Archive for the ‘cosmetic-dentistry’ Category

Good dentist, bad dentist

Posted by Dental News Team On February - 22 - 2010

Wouldn’t you like to know whether your dentist is good or bad?

We assume you do, which is why this week we are going to tell you all about what to consider when looking for a dentist and how to find a good one.

As usual, we will provide you with an overview of this week’s main topic!

  1. Good dentist – the cost estimate
  2. Dentists and their teams
  3. Hygiene in the dentist’s office
  4. Explaining procedures
  5. Trouble-shooting

Good dentist – the cost estimate
First of all, does your dentist even bother giving you a cost estimate?
No? Then s/he has no idea what s/he is doing!

If yes, how is the estimate structures?
Did you get a thorough check-up before you got the estimate? You should know what has to be done in your case and what will only be performed to fill the dentist’s pockets. What are we going on about? Well, in order for the dentist to provide you with a good cost estimate, s/he needs to have a good idea of the current status of your teeth and mouth.

If s/he does not bother performing a check-up, then it is likely s/he will only do things that cost a lot, namely implants and crowns.

You can always tell good estimates from bad ones, because good estimates always provide detailed information, which is collected during a check-up (assuming, of course, that your mouth really needs an overhaul, not just one bridge or implant if your teeth and mouth are otherwise healthy, otherwise, what would be the point of collecting data!).

A good cost estimate includes:

  • An anamnesis (medical history) / Patient’s request
  • Findings
  • Diagnosis
  • Recommendations for therapy / Alternatives
  • Description of procedures as needed

This information lets the dentist know what you wish to be done, the condition of your teeth (periodontal status, photos, models of your teeth, …), anything and everything you’ll need to set up a treatment plan.
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The cost estimate should consider all kinds of work, even work which is less lucrative to the dentist. This includes fillings, root canal treatment, operations such as removing wisdom teeth, etc.

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But this is the kind of work which should usually be done first, before doing more complicated procedures – you should make sure the ground is in good shape before you start building houses on it (crowns, implants etc.).

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Summing up, a simple cost estimate can and should tell you quite a lot!

  • If your dentist offers you any treatment without performing a thorough check-up first, then chances are that s/he is only going to do things which cost the most money!
  • If the cost estimate starts out with an extensive check-up, then you’re on the right path!
  • If a cost estimate begins with the least expensive types of treatment (renewed root treatment, removing wisdom teeth, periodontal work, …) with dentures (crowns, bridges) last on the list, then stick with that dentist!

More on this topic tomorrow, and by the end of the week you should be able to tell a good dentist from all others!

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cosmetic-dentistry endodontology general topics implantology oral surgery orthodontics periodontology prostethics

Extracting milk teeth

Posted by Dental News Team On January - 28 - 2010

Should milk teeth be pulled or shouldn’t they?

Parents are not the only ones who ask themselves this questions, but quite a lot of dentists do as well!

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Milk teeth are not only needed to chew and talk, but they also stimulate the growth of the jaw. But if parents do not teach their children proper dental care, it is sometimes necessary to remove milk teeth ahead of time.

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This is necessary when:

  • the next tooth cannot come out (guided extraction)
  • there is a chronic infection, e.g. a fistula has formed at the tip of the root causing problems
  • the tooth has been so severely damaged by cavities that it can no longer fulfil its function as a placeholder.

Milk molars play a very important role in the development of a child’s jaw and should be kept intact until the first permanent molar (six) comes out. If the milk tooth in front of a permanent tooth has a filling, then it is crucial to run a thorough cavity check! – -

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Chipped tooth?

Posted by Dental News Team On January - 7 - 2010

Chipped tooth – what now?

zahn_abgebrochenWhether incisor or molar, there are two things you need to consider.

If only the enamel was chipped, then it is usually enough to smooth out the sharp edges. Larger defects may require reconstruction using plastic.

If there is an enamel/dentine fracture, then check whether the dental nerve is exposed.

If so, then you need to go a dentist right away, and you may just be able to avoid getting root treatment! If only the dentine is exposed, but not the dental nerve, you should still go to a dentist as soon as you can, because the dental nerve could still be damaged. The chipped dentine can be repaired using plastic, ceramic filling, or a veneer.

Moreover, the dentist can check whether you have a fracture in your root, or the joint head of your jaw and/or alveolar appendage – these complications can still be painful, especially if e.g. a small child hurts its chin, the jaw should be examined very carefully!

More on the topic of teeth at our video portal checkdent.com!

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Once upon a time there was the tooth II

Posted by Dental News Team On December - 15 - 2009

Toothache 2/5

zahnodyssee_iiOne root canal after the other, but the toothache won’t go away?!
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Going to a dentist helps – doesn’t it?
„You have a bad tooth“ whatever that means – it’s something patients hear all the time.
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A tooth can’t help being “bad”, after getting „poisoned“ by the monomers injected into it. Good root treatment is performed using a coffer dam, a magnifier and a lot of patience – here you can see how it’s done.
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Sometimes things don’t run that smoothly, sometimes the root canal is not thoroughly cleaned to the tip, sometimes the instruments are not well-sterilized, and sometimes the tooth is not filled up.
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Pain after root treatment?!

Badly performed root treatment means that problems persist, and this is where it gets complicated, because it’s hard to tell whether the pain is the result of a badly performed operation on a specific tooth, or whether it’s coming from the tooth right next to it, which also got some plastic filling. Are you allergic to this type of filling?
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This is not an allergy!
An allergic reaction requires the presence of immune cells and therefore blood. But the tooth is a mineral, and although monomers can seep through it and damage the nerve, the dentine does not contain any blood. At most, you may have a contact allergy, which will make itself felt in the membrane, but this is a different kettle of fish.
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One root canal after the other!
Because dentists don’t know what to do in cases like these, they just keep performing root canal treatment. But the toothaches continue, so they go on to perform root tip resections. Normally the ordeal should be over, but then even more problems may appear:
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If the resection was not properly performed, and the canal not cleaned, either from above (orthograde) or from below (retrograde)!

  • Are there still any teeth left which have plastic fillings?
  • Has the inflammation/ have the monomers spread even further?
  • Was faulty root treatment performed at some point, and is only now starting to cause problems?
  • Was root tip resection performed correctly  – using sterile instruments in a sterile environment?

Stay tuned for: Once upon a time there was the tooth III

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cosmetic-dentistry general topics
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Once upon a time there was the tooth I

Posted by Dental News Team On December - 14 - 2009

Toothache 1/5

zahnodyssee_i1This week we would like to show you how it all began, just like one of those cartoon documentaries on evolution – except that we’re doing the evolution of the tooth!

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You know how some stories are long and need to be told in parts. Well, this is going to be a five-part series, which we personally think is long enough!
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Here is a short preview of all of this week’s episodes

  1. Getting my fillings replaced was a good idea, so why do I still have a toothache!
  2. One root canal after the other, but the toothache won’t go away?!
  3. Maybe you don’t have a toothache, but your face kind of hurts, is this a case of trigeminal neuralgia?!
  4. Teeth gone, toothache and desperation still around!
  5. The journey’s over, now you’ve made it to this article!

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Getting my fillings replaced was a good idea, so why do I still have a toothache!
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The sun is shining.
You’re finally making money on your own, you have long since left your parents’ house, and you may even have a family of your own. You have everything anybody could ever want – there’s a nice car in the driveway in front of your house, your four children are happily playing in the garden. You and your partner have achieved all your goals, you got your college degree, and then embarked on a great career – you’ve spent 15 years abroad and speak 4 languages.
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We are parents, lovers, adventures and friends in one, the only thing we always forget about is our teeth, until one fine day we decide to replace our old amalgamate fillings by something newer, whiter and more natural, composite fillings (white fillings). For a small sum, say 50-150€ we get our spanking new white fillings.
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Clouds on the horizon
You’re already on your way home when you start feeling pain after getting your fillings – one or more of your teeth start to ache! And when you bite down on something you get some kind of unpleasant „feeling“. Some of us are lucky, and it takes days, weeks, months, or even years until you start having problems with your teeth. Many of us only have problems for a short while but years later they come back in full force, and you have a bumpy ride ahead.
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Toothache – what now – what happened?
Plastics fillings consist of little building blocks, called monomers – kind of like legos. Once the dentist points the strange lamp at the fillings, these  monomers turn to polymers. The light puts the legos together – and the plastic hardens, a process called polymerisation.
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But the plastic can only harden thoroughly if moisture is kept away from the tooth, and this can only be done using a cofferdam. Moreover, the plastic should be applied in thin layers and allowed to harden immediately, otherwise the bottom layers will stay soft. Done properly, this may take up to an hour!
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These fillings should not be used on chewing surfaces either, as the polymers are unstable and monomers can start breaking out of the structure.
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Depending on how the procedure was performed (moist, without layering, deep fillings) loose monomers may be present from the very beginning, and start to break away eventually. These monomers are also “poison” to the dental nerve, which gets damaged and gives you a toothache. This may happen right away, or it might take days, weeks, or months, depending on the depth of the filling, how well the filling was made and the quality of the materials used. Your judgement may also be influenced by your sensitivity to pain.

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Stay tuned for: Once upon a time there was the tooth II

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