Archives for August 2015
Many of us , myself included, find ourselves clenching and grinding our teeth, when concentrating, driving or working. But surprisingly most of us do it in our sleep. There are ways we can tell that we have been engaging in this destructive behavior by listening to our body. The signs that tell what went on at night are: feeling headaches, sensitive teeth, pain around the ear, neck pain, clicking joints, jaws that ‘lock’ in the open or closed position or muscle fatigue. Sometimes even psychological illnesses such as depression or anxiety may be connected with the clenching, which only make clinical diagnoses harder and the effective treatment more difficult to implement.
Conservative measures of treatment such as massage, physical and behavioral therapy, anti-inflammatory drugs and muscle relaxants are usually employed for those who suffer from pain. However, these approaches can fail to succeed and they do not prevent the damage to the teeth or reduce the force applied.
Botulinum, a toxin that is usually used to treat blepharospams and chronic migraines that cause muscle paralysis has been used to help those who suffer from bruxing. The effects of botulinum toxin on bruxing, which happens unconsciously, have been intensively studied and it has been proven to be an it has been found to be an ideal treatment for excessive muscle movement during daytime and night-time. Although the way how botulinum toxin works on of temperoromandibular disorders are poorly understood, the studies of botulinum toxin show that they provide significant relief in the intensity and duration of pain including headaches and neck pains, whilst protecting teeth from further damage in bruxing patients.
Not a day goes by without a patient coming in with a cracked or chipped tooth. In most cases the reason for the damage is clenching or grinding. But sometimes the patient is not convinced that, the reason the tooth broke, is his habit. The main reason is that most people do it at night when they are asleep. This is where a recently introduced splint comes in handy. It is a thin layer of plastic coated with pink paint. The patient can wear it during the night and examine it in the morning. If the paint comes off the plastic, it is a clear sign that there was clenching and grinding going on at night.
If you have been advised that you wear your teeth at night, please call Tooronga Family Dentistry, Phone number 98227006.
When decay appears in infants and very young children is often referred to as Baby bottle tooth decay or Nursing bottle decay. The common reason, is sweetened liquids( like tea, soft drinks) or those with natural sugars (like milk, formula, and fruit juice) staying in contact with the teeth for a long time allowing bacteria in the baby’s mouth to thrive on this sugar and make acids that attack the teeth. It happens when the children’s pacifiers are sweetened or they are given a sugary drink at nap time or nighttime.
Usually the upper front teeth are typically affected, since the tongue covers and protects the lower teeth. But in severe cases the decay, a bacterial infection, can spread to the lower teeth. Tooth decay in infants can be minimized or totally prevented by :
- Not allowing infants to be with the breast or the feeding bottle in their mouth while asleep.
- For infants that need a bottle to comfortably fall asleep, allow only a water-filled bottle or a pacifier.
- If you notice any signs of decay or anything unusual in your child’s mouth, please bring them to us for an examination.
Baby teeth are temporary, but important, they are necessary for chewing, speaking, and smiling. They also serve as placeholders for the adult teeth. If the tooth decay is left untreated the bacteria will find their way to the jaw bone and developing adult teeth and cause pain and infection.
As recommended by the ADA for babies the first visit to the dentist should be by the first birthday. If you would like to book in an appointment for your child, please call Tooronga Family Dentistry, Phone number 98227006.
The visit to the dentist is for some an unpleasant memory, due to a painful experience. For those who dislike the idea of coming to the dentist there are other ways to have the treatment, with dental sedation, sleep dentistry or treatment under general anesthesia. When comparing the different types of pain relief, local anesthesia has several advantages and avoids some of the risks and unpleasantness associated with sleep dentistry and general anesthesia. It gives the patient a comfortable experience , a sense of being “in control” and the possibility to have the treatment without fear. When local anesthesia is given the patient returns to normal eating, walking etc. faster than in a general anesthesia. He is free to leave as soon as the treatment is over and unpleasant sensations like such as nausea and vomiting are avoided.
Other advantages of the local anesthesia have to do with the extent and duration of the anesthesia. Since local anesthesia provides a smaller anesthetized area and shorter duration it allows us to use it more frequently. I can customize the location and duration to the treatment needed. While with the other types of anesthesia, the duration is longer and it anesthetizes the whole body, which leads to the need to have all treatment done at once. That is why the local anesthesia can allow for a staged treatment where the financial cost can be spread over time. The staged approach can allow us, to monitor healing over a period of time before continuing with other treatment in the same tooth, which is important when performing a root canal treatment.
Due to the need to achieve a stronger effect, the drugs given for sleep dentistry and general anesthesia are more potent and the dangers of “side effects” are larger too.
Since all dental treatment, from a simple clean to a complicated extraction can be performed safely and comfortably with local anesthetic, it is my advice to have dental treatment with local anesthesia and nitrous oxide sedation, for the best outcome.
If you would like to visit for a checkup or hygiene clean, please call Tooronga Family Dentistry, Phone number 98227006.
Many times when a single tooth has a dark color it is due to a trauma or a root canal treatment. Since the dark color comes from within the tooth, it requires “internal whitening”, which is a different approach to the whitening of sound teeth. In these teeth the broken down blood cells, bacteria or root canal filling material( as shown in the image) create a dark staining inside the tooth. The treatment has to start with removing the cause, followed by the application of a special mixture of sodium perborate. The reason I use a different whitening agent, for these delicate teeth is that while peroxide, the ingredient in whitening gel, penetrates the tooth enamel and dentin layers, the sodium perborate whitening products, do not penetrate the enamel. This way the sodium perborate is safer, since it does not “escape” from inside the tooth, leading to a great outcome with little effect on surrounding areas.
After the tooth reaches the desired color, we can stop the application of the whitening agent and restore it’s shape.( As shown in the second image.)
If you would like to know more about teeth whitening, please call Tooronga Family Dentistry, Phone number 98227006.
An infected tooth partially cleaned with flint tools represents the oldest known dentistry, says a new international study on a 14,000-year-old molar. The patient was a young man, about 25 years old, living in northern Italy. At that time, toothpicks were probably made of bone or wood and were used to remove food particles between teeth. Since local anesthesia has not been discovered then, it is possible that it was a painful experience. In other historical findings, Beewax dental filling was discovered in a 6,500 year old human tooth from Slovenia, while dental drilling, likely to remove decayed tissue, was discovered in 9,000-year-old molars from a Neolithic graveyard in Pakistan. Today we are lucky to have better materials and techniques that allow us to provide a comfortable and long lasting treatment.
For more information about this discovery click here.
For a crown to withstand the forces of mastication and sticky food, the underlying tooth has to be shaped with precision. It has to be long enough to provide enough surface area to grab the cement and be only slightly tapered. If the prepared tooth resembles a short pyramid, it may not hold the crown. This is why preparing a tooth for receiving a crown is a process, that requires rigorous planning, use of good lighting and magnifying lopes and experience.
Another possible reason for the crown coming off, is poor fit. After tooth preparation, the following delicate step is making a precise copy of it’s shape. If the shape is not accurately copied the crown does not hug the tooth well enough for the crown to stay put. It is like when 2 pieces of furniture don’t have good joinery they are only held by the glue and separate easily. The space between the crown and the tooth should be minimal in order for the “glue” to provide maximum adhesion, since the glue is many times the weak link. Sending the “copy” of the tooth to an excellent dental technician is another important ingredient to a successful outcome.
When a patient presents with a permanent crown that comes off, many dentists will first try to cement it without trying to identify the reason why it came off. In my practice, I first examine to see what was the reason that led to the separation. Frequently I find that preceding the crown coming off, the poor preparation or fit, allowed bacteria to establish themselves and the tooth has already been broken down by decay too. Before re cementing the crown I remove the bacteria, debris of old cement and the decay to allow for a good fresh bond between the crown, cement and tooth. I cement it using the strongest cement. But many times the initial cause that led to the crown coming off previously, persists and even with the strongest cement, we do not always achieve a long term solution and I am faced with the need of making the crown over. When I do so, I pay special attention to correcting any shortcomings in the preparation and I make sure that I send to the dental technician a perfect copy of the tooth.
There can be other reasons for crowns coming loose. If the way teeth come together is unfavorable, crowns can be more likely to come loose. This is the reason that before providing a tooth with a crown, there should be sound planning. Some patients have a large overlap between their upper and lower front teeth which is called, a deep bite. The outcome of having a deep bite, are high horizontal forces on the teeth and crows, which can lead to teeth or crowns breaking or come off. Other patients have habits that are just not that friendly to crowns, such as eating pencils or very hard and sticky candies. When chewed often these sweets, tend to loosen even well fitting crowns.
If you are having issues with a crown that keeps on falling off, please call Tooronga Family Dentistry, Phone number 98227006.
My patients give me a sheepish look when they ask to have their regular clean with “Happy Gas”. Even though Nitrous oxide is most needed for anxious patients, to put their fears at rest, a significant number of patients who are not anxious, have discovered it’s pleasant effects and request it for all treatments. The Nitrous oxide makes the regular hygiene appointment, pleasant by reducing sensation and relaxing the muscles.
We ask patients who would like nitrous oxide during the cleanings to tell our patient coordinator in advance when making the appointment, so it is available when they come for their visit.
Increased body weigh and size are accompanied by profound changes in the function and metabolism of individuals . These changes have effects on the well being, oral health and function. Listed here are some oral consequences of obesity and possible solutions:
- The increase in size causes difficulty in function which can lead to a deterioration in oral hygiene. The outcome would be decay and gum disease , for which early detection in a three monthly dental exam, will help prevent.
- Research has shown that “From a biological standpoint it seems indisputable that obesity impacts processes that involve inflammation, including but not being restricted to periodontitis.” In order to reduce the gum disease frequent oral hygiene visits are required to aid in maintaining a healthy mouth and body.
- It has been found in research that obese children suffer more from decay . The possible reasons is the composition of the diet. The risk of teeth breaking down due to decay can be reduced by changing the diet and using products containing fluoride, calcium and phosphate.
- Obesity can lead to several medical conditions, Diabetes, Hyper tension, hearth disease, obstructive sleep apnea. The fat in the neck and face can decrease the flow of air to the lungs, especially while the person is sleeping. I can make an appliance that increases the air flow and help with the sleep apnea.
- The presence of bacteria in the mouth allows then to invade the blood stream and reach other organs. To prevent the spread of oral bacteria and their toxins to other organs we need the awareness of the caring team. I can instruct the caring team how to help the obese person reach and maintain good oral hygiene, use the correct tooth paste, mouth wash and dental appliances.
If you would like to discuss the possible ways to keep your teeth and gums healthy, please call Tooronga Family Dentistry, Phone number 98227006.