Dentalnews (en)

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!

Our body doesn’t like being put under pressure!

You know how it is when you press your thumb to your skin, the area turns white. This is because the blood vessels get squeezed together – leading to a temporary lack of blood, which makes the skin look pale. But it doesn’t matter if you only do this for a few seconds, after that blood circulation starts up again.
Being confined to a bed for a long time can have the same kind of effect, but worse – tissue can die, because this is not just a few seconds of pressure from the thumb, but the body’s own weight acting over a much longer period, which causes bed sores – as shown in this picture.

Obviously, pressure is bad. Now, the teeth „hang“ in the gums on a system of connective tissue, the desmodont. This desmodont consists of a multitude of little fibers strung up between the root and the bone. The motion of chewing turns into a tugging motion, tugging at the bone, that is!

Teeth start to move!

Teeth are not permanently set into the bone, they are „moveable“. If e.g. braces put pressure on a tooth, the desmodont can re-group, causing teeth to shift. This is how braces work, although our tongue and face muscles also put pressure on the teeth.

While the teeth tend to move together during adolescence (tertiary narrowing), as the lips and facial muscles continue to get stronger and exert more pressure, after about the age of 50 the opposite happens.

Lip pressure decreases, as does the tightness of the facial muscles (especially in the cheeks) and the tongue ends up exerting more pressure from inside the mouth. Moreover, recession of the gums, whether naturally or due to some illness (such as periodontosis) and the accompanying loss of bone, as well as  osteoporosis, means that the teeth are no longer as securely anchored in the jaw.

The front teeth start to fan out!

All of these factors cause the front teeth to slowly start to fan out. The teeth push forward, causing gaps to form. The longer this goes on, the quicker teeth start to shift, until the patient finally notices this and goes to a dentist.

Aligners are very effective in treating this displacement!

Receding gums can have many causes, but cleaning alone won’t help!

Some things that may cause your gums to recede are

* untreated periodontitis
* faulty tooth positioning
* anomalies in dental enamel (protrusions, bubbles)
* generally any kind of illness such as HIV, diabetes, or nicotine dependency
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During the second trimester of pregnancy, hormonal changes also make a woman more susceptible to illnesses of the gums.  But proper therapy can help to prevent receding gums during pregnancy!

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Depending on the cause, receding gums can be treated using the appropriate therapy. Watch the videos on these topics – simply follow the links below:

Periodontitis

Periodontosis

Recessions

Recession treatment

Does it matter what type of braces I use to fix my teeth?

Yes, because each type has its own pros and cons.

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Removable braces only work when a child is still growing, when it’s still very young.

Aligners do practically nothing to fix teeth which are twisted out of position, especially cuspids.

The lingual technique cannot be used in many cases.
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So which treatment is right for you?

Your orthodontist (a dentist who specializes in braces) can tell you. A „real“ orthodontist is one who has done at least for years of special training and now concentrates on doing „braces“, he or she even gets somebody else to pull teeth.

Although dentist are legally allowed to provide orthodontic treatment, this type of treatment usually lasts a long time (over 2 years) and may cause damage to the teeth or periodont.
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Ask your orthodontist what type of training he or she has done!

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More on the topic of “invisible” braces here!

• Who needs braces?

• How do braces from adults differ from braces for children and

• how much do braces cost?

>>These are the questions concerning most people

You can get braces no matter how old you are.
When you are young then removable braces may suffice. While a person is still growing, it is usually enough to get a slight „impulse“ in the „right“ direction – e.g. from removable braces!
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Once a person has stopped growing, then it is possible to get teeth into „order“ using fixed braces, no matter how old the patient is. Whether a retainer is necessary or not depends on whether the teeth are arranged in the best possible way – Category I.
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A lot depends on musculature, the size of the tongue and a host of other factors: whether the teeth begin to wander after treatment or not. Ask your orthodontist what kind of treatment would be best for you.
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Make sure to go to an orthodontist for treatment!

An orthodontist is a dentist who has had specialized training. Orthodontists usually only perform orthodontal work, they do not extract teeth or insert fillings. But they can answer your questions on whether the arrangement of your teeth is detrimental to your overall health. Some defective tooth positions may damage teeth, the jaw or the periodontal apparatus.
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Unfortunately, „normal“ dentists are also allowed to perform orthodontal work without undergoing specialized training. They usually offer different types of treatment. Simply ask a practitioner what kind of training they have had.

Treatment is usually charged on an annual basis.
This is why treatment may take three or four years, or even more. It is better to pay for the treatment as a whole, an experienced practitioner should be able to estimate the cost before the start of treatment. Moreover, most defective tooth positioning can be treated in about one or two years, anything which takes longer requires an operation.

Treatment may cost around 4 000€ to 12 000€ (app. 5 900 – 18 000$) , depending on the severity of the defect and the type of braces used. Find out more about the  lingual method, or „Incognito“ braces here.

Defective tooth placement can have many different causes, the most common being cavities in the milk teeth.

This often necessitates premature removal of milk teeth. However, milk teeth stimulate the jaw to grow. If this stimulus is lacking, then jaw growth slows down and the remaining teeth do not have enough space, resulting in over-crowding and displacement.

Good dental hygiene and well-planned treament can put a smile back on your face.
Good dental treatment requires an oral irrigator – more on that topic here.