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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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.

4Porc Onlay Fracture 2

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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Composite Bonding Rehabilitation

October 30, 2011

This lady had worn and chipped her upper teeth on the inside until they were so thin they were about to break. The yellow tooth on the right second from the middle is an old crown which the patient couldn’t afford to redo so we had to match it in colour and shape. Crowns are hard and durable but bonding often means less tooth needs to be removed and they are cheaper. Because all of this patients teeth had worn we were needed to build them all up (or at least 10 of them) – compare $250-$300 per tooth for bonding vs. $1500 per tooth for crowns. They may not last as long or be quite as perfect in appearance but they can be a great low cost option without losing teeth and getting dentures. It was done in one day and crowns would take weeks or even months.  I would be happy to get 5 years up to 10 years for this kind of procedure.  Despite the cost, in the long term I would still prefer porcelain crowns.


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.


Loose Dentures? No worries

June 6, 2011

Over the years I have been grateful to have studied under some great professors regarding denture making because full dentures.  Many newer graduates are seeing fewer cases of full dentures and find it harder to gain experience.  Nevertheless, even well made full dentures are often a nightmare for both dentist and patient.  Bottom dentures especially have little going for them – the jaw atrophies when you loss teeth which leaves no support to bite against, no jawbone left to hold the dentures firm, and the end result is poor diet, discomfort, ulcers and unhappy people.

I have been excited to see mini dental implants as another option for us to help retain full dentures.  Traditionally, full implants were required at great cost, and many patients don’t have enough bone to support these implants, or the money to pay for them.  The mini dental implant is an in between option – aimed at stabalising the denture against loosening or falling out, but still being removable.  I have just finished a case and the patient is thrilled.  he lost his teeth 3 years ago and hasn’t been able to wear a denture since – now he is regained his confidence an smile.

  


Decayed Teeth

October 14, 2010

This patient is likely to have further complex problems with his front teeth due to the extent of the decay.  Decayed teeth if untreated eventually get damage to the nerve inside and end up needing root canal treatment to save, and also the tooth can be so weakened that it can break off.  Fortunately, we have been able to repair these teeth with filling for now.  These teeth are still at great risk, but the fillings will stabalise the problem and should be serviceable for a few years.  The advantage is that all this could be fixed in one day for a few hundred dollars with a very cosmetic result.

The front tooth without any decay is a root treated and crowned tooth treated many years ago.