Tooronga Family Dentistry in Glen Iris

Archives for May 2015

Can you have bad teeth?

Frequently young patients come to me asking for a tooth to be removed, because their teeth are bad. But are they really bad and is removing the tooth the best way to go?

The broken down teeth are usually consequences of two common diseases. The first is decay, which is a bacterial assault on our teeth fueled by sugars from our die234t. The second is gum disease caused by bacteria colonizing the soft tissue around the teeth and making an infection there which can penetrate further to the bone, blood system and from there to the whole body. These problems are caused by bacteria and their removal will sort things out.

So there are no bad teeth, removing the bacteria and dealing with the causes to tooth break down will keep them in your mouth.  Having the teeth removed will only make things worse for the remaining ones, by overloading them, leading them to move and make chewing difficult. Once the teeth are removed, the bone that surrounds the them will go leading to changes in your appearance that make you look older.

Please come and see us to keep your teeth.

 

 

 

The reason for tooth pain.

When I was 6 years old I had a sleepless night that I can still remember many years later – toothit was because of a tooth pain.

The reasons that teeth hurt so much is due to the large number of nerve endings that “sense” what happens inside our teeth and the position of the nerve endings inside the tooth and in the gum around it.

The nerve endings inside our teeth are a part of the tooth pulp. The pulp is confined in a hard shell which is the tooth. Once the bacteria reach the pulp they cause an inflammation, which leads to the pulp being swollen and more sensitive. Having this in the small confines of the tooth leads to an increase in pressure and pain, leading to more inflammation, which in a vicious cycle leads to more pain. The outcome is a very strong pulsating pain, which many times keep us awake at night. At times, the pain goes away after a while without treatment since the bacteria manage to kill all the pulp tissue and the nerves included. But this is a short lived respite since the bacteria soon reach the tip of the root to cause an abscess which hurts and can cause swelling that lead to more dire consequences when the bacteria reach the blood stream.

The best treatment for a tooth emergency is to prevent it by coming for a examination. This way I can stop the disease before it progresses and causes pain.

Different people need different approaches to prevent decay.

Scientific innovations offer a wide variety of solutions for preventing cavities in teeth or decay. Prevention does not treat the cavity once established, but the risk of developing it. Because there are many factors that can lead to the development and progression of decay, we first need to identify the individual causes of it in order to prescribe an effective solution. The assessment includes examining three factors:

  1. The past incidence of cavities and prevalence of plaque.
  2. The quality and amount of saliva.
  3. The frequency of sugar intake.

Once the harmful factors leading to decay can be established a solution can be formulated. For example here are some prevalent problems and solutions:

  1. For high sugar consumption the solution is the use of sugar free or xylitol products and snacks.
  2. For high deposits of plaque – there is a need to increase the frequency of effective cleaning.
  3. For low fluoride supply – additional products can be recommended to provide more protection.
  4. For a low chewing diet – change to a fiber rich diet.
  5. For inadequate restorations that trap food – overhang removal.
  6. For low saliva – saliva stimulating food or saliva replacing products.
  7. For bacteria retentive fissures – fissure sealants.

For an individual assessment of your risk for decay please contact us or make an appointment.

Soda and fruit juice consumption lead to tooth erosion

In a study done in the United States and published in the Journal of Public Health Dentistry, it has been found that for people who consume sugary soft drinks and fruit juices, a large number show signs of dental erosion. Surprisingly the worst tooth wear was an outcome of Fruit drinks consumption, while milk tended to be a more common beverage for people with lower levels of tooth wear.

The conclusion is that, water and milk are the best beverages to consume in order to avoid tooth wear and erosion since they lack sugar, whilst beverages like soda and fruit juices which contain sugar should be consumed in moderation.

What is an overhang?

Frequently when I examine patients suffering from food trapped between their teeth or bleeding gums, I find restorations with an overhang. overhang.001-001As seen on the right an overhang is an excess of dental filling material that projects beyond the margin of a tooth. It leads to food being trapped under the ledge giving an idea hideaway to bacteria since it is very difficult to clean. As seen in the image on the lower left, the gums swell and only after my professional cleaning, the amalgam excess became evident on the lower right. But the overhang needs to be removed to achieve a complete resolution of the food trap.

Overhangs can be created not only from fillings, but from poorly fitted crowns, veneers or excess of dental cement. It is important to have the excess of dental material removed to prevent further damage to the tooth or the supporting bone from decay or gum disease.

If you find that there is an area where food always remains after eating, you may have an overhanging restoration. Please make an appointment for me to check it.

Anxiety can lead to dental problems.

Frequently I find that my patients suffer from tooth grinding as a result of work or social related stress. An article about Stress and bruxism published in the Journal of Oral Rehabilitation found that anxiety experienced in social circumstances elevates the risk of bruxism, which can cause jaw pain, tooth wear and fractures. It has been known for a long time that stress and anxiety are related to acute gum disease but this new finding highlights another dimension of the stress problem that lead to dental consequences.

 

Smoking cessation is important for you.

Smoking is a common habit that has consequences on your wellbeing as a whole and in the mouth in particular since:

  1. Smoking increases the risk of developing gum disease 6 times.
  2. Former smokers are twice more likely to have periodontitis compared to non smokers.
  3. Smoking lower the oxygen concentration in the mouth, creating a favourable environment for bacteria, and it prevents the healing following treatment.
  4. If the outcome of gum disease is an extraction, the best replacement is an implant. But failure rates for smokers are three times higher for smokers.
  5. A smoker is four times more likely to develop oral cancer.

If you would like to receive more information about smoking cessation or its effects on your mouth please make an appointment to see me.

Treating gum disease prevents prostate disease

Previous studies have found a link between gum disease and prostatitis, a disease that inflames the gland that produces semen. Since gum disease not only affects the mouth, its effects are systemic and can cause inflammation in various parts of the body. In a study done at Case Western Reserve University School of Dental Medicine on men already diagnosed with prostate malformations, it has been shown that if we treat the gum disease, it can improve the symptoms of prostatitis and the quality of life for those who have the disease.

If you suffer from bleeding gums when you brush your teeth or eat it is not normal. Avoiding those areas when you brush or floss will not make it better. Leaving areas of your mouth untouched will only create a safe-haven for the bacteria and lead to the progression of the destructive effects of gum disease both in the mouth and the body as a whole. Please contact us to check your gums.

What is overeruption.

Our teeth have the ability to adjust to changes that happen over time in our mouth. This is achieved by a special feature called the periodontal ligament or PDL in short. This is a tissue that attaches the tooth to the bone and rearranges itself in response to the forces applied on the tooth. A major function of the PDL is to compensate for the wear that teeth have when we chew, by pushing the tooth out of the bone when there is no resistance. But when an opposing tooth is removed this function is detrimental and leads to “Over eruption”. Overeruption is when a tooth pushes out of the bone more than the other teeth in that jaw leadingovereruption to an uneven bite and drifting of neighboring teeth as shown in the image on the right. It is usually following an extraction, if the removed tooth is not replaced. As a result of the changes in the bite food is being trapped between neighboring teeth and the “overerupted” tooth can prevent the placement of an implant or a denture in the opposing jaw. After the tooth has shifted it is more difficult, lengthily and costly, to have a healthy bite again and may involve orthodontic treatment, root canal treatment and crowns.

If you need to have a tooth removed, it is important to plan ahead for its replacement in order to avoid unnecessary and expensive treatment. Please contact us to have a comprehensive examination and get a detailed plan for a healthy dentition.

Jaw pain can be hereditary.

Increasing evidence suggest that there is a hereditary tendency to suffer from jaw pain. In a recently published review in the Journal of Oral Rehabilitation, it has been found that there are genes that may predispose you to back, neck and jaw pain. Another evidence is in twins where if one sibling is suffering from pain then there is a 68% risk that the other one will too.