Tooronga Family Dentistry

we are serious about making you smile

My child has “shark teeth”, what should I do?

We as parents want set our children for life with beautiful straight pearly white teeth. But sometimes when the permanent teeth start erupting the “baby teeth” linger on. This is how two rows of teeth develop, which are called “shark teeth”.

When permanent teeth naturally replace baby teeth, the root of the baby tooth is dissolved by the erupting permanent tooth. This way the baby tooth becomes loose and falls off. But if for some reason this process does not happen, the remanent tooth cannot erupt in its correct position and it has to shift place to come out. This can happen with the front teeth or the back teeth and it needs immediate attention.

If the permanent tooth grows into an incorrect position, in many cases it can get trapped between other permanent teeth, which will make the condition more permanent. For this reason, the solution many times, is to remove the delayed baby tooth, to allow the permanent tooth to correct its position.

If your child has a tooth that is erupting behind the baby ones, it is important to come and see Dr. Kaufman to check what the solution is. He will be happy to examine and explain what is the condition of your child’s teeth. Waiting for the teeth to sort themselves out will only lead to a more difficult condition.

Is an Orthodontic treatment with Aligners right for me?

Clear Aligners can effectively treat bite problems, including:

  • Crowding
  • Gaps between teeth
  • Underbite – when all the upper teeth sit behind the lower jaw
  • Overbite – when the upper front teeth cover part of the lower front teeth
  • Crossbite – when one or more upper teeth fit inside of the lower teeth

Dr. Daniel Kaufman has successfully treated patients experiencing the following bite problems with SureSmile® Clear Aligners:

  • Crowding
  • Gaps between teeth
  • Underbite – when all the upper teeth sit behind the lower jaw
  • Overbite – when the upper front teeth cover part of the lower front teeth
  • Crossbite – when one or more upper teeth fit inside of the lower teeth

To find out if aligner treatment is right for you, please make an appointment with Dr. Kaufman. We will be happy to examine and explain what is the condition of your teeth and the way to improve the appearance and function of your teeth.

The Right Fit: Why SureSmile® Clear Aligners are a Trusted Option

As dental technology evolves, so does our practice and Dr. Daniel Kaufman is proud to offer SureSmile® Clear Aligners to our patients. Advanced treatment planning and proven materials combine to give you a personalised plan with predictable results. More than 1,000,000 patients have trusted SureSmile® technology to straighten their teeth.

Getting Started with SureSmile® Clear Aligners

On your first appointment Dr. Kaufman will examine the condition of your teeth, take photos and a digital scan of your teeth to assess how clear aligners will work best for you.

  1. Developing your treatment plan: Dr. Kaufman will instruct the technicians at the SureSmile® Digital Lab, how to move each tooth for optimal movement.
  2. Once your plan is ready, Dr. Kaufman will explain to you the planned treatment.
  3. If you have happy with the plan your smile journey will begin: You will get your SureSmile® Clear Aligners and you’re on your way to a smile you’ll feel confident about.
  4. Periodically Dr. Kaufman will make sure everything is on track during routine check-in visits.

 

Everyone’s journey is different, and Dr. Kaufman wants to make the process is comfortable and rewarding at every step of the way. Let us know how we can support you or make an appointment to start your journey!

Can the wire in my teeth be removed?

Many of us have a wire holding the teeth together after we had an orthodontic treatment. These wires are called in the dental literature fixed retainers. These retainers are important to help stabilise the teeth, since they tend to return
to their former positions due to a variety of factors.

The wire retainers need to be left on the teeth, for years after the orthodontic treatment had been completed. They should not be removed till the person finishes his growth which in women is around the age of 20 years old and in men around the age of 25. Once growth had been completed there is a need to assess the position of the teeth and surrounding structures to see if the fixed retention is still needed.

There are several reasons, why it would be a good idea to have these wires removed:

  • Fracture of the retainer wire or debonding of one or more of the resin pads that hold them to the teeth.
  • Distortion of the retainer wire
  • Unwanted tooth movement even when there is no change in the wire.
  • Risk for Periodontal disease.
  • Risk for food impaction that will cause gingival inflammation.

On the other hand if the wire is removed there is a risk that the teeth will start to move, without a brace that will hold them in place. In order to check if the wire on the upper or lower teeth can be removed, there is a need for an examination with Dr. Kaufman. Please do not hesitate to contact us for advice about your condition or to make an appointment. We will be happy to examine and explain what is the condition of your fixed retainer and if there is a risk of that the front teeth will shift.

 

 

Do wisdom tooth eruption lead to crowded teeth?

Crowding of the lower front teeth is common problem for adults, regardless if they had or had not undergone orthodontic treatment when growing up. At the time that crowding starts to develop in the front teeth, wisdom teeth are starting to erupt too. For this reason it seems reasonable that the eruption of wisdom teeth, or third molars as they are described in the professional literature, was often cited as one of the causes for this development, claiming that as wisdom teeth erupt they push the other teeth, leading to crowding.

Research that was done in 1961 by Bergstrom & Jensen in patients that had wisdom teeth on only one side and they found more crowding of the teeth in the side where the third molar was present. Later in 1982, another group of researchers found that once the wisdom teeth were removed on one side only, the crowding had decreased on that side compared to the side where the wisdom teeth were present, but that happened in only 70% of the patients. These articles point to wisdom teeth as the reason for the crowding and the solution then would be the removal of the wisdom teeth.

However,  other evidence in the literature did not find that third molars contribute to crowding. In those articles the researches compared the crowding of the teeth in patients that had undergone orthodontic treatment, who had  or had not wisdom teeth. In those articles researchers found that crowding occurs regardless of the presence of third molars, and they do not appear to have a significant influence on the changes of tooth position after orthodontic treatment.

In a large review of the literature that was done in 2020 it was found that in those that had their wisdom teeth removed there was only a very small change of 1mm in the crowding in the front teeth. Hence it was concluded that it was not justified to remove wisdom teeth on the grounds of preventing crowding.

In summary there can be many reasons for the growing crowding in adults. These can be related to diet, growth of the jaws, shape of the teeth or the way orthodontic treatment was done. In order to prevent or treat the crowding of the lower incisors, there is a need for an examination with Dr. Kaufman. Please do not hesitate to contact us for advice about your wisdom teeth and crowding. We will be happy to examine and explain how your wisdom teeth are positioned and if there is a risk of crowding in the front teeth.

Recent study found link between gum disease and hypertension

On March 2021, Dr Francesco D’Aiuto, head of the periodontology unit at University College London Eastman Dental Institute, has published a study outlining the association between severe gum disease and high blood pressure. According to these findings, a person experiencing an advance stage of gum disease is significantly more likely to develop high blood pressure.

Dr D’Aiuto explained that “evidence indicates that periodontal bacteria cause damage to the gums and also triggers inflammatory responses that can impact the development of systemic diseases including high blood pressure”.

The study analysed data from 250 adults with severe periodontitis and 250 adults without gum disease. All the participants were healthy otherwise. The findings were that participants with gum disease were twice as likely to have high systolic blood pressure (140 mm Hg or more), than those with healthy gums (14% and 7%, respectively). The results suggest that 50% of adults could have undetected high blood pressure due to gum disease and consequently many individuals may be unaware that they are at increased risk of heart-related problems.

The author of the present research explained that “Oral health strategies such as brushing teeth twice daily are proven to be very effective in managing and preventing the most common oral conditions, and our study’s results indicate they can also be a powerful and affordable tool to help prevent hypertension”.

Please contact the practice if you have any questions regarding your health condition.

Association between gum disease and severity of COVID‐19 infection

A recent study published in February 2021 (https://doi.org/10.1111/jcpe.13435) has found that gum disease or periodontitis is linked to the severity of Covid-19 complications.

According to the authors, COVID‐19 is associated with an exacerbated inflammatory response that can result in fatal outcomes. Since systemic inflammation is also a main characteristic of periodontitis, the association between periodontitis and COVID‐19 complications has been investigated.

COVID‐19 infection severity has been associated with patients suffering from hypertension, diabetes, cardiovascular disease, older age and obesity. However, the specific risk factors leading to severe clinical outcomes are still not clear.

The role of gum disease as exacerbated factor in severe Covid-19 outcomes has been investigated in this research.

Periodontitis is characterized by chronic non‐resolving gingival inflammation resulting in bone loss and teeth detachment, and it has been already linked by multiple studies as a risk factor in other medical conditions, like cardiovascular disease, hypertension, diabetes, renal disease, pneumonia and cancer.

The present study analysed the data of 568 Covid-19 patients. Among them, 40 experienced COVID-19 complications such as death, ICU admission and need for assisted ventilation, and 528 were discharged without any complications. The periodontal status was studied from these patients’ posterior bitewings and panoramic radiographs.

Out of the 568 patients included in the study, 258 presented periodontitis. Among the patients who presented periodontitis, 33 experienced Covid-19 complications, while only 7 of the 310 patients without periodontitis presented COVID‐19 complications

This study identified that the risk of COVID‐19 complications was significantly higher among patients with moderate‐to‐severe periodontitis compared to those with milder or no periodontitis.

Several hypothetical mechanisms may explain the strong associations observed between periodontitis and COVID‐19 severity. The oral cavity, and especially periodontal pockets could act as a viral reservoir and as a consequence the aspiration of periodontopathic bacteria might aggravate COVID‐19 virulence.

Gum disease is one of the most common chronic diseases in the world, although it being preventable and treatable. Multiple studies back the idea that by maintaining good oral health, specifically healthy gums, serious medical complications, from coronavirus included, can be reduced significantly.

Some of the signs of gum disease are bleeding when brushing or eating and bad breath. Since the symptoms are not painful, people tend to ignore them, leaving the disease untreated and increasing the risk of losing teeth and medical complications.

In order to prevent gum disease, it is very important to brush the teeth with a fluoride toothpaste at least twice a day, paying attention to clean along the gum line as well and flossing in between teeth.

Periodical visits to the dentist are important in assessing the teeth and gums condition and providing a professional clean.

For more information about gum disease, or if you are concerned about your oral health, please contact the practice.

Black line at the base of a crown

Why do I have a black line at the base of my crown?

Over time, after a crown is made, it is common to have black lines that form just at the base of the crown or visibly seen on the gums surrounding your crown. Typically, no pain is felt as this should only be a cosmetic problem.

If pain is present, it is recommended to see the dentist as soon as possible.

Whether it is an individual crown or a crown from a root canal treatment, the main causes of its unsightly appearance are:

  • Having a porcelain-fused to metal (PFM) crown made by your dentist. When your gums recede as time goes, it reveals the top metal part of your crown
  • Staining by the metal on your PFM crown where your gums touch the area with metal.
  • Cavity formation between your crown and gums.

 

Dr Kaufman will assess the cause of the problem and recommend an appropriate solution, which can be:

  • Replacing your old crown with a fully porcelain crown to get rid of the black lines and any stains that come along with it.
  • In the case of a cavity, it  be treated as soon as possible to prevent further complications.
  • Every treatment should be followed by proper dental hygiene at home and regular check up and  hygiene appointments at the dental practice.

Wisdom Teeth

WISDOM TEETH

WHAT ARE WISDOM TEETH? DO WE NEED TO REMOVE THEM?

Wisdom Teeth are located in the very back of our mouth and they are the last teeth to develop. They belong to a type of teeth called molars, which are wide and sturdy, fit for grinding food down.

While our molars erupt after we turn 6 years old, Wisdom Teeth erupt usually in the late teens or early 20’s.

There are four wisdom teeth: upper left, upper right, lower left, and lower right and they start their development at the age of 6-7 years of age when they can be seen on an x-ray. Since these teeth erupt after all the others, they may find that there is not enough room to erupt to, leading to their impaction. The reason there is not enough room for them to erupt stems from our evolution. Anthropologists believe wisdom teeth, usually called the third set of molars, were the evolutionary answer to our ancestor’s early diet of coarse, rough food – like leaves, roots, nuts and meats – which required more chewing power and resulted in excessive wear of the teeth. The modern diet consists in more processed and softer foods, causing the need for wisdom teeth to be non-existent. As a result, evolutionary biologists now classify wisdom teeth as vestigial organs, or body parts that have become functionless due to evolution.

Additionally, in our evolution the size of the our jaws has been decreasing, leaving at times not enough room for wisdom teeth to come through. The result is wisdom teeth that erupt in an angle, pushing into the gum or the tooth beside them. When a wisdom tooth is on an angle, it can’t help with chewing, which makes it useless and sometimes painful when bacteria manage to establish themselves around it and cause an abscess.

When a tooth erupts against another tooth, bone or soft tissue, it is called impaction. Impacted wisdom teeth can result in pain, damage to other teeth and other dental problems. Impacted wisdom teeth that cause pain or other dental complications are usually removed.

It is very important to check the wisdom teeth eruption development and their position at about the age of 15-16 years. This way we can evaluate the available space, if they are likely to cause problems and plan for the moment the teeth will be fully developed. An early assessment is key to avoid pain, discomfort or other dental complications.

In some cases, impacted wisdom teeth may cause no apparent or immediate problems. But because they’re hard to clean, they may be more vulnerable to tooth decay and gum disease than other teeth are. For that reason, Dr Kaufman may recommend removing impacted wisdom teeth that don’t cause symptoms in order to prevent future problems.

The wisdom teeth evaluation is part of our comprehensive periodical examination.

Dr Kaufman has much experience in the removal of wisdom teeth, done under local anaesthesia, nitrous oxide sedation, deep vein sedation and general anaesthesia.

In order to aid our patients during Wisdom Teeth extractions, Dr Kaufman has purchased the latest ultrasonic surgical system which is much efficient than the previously used drills. This modern system allows for the immediate removal of the wisdom teeth.

 

For more information about your wisdom teeth, please don’t hesitate to contact Dr Kaufman or to call Tooronga Family Dentistry

Good oral health can reduce the risk of COVID-19

While there is sparse data on COVID-19 due to its relatively recent emergence, the German Society of Dentistry and Oral Medicine (DGZMK), has “stressed the importance of dental prevention and the systemic relevance of dentistry , especially in times of the pandemic.”  They cites a number of recent studies that suggest good oral health can reduce the severity  of cases of COVID-19. Prof. Roland Frankenberger, president of the DGZMK stated: “In the context of the COVID-19 pandemic, dentistry has a particularly important role to play in keeping the oral cavity healthy. Dental prophylaxis strengthens the immunocompetence at the point of entry of the virus and helps to avoid infection or to mitigate its course.”
It is important to remember that a healthy oral cavity is a barrier against a wide range of diseases in normal circumstances and this remains true, notes Dr Frankenberger, in the case of COVID-19 which studies have suggested may take a more severe course where good oral hygiene has not been maintained.