The NobleDentist Blog

Our dentists have once again put together a paper to assist you. This time on Parkinson’s Disease.

New York University (Medicine Faculty) has made observations over 3 years on more than 100 people with Parkinson’s Disease. Findings suggest an urgent need for dental treatment for people with Parkinson’s Disease.

Dental Health Findings

• Dental cavities and the build up of dental plaque do increase. This is associated with the increase in gum inflammation, gum disease, tooth mobility, and pain. All of which are due to the diminishing ability to brush teeth and the reduction of hand-to-mouth mobility associated with Parkinson’s Disease.
• The fit of removable partial or complete dentures can be poor and usually there is a loss of bite stability (particularly when worn for a long time). The dentures generally have inappropriate chewing contacts when the upper and lower teeth bite against each other. This irregular bite loosens the fit of the dentures, can break both natural and artificial teeth, and often causes ulceration and pain in the supportive gum tissue.

Recommended Treatment

• Dental examinations at least twice a year to find and treat dental cavities, plaque accumulation, gum disease, ‘bad bite’, missing teeth, defective bridges and breakdown of restorations.
• Preventative care every 6 months or if necessary every 3 months. A dentist or dental hygienist should provide preventaive care and a home-care regime.
• Clear instructions and demonstrations of home oral hygiene are essential. This includes information about choice of toothpaste, tooth-brushing, dental flossing, mouth rinses and saliva control. There are electric toothbrushes and electronic devices available. These are all helpful for people with limited hand skills.


• It is important to have a care-giver (partner, child, aide, nurse) assume responsibility for oral hygiene on a daily and regular basis when people are in an advanced stage of Parkinson’s disease. The dentist should give thorough advice to this care-giver and follow up the care during professional clinic visits. The care-giver should also be instructed to wear gloves and told how to maintain an infection-free environment.


• It may be possible to arrange limited home dental care by a private dentist when unable to attend the dental practice.
• Dental care treatment options for people with Parkinson’s Disease should be aimed at maximising oral health and function. This will reduce the risk of requiring extensive maintenance as the person’s physical condition deteriorates and their oral hygiene and access to dental care become difficult. The care also includes cancer screening and review of other oral functions and their oral hygiene.

Quality of Life & Dental Care

It is critical for people with Parkinson’s Disease to consider dental issues relating to oral functions in order to have a better quality of life. These include the following:

• Swallowing disorders.
• Nutrition disorders.
• Language and communication disorders.
• Loss of self esteem.
• Impairment of job and vocational function.
• Impairment of social communication.

Swallowing Disorders

Swallowing difficulties may relate to any of the 3 stages of the swallowing process that takes place sequentially in 3 chambers.

Stage 1 – The Mouth

• The mouth and teeth compose the first chamber. The act of swallowing is initiated by the closure of the lips after chewing and preparation of food. When the lips close, the food is propelled backwards toward the throat by pressure of the tongue tip against the hard palate and the teeth. The food at this stage is at the person’s voluntary control. If the food particles are perceived as too large, the food can be chewed further. If the food is too dry, it can be moistened with either saliva or more fluid such as water or an artificial moistener fluid.
• It is during the first stage of swallowing that dental care can be most effective in assisting swallowing. If the lip and face muscles are weak because of the disease, or if food cannot be chewed adequately because teeth are missing, dental care can both strengthen the lip action and restore chewing efficiency so that food particles can be prepared for swallowing.
• Another factor in swallowing difficulty is pain caused by inflamed dental pulp and gum tissues. Pain caused by pressure on the teeth or by hot or cold foods can cause difficulties in swallowing. The dentist can always relieve pain caused by gum inflammation, decayed teeth, faulty fillings, crowns, dental bridges or removable dentures.
• The final consideration in the mouth and facial part of the swallowing process is the stability of the bite when the opposing teeth close together during chewing. This preparation for swallowing is all voluntary and usually dependent on intact teeth, or their replacement, to be most effective. When teeth are missing or faulty, the tongue becomes a more dominant swallowing agent. In these cases the tongue braces the jaws for swallowing by being pushed between the opposing jaws. This abnormal swallowing pattern requires a more fluid and softer diet.

Stage 2 – The Pharyngeal Chamber

• When food is passed into the throat, the lower jaw must be fixed in position (stabilised) so the floor of the mouth can be elevated. This allows the laryngeal valve (vocal folds) to be closed, preventing food from being aspirated into the lungs. Associated with the elevation or tucking forward of the larynx is the control over head posture.
• It is advisable for people with Parkinson’s Disease to sit upright when eating so that gravity does not cause food to pass into the pharynx before one is ready to initiate the second phase of swallowing. People should not eat or drink lying on their backs. If people are bedridden, they should drink lying on their sides with the head elevated as high as possible.
• Another factor is that it is normal to swallow up to 2,000 times a day, which makes it a full-time activity during the waking day. Since many people with Parkinson’s Disease salivate excessively, they should sit forward when watching TV for a long period of time. A pillow behind the back to move the trunk forward when they have to swallow usually facilitates this function. Aspiration of saliva into the larynx and lungs can cause coughing spasms which sometimes are very debilitating. It is also advisable not to speak when chewing or swallowing, since doing several things at once is difficult for people with Parkinson’s Disease.
• The second phase of swallowing is under only partial voluntary control, so the precautions about type of fluid, body posture and healthy teeth are essential for effective swallowing.

Stage 3 – The Oesophagus

• In this stage food passes from the oesophagus to the stomach; the third stage of swallowing relates to the oesophagus and its upper valve, from pharynx to oesophagus, and the lower valve from the oesophagus to the stomach. When these valves don’t function properly, reflux or regurgitation of gastric fluid can cause heartburn.
• Difficulty with this part of swallowing is a medical problem and should be investigated by a physician or speech pathologist. Some hospitals have a swallowing clinic to assist people with the second and third phase of swallowing disorders.

Summary

Healthy teeth and gums and controlled posture can provide an effective swallowing function for people with swallowing disorders. Sometimes a speech pathologist trained in oral and dental aspects of swallowing co-operates with the dentist to improve and maintain effective swallowing.

Nutrition Disorders

Nutritional deficiency may occur with progressive loss of motor skills and diminished dental health care in people with Parkinson’s Disease.

As Parkinson’s Disease progresses, or if the teeth are defective, food intake may become a problem. People may no longer be able to eat the foods they prefer. Since protein and other dietary requirements are altered as the disease progresses, it is essential that dental health be considered a major factor in nutritional management for people with Parkinson’s Disease. Their physician and dietitian should inquire into their dental health status and make the appropriate referral to their own dentist. If they do not feel experienced enough about treating people with movement disorders like Parkinson’s Disease, they may contact the Australian Dental Association.

Speech and Language Disorders

Speech impairment often accompanies Parkinson’s Disease. It has been estimated that 70 per cent of people with Parkinson’s Disease show signs of speech impairment but that only 5 per cent receive speech therapy. One of the main contributing factors to speech problems is poor dental health, especially loose teeth, missing teeth and defective dentures.

The teeth are the principal skeletal support for the pronunciation of many consonant sounds (e.g. labials like F and V, lingual dental sounds like T, D, R and L, and continuant sounds like S, Th and Ch). When the anterior teeth are missing or defective, the absence or distortion of these consonants causes speech to be less intelligible. In people with Parkinson’s Disease whose muscle movements are unco-ordinated, the speech may be totally incoherent.

When dentures are ill-fitting, their looseness distorts not only the consonants but also the vowel sounds, making the person fearful of speaking. This looseness and anxiety magnifies the speech difficulty. People with Parkinson’s Disease often reduce their breathing energy and their speech becomes inaudible. Appropriate bite allows more effective diaphragmatic breathing to give a supportive breath stream for speech. Furthermore, when dentures are loose many people with Parkinson’s Disease who salivate excessively cannot swallow their saliva effectively, and either drool or spray their saliva when attempting to talk.

Faulty breathing patterns also prevent a long enough stream of air to be exhaled when a person is speaking. The breathing patterns have to be co-ordinated with an appropriate head and jaw posture for speech. A dentist can check the bite to see if it prevents or assists in proper air exhalation and inspiration for speech.

Faulty tooth alignments and gross irregularity of bite between the upper and lower jaws cause poor lip approximation to produce faulty labial sounds like P and B.

Associated with lip difficulties in speech is the distortion of lip form which causes excessive creasing and folding of the muscles around the mouth and lips. Routine dental examination, tooth replacement, denture repairs and properly restored teeth will improve speech.

Loss of Self Esteem

The impairment of speech, coupled with changes in facial contour and salivary drool, often undermines the self-esteem and self-image of people with Parkinson’s Disease. They often choose to eat alone and thereby avoid embarrassment. One of the more critical aspects is the effect on their psychosexual feelings. They often feel their general disability makes them less desirable as a connubial partner. This feeling of inadequacy is heightened where the face and lips are distorted, and when the teeth are decayed or filled with plaque and gums bleed easily. Appropriate and sustained dental care and prophylaxis may alleviate the stress on their libido and sex drive.

Job and Vocational Status

Many people with Parkinson’s Disease are still employed in a wide variety of vocations. Often their ability to continue gainful employment depends on their oral and facial appearance and their ability to communicate. Dental care to improve their appearance and speech and diminish salivary drool may be a critical factor in continued employment. A dentist, often in co-operation with other professional associates, can solve these problems.

Socialisation and Community Activity

People with Parkinson’s Disease often become dependent on their care-givers. They tend to withdraw, eat alone and become socially isolated. Caring for their facial and oral needs often facilitates and/or improves socialisation. Improving the arrangement of teeth, cleaning the gums of plaque and stains and replacing missing teeth and dentures give people more confidence to socialise and to be a part of community activity.

Summary

People in all stages of Parkinson’s Disease can play an active role in maintaining or improving their oral and dental health. The following points are very important.

• Regular oral hygiene by a dentist or hygienist at least every 6 months.
• Regular periodic dental examination at least every 6 to 12 months if oral hygiene is maintained.
• Use of special-handle toothbrushes to facilitate hand grasp.
• Training in home care for care-givers in advanced cases.
• Monitoring of changes in oral function such as changes in speech, swallowing or nutritional habits.
• Home care, if necessary, for both emergency and routine care for home-bound people may also be available.

Choosing a Dentist

Keep in mind that many dentists are not equipped professionally or psychologically to treat people with moderate to severe Parkinson’s Disease. If you do require assistance, you could contact the Australian Dental Association. They may be able to identify a dentist in your area that could assist you.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Conscious Sedation.

What is conscious sedation?

Conscious sedation is a very safe, very efficient and very effective way of providing anxiety relief and pain control during dental procedures. There are 2 groups of patients who benefit from this technique:

• Patients undergoing relatively unpleasant or lengthy procedures such as removal of wisdom teeth or other complex procedures.


• Patients who fear most forms of dental treatment and who often avoid going to the dentist.

The drugs we use in sedation are given intravenously – usually into a vein on the forearm or the back of the hand. The injection may cause mild discomfort. These drugs are the same or similar to drugs used in general anaesthesia but given at a slower rate and/or in smaller doses.

As the name implies, conscious sedation is not a general anaesthesia. The aim of conscious sedation is to reach a state of calm relaxation and drowsiness, so that you:

• know very little of what is going on;


• do not care about what is going on; and


• remember very little, if anything, of what goes on.

With conscious sedation, time seems to pass very quickly and before you know it the procedure is completed and it is time to go home.

Other options?

• Conscious sedation is not a replacement for good basic dental care – it simply provides a means of making some procedures less of an ordeal.


• Conscious sedation is not usually for children.


• Hospitalisation and general anaesthesia is also a very safe treatment option. However, with the simplicity of conscious sedation and the excellent drugs we have available today, it is only on rare occasions that we recommend this option for fit, healthy adolescents and adults.

How safe is conscious sedation?

• Modern methods of sedation are low risk and very safe.


• Throughout the procedure you are under the care of 2 clinicians. The first provides the actual dental/surgical treatment. The other (i.e. the sedationist) is fully involved with administering the sedation and monitoring your breathing, blood pressure, heart rate and rhythm, and oxygen saturation with the aid of specialised monitoring devices.

What after effect should I anticipate?

• You will be drowsy for several hours after having conscious sedation. It is therefore important that you follow the postoperative instructions given to you.


• Postoperative nausea and/or vomiting are rare but can occur. If such symptoms persist the day after the procedure, you should contact the dental centre for further advice.


• Tenderness or bruising around the intravenous injection site is also rare. If it does occur, it will normally resolve within a few days.

Does conscious sedation always work? Will I be aware of/remember what is occurring?

• As alluded to above, conscious sedation is not general anaesthesia. You may hear us talking and be vaguely aware that something is being done – but it won’t worry you.


• On very rare occasions a patient may not respond to the drugs/dosage that we use in conscious sedation. On these rare occasions it may be necessary to stop the procedure and resort to alternative treatment methods.


• The most important thing for you to do on the day of your operation is to arrive relaxed, confident and trusting your dentist.

Preoperative Instructions
(Failure to comply with these instructions may result in the cancellation of your procedure)

• Limited solid food may be taken up to 6 hours prior to your procedure. If your appointment is not until the afternoon, you may have light breakfast – but this must be at least 6 hours prior to your appointment.


• Routine medications (e.g. blood pressure tablets) are to be taken as normal but with just a sip of water.


• Otherwise only medications ordered by the sedationist may be taken less than 24 hours prior to your procedure.


• Smoking affects your blood’s ability to transport oxygen. Therefore, to ensure you are in the best physical state to undergo sedation, smoking should be ceased at least one week prior to the procedure.


• As a bare minimum, smoking should cease or be significantly reduced at least 24 hours before your procedure.


• For your own comfort and to allow us to readily attach our monitors, please wear loose fitting clothes. We ask that you wear short sleeves and either long pants or shorts.


• Veins are sometimes harder to find in cold weather – please wear warm clothes if it is cold.


• As our monitoring equipment is very sensitive and subject to interference, please refrain from wearing neck and wrist jewellery/watches and please remove finger nail polish.


• Contact lenses should not be worn.


• You will be unable to drive following your procedure.


• You will need to arrange suitable transport home.


• A responsible adult who can take you home must accompany you.


• To help minimise the risk of postoperative infection, please brush your teeth thoroughly before coming to the dental centre.


• Remember to rinse only – do not swallow the water.


• Upon your arrival, you will be asked to sign a consent form for conscious sedation, confirming that you understood and complied with the preoperative instructions.


• During the procedure, you may be given some fluids intravenously. For your personal comfort in the immediate postoperative period it is recommended that you use the toilet immediately prior to coming through for your procedure.

Postoperative Instructions

It is important that both you and the person accompanying you understand that for at least 12 hours following your conscious sedation:

• No alcohol may be consumed.


• Your concentration and memory will be poor. You should therefore avoid potentially dangerous activities such as driving, operating machinery, climbing ladders, or crossing roads unescorted.


• Avoid making important decisions or commitments.

Please remember to relax and enjoy yourself during the procedure. Be secure in the knowledge that the dentists will be looking after you whilst providing high quality dental treatment.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Bad Breath.

Overview

Bad breath is an awful condition that can cause us to feel self conscious when talking with others. So serious is this condition that it can create social and psychological impediments which affect our relationships. Many sufferers of bad breath are unaware. Others rely on items such as mints and mouthwashes that only assist temporarily.

Thankfully bad breath can in some cases be improved with proper oral hygiene. It is recommended that you visit a dentist in the event that proper oral hygiene does not provide an adequate solution. A dentist can ascertain the cause of your bad breath and advise you on a course of action to end the bad breath. You should comforted by the high rate of success achieved by dentists in managing or eliminating bad breath.

Do I suffer from bad breath?

It is very difficult to tell on your own. Efforts to yield results by cupping your hands over your mouth and smelling your own breath will be ineffective. The most effective method used to determine whether you have bad breath is to ask someone as bad breath becomes apparent when we are talking.

What causes bad breath?

There are several causes of bad breath.

1. Food is the most well known cause of bad breath. Bad breath can be a result of foods containing particular oils such as onions and garlic. Other foods including some vegetables and spices can contribute to bad breath. Another source of bad breath arises when food left in your mouth that is caught between your teeth or stuck to your teeth begins to breakdown.

2. A lack of dental hygiene can be a reason for bad breath. Food particles left within your mouth will emit an odor in the event you do not brush and floss effectively. Plaque will form on your teeth and fill pockets between your teeth affecting your gums. The result will be gum disease and bad breath. It is imperative that proper dental hygiene is maintained.

3. A dry mouth can result in bad breath. This is because dead cells congregating on your tongue, gums and cheeks breakdown and emit an odor. Most people would be familiar with this occurrence as it is the reason for having bad breath when we awake in the morning. Dry mouth can be made worse as a result of smoking, issues with your salivary glands and various medications.

4. Smoking will adversely affect your breath. Smoking dries the mouth resulting in bad breath. Gum disease which causes bad breath is also more prevalent in smokers.

5. Dieting can also be a source of bad breath. The breakdown of body chemicals during dieting can result in bad breath. This bad breath is sometimes described as smelling ‘fruity’.

6. Bad breath can be associated with certain illnesses and conditions. These include diabetes, kidney failure, chronic lung infections and lung abscesses, and chronic reflux of stomach acids from your stomach. Hiatal hernia can also be a source of bad breath.

7. Sinus infections can also result in bad breath. This is because a nasal discharge from your sinuses into the back of your throat can cause bad breath. A throat infection such as tonsillitis, strep throat and mononucleosis can also be the reason for bad breath. Other culprits include some upper respiratory infections and bronchitis due to the coughing up of odorous sputum. Canker sores when in the company of gum disease can also be a source of bad breath.

What can be done about bad breath?

Maintaining good oral hygiene is a critical factor in preventing bad breath. You should brush twice a day using fluoride toothpaste. And clean between your teeth daily with dental floss ensuring to also brush your tongue. Refrain from wearing your dentures at night and clean them well before replacing them the following morning.

Visits to the dentist for a check-up will ensure any issues that cause bad breath may be detected and treated. It is also advisable to receive regular dental cleanings.

How do I find a dentist who treats bad breath?

Identifying the source of your bad breath can be done by a visit to the dentist. A treatment plan can then be developed to manage or eliminate your unpleasant breath.

How is bad breath treated?

Bad breath is generally caused by a problem within the mouth so it is very likely that a dentist can assist you with your problem. It is advisable not to disguise your bad breath when visiting a dentist. This way the dentist can assess the full extent of the problem.

Your dentist will first ascertain whether the source of your bad breath is within your mouth and then propose a treatment plan. You may be referred to a periodontist in the event that you are suffering from gum disease. It may be necessary to visit other health professionals if no oral cause can be identified by the dentist.

How can I help myself?

1. Brush your teeth after you eat. Keep a toothbrush at work to brush after eating.

2. Brush your teeth with a soft-bristled toothbrush and change your toothbrush every three to four months.

3. Brush your tongue. This will remove dead cells, bacteria and food debris. Use a soft-bristled toothbrush and brush your tongue with at least 5 to 15 strokes.

4. Floss at least once a day. This will remove food particles and plaque from between your teeth.

5. Use a mouthwash recommended by your dentist or pharmacist before going to sleep.

6. Consume plenty of water to keep your mouth moist. Chewing sugarless gum or sucking on sugarless candy also stimulates saliva which washes away food particles and bacteria. Resist coffee, soft drinks or alcohol.

7. Clean your bridge or denture thoroughly at least once a day or as directed by your dentist.

8. Visit your dentist at least twice a year to have your teeth or dentures examined and cleaned.

Will mouthwash help with bad breath?

Mouthwashes are only a temporary measure in the fight against bad breath. The alcohol contained in mouthwash dries your mouth which will leads to bad breath. The ideal time to use mouthwash is when going to sleep as the bacteria in your mouth that causes bad breath will be eliminated while you sleep. Your dentist or pharmacist should be able to recommend a suitable mouthwash.

Will sugarless gum help with bad breath?

Bad breath can be assisted by chewing sugarless gum as it encourages saliva flow. Sulfur particles that cause bad breath are dissolved by saliva. Saliva also cleanses the teeth of bacteria and food particles.

Can talking a lot during the day cause bad breath?

Talking excessively can dry your mouth and stimulate bacteria that causes bad breath. The solution is to drink water consistently or place a drop of lemon on your tongue. This will keep you mouth moist and encourage the flow of saliva.

Can my menstrual period cause bad breath?

Women may experience bad breath during their menstrual cycle. The gums become more accommodating for bacteria causing bad breath during this time. Capillaries running through the gums sometimes burst releasing a little blood into the gums. An unpleasant odor is produced as a result of bacteria feeding on this blood.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Dental Phobia.

What is dental phobia?

A fear or anxiety associated with visiting a dentist is often referred to as dental phobia. Dental phobia is often the reason people avoid regular check-ups with a dentist. This naturally has serious consequences for the state of oral health and general well-being for many people.

Neglecting your oral health can have numerous unfavorable effects. One of these could be chronically infected gums which can seriously compromise your ability to chew and digest. You may even lose teeth. Your speech may then be affected. You may also develop consistent bad breath and an unattractive smile. All these things are likely to create social and psychological barriers in your relationships. It is also well documented that poor oral health can have resounding effects on your general health. It is for this reasons and many more that dental phobia must be addressed.

Are you affected by dental phobia?

The questions below will give you some idea as to whether you suffer from dental phobia. It is advisable to continue reading in the event that you answer yes to any of the questions. You should feel encouraged that there are many ways to combat dental phobia and the success rate in managing dental phobia is significantly high.

• Do you recall a previous visit to the dentist that was unpleasant?
• Are you concerned that you will be embarrassed as a result of remarks the dentist will make due to the state of your oral health?
• Do you avoid your appointment with the dentist due to an uneasy feeling prior to your dental visit?
• Do you feel anxious while in the waiting area of the dental practice?
• Do you have feelings of uneasiness or tension whilst in the dental chair?
• Does the sight of dental instruments invoke unpleasant feelings?
• Do you feel ill or anxiety at the thought of an injection?
• Do objects placed in your mouth during the dental visit make you panic and feel like you can not breathe correctly?
• Do you feel that your dentist is unsympathetic only with you?

Why are you affected by dental phobia?

Dental phobia can come about for many different reasons. Below is a list of those reasons described most often by people. You may be familiar with some of these.

• A previously unpleasant visit to a dental practice. This could be for many reasons including careless remarks made to you by a dentist or hygienist that adversely affected your dental experience.
• You have heard concerning stories from friends and family regarding visits to the dentist.
• You have seen or read sensationalized and frightening depictions in the media of dentists.
• You feel a lack of control in the dental chair that makes the situation uncomfortable.
• You feel very self conscious about the poor state of your teeth and as a result are embarrassed to highlight the fact with dental staff.
• You have a negative feeling at the thought of visiting a dentist due to their use of dental gowns, masks, and latex gloves.

How do you put an end to your dental phobia?

1. Dental fear can be overcome.

Understanding that dental phobia can be overcome is a good beginning. You are not destined to suffer from dental phobia for your entire life. The fear you associate with visiting the dentist can be unlearned. Keep in mind when visiting the dentist that you are not simply a set of teeth but a person. A concerted effort to make use of techniques discussed below can put your fear to rest.

2. A suitable dentist.

It is essential to have a dentist and staff that are suitable. Your visit to the dentist can be pleasant with a dentist who is sympathetic towards your dental phobia. Dentists genuinely concerned about your welfare will listen carefully to your needs and proceed accordingly. You should not hesitate to seek out an alternative dentist in the event that this is not the case.

3. Be honest with your dentist.

There are many treatment options that people do not know about. Several of these could assist you greatly. Try to put aside any embarrassment you feel for the current state of your oral health. Your dentist will be able to help you to a greater degree if you communicate openly and honestly about your concerns.

4. Good communication.

Effective communication between you and your dentist can go a long way to making you feel comfortable. You could eliminate the fear of the unknown by communicating to your dentist such pieces of information as lengths of appointments that you can tolerate. Establishing a signaling system to indicate the need for a break or some other message can also give you confidence. Raising a hand while in the dental chair is a commonly used hand signal.

5. Knowledge.

Obtaining knowledge about prospective dental procedures can put to rest any anxiety. Information regarding dental procedures is readily available in brochures in the practice, books and the internet. Any remaining questions can be answered by your dentist. Your dentist is well aware of the seriousness of dental phobia. So do not hesitate to take part in decisions relating to your treatment plan.

6. Relaxation techniques.

Learning to relax when visiting the dentist is imperative. Various physical relaxation techniques can put your mind at ease. It may do you some good to look into books on diaphragmatic breathing, progressive muscle relaxation, or yoga.

7. Distraction techniques.

Distraction techniques can assist you to make dental visits more tolerable. One common method used for distraction is to listen to music while your dentist works. Some dental practices keep on hand Walkmans or Discmans. Keep in mind not to hinder your communication when making use of distraction techniques.

8. Predictable pain control.

Local anesthetics can be utilized to prevent pain. Some people though require more customized techniques in order to attain proper local anesthesia. It is therefore important that your dentist be made aware of your situation.

Nitrous oxide, otherwise known as ‘laughing gas’, can relieve pain. Several oral medications can also assist you with dental phobia. Medication such as valium can make you feel considerably relaxed throughout any dental procedure.

A discussion with your dentist could help you to identify a suitable option.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Cosmetic Dentistry.

Are you happy with your smile?

A smile is a person’s most prominent facial feature. It is an important part of a first impression and often remembered long after you have left the room. There are, however, people that try to hide their smile. This is due largely to imperfections with their teeth. You no longer have to settle for stained, chipped, missing or misshapen teeth. Advances in dentistry have come up with answers to these problems. You now have choices that will help you smile with confidence.

Importance of your smile

A recent American study has found that teeth are the number one facial feature that people would change. 75% of adults think that a nice smile is important to career success. 84% think that an attractive smile is important for meeting Mister or Miss Right.

The study was conducted on a representative sample of 1000 American adults both men and women between 18 and 50 years of age. The poll explored the importance of smiles in relation to business and careers, dating and marriage, the social arena, and the overall value of smiles and self-esteem.

Smiles and the Social Arena

94% of those polled said they are likely to notice a person’s smile when they meet them for the first time. People are less likely to notice someone’s height, eyes or figure. More than one half (71%) believe people with a nice smile make friends more easily. Over one third agree that bad teeth overshadow the rest of a person’s appearance. An overwhelming majority of adults (85%) consider a person’s smile to be very important when meeting someone for the first time.

Smiles and Self Esteem

Almost two-thirds (64%) agree that people with a nice smile are more outgoing. 77% think that having discoloured teeth as an adult makes a person feel self conscious. 87% think a person’s smile is very important to their self esteem. When asked which facial characteristic they would change if they could, one in four adults (25%) would change their teeth/smile. Smaller proportions would change their skin (17%) or nose (13%).

Smiles and Relationships

84% of adults perceive having an attractive smile as important for getting a date with Mister or Miss Right. Over one-third would not be likely to set up their best friend on a blind date with someone with bad teeth. One-third would not be likely to kiss someone with bad teeth. An overwhelming majority of adults (85%) consider a person’s smile to be very or somewhat important when meeting someone for the first time. Almost 9 out of 10 (86%) think people with good teeth are more attractive.

Improve your smile

Even the most subtle change in your smile can make a dramatic difference in the way you look and feel about yourself. Our Brisbane cosmetic dentists can help you show off a bright and wonderful smile using various cosmetic dentistry procedures. Such cosmetic procedures include the use of white fillings, teeth whitening, dental bonding, dental crowns and dental veneers. Our Brisbane cosmetic dentists have helped many individuals gain an attractive smile they have always wanted. We could do the same for you.

White Fillings

1. Are white fillings for you?

If you have a cavity in a tooth, broken fillings, mercury fillings, or amalgam fillings, this type of dental filling is well worth discussing with our Brisbane cosmetic dentists. Mercury fillings or amalgam fillings can be easily removed and replaced with tooth coloured fillings. These fillings actually strengthen your tooth beyond the level it had with the amalgam fillings. Composite resins may also be used to enhance the appearance of any tooth.

2. How white fillings will benefit you?

• They look better and are colour blended to match your natural tooth colour.
• The white fillings add further support to the remaining tooth structure which helps prevent breakage and damage to your tooth.
• Studies and tests show that the allergy potential is reduced considerably with white fillings.
• The modern composition provides white fillings with high stress resistance. Tests confirm that the fillings are more dimensionally stable and more abrasion-proof under chewing stress.
• White fillings last about 6 to 12 years.
• The procedure usually takes only one visit to your dentist.

3. What are composite resin fillings (white fillings)?

Many people have amalgam fillings (silver) or gold filling restorations. Metal fillings are effective but very noticeable and tend to blacken in colour over time. Composite resin fillings were created as an alternative to traditional metal fillings. Composite resin fillings are tooth fillings coloured to look like a natural tooth. Composite resin fillings are strong, durable, and make for a very natural looking smile.

4. How much do composite resin fillings (white fillings) cost?

Composite Resin Fillings (white fillings) – Usual Fees $100-$330 – NobleHealth $80-$160

Joining NobleHealth for 24 months is a total of only $99.95 for an individual or a total of only $149.95 for couples & families.

Teeth Whitening

1. Is teeth whitening for you?

If you drink coffee, tea or red wine, smoke, enjoy curry then teeth whitening is well worth discussing with our Brisbane cosmetic dentists. Whitening of the teeth is performed for you if you desire a brighter smile. Teeth whitening can be performed to reduce discolouration and staining or simply to provide you with whiter, brighter teeth.

2. The benefits for you?

• You will feel more confident especially when talking with others.
• A whiter smile will give you a more youthful and energetic appearance.
• Whiter teeth are associated with beauty and a healthier lifestyle.
• You will smile more often and be less self-conscious with a brighter smile.
• A whiter smile gives you a friendlier appearance.

3. What is teeth whitening?

Teeth whitening is a bleaching process that lightens discolorations and removes stains from the enamel of your teeth. The ‘Custom Trays’ teeth whitening is a straightforward and painless procedure.

4. How the procedure is performed?

Custom made bleaching trays are made from impressions taken of your teeth. These custom made bleaching trays are designed to fit over your teeth. You then place the bleaching gel solution in the trays and it works to remove stains and discoloration from your teeth. The trays can be worn while you sleep. An improvement in the appearance of your teeth is often noticeable after only a few days. Your dentist will help you decide on the duration and intensity of treatment best suited to your needs.

5. How long does teeth whitening last?

Lightness should last from 1 to 5 years. This will depend on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch up. This procedure may not be as costly because you can probably still use the same custom made trays. Re-treatment time is also much shorter than the original treatment time.

6. How much does teeth whitening (‘Custom Trays’) cost?

Teeth Whitening (Take Home) – Usual Fees $475-$575 – NobleHealth $350

Health insurance does NOT typically cover the cost of the teeth whitening procedures.

Joining NobleHealth for 24 months is only $99.95 for an individual or only $149.95 for couples & families.

Dental Bonding

1. Is dental bonding for you?

If you have small gaps between your front teeth, chipped or cracked teeth, crooked teeth, discolored teeth, uneven teeth, gum recession or tooth decay then it may be well worth discussing dental bonding with our Brisbane cosmetic dentists.

2. How dental bonding benefits you?

• Composites will match the color of your other teeth.
• Composites permit your dentist to remove only the decayed area of your tooth.
• Composite bonding is less likely to cause cracks in your tooth unlike silver fillings.
• Composites bond directly to the tooth providing support.
• Composites can be used to fill in cracks, chips and gaps.

3. What is dental bonding?

Bonding is a procedure in which composite resin is applied to the front surface of a tooth. Composites are the solution for restoring decayed teeth. It can whiten stained teeth, lengthen short or chipped teeth, close minor gaps between teeth and can be used to correct crooked teeth. This method works well with brownish or greyish-tinged teeth which do not always respond to bleaching.

4. How the procedure is performed?

The dentist applies phosphoric acid to the tooth to remove the shine of the enamel. This step is necessary in order for the resin to stick to the tooth. Next, the dentist applies the resin to the tooth. Your dentist sculpts, colors and shapes it to provide a pleasing result. The dentist then flashes a high-intensity light which hardens the resin and the surface is finely polished.

5. How long does dental bonding last?

Dental bonding lasts about five to ten years. At that time, the process may have to be repeated as plaque and other stains may have caused the tooth to lose its shine.

6. How much does dental bonding cost?

Dental Bonding (per tooth) – Usual Fees $300-$395 – NobleHealth $195

Health insurance does NOT typically cover the costs of dental bonding procedures.

Joining NobleHealth for 24 months is only $99.95 for an individual or only $149.95 for couples & families.

Dental Crowns

1. Are dental crowns for you?

If you grind your teeth, have an improper bite, aging teeth, poor chewing patterns, fillings and tooth decay then it may be well worth discussing dental crowns with our Brisbane cosmetic dentists as these can all be contributing factors in the wearing down, cracking or breakage of your teeth. Crowns are a cover or cap that is fitted on your affected tooth to improve its strength, durability and appearance. Crowns are also used to replace a missing tooth.

2. How dental crowns benefit you?

• Dental crowns can dramatically improve the appearance of your teeth.
• Crowns in general add strength to weakened or worn teeth.
• Crowns can replace missing teeth.
• Provides support to misshapen teeth or badly broken teeth.
• Fixes major “smile” and functional chewing problems.
• Looks completely natural. Porcelain crowns or new reinforced resin are considered to be the most aesthetically pleasing as it is easily matched in colour to the surrounding teeth.

3. What are dental crowns?

A dental crown, also known as dental caps, is an artificial material used to replace large parts of a tooth or a whole tooth that has been fractured or decayed. Crowns fit over and cover the outside of teeth starting at the gum line. They are usually made of gold, porcelain or a combination of both.

4. How the procedure is performed?

The “capping” procedure takes place under anaesthetic. As the crown is about two millimetres thick, the dentist first shaves this same amount off your existing tooth to avoid awkward-looking, oversized teeth. The dentist will also re-shape your tooth into a form upon which a cap can easily sit. The dentist will then make a replica of your tooth. Usually, this replica will be a putty mold. This mold is then sent to a laboratory where the crown will be made based on this mold. In the case of a porcelain crown, the dentist will choose a shade close to the colour of the surrounding teeth. You will return about two weeks later to have the crown fitted and once both you and your dentist are satisfied with the “look and feel” of the crown, it will be cemented over your original tooth.

5. How much do dental crowns cost?

Metallic Crown – Usual Fees $1000-$1345 – NobleHealth $800
Metallic & Ceramic Crown – Usual Fees $1100-$1450 – NobleHealth $900
Ceramic Crown – Usual Fees $1400-$1650 – NobleHealth $1050

Health insurance does NOT typically cover the costs of dental crown procedures.

Joining NobleHealth for 24 months is only $99.95 for an individual or only $149.95 for couples & families.

Tooth Veneers

1. Are tooth veneers for you?

If you have teeth that are too small, too big, or have uneven surfaces then it may be well worth discussing tooth veneers with our Brisbane cosmetic dentists. It is very common for people to have imperfect teeth. This includes oddly shaped teeth, chipped teeth, crooked teeth, teeth with small holes in them, an inappropriate sized tooth or unwanted or uneven spaces. Veneers solve such irregularities and create a durable and pleasing smile.

2. How tooth veneers benefit you?

• You can have the smile of your dreams in a very short period of time with porcelain veneers.
• Typically veneers are difficult to stain making veneers a very popular solution for many people seeking that perfect smile.
• Strong and very durable, veneers last from 10 to 15 years, and come in colours that will brighten dark teeth without ever changing colour.
• Veneers are typically done in only two one and a half hour long appointments and can actually strengthen your teeth.
• There is no additional maintenance other than a follow-up visit to your dentist and proper brushing and flossing on a daily basis.
• A whiter smile gives you confidence and a friendlier appearance.

3. What are tooth veneers?

Porcelain veneers are thin, shell-like slices of ceramic bonded to the front of the teeth. They are used to cover gaps, to reshape chipped teeth or whiten stained teeth. They are also one of the most natural-looking and long-lasting whitening options available.

4. How the procedure is performed?

The application of porcelain veneers requires 3 trips to your dentist. You firstly visit your dentist for a diagnosis and treatment-planning session. This is when you and your dentist will discuss your specific needs. Next, return for a preparation session. This time, your dentist will buff about half a millimetre off your teeth to create room for the veneer. The dentist will also create a mold of your teeth and send it to a laboratory. Within two weeks, the laboratory will send back the veneers based on this mold.

You return for the bonding session. Your dentist will first give you a “trial fitting” of your veneers. The dentist will use water or glycerine to attach them to your teeth. This fitting is your chance to comment on the fit and colour of the veneers and to request any final changes or adjustments. Once you are satisfied with the look of the veneers, your dentist will clean your teeth with bond-aiding chemicals and cement the veneers to your teeth. Finally, the dentist will flash a high-intensity light on the veneers to speed up the hardening of the cement.

5. How long do tooth veneers last?

Porcelain veneers are strong and very durable lasting from 10 to 15 years.

6. How much do tooth veneers cost?

Porcelain Veneers (per tooth) – Usual Fees $800-$1125 – NobleHealth $630

Health insurance does NOT typically cover the cost of tooth veneers.

Joining NobleHealth for 24 months is only $99.95 for an individual or only $149.95 for couples & families.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Dentures.

Overview

Dentures can replace your missing teeth and your smile. This may be required in the event that you have lost your natural teeth from gum disease, tooth decay or injury.

Replacing missing teeth will benefit your appearance and your health. Facial muscles sag without support from a denture which makes a person look older. You will also be able to eat and speak, things that people often take for granted until they have lost their natural teeth.

What is a denture?

A denture is an appliance which is worn to replace lost or missing teeth. The base of a denture is called a plate and can be made of either acrylic (plastic) or metal. The teeth are normally made of acrylic and can be made to match your natural teeth. A complete or full denture is one which replaces all of the natural teeth in either the upper or lower jaws. A partial denture fills in the spaces created by lost or missing teeth and is attached to your natural teeth with metal clasps or devices called precision attachments.

Who needs a denture?

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

Why bother with dentures?

Replacing lost or missing teeth has substantial benefits for your health and appearance. A complete or full denture replaces the natural teeth and provides support for cheeks and lips. Without this support, sagging facial muscles can make a person appear older and reduce their ability to eat and speak.

What is the difference between conventional and immediate dentures?

Conventional dentures are made and inserted after teeth have been removed and the tissues have healed. Healing may take several months.

Immediate Dentures are inserted immediately after teeth have been removed. To do this, our participating dentists take measurements and impressions of your mouth during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bone and gums can shrink over time, especially during the first six months after teeth have been removed. When gums shrink, immediate dentures may require relining or even replacing to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.

What is an overdenture?

An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture. Our participating dentists can determine if an overdenture would be suitable for you.

What will dentures feel like?

New dentures may feel awkward or even uncomfortable for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place. Should this continue, consult our participating dentists.

It is not unusual to experience minor irritation or soreness during this period. You may also find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should diminish. If any problems persist, particularly irritation or soreness, be sure to consult our participating dentists.

Will dentures make me look different?

Dentures can be made to closely resemble your natural teeth so that little change in appearance will be noticeable. Modern dentures may even improve the look of your smile and help fill out the appearance of your face and profile.

Will I be able to eat with dentures?

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the denture from moving. As you become more used to your denture, add other foods until you return to your normal diet. Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Will dentures change how I speak?

Pronouncing certain words may require practice. Reading out loud and repeating difficult words will help. If you find that your dentures occasionally slip when you laugh, cough or smile, reposition the denture by gently biting down and swallowing. If this continues consult our participating dentists.

How long should I wear my dentures?

During the first few days, you may be advised to wear them for most of the time, including while you are asleep. After an initial period of adjustment our participating dentists may advise that you remove them before going to bed. This allows your gums to rest and helps promote oral health. It is not desirable that the tissues be constantly covered by denture material.

Should a denture be worn at night?

While you may be advised to wear your denture almost constantly during the first two weeks including while you sleep, under normal circumstances it is considered best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.

Should I use a denture adhesive?

Denture adhesive can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture which causes constant irritation over a long period may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose or cause pronounced discomfort, consult with our participating dentists immediately.

How do I take care of my dentures?

The general rule is brush, soak, and brush. Always clean your dentures over a bowl of water or a folded towel in case you drop them. Brush your dentures before soaking to help remove any food debris. The use of an effervescent denture cleaner will help remove stubborn stains and leave your denture feeling fresher – always follow the manufacturers’ instructions – then brush the dentures again, as you would your own teeth, being careful not to scrub too hard as this may cause grooves in the surface.

Most dentists advise using a small to medium headed toothbrush and toothpaste. Make sure you clean all the surfaces of the dentures including the surface which comes into contact with your gums. This is especially important if you use any kind of denture fixative. If you notice a build up of stains or scale, have your denture cleaned by our participating dentists or hygienist.

Can I make minor adjustments or repairs to my dentures?

You can seriously damage your dentures and harm your health by trying to adjust or repair your dentures. A denture that is not made to fit properly can cause irritation and sores.

See our participating dentists if your dentures break, crack, chip, or if one of the teeth becomes loose. A dentist can often make the necessary adjustments or repairs on the same day. A person who lacks the proper training will not be able to reconstruct the denture. This can cause greater damage to the denture and may cause problems in your mouth. Glue sold over-the-counter often contains harmful chemicals and should not be used on dentures.

Will my dentures need to be replaced?

Over a period of time, dentures will need to be relined or re-made due to normal wear or a change in the shape of your mouth. Bone and gum ridges can recede or shrink causing jaws to align differently. Loose dentures can cause health problems including sores and infections not to mention discomfort. A loose or ill-fitting denture can also make eating and speaking more difficult. It is important to replace worn or poorly fitting dentures before they cause problems.

Must I do anything special to care for my mouth?

Even with full dentures, you still need to take good care of your mouth. Every morning and evening, brush your gums, tongue and palate (roof of your mouth) with a soft–bristled brush. This removes plaque and stimulates circulation in the mouth. It is vitally important that partial denture wearers brush their teeth thoroughly every day to prevent tooth decay and gum disease that can lead to further teeth being lost. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.

How often should I see my dentist?

Regular dental check-ups and having your teeth professionally cleaned are vital for maintaining healthy teeth and gums. Most dentists recommend that under normal circumstances this should be done every 6 months. Full denture wearers should consult their dentist as to the frequency of visits. With regular professional care, a positive attitude and persistence, you can become one of the millions of people who wear their dentures with a smile.

Are there any alternatives to dentures?

Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed support, or implants, can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble the ‘feel’ of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants.

Call your dentist for advice.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Cosmetic Dentistry.

Overview

A smile can be the most eye-catching feature of a face. With dentistry’s many advances, you no longer have to settle for stained, chipped, misshapen teeth, or gaps between your teeth. Advances in dentistry give you choices that can help you smile with confidence.

Even the most subtle change in your smile can make a dramatic difference in the way you look and feel about yourself. You can talk to our participating dentists about the options most suitable for you, your expectations, and the dental fees involved.

What is cosmetic dentistry?

Dentistry is no longer just a case of filling and extracting teeth. Nowadays, many people turn to cosmetic dentistry as a way of improving their appearance. This is similar to the use of cosmetic surgery or even a new hairstyle. The treatments can be used to straighten, lighten, reshape and repair teeth. Cosmetic treatments include tooth-coloured fillings, teeth whitening, veneers, crowns, and bridges.

How do I choose an appropriate dentist?

It is very important that you select a dentist adequately trained and experienced in cosmetic dentistry. Our participating dentists are general and cosmetic dentists who are well trained and experienced in cosmetic dentistry.

Can I have white fillings?

For over 150 years standard fillings have been made out of a silvery-grey material called ‘amalgam’. This is still one of the strongest and longest-lasting materials available for fillings. However, many people find it unattractive and some are concerned about possible health risks.

White fillings are now becoming a popular alternative to amalgam fillings. The new dental materials mean it is much easier to find a perfect match for the shade of a particular tooth. In most cases, it is quite impossible to see that the tooth even has a filling.

Can I lighten the colour of my teeth?

Years of drinking coffee, tea, cola, red wine, or smoking eventually takes their toll on teeth. The results are dull, yellowish-colored teeth. Some teeth may have darker grey-coloured stains due to antibiotics. Most teeth will benefit from teeth whitening. Teeth whitening is a proven safe and effective way to brighten stained, discolored teeth.

What does teeth whitening involve?

Professional bleaching is the most common form of teeth whitening.

Our participating dentists will prepare a specially made tray which fits into your mouth and over your teeth like a mouthguard. You then insert the whitening gel in the trays and fit them over your teeth.

The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, oxygen gets into the enamel on the teeth and the tooth colour is made lighter.

How long does teeth whitening take?

The total treatment can usually be done within three to four weeks. This means regularly applying the whitening product at home over two to four weeks for 30 minutes to one hour at a time.

However, there are some new products which can be applied for up to eight hours at a time. This means a satisfactory result can be achieved in as little as one week.

What other teeth whitening procedures are there?

There is now laser whitening or ‘power whitening’. During this treatment a light or laser is shone on the teeth to activate the chemical. The light speeds up the chemical reaction of the whitening product and the colour change can be achieved more quickly. Laser whitening can make teeth up to five or six shades lighter. This procedure usually takes about one hour.

What can I do with a badly broken tooth?

Our participating dentists may need to crown or ‘cap’ it to restore its appearance and strength when a tooth is badly broken or heavily filled.

How does the dentist make a crown?

The usual procedure for fitting a crown involves shaping the tooth and then taking an impression using a rubber-like material. The impression is then sent to the laboratory along with the details of the shade to be used. A laboratory technician then makes the crown.

What happens to my teeth while the crown is being made?

The prepared tooth can be protected with a temporary crown which is easily removed just before fitting the permanent one. The temporary crown is in place for about two weeks in most cases.

What is a crown made of?

Crowns can be made of a variety of different materials such as porcelain or porcelain bonded to gold. New materials are continually being introduced. There are different crowns for different situations and it is a good idea to discuss with our participating dentists which crown would be best for you.

I have a gap – should I have it closed?

If a tooth is missing, or needs extracting, there are several ways to fill the gap that is left. In some cases it is important to try to replace any missing teeth in order to balance the way your jaw bites. If you have several missing teeth, the remaining teeth are under more pressure, which can lead to broken fillings or even jaw problems.

How can my dentist fill the gap?

A partial denture is the simplest way of replacing missing teeth. However, some people find dentures uncomfortable and eventually decide to have a bridge made.

What is a bridge?

Bridges are ideal for people who don’t like dentures or only have one or two teeth missing. Conventional bridges are made by crowning the teeth on either side of the gap and attaching a false tooth in the middle. They are fixed in the same way as crowns. These bridges are usually made of precious metal bonded to porcelain. Sometimes other non-precious metals are used in the base for strength.

What if I don’t want my remaining teeth drilled?

Adhesive bridges are another way of bridging a gap and less of the tooth needs removing. These bridges are made up of a false tooth with metal ‘wings’ on either side. These wings are made to bond to the teeth on either side with very little drilling of these teeth. The teeth are roughened and the bridge is fitted using a very strong composite resin.

Can I have teeth screwed in?

‘Implants’ are an alternative to dentures or bridgework, but they are more expensive. Implants are titanium rods, which are surgically placed into the jawbone leaving parts sticking out through the gum. These act as anchors for fastening dentures or crowns onto.

What is an incorrect bite?

This is when the teeth do not fit in the jaw properly – the teeth are not in the correct relationship with the rest of the face or if teeth are missing and not replaced.

What can happen if an incorrect bite is not treated?

If an incorrect bite is not treated the face can ‘collapse’. This can cause the face to sag, the chin to stick out or the smile to droop. It can even cause headaches, neck pain and other pains in the body.

How can an incorrect bite be treated?

There are a number of treatments, including crowns, bonding and orthodontics (braces). Ask our participating dentists which treatment is most suitable for you. Our participating dentists will give you an estimate of the fees and a written treatment plan before you start.

Can my crooked or twisted teeth be straightened?

Teeth can be straightened with orthodontics (braces). This is usually done during the teenage years when the teeth are going through a period of growth. However, many adults also have treatment to straighten their crooked teeth or to improve their appearance. The procedure can take much longer in adults and may therefore be more expensive.

Are there any alternatives to orthodontics?

Cosmetic contouring can be used to improve the appearance of teeth. It is ideal if you have slightly crowded teeth. It takes about one hour and is less expensive than other forms of cosmetic treatment. It is not recommended for young children.

What is a veneer?

Veneers are thin slices of porcelain. These are precisely made to fit over the visible surface of front teeth like a false fingernail fits over a nail.

Why might I have a veneer?

Veneers are an ideal way of treating discoloured or unsightly teeth, closing gaps between front teeth, or repairing chips and cracks.

How are veneers made?

They are made by a dental technician using impressions taken by our participating dentists. The veneers are made in the laboratory and bonded to the tooth to form a strong and natural-looking repair. Sometimes a natural colour ‘composite’ material is used instead of porcelain. Composite veneers can be completed in one visit and involve bonding tooth-coloured filling material to the front of the tooth.

Can I use veneers to close the gaps between my front teeth?

Yes. Again, using tooth-coloured material or porcelain, our participating dentists can change the shape or size of the tooth very slightly, closing the gap between the teeth.

What is tooth jewellery?

Tooth jewellery involves sticking small accessories onto the teeth. They come in many different designs and can be in the form of gems, or gold or silver shapes. They are stuck onto the teeth using dental cement although our participating dentists can easily remove them if necessary.

Is tooth jewellery safe?

We recommend you contact our participating dentists for advice if you are considering having tooth jewellery. A dentist has the skills and knowledge needed to apply the jewellery safely and will be able to advise you how to care for your teeth afterwards. It is important to keep to a good oral hygiene routine at home as you may find you are more likely to get dental decay if this area is not kept clean.

Is mouth piercing safe?

Piercing the mouth, lips or tongue is not recommended for a number of reasons. When the piercing is first done, there is a high risk of infection, inflammation of the surrounding tissues or even severe blood infections.

Piercing the tongue can cause it to swell. It can also cause damage such as chipping and fracturing to other opposing teeth. It can also affect speech, eating and swallowing and make oral hygiene difficult to maintain.

Piercings, particularly on the tongue, can make dental treatment difficult, especially if x-rays are needed.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Teeth Whitening.

Overview

Teeth whitening is one of the easiest ways to improve your appearance. Whiter teeth can boost your self-esteem and confidence. Years of drinking coffee, tea, cola, red wine, and smoking eventually takes their toll on teeth. The results are dull, yellowish-colored teeth. Some teeth may have darker grey-coloured stains due to antibiotics. Most teeth will benefit from tooth whitening. Teeth whitening is a proven safe and effective way to brighten stained, discolored teeth.

Your Brisbane cosmetic dentist has a variety of methods for restoring a bright white smile including porcelain veneers, composite bonding, implants and whitening, also known as bleaching. However, of all the advances made in dentistry to enhance the appearance of the teeth, whitening is the easiest and least invasive, and effective for 3 out of 4 cases. The procedure is safe, simple, and more affordable than ever before. Because of these reasons and more, whitening has become very popular.

What should you ask your dentist?

You may want to start by speaking with one of our Brisbane cosmetic dentists. They can tell you whether teeth whitening procedures would be effective for you. Whiteners may not correct all types of discoloration. For example, yellowish hued teeth will probably whiten well, brownish-colored teeth may not whiten as well, and greyish-hued teeth may not whiten well at all. Whitening may not enhance your smile in the event you have had bonding or tooth-coloured fillings placed in your front teeth. The whitener will not affect the colour of these materials and they will stand out in your newly whitened smile. You may want to investigate other options in this case such as porcelain veneers or dental bonding.

What teeth whitening techniques are available to me?

All teeth whitening products contain peroxide either as carbamide peroxide (CP) or hydrogen peroxide (HP). Peroxide dissolves the organic stains in the tooth to change the color and produce a whitened effect.

There are four types of peroxide-containing teeth whitening products available:

• In-practice products are applied by a dental professional. These products contain a high percentage of CP or HP and are applied directly to the teeth. Some activated by heat, light, or laser. This may be the product for you if you’re in a hurry for whiter teeth and you don’t have tooth sensitivity. For very dark-colored teeth, the teeth whitening process can be sped up in two to three hours followed by a take-home product until the desired whiteness is achieved.
• A take-home product supervised by a Brisbane cosmetic dentist is the most popular teeth whitening method. These products contain a lesser percentage of CP or HP than in-practice products and are worn in a tray overnight or during the day at home. A custom-fitted tray is made to hold the teeth whitening product directly against the teeth while lessening its contact with the gums. Some products have fluoride added to help prevent or treat mild tooth sensitivities. The typical stains of ageing will whiten in seven to fourteen days when the tray is worn overnight.
• Over-the-counter (OTC) whitening products contain a small percentage of HP or CP. Caution should be used with these products as many contain an acidic solution that can wear away tooth enamel. OTC products use a bulky, one-size-fits-all tray to hold the product. Usually more product is swallowed than stays in the tray because of the trays poor fit against the teeth. It can take up to six months and the purchase of several kits to get whiter teeth. Flexible strips coated with whitening gel have recently been introduced as an OTC at-home teeth whitening method. The strips are worn on the front teeth and folded over to keep them in place. Results are reported to be noticeable after fourteen days and effective for 6 months.
• Over-the-counter teeth whitening toothpastes contain a small percentage of HP, CP, or polishing ingredient. The toothpastes are effective in keeping teeth cleaner and whiter looking but some may be very abrasive. The harsh abrasive will wear away the enamel with repeated use gradually making the teeth look yellow. Teeth whitening toothpastes remove surface stains and prevent new stains from building up. Teeth whitening toothpastes however aren’t in contact with the teeth long enough to remove internal stains. Ask our Brisbane cosmetic dentists about the safety and cavity protection of specific toothpastes before you buy.

How should I choose a teeth whitening technique?

It is highly advisable to inform your Brisbane cosmetic dentist about your goals regarding teeth whitening. They can advise you about the most suitable method for you and also outline the procedure, likely results, side effects and address any questions you may have.

How does teeth whitening work?

The whitening gel is usually hydrogen or carbamide peroxide that breaks down into oxygen molecules. These molecules go into the tiny pores of the enamel and dentin and break up the stains that block out the light. More light passes through the teeth and makes them look lighter as the stains are broken into smaller and smaller pieces. Stains that are accumulated over time that are yellow to slightly brown produce the best results. Teeth that are dark brown to blue-grey are the most difficult to whiten because the stain is deeply embedded in the structure of the tooth. These types of stains are usually caused by medications taken during the development of the teeth such as tetracycline and can take a minimum of three weeks to see results and as much as six months for complete results.

Results can be seen within an hour, overnight or within three to four days depending on the teeth whitening gel used and the length of time it is worn. Complete results can be achieved in as little as a week or as much as several months depending on the source of the stain and the ability of the teeth or tooth to be whitened. The teeth whitening procedure may last for up to three years and even longer in some cases depending on personal habits. A simple process of whitening for one or two nights with a single gel syringe is usually sufficient to brighten the color again.

What will happen at the initial consultation?

You will be able to talk with your Brisbane cosmetic dentist about the changes you would like to make in your appearance at the first visit with your dentist. Your Brisbane cosmetic dentist will explain the different options available to you, the procedure itself, and its risks and limitations.

Your Brisbane cosmetic dentist will begin with a complete medical history and examine your teeth. They may also take photos or x-rays and give you specific instructions on how to prepare for the procedure. Any large cavities may need to be addressed before teeth whitening can begin. Take this opportunity to ask all the questions you have about the procedure. Learning everything you can about your options, risks and benefits is the key to making an informed decision.

How are the treatments performed?

There are three types of teeth whitening procedures to choose from. Two of them are performed in the dental practice and the third is a take-home self-administered treatment.

• In-Practice whitening procedures

For laser and power whitening, a Brisbane cosmetic dentist begins by applying a protective material to your gums and lips in order to isolate the teeth. A special teeth whitening solution usually containing hydrogen peroxide is applied to the teeth. A high intensity light or laser is directed at the teeth and activates the bleaching agent causing the gel to release the oxygen molecules. Treatments for both power and laser whitening can take as little as 45 minutes but usually last somewhere between one and two hours.

These techniques work great for a single discolored tooth as well. The whitening solution is placed on the outside of the tooth if the tooth has become dark due to trauma but has not had a root canal. The solution can be placed on the outside as well as the inside of the tooth if the tooth has had a root canal. Leaving a teeth whitening solution inside the tooth and sealing the opening is referred to as “walking bleach”. The solution inside the tooth for a walking bleach is changed about once a week. Results can take several weeks but nothing has to be worn in the mouth.

• Take-home whitening

Take-home whitening is performed at home under the indirect supervision of a Brisbane cosmetic dentist. The Brisbane cosmetic dentist takes impressions of the patient’s teeth and then creates a perfectly fitted tray at the first appointment. This tray will allow the patient to apply a teeth whitening solution to the teeth while protecting the rest of the mouth from contact with the whitening chemicals.

The concentration of hydrogen peroxide or carbamide peroxide in the gel is not as strong as that used in power or laser whitening procedures. No strong light source or laser is needed to activate the whitening agent. It is contact with the teeth that causes the gel to release oxygen. Take-home teeth whitening in most cases can take from one to three weeks to achieve maximum results. The Brisbane cosmetic dentist during this time may want to check the progress of the treatment.

How much pain is involved?

The amount of discomfort experienced varies from person to person and depends on the method used. Most adults usually experience little if any discomfort. An over-the-counter anti-inflammatory may help in the case of some discomfort. Consult your Brisbane cosmetic dentist for more options if the discomfort lasts for more than 2 to 3 days.

Decreasing the sensitivity may be as easy as placing a gel fluoride under your dentist’s instruction in your teeth whitening tray for an hour or so. Other materials may be used to address the sensitivity you may experience. Check with your Brisbane cosmetic dentist for the best options for your particular needs.

You should discuss your goals, budget, and pain tolerance with your Brisbane cosmetic dentist in order to help them determine the procedure, or combination of procedures, that will produce the best results for you.

What can I expect after teeth whitening?

The results of teeth whitening vary but most people are happy with the results. Patients should avoid foods that stain such as tobacco and red wine for about a week after any teeth whitening treatment. Keeping teeth clean with flossing and brushing can maintain whiteness. Teeth whitening lasts on average about 1 to 3 years. Teeth whitening may last even longer if you are not a regular tobacco user and do not eat many foods that are known to stain teeth.

Decalcified spots are white spots that affect the calcium in the enamel. These spots appear chalky white and are difficult to treat with just teeth whitening. Your Brisbane cosmetic dentist may recommend a procedure called micro-abrasion. This procedure can be done by itself or in conjunction with teeth whitening. The micro-abrasion material is much like the paste used to clean and polish teeth. The paste consists of an abrasive combined with a hydrochloric acid used to “polish” out the white or brown spots. The procedure can be performed usually in one practice visit and can be done without anesthesia.

How long will the teeth whitening last?

The effects of the teeth whitening should last for 1 to 3 years. Daily brushing and flossing will assist in maintaining the whiteness. The duration of the whiteness will also depend on your personal habits. Drinking red wine, tea, coffee or smoking will shorten the life of the new whiteness. You may want to conduct a re-treatment in the future. This should not be as costly and time consuming as the original teeth whitening procedure as you will already have the custom made trays.

Am I an ideal candidate for teeth whitening?

In general, the best candidates for teeth whitening are:

• Mature enough to fully understand the procedure
• Experiencing stained and marked teeth
• Knowledgeable about the procedure
• Wanting to improve their appearance and confidence
• Realistic in their expectations

The above is only a partial list of the criteria that your Brisbane cosmetic dentist will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your Brisbane cosmetic dentist if they consider you an ideal candidate for this procedure.

Are there any alternatives?

Teeth that have dark stains may be better candidates for another whitening option such as veneers, bonding, or crowns. Your Brisbane cosmetic dentist can discuss the options best suited for your situation.

Patients interested in teeth whitening should consult a Brisbane cosmetic dentist before taking on any form of treatment whatsoever. A consultation with a Brisbane cosmetic dentist will help you understand the benefits and risks associated with each of the options.

What are the risks and limitations?

Teeth whitening can produce side effects ranging from increased tooth sensitivity to pain and tenderness in the gums, tongue and other soft tissues. There is also a possibility of over-whitening. The result will be a translucency that may appear grey from the shadows of the mouth. There is a very low percentage of this occurring and only if the whitening process is over-extended. Having a Brisbane cosmetic dentist supervise the process can eliminate this risk.

With take-home whitening there is a small risk of ingesting the gel administered by the Brisbane cosmetic dentist. The chances of this occurring are relatively small since your teeth whitening tray should fit almost perfectly around your teeth. However, if the gel is ingested, it may result in nausea, vomiting or burning. You should contact a doctor immediately if this occurs to you.

How do I choose an appropriate dentist?

It is very important you select a Brisbane cosmetic dentist adequately trained and experienced in teeth whitening. Our Brisbane dentists are general dentists and cosmetic dentists equipped to administer teeth whitening. They will be able to assist you achieve your goals pertaining to teeth whitening.

What questions should I ask my dentist?

• Are the desired results I described realistic?
• Is there an alternative treatment that I should consider as well?
• How long will the procedure take?
• How much does it cost?
• What is your experience in performing this procedure?
• Have many patients had significant complications?
• Can you give me some idea of the result I will achieve after the teeth whitening?
• What should I expect after the procedure and what things should I avoid?

Anything else I should know?

• Tell your Brisbane cosmetic dentist about any allergies you have to foods, drugs, vinyl, peroxide, or environmental elements.
• Tell your Brisbane cosmetic dentist about all medications you are taking including prescription and non-prescription.
• Carefully follow any instructions your dentist gives you.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Wisdom Teeth.

Wisdom teeth also known as third molars are the last teeth to erupt. Wisdom teeth may become a problem for you as they grow and develop in each corner of your mouth. Problems often develop gradually since development normally spans several years. Nevertheless, these gradual changes can cause sudden and severe pain. Understanding why such things can happen may help you to deal with these problems, or better still, to encourage you to take preventive measures before they occur.

The jawbone grows to approximately its adult size by your late teens. Unfortunately, that size is often too small to hold developing wisdom teeth. This happens because our jaws are smaller than those of early humans who needed large jaws and more teeth for their tougher diet.

When there is not enough room for your wisdom teeth, they may become impacted, or partially trapped in the jawbone and gums. The crown, or top of the tooth, may erupt, or just break through the gum, or it may remain completely within the bone. The roots can grow in unusual directions and may cause a variety of problems in your mouth and with your sinus cavity or the nerve in your lower jaw. The primary preventive measure for wisdom teeth is removal, preferably at an early stage.

Impacted Wisdom Tooth

A tooth becomes impacted due to lack of space in the dental arch and its eruption is therefore prevented by gum, bone, another tooth or all three. Lack of space occurs because our jaws have become smaller through evolution. We do not lose teeth through decay as frequently as in the past and our diet does not wear down our teeth as much.

Impacted wisdom teeth can grow in a variety of directions.

A wisdom tooth may grow toward your other teeth, away from them, or even in horizontal or vertical positions. When such conditions occur, it’s far simpler and less painful to have them removed early before they have a chance to firmly anchor in your jaw as the teeth grow and the roots lengthen.

Wisdom Tooth Assessment

Not everyone has problems with their wisdom teeth. Factors that determine whether you will have problems include the size of your jaw and how your wisdom teeth grow in. There may be pain and swelling, or you may have no symptoms at all even though the other teeth in your mouth may be at risk of damage. In addition to actual pain, common problems caused by wisdom teeth can include gum disease, crowding, decay, poor position, and cysts.

Since it is not practical for most people to evaluate how their wisdom teeth are developing, the best approach is to visit our Brisbane dentists for an evaluation. The dentist will review your dental history, take dental X-rays, and perform an examination to determine the general health of your mouth and the condition of your wisdom teeth. If a problem with your wisdom teeth is detected, our Brisbane dentist may recommend surgery to remove them and eliminate or avoid any unpleasant symptoms. Early removal is best for most patients as it usually helps to avoid more serious problems later on.

It is very important to talk to our Brisbane dentists about extraction procedure, risks, possible complications and outcomes of the removal of these teeth. The actual extraction may be done by a dentist or it may be referred to a specialist. This decision is based on the dentist’s preference and the unique features of each individual case. If you are unsure about whether or not to proceed with the treatment suggested by our Brisbane dentists, it is a good idea to get a second opinion. If you decide after consulting with a dentist to not have any teeth extracted, they should be monitored at every dental visit.

Why Remove Wisdom Teeth?

Wisdom teeth generally cause problems when they erupt partially through the gum.

Below are the most common reasons for removing wisdom teeth.

1. Tooth decay

Saliva, bacteria and food particles can collect around an impacted wisdom tooth, causing it, or the next tooth to decay. It is very difficult to remove such decay. Pain and infection will usually follow.

2. Gum infection

When a wisdom tooth is partially erupted, food and bacteria collect under the gum causing a local infection. This may result in bad breath, pain, swelling and the inability to open your mouth fully. The infection can spread to involve the cheek and neck. Once the initial episode occurs, each subsequent attack becomes more frequent and more severe.

3. Pressure pain

Pain may also come from the pressure of the erupting wisdom tooth against other teeth. In some cases this pressure may cause the erosion of these teeth.

4. Orthodontic reasons

Many younger patients have had prolonged orthodontic treatment to straighten teeth. Wisdom teeth may cause movement of teeth particularly the front teeth when they try to erupt. This will compromise the orthodontic result.

5. Prosthetic reasons

Patients who are to have dentures constructed should have any wisdom tooth removed. If a wisdom tooth erupts beneath a denture it will cause severe irritation and if removed, the patient will need to have a new denture constructed as the shape of the gum will have changed.

6. Cyst formation

A cyst (fluid filled sac) can develop from the soft tissue around an impacted wisdom tooth. Cysts cause bone destruction, jaw expansion and displacement or damage to nearby teeth. The removal of the tooth and cyst is necessary to prevent further bone loss. Tumors may develop within these cysts or the jaw may fracture spontaneously if the cyst grows very large.

Why remove an impacted wisdom tooth if it hasn’t caused any trouble?

Impacted wisdom teeth are almost certain to cause problems if left in place. This is particularly true of the lower wisdom teeth. Such problems may occur suddenly and often at the most inconvenient times.

When is the best time to have my wisdom teeth removed?

It is now recommended by dentists that impacted wisdom teeth be removed between the ages of 14 and 22 years whether they are causing problems or not. Surgery is technically easier and patients recover much more quickly when they are younger. What is a relatively minor operation at 20 can become quiet difficult in patients over 40. Also the risk of complications increases with age and the healing process is slower.

Traveling to foreign places

It may be advisable to have them removed before traveling if you are going to an area where specialist dental services are not readily available and your wisdom teeth are impacted.

Should a wisdom tooth be removed when an acute infection is present?

Generally, no. Surgery in the presence of infection can cause infection to spread and become more serious. Firstly, the infection must be controlled by local oral hygiene, antibiotics and sometimes the extraction of the opposing wisdom tooth.

The ‘Pros & Cons’ of wisdom tooth removal

1. Some ‘Pros’ of removing a wisdom tooth.

Wisdom teeth may be hard to access with your toothbrush or floss. Over time, the accumulation of bacteria, sugars and acids may cause a cavity to form in the tooth. If it is not restored with a filling, the cavity may spread and destroy more tooth structure causing severe consequences to the tooth and surrounding supportive structures.

Due to the difficulty of keeping these teeth clean with your daily brushing and flossing, bacteria and food debris remaining on the wisdom teeth may present a foul smell causing bad breath.

A wisdom tooth that is still under the gums in a horizontal position rather than a vertical position may exert pressure on surrounding teeth causing crowding and crooked teeth. This also may occur if there is not enough space in the mouth for the wisdom tooth. This may warrant braces to repair the damage.

A wisdom tooth that is still under the gums may become irritated. The gum tissue that lay over the tooth may harbour food debris and bacteria that gets trapped under the gum resulting in an infection in the gums.
There is the potential for more problems to occur the longer you wait and the older you get. This is because as you get older, the bone surrounding the tooth becomes increasingly dense making the tooth more difficult to remove. The healing process may also be slower.

2. Some ‘Cons’ of removing a wisdom tooth.

Depending on the size shape and position of the tooth, removal can vary from a simple extraction to a more complex extraction. With a simple extraction, there is usually little swelling, bruising and bleeding. More complex extraction will require special treatment which may result in more bruising, swelling and bleeding. However, our Brisbane dentists will provide you with post treatment instructions to minimise these side effects.

Following an extraction, a condition called “dry socket” may occur. If the blood clot that formed in the extraction area becomes dislodged, it exposes the underlying bone. This condition is very painful but resolves after a few days. It is preventable by following the post treatment instructions provided by your dentist.

The operation

Surgery is often done at your dentist’s practice rather than in a hospital. Your dentist will review the recommended procedure with you so that you will fully understand and be comfortable with the procedure before it is done. You will also be given information about eating, medication, rest, driving, and other considerations before surgery as well as after.

Many people have their wisdom teeth removed under local anesthesia by their dentist. This means that they are awake but the area around the wisdom teeth is completely numb. Sedative drugs can be given with local anesthesia to help people relax during the procedure.

The operation will not start until the anesthetic has taken effect. It is often necessary to make a small cut in the gum over the wisdom tooth, and to remove some bone so that the tooth can be lifted out. Stitches are usually put in to help the gum heal.

Post operative healing

The healing process begins immediately after surgery as your body sends blood to nourish the tooth socket. Simple pressure from a piece of gause is usually all that is needed to control the bleeding and to help a blood clot to form in the socket, which promotes healing. Within a day or two, soft tissue begins to fill in the socket, aided by the blood clot. Eventually, the bone surrounding the socket begins to grow, filling in the socket completely.

As your mouth heals, you can promote faster healing and avoid complications by simply following the care instructions that our Brisbane dentists will give you. While you may experience some discomfort as your mouth heals, following simple instructions will normally be all that is needed. However, you should call our brisbane dentists if you experience excessive bleeding or swelling, persistent and severe pain, fever, or any reaction to medications. A follow-up examination may also be scheduled to make sure that the socket is healing properly and that your mouth is returning to a normal, healthy state.

Post operative care

Following the removal of your wisdom teeth it is important that you call our Brisbane dentists if any unusual bleeding, swelling or pain occurs. The first 6-8 hours after the extraction are typically the worst but are manageable.

At first, it may be possible to feel small fragments of bone with your tongue. These are the edges of the tooth socket and will soon disappear as the gum heals. Depending on the type of stitches used, they may need to be removed. Arrangements will be made for this to be done. If dissolvable stitches have been used, they will disappear 7 to 10 days after the operation.

Below are some tips to assist you after the operation.

1. Do not disturb the wound.

Disturbing the wound may invite irritation, infection and bleeding. Chew on the opposite side for the first 24 hours.

2. Do not smoke for 12 hours.

Smoking will promote bleeding and interfere with healing.

3. Do not spit or suck through a straw.

This will promote bleeding and may dislodge the blood clot which could result in a dry socket.

4. Control of bleeding.

If the area is not closed with stitches, a pressure pack made of folded sterile gauze pads will be placed over the socket. It is important that this pack stay in place to control bleeding and to encourage clot formation. The gauze is usually kept in place for 30 minutes. If the bleeding has not stopped once the original pack is removed, place a new gauze pad over the extraction site.

5. Control of swelling

After surgery, some swelling is to be expected. This can be controlled through the use of cold packs which slow the circulation. A cold pack is usually placed at the site of swelling during the first 24 hours in a cycle of 20 minutes on and 20 minutes off. After the first 24 hours, it is advisable to rinse with warm saltwater every two hours to promote healing (one teaspoon of salt to a glass of warm water). Do not rinse your mouth out during the first 24 hours because this disturbs the blood clots that are part of the healing process.

6. Medication for pain control

Anti-inflammatory medication such as Panadol is used to control minor discomfort following oral surgery. Stronger analgesics may be prescribed by the dentist if the patient is in extreme discomfort.

7. Diet and nutrition

A soft diet may be prescribed for the patient for a few days following surgery. You can gradually return to a normal diet once any jaw stiffness has settled. Very hot drinks and spicy food can increase pain and bleeding and should be avoided until the gum has healed. Also avoid alcohol as alcohol can increase bleeding and delay healing.

Most people do not experience any complications after having their wisdom teeth removed. Nonetheless, you should plan to see our Brisbane dentists approximately one week later to ensure everything is healing well.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

Our dentists have once again put together a paper to assist you. This time on Root Canal Treatment.

Overview

In the past you would probably lose a tooth if the tooth had a diseased or injured nerve. Today you may save that tooth with a special dental procedure called root canal therapy. Inside each tooth is the pulp which provides nutrients and nerves to the tooth. It runs like a thread down through the root. The pulp tissue dies when the pulp is diseased or injured. If you don’t remove this pulp tissue, your tooth will get infected and you could lose it. The root canal is cleaned and sealed off to protect it after the dentist removes the pulp. Then your dentist places a crown over the tooth to help make it stronger.

A root canal is usually a simple procedure with little or no discomfort involving one to three visits to the dentist. Most patients report that having root canal treatment today is as unremarkable as getting a filling. The best news is that it can save your tooth and your smile!

What is a root canal treatment?

Our brisbane dentists use a root canal procedure to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The soft tissue around the tooth contains nerves, blood vessels, and connective tissue. Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment has given our Brisbane dentists a safe way of saving teeth.

Why do I need root canal treatment?

The simple answer is because your tooth will not heal by itself. The infection will spread without treatment. The bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until you are forced to seek emergency dental attention. The only alternative is usually extraction of the tooth which can cause surrounding teeth to shift crookedly resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal treatment. If you have the choice, it’s always best to keep your original teeth.

What causes pulp nerve damage?

There are two common causes of pulp nerve damage. Physical irritation is generally brought on by aggressive tooth decay reaching down to the nerve or through deep fillings which allows harmful bacteria to reach the nerve resulting in infection and decay. Receiving a blow to a tooth can also cause damage to sensitive nerve tissue within the tooth.

What are the symptoms of pulp nerve damage?

There are several common symptoms of pulp nerve damage. Each individual may experience the symptoms differently. These symptoms may include:

• pain in the tooth when biting down


• tooth pain while chewing


• oversensitivity of the teeth with hot or cold drinks


• facial swelling

The symptoms of pulp nerve damage may resemble other oral health conditions. You should consult a dentist for a diagnosis.

Why do I feel pain?

Pulp can die when it becomes infected due to a deep cavity or fracture as it allows bacteria to seep in. Pulp can also die because of injury due to trauma. Damaged or dead pulp causes increased blood flow and cellular activity and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.

What is a ‘root canal’?

Underneath your tooth’s outer enamel and within the dentin is an area of soft tissue called the pulp which carries the tooth’s nerves, veins, arteries and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.

What is the ‘dental pulp’?

The pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.

What happens if the pulp gets injured?

The pulp dies when it is diseased or injured and can’t repair itself. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp. Germs can cause an infection inside the tooth. Pus builds up at the root tip in the jawbone when not treated and forms a “pus-pocket” called an abscess. An abscess can cause damage to the bone around the teeth.

What does treatment involve?

Treatment often involves from one to three visits to our Brisbane dentists. A dentist or endodontist will remove the diseased pulp during the treatment. The pulp chamber and root canal(s) of the tooth are then cleaned and sealed.

Here’s how your tooth is saved through treatment:

1. An opening is made through the crown of the tooth.

2. An opening is made through the crown of the tooth into the pulp chamber.

3. The pulp is then removed. The root canal(s) is cleaned and shaped to a form that can be filled.

4. The pulp is removed and the root canals are cleaned, enlarged and shaped.

5. Medications may be put in the pulp chamber and root canal(s) to help get rid of bacteria and prevent infection.

6. A temporary filling will be placed in the crown opening to protect the tooth between dental visits. Your dentist may leave the tooth open for a few days to drain. You might also be given medicine to help control infection that may have spread beyond the tooth.

7. The pulp chamber and root canals are filled and sealed.

8. The temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled.

9. The final step usually involves a gold or porcelain crown placed over the tooth. An endodontist performing the treatment will recommend that you return to your dentist for this final step.

10. The crown of the tooth is then restored.

What is an “endodontist”?

An endodontist is a dentist with special training in diagnosing and treating problems associated with the inside of the tooth. They do only endodontic procedures in their practices because they are specialists. They perform routine as well as difficult and very complex endodontic procedures including re-treatment of previous root canals that have not healed completely and endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

How long will the restored tooth last?

Your restored tooth could last a lifetime assuming you continue to care for your teeth and gums. Regular checkups will be necessary. Your tooth will remain healthy as long as the root(s) of a treated tooth are nourished by the tissues around it.

Are there any risks?

If root canal therapy is suggested by a dentist then is important to have a tooth treated as soon as possible. An infection that is allowed to continue is likely to result in the formation of an abscess at the root of the tooth. This will lead to destruction of the underlying bone tissue and may make it impossible to save the tooth. The infection can also spread to adjacent teeth and could result in blood poisoning, fever, swelling in the face and neck and a general ill feeling.

More than 95 percent of root canal treatments are successful. Sometimes a case needs to be redone due to diseased canal offshoots that went undetected or the fracturing of a canal filing instrument used. This rarely occurs. A root canal therapy that has not been completed correctly is marked by a return of pain.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days. This can be controlled by an over-the-counter analgesic. A follow-up exam will be to monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth, and see your dentist regularly.

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.