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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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.


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 🙂


Decay

August 9, 2009

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It’s so sad to see unfortunate cases such as this.  Mostly because it is preventable, and secondly because it is a long hard road to any future recovery.  The causes of such extensive damage are many – fear of dentistry, poor diet, poor hygiene, lack of understanding the process of decay, medical issues such as reflux or bulemia, drug use, or a lack of access to a dentist.  Treatment will depend on what this person wants, can tolerate, and can afford.  I always quote my favourite three C’s – Comfort, Cosmetics, Cost

Comfort – the best option would be to save all the teeth possible, and replace the missing teeth with implants.  This would look and feel like a full set of natural beautiful looking teeth.  The problem is each tooth is so damaged it would probably need a root treatment and crown, and at roughly $5000 per implant tooth, this patient is unlikely to be able to afford such a complex treatment.  This is why I do my best to educate and help people understand the need to prevent this damage in the first place.

Cosmetics – the above result can look perfect, but so can a really well made denture.  I see very few people that can eat well with full dentures, although some tolerate a full upper denture reasonably well.  I emphasise tolerate – most people with dentures have forgotten how good it used to be to have teeth and just deal with it as best they can.  As they get older, the bone in their mouths becomes less able to support the denture, and I end up seeing many older people with intolerable dentures – usually blaming the fact that they can’t eat, have pain, and blame the fact on not being able to find a dentist that knows how to make a denture that fits.  These people really need an implant to help stablise the denture – back to cost.

Cost – it is all about balance at the end of the day.  If I was the above patient I would want to save whatever teeth I could – depending on my finances.  We could probably patch the decay and slow the breakdown process.  make some partial dentures to replace the spaces and build up the teeth which have worn down from the incredible workload.

The bottom line is – if you have teeth, prevention is better than cure (see my segment on general dentistry).  If you have damage to your teeth, the sooner you get them looked at the better.  If you have damage to your teeth, there are many options to get your mouth back on track.  You need to find a dentist who can discuss the options with you.  Finally – you have to be realistic – about your future level of care, or your budget, or what expectations you have.  You can’t get complex treatment, implants, and crowns for the price of a denture, and you can’t get a denture that feels like your on teeth.


White Fillings

February 28, 2009

Just a quick case that came in the other day.  There was decay in the pit on the side of the tooth which had penetrated all the way to the metal filling in the top of the tooth.  These old metal fillings also swell and corrode over time.  With chewing and cycling of hot and cold food/drinks, the teeth can crack.  (you know – that wonderful uh-oh moment while eating crackling at Christmas).  By the way – note the old white resin sealant on the tooth behind aimed at preventing getting the decay in the groove in the first place.

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Tooth coloured resins are ideal in this situation.  They bond to the tooth – especially to enamel above the gum, and help restore the tooths former strength.  They may have to be replaced more often than the old metal fillings due to chipping or wear – but generally technology has advanced to the point where these are the first choice material for such cavities.

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Apart from that they look great. 

 

 


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!