Underwood Dental Care

Many patients see me knowing that they need things “fixed”… but never come around to it as they’re terrified not so much of how much it’ll hurt, but more so how much it’ll hurt their hip pocket.

What patients aren’t aware of, is the number of options available to “fix” their teeth, without costing an arm and leg.

Take this patient for example. She originally presented with “black spots” on the front 4 teeth. She was conscious of it for a long time, but was fearful of the costs involved. When the picture below was taken, two of the teeth had already been treated.

The procedure was simple. The “black spots” (decay) were removed, followed by restoration of the front surfaces of the teeth with composite resin- a white tooth-coloured filling.

You can see that there are a few other areas in the lower jaw that still need attention. As the patient is now aware of the procedure, she has since re booked for further treatment.

The fillings took no longer than 20 minutes to complete, and cost her $115 each. Of which 80% was covered by her health fund.

This next patient complained of “ragged and chipped front teeth”.

With the help of a little composite resin, we were able to restore his incisal edges to a more uniform colour, form, and allowed him to function/eat properly.

So if there is a “niggling spot” that you’re aware of in your mouth, and have not come around to it as you are fearful of the “unknown”… give us a call- you’d be surprised at how easily the issue can be sorted out

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Often, when the words “Root Canal” is mentioned to patients, unpleasant images instantly flash through their minds. But what it comes down to is simply, a lack of understanding of what root canal treatment actually entails. Let’s discuss this further…

1.  What is a Root Canal treatment?

Firstly, what patient’s don’t realise is that if I am to offer a root canal as a treatment option, it means that I am suggesting that this tooth CAN BE SAVED! Often fillings are needed when the cavity only “outside layers” of your teeth (ie. your enamel and dentine). However, once the bacteria continues to progress deeper, it gets closer to the pulp (the nerve tissue). Once inside, the nerve becomes infected and can cause severe tooth ache.

A root canal would simply be removing that infected nerve tissue, cleaning it thoroughly and sealed so no further bacteria can enter the tooth.

image thanks to Sunrise Dental Group, USA.

2. But don’t root canals hurt?

A root canal, as I describe it, is basically a filling done over a longer period of time. The tooth is still anesthetized, so like a filling, you won’t feel a thing! Understanding the root canal process is the first step in easing your own nerves (not the tooth’s!)

3.But don’t root canals take a lot of dental visits?

Often with root canal treatment, one appointment is required to clean out the infected tissue. Once all the bacteria is cleaned out, a medicament is placed into the tooth to settle the tooth down for a 2-4 weeks. In that period, a temporary filling sits over the tooth, to allow for normal function.

Once that’s done, a second appointment is required to remove the temporary filling and seal off the root canal(s).

4. But I heard from my friend that their root canal fell apart- which then led to her removing the tooth anyway!

The success rate of root canal therapy is in the high 90% .  The problem with “root canals” isn’t so much the actual root canal treatment itself, it is in the remaining tooth structure that lies on top. For a tooth to need root canal, usually the decay is quite deep to involve the nerve tissue.

With the amount of damage the tooth has had, only little good tooth structure remains.  Also, after “hollowing out” the contents of the tooth, the tooth can be quite brittle and prone to fracture. Especially in molar teeth, it is advisable to place a custom porcelain crown over the tooth to protect the root canal. This way, rather than placing fillings into the tooth, bonding it to very thin tooth structure, we would be “capping” it with a “helmet-like” structure on top of the tooth.

5.But isn’t pulling the tooth better than getting a Root Canal?

There is nothing better than keeping your own natural teeth. It is our job as dentists to do everything we can to keep your teeth for as long as we can for proper eating and chewing functions. Although there are many options in restoring missing teeth eg. dentures, partial dentures, bridges, implants etc… however these alternatives can often be more expensive than saving your tooth with root canal, as well as inconvenient.

I hope that has helped clear out a few questions about root canal. If you’re still unsure about anything… please feel free to drop us a line!

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Many patients have asked us about this so I’ll make a quick note of it here.

Underwood dental care’s current promotion is that if you are a new patient to our clinic, we would like to welcome you by offering a free dental check and clean. The offer applies to all new patients who have private health insurance with our preferred providers. They are- Commonwealth Bank Health Insurance, MBF, Manchester Unity, HCF and HBA.

What that means to you is that you will not pay a gap fee for your check up and clean.

If you’d like to know further details about this offer, please feel free to contact us.

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Let’s face it… many of us know we need to floss, but many of us do not floss.

Why is that the case? Is it because we don’t know how? It’s too hard to reach the back areas? Or is it because we just don’t think we need to as mouthwash will “blast away” all the plaque like “dynamite against germs”?

Why do we floss?

Firstly, we floss because it enables us to remove plaque and food particles in places where a toothbrush cannot easily reach — under the gumline and between your teeth. Because plaque build-up can lead to tooth decay and gum disease, daily flossing is highly recommended.

One of my university lecturers once told me “you don’t have to floss… you just floss the teeth you want to keep!”

Do yourself a favour and let’s get flossing! brushing alone is only doing half the job!

How do we floss?

The following information is thanks to Colgate. It’s an American site, so the measurements are in inches… 18″ is equivalent to about 45cm. I personally think that’s a bit too much. You’d get by with about 30cm… enough to twirl around your index fingers 2-3 times.

To receive maximum benefits from flossing, use the following proper technique:

• Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with
• Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
• Gently curve the floss around the base of each tooth, making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue
• Use clean sections of floss as you move from tooth to tooth
• To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth

Common problems that people face with flossing is that they leave themselves too long a piece to work with, which becomes very difficult to maneuver at the back of the mouth. 5cm or so is more than enough.

Are there alternatives to flossing?

I believe very strongly in flossing, but as I said earlier… not everyone flosses. That is why interdental brushes such as Piksters were formed. Piksters come in different sizes from size 0 to size 7. The smaller piksters are very good for general use, whereas the larger piksters are good for patients with braces or larger spaces due to periodontal disease.

This video link (which I have nothing to do with!) gives you an idea of how they work.

What about toothpicks?

Toothpicks are very thick and rigid. Although toothpicks as their name describes, are useful in ‘picking’ food debris from teeth, if used improperly by wedging them in between teeth, will create spaces. This damages the gums and supporting tissue of teeth, resulting in gum disease in the long term.

An American dental report states:

“Toothpicks should be used only when a toothbrush or floss is not available, for example, when you are in a restaurant and have food trapped between teeth,” explains April Grandinetti, D.D.S., a general dentist. “Toothpicks that are used overzealously can damage tooth enamel, lacerate gums, and even cause a broken tooth in severe cases. People who have bonding or veneers can chip or break them if they aren’t careful. Overly aggressive use of toothpicks can severely wear the roots of teeth, especially in cases where gums have pulled away from the teeth and leave teeth with root surfaces exposed, notably in the elderly.”

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Due to the overwhelming amount of phone calls I’ve received about my mother in law’s veneers, I thought I’d also explain some other cases which you might be able to relate to.

Some patients have called and asked whether I could be able to “fix their teeth” even if they’re “crooked and dark”. The answer in short, most likely… yes.

Below is another case of veneers, this time on a much younger patient.

She presented complaining of having “gappy teeth”.

She had her teeth whitened with take home trays for 5 days, before proceeding to preparation stage of veneers. The reason why she did this was because porcelain is semi translucent. To allow for a more “natural” look, the porcelain would inevitably allow light to pass through to the underlying tooth.

The same procedure as explained below…

appointment 1: discussion and treatment plan

appointment 2: preparation of teeth to end in temporary veneers

appointment 3: cementation of porcelain veneers

appointment 4: review

After temporary veneers

After cementing the veneers

1 week review

I could go on explaining the nitty gritty details of what’s involved in the procedure… but I don’t want to bore you. So please drop me an email if you’d like to know more.

Otherwise, other alternatives to porcelain veneers is to use composite resin. Composite resin is the same material we use for “white fillings”. With improvements in bonding technology, these fillings are conservative, strong, and very easy to do.

The gentleman below had his fillings replaced in just 1 hour, and it was all complete in the first visit.

Stained, old fillings

Repaired with composite resin in 1 hour

Composite resin is also a much cheaper option- at a fraction of the cost of porcelain.

You can also use composite resin to close “gappy teeth”… as you see below.

Before:

After:

All performed in under an hour.

Again, if you have any issues you’d like answers to, please feel free to contact us or call us on (07) 33419770.

Hope that helps!

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Before I continue on with my veneers post of my mother-in-law, I thought it’d be good for me to identify an issue that keeps arising amongst my patients.

“How do I get rid of fluoride from our water system?”

…Firstly, why would you want to get rid of the fluoride from the water? Time and time again I’ve seen people from interstate and overseas with not a filling in their mouth… is it because they are great brushers, flossers, and mouthrinsers? Probably… but it’s also due to the fluoride exposure as their teeth were forming!

“Fluoride acts in a number of ways to strengthen teeth and make them more resistant to tooth decay. Originally it was thought that the benefits of fluoride were only systemic, ie fluoride being built into a child’s developing tooth enamel, making the enamel more resistant to the acid that causes tooth decay. This would have meant that only people exposed to fluoridated water as a child could benefit from water fluoridation. We now know that while some of fluoride’s effect is systemic, most is a topical effect, ie fluoride applied directly to the tooth surface and strengthening tooth enamel”

Check out the Australian Dental Association website to answer all your questions about fluoride.

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Hi all… this is my first post in the newly re-vamped Underwood Dental Care website. Keep checking back as I will be making regular posts on dental topics from things I see, to things I hear patients want explained. Or better still… post your questions to enquiries@underwooddentalcare.com.au and I will be sure to blog about it!

My first post will be on my lovely mother-in-law. I will be getting married in October and like all mother of the brides, they want to look their best. I will use her as a discussion case for those who have always been curious about veneers… made “famous” and “publicly aware”  on “Extreme Makeover”

Before:

As you can see there is slight crowding in the upper front teeth. She was mainly concerned about her right lateral incisor which she complained to buckle out when she smiled.

Veneers are thin, tooth coloured porcelain shells that are custom made to bond to and cover the front of teeth to hide any blemishes, misalignments etc…

They are more conservative than preparing for a crown and can often be used if the underlying tooth is strong and healthy (like in this case!)

Appointment 1:

For my mother in law, the first appointment involved a brief discussion about what she expected, what she was happy with, what she was unhappy with. Moulds of her teeth were taken to form study models. On these models, we were able to do a “mock” set up of her veneers in wax. This gave her an idea of what the finished product would look like. Once she was happy to go ahead, we jumped to appointment number 2, the next day!

Appointment 2:

This appointment took about 2 hours. The teeth were trimmed approximately 0.3mm to make room for the porcelain to bond over the top. If no space was created, the porcelain would bond over the teeth too prominently and would give her teeth “horse teeth”.

Once the teeth were trimmed to the appropriate depth, an impression was taken to be sent off to the dental lab to have the veneers made up.

My mother in law walked away with a temporary set of veneers… which she was very happy with. (You can see it in her smile on the photo below!)

Appointment 3:

A week later… the veneers were ready to insert…

stay posted for my next post… photos attached!

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