Tooronga Family Dentistry in Glen Iris

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Suite 1.02, 1 Crescent Rd., Glen Iris 3146
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Archives for April 2015

We have embraced the new Piezosurgical revolution.

Posted on 04.23.15

In my search for new ways to provide better treatment for my patients I have discovered a novel innovation: Piezosurgery which is a true revolutionary way to make treatment safer and simpler for the patient. Piezosurgery uses a low frequency ultrasonic energy to produces microvibrations that facilitate safe and precise treatment for hard tissues like tooth and bone, without damaging underlying vital structures like nerves, oral lining and vessels. Due to the fast action of the tip there is need for only gentle touch to achieve the needed function. In addition to the great advantages for the patient, it overcomes technical difficulties for myself, such as visibility and   debris removal through  the internal irrigation mechanism. But the piezosurgery not only makes the procedure safer and gentler it has been shown to provide more favorable healing. In a recently published article“Piezosurgical treatment of crestal bone: quantitative comparison of post-extractive socket outcomes with those of traditional treatment.”  it has been found that less bone has been lost following extractions with the Piezosurgery unit in comparison to the traditional technique.

We have purchased the newest state of the art Mectron Piezosurgical touch unit to join this revolution and continue to provide the best treatment for our patients. This way I can better perform treatment for gum disease, complex root canal treatment  and  surgical procedures like wisdom tooth removal and implant placement.

 

The advantages of nano materials in Dentistry.

Posted on 04.18.15

Nanomaterials are made of small particles and they have unique properties that differ from the larger bulk materials and the atomic level. The most common use of nano materials in dentistry today is in the form nanoparticles used in the composite materials. The transition to nanoparticles in dental composites has allowed for improved resistance to wear and less shrinkage all of which make the fillings better and long lasting. I use a nanoparticle composite which allows me to restore broken down teeth without any sensitivity after the treatment.

But recently other uses are starting to emerge. It has been found that small graphite particles can kill bacteria. This has been developed into a new technique to apply medication to dental plaque. As presented in the Dentistry Today journal  the technique uses nanoparticles that can bind to the saliva-coated teeth within the plaque and transport the antibacterial agent to the targeted sites.

 

Why does my dead tooth need a root canal retreatment?

Posted on 04.16.15

IMAGE4031Teeth that have had a root canal treatment performed in them loose the ability to fight bacteria which try to infiltrate them, since the dental pulp or it’s remnants were removed. Most teeth with a root canal treatment were found to last in function more than 10 years as published in a  long term study . With the right restoration and proper care, the teeth that have had a root canal treatment can last a lifetime. But sometimes, as seen on the right, a tooth that has been treated can become painful or diseased months or even years after treatment. In most cases the reason is that bacteria have managed to establish themselves inside the tooth and migrated down the canals to the tip of the root, where they create a new infection or abscess, as shown with the red circle in the image on the right. The common reasons that bacteria have managed to refill the tooth are:

  1. The filling or crown that were placed on the tooth do not seal the cavity well leaving a door for the bacteria to reenter and establish themselves.
  2. The filling or crown that we placed have become loose or come off and the root canal was exposed to the oral environment.
  3. One or more canals have not been cleaned the first time.
  4. The canals were not cleaned all the way.
  5. The sealing material inside the canal did not fill all the canal volume.
  6. Cracks in the roots that allow bacteria to proliferate.

If your tooth failed to heal or develops new problems, there is possibility to make a root canal treatment for a second time, called a retreatment, which may be able to save your tooth. The aim of retreating a tooth which has had a root canal treatment in the past is to try and disinfect it again. This way you can retain the tooth and prevent its removal.

IMAGE4531In the retreatment, the previously placed sealant is removed and all the canals are cleaned and disinfected. The retreatment may be more complicated from the initial treatment, since many times there are hurdles to cleaning the canals like a post or a crown that have been cemented on top of the root canal filling.  Once the pathogenic bacteria have been eradicated and the canals are clean, they can be resealed to avoid the bacteria from re-entering the canals and a new filling or crown can be placed, as seen on the right. The success rate of the retreatment is quite high and stands at 83%.

If you suffer from a tooth that was treated with a root canal treatment, please contact us to examine the reason.

 

 

Confusing Tooth Pain or Referred Pain.

Posted on 04.15.15

At times my patients come to see me  because of pain, but they find it difficult to tell where the pain is coming from. Tooth pain can radiate to adjacent teeth, opposing teeth, the head, the eye or the ear. The reason, why it is occasionally difficult to pinpoint the origin of tooth pain, is because it can result from an infection in the tooth itself, or of the gum, or even from clenching  and grinding the teeth together, called bruxism or from trauma. Each one of the possible causes can lead to a different kind of pain, and it is always important to sort out what is going on so that I can provide the right treatment to the right tooth.

The source of pain, frequently is due to bacteria penetrating the tooth and the tooth becomes decayed or due to bacterial build up around the tooth causing a gum inflammation. The decay will lead to an inflammation in the pulp , with pain symptoms being sharp or dull, constant or intermittent, localized or spread out. But usually the pain is triggered by a change in temperature or pressure. While the bacterial accumulation around the tooth leads to a gum inflammation that has a tendency to spread to the surrounding bone.  There are nerve fibers that convey pain, but there are no nerves that pinpoint, “it’s this tooth right here” and the brain tries to figure out the source of pain. Since one single nerve conveys the pain sensation from several areas the brain tries to form a picture of where the pain is coming from, using information what we see or feel for example: a brown patch that we see in the mirror, a tooth that feels different when we test it with the tongue or finger, a tooth that feels rough or fractured or a tooth that was treated with a filling and the dentist said that it may need a root canal treatment. Once the brain reaches a conclusion it will provide you with a location where the pain is or at times it cannot find the source and then it will feel as a dull pain .  But at times the location the brain has deducted is wrong, and the reason too. An example is when the person points for the wisdom tooth, when it is not there. This phenomenon is called  a “Red herring” and it is quite common. This among other is the reason that when I test for the source of pain I check all possible sources of pain including teeth on both sides of the same jaw and the  opposing one as well and I use the camera to take pictures. Only after I have examined all possible causes do I summarise the evidence and provide the diagnosis, this I found is the only way to reach the source of pain.

 

 

 

What happens when the tooth dies?

Posted on 04.14.15

toothrctInside the tooth, under the white hard layer of enamel and the softer layer called the dentin, there is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue that develops the tooth from within and once fully mature helps maintain it.

The pulp can become inflamed or infected from a variety of causes: deep decay, exposed roots, periodontal disease, faulty crowns, or a crack or chip in the tooth, the pulp soft tissue cells may die. This is at times referred to as a “dead tooth”. But it is only the soft tissue inside, that is not viable any more, the hard part of the tooth, the enamel and dentin, can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it. Since the pulp tissue was acting as a barrier to the advancing bacteria if it is dead, bacteria can now progress unchallenged though the canals to the jaw bone, cause pain or lead to an abscess.   To stop the progression of the bacteria I need to perform a root canal treatment.

Does getting dental health insurance cover benefit you?

Posted on 04.11.15

In my last post I highlighted the statement made by Private Health Insurance Administration Council (PHIAC) CEO Shaun Gath that purchasing “extras” health cover is an Irrational decision. Now there are more voices advising action.

Consumer group Choice spokesman, Tom Godfrey, has been quoted in “The Senior” that “If you are receiving extras cover it’s worthwhile checking to ensure the benefits you receive are at least as much as the premium you pay, as some policies are pretty poor value.”  and he has indicated that people would be better off keeping the premiums in their bank account and paying their own ancillary health bills. Mr Godfrey said if you are struggling with the 1 April health fund price hike, consider dropping your extras (ancillary) cover.

Mr Graham Middleton from Synstrat group posted a recommendation to :

“Review your dental, optical, physio, chiropractic and podiatry services and the rebates that you obtained and compare them to the ongoing cost of ancillary cover. Most fund members doing the analysis will conclude that ancillary (general) cover represents poor value for money, and cancel it. Anybody contemplating cancelling should immediately book any imminent dental treatment or visit their optometrist if they are intending to get a new pair of spectacles, and then cancel.”

In conclusion it is advisable to consider the advice of the growing number of voices to check the benefits received and compare it to the cost in order to make a wise decision.

Does getting private health insurance dental cover make financial sense?

Posted on 04.8.15

In an article published recently, the CEO of  the Private Health Insurance Administration Council has been quoted saying, that the purchase of extras cover as part of your health insurance does not make financial sense. The reasons are mentioned in the Operations of the Private Health Insurers Annual Report 2013–14:

1. Insurers usually specify a maximum benefit limit for each service covered as either a dollar amount or a percentage of the total charge.

2. A total annual benefit limit can also apply to payments for specific treatments, goods or services.

The Australian Dental Association on its internet site has published more information about health insurance cover and the considerations for taking it.

Last but not least, many times I find that patient’s choice of treatment are made by the coverage of their private health insurance. For example they may choose to have an extraction instead of restoring a tooth with a root canal treatment because their cover does not include the root canal treatment. But having the tooth removed may have more implications which eventually may cost more than the benefits paid for the extraction.

In conclusion before you buy a health insurance, because you feel that it will benefit you for dental treatment, consider that advice given by the CEO of the Private Health Insurance Administration Council and the Australian Dental Association to make an informed decision.

Don’t let it break!

Posted on 04.7.15

Many people refrain from visiting the dentist because they had a bad experience in the past or were given a very graphic description of somebody’s else unfortunate visit to one. They may feel that their teeth are in good shape, till that moment when suddenly a tooth fractures without warning or they get a swollen jaw overnight. At that point in time they come to see me and I’m heart broken when I have to show them the pictures and discuss the treatment options.  Because when a tooth is severely damaged, the treatment options are both complicated and lengthy. It is important to keep in mind that even if the broken tooth is not entirely visible, it can affect your bite,  can cause you much trouble, can affect your chewing , your other teeth and your self-esteem. Infections from your teeth can travel via the bloodstream to other organs as well.

My best advice to those who don’t like visiting the dentist, is to come and see us regularly every 6 months.  In my examination I look not just at your teeth, but at your gums, cheeks, jaw bone, jaw joint and function to make sure that you can enjoy a healthy lifestyle. This way I can catch and monitor with my camera all your teeth. If I see a problem arises I can point it out and together we can decide what should be done about it. This way there is very little chance that things will break and you can make knowledgeable decisions about your teeth. Left untreated problems tend to grow and the treatment required involves multiple visits.

Please don’t hesitate to call us to make an appointment or enquire online.

Tooth-grinding or Bruxism in children.

Posted on 04.2.15

When parents watch their child sleeping they hope to hear easy breathing and sweet dreams, but sometimes they hear the harsher sounds of tooth grinding or bruxism, which is common in kids. A recent study found that up to 49.6% of the children grind their teeth and most will outgrow it.

Many studies have been done, but no definitive answer had emerged for the reason children grind their teeth. Some of the possible reasons are:

  1. As a response to pain, such as an earache or teething.
  2. When they are nervous, tense or angry.
  3. hyperactive kids also experience bruxism.
  4. Kids with neural medical conditions like cerebral palsy.
  5. Children on certain medications can develop tooth grinding.

The grinding becomes noticeable for the child when the teeth start to wear down. Unlike adults, most children who grind do not have TMJ problems unless their grinding and clenching is chronic and severe.

For more information about children grinding their teeth please contact us.

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