet affects the greatest population.  Brush with a soft brush effectively twice a day, floss each night, eat healthily, avoid soft drinks, and visit a dentist six monthly for a check and clean.

I’d much rather clean teeth every 6 months than do fillings, root treatments, crowns and extractions.  Hope to see you soon!


Pregnancy and Dentistry – Mythbusters

June 6, 2008

A patient rang our practice recently querying some problems about their wisdom teeth but having heard that you shouldn’t see a dentist while you are pregnant.  This is a common story for us so it’s time to bust the myth.

  • When you are pregnant you shouldn’t see a dentist – wrong – overall health during pregnancy is essential – healthy mother healthy body.  Your mouth is the first line of defense to infection in the body and the immune system hypes up during pregnancy.  If your hygiene drops (not uncommon when you have a lot of issues going on while you are pregnant) your gums may become more red or bleed.  Your dentist can continue regular cleans and hygiene and give advice on keeping things comfortable.
  • My mother lost all her teeth because the baby took all her calcium.  wrong – your body gets calcium from your diet and failing that from your bones.  Your bones can be formed and reformed but your teeth grow once and then they are as hard as they will get.  Usually what has happened is the person already had decay or problems not picked up before they found out they were pregnant.  They then didn’t have dental care for the period of pregnancy and early childhood due to the business of motherhood.  By the time they go to the dentist they are in pain, have multiple large cavities and may opt to extract some teeth.

So why should we go to a dentist if we don’t feel any problems?

The problem of dentistry and pregancy is related to risk assesment.  Ideally, we would rather do nothing other than a check and clean during pregnancy and avoid X-rays (unfortunately X-rays may be the only way to detect some problems but usually we can leave for a few months).  If a patient has some small cavities and we know about it we can try simple preventive measures to see that the teeth will last until the baby is born then fix them.

If decay is deep there is a chance of an abcess (an infected tooth).  If you leave a tooth until it is abcessed then we have several concerns.  Leaving the abcess means the mother carrying an infection and this can be a threat to the mother and child.  Abscesses are treated by removing the tooth (an X-ray may be needed) or root canal treatment (many Xrays are needed) or antibiotics (what about the safety of the child?).  By finding deep decay early we can dress the tooth and reduce the risk.

Basically waiting until you have problems puts you and your child at risk.  If we know about the problems early we have less risk and more options.  But that goes for everyone whether pregnant or not.  I have one filling – but I go for a check and clean every 6 months, brush twice a day, floss every night. 

Remember – there are no wrong choices in life – only consequences