small-prophet

How to Manage Toothache and Dental Pain

Fri, 10 Jan 2020 21:16:02 GMT

We do not want you to be in any pain! However there are situations where pain relief is needed. COVID-19 Alert Level 3 and 4 are examples we would not have anticipated in the past. You might also be travelling in to see us with a sore tooth, or healing an infected or damaged tooth. Here are some guidelines on how best to manage dental pain.

Analgesics (painkiller medications)

Analgesics or ‘painkillers’ include drugs such as paracetamol, NSAID’s (non steroidal anti-inflammatory drugs) and opioids. They are often combined, as in panadeine (paracetamol and codeine) or maxgesic (paracetamol and nurofen). Instructions on how to take analgesics are listed below.

Remember analgesics only block the pain, they do not cure infection or kill bacteria. If you are in pain and are not receiving treatment, it is important to come and see us as soon as possible.

Paracetamol

Paracetamol (Panadol) is very good for managing mild to moderate pain. It can be used for severe pain but is usually combined with other medications. During the first 48-72 hours it is best used at regular intervals, instead of ‘as required’.

Paracetamol is a very safe analgesic. It has few side effects providing you never exceed the recommended daily dose. Be careful when combining with other medications as some pain, cough and cold products also contain paracetamol.

The recommended total daily adult dose is 4g which is 8x 500mg tablets. This is commonly taken as 2x 500mg tablets, 4 times per day (every 6 hours).

NSAIDs: Non-Steroidal Anti-inflammatory Drugs

NSAIDs are excellent for managing mild to moderate pain. When combined with other medications they are very effective against severe pain. They include aspirin, ibuprofen, diclofenac, naproxen and voltaren.

A side effect of NSAIDs is possible indigestion and stomach ulcers. For this reason they should always be taken with food and at the lowest dose for the shortest possible time. They should not be taken for more than 2 weeks without the supervision of your GP.

NSAIDs are safe but should not be used in the following cases:

Allergy to aspirin or any NSAID
Aspirin should not be used under the age of 16 years
During pregnancy or breast feeding
On blood thinning agents (anticoagulants)
Suffering from a defect of the blood clotting system (coagulation)
Active stomach ulcer

Care is needed if you have:

Asthma
Kidney impairment
Heart impairment
Liver impairment
You are elderly

Rubbing on topical anti-inflammatory gels such as Voltaren Emugel can reduce joint or muscle pain. However they can also cause the problems listed above. Make sure you wash your hands after use and avoid contacting your eyes.

Mild Opioids (Codeine Phosphate/Dihydrocodeine/Tramadol)

Opioids work well for mild to moderate pain. However they are most effective when used in combination with paracetamol and/or NSAIDs. Opioids are usually used during the early phase of treatment and for shorter periods of time because of their side effects. These include constipation, vomiting, nausea, drowsiness and light headedness. People may also develop a tolerance or addiction to the drugs. To prevent constipation you may need to adjust your diet and drink more fluids.

Tramadol may interact with other medicines (including other opioids, warfarin, antidepressants, and antipsychotics ). It is very important you inform your prescriber of all your medications to avoid this.

If you become dizzy or drowsy do not drive or operate machinery.

How to take analgesics

The trick to getting the best pain relief is to take the drug as a course of medication at regular intervals for a set period of time. This means the blood levels of the drug are kept high and best pain relief is obtained. Most analgesics need to be taken every 4-6 hours

For Mild Pain

Use Paracetamol 500mg tablets.

Take 1-2 tablets every 4-6 hours to a maximum of 8 tablets per day (4g total/24 hours)

Use Ibuprofen (Nurofen/Brufen) 400mg tablets.

Take 1 tablet every 4-6 hours to a maximum of 6 tablets per day (2400mg/24 hours)

For Moderate Pain

In adults, excellent pain relief can be achieved by taking paracetamol and ibuprofen alternately every 2 hours (so each individual drug is only taken at 4 hour intervals). The paracetamol can usually be stopped after 24-48 hours.

Use Paracetamol 500mg tablets.

Take 1-2 tablets every 4-6 hours to a maximum of 8 tablets per day (4g total/24 hours)

PLUS

Use Ibuprofen (Nurofen/Brufen) 400mg tablets.

Take 1 tablet every 4-6 hours to a maximum of 6 tablets per day (2400mg/24 hours)

For Severe Pain

In adults, excellent pain relief from severe pain can be achieved by taking paracetamol and codeine together, and ibuprofen alternately every 2 hours (so each individual drug is only taken at 4 hour intervals). The paracetamol and codeine can usually be stopped after 24-48 hours.

Use Paracetamol 500mg tablets.

Take 1-2 tablets every 4-6 hours to a maximum of 8 tablets per day (4g total/24 hours)

PLUS at the same time

Use Codeine 30mg tablets.

Take 1-2 tablets every 4-6 hours to a maximum of 8 tablets per day (240mg total/24 hours)

PLUS

Use Ibuprofen (Nurofen/Brufen) 400mg tablets.

Take 1 tablet every 4-6 hours to a maximum of 6 tablets per day (2400mg/24 hours)

How else can I manage pain?

Apply a cold pack to the site of the pain.
Gently increase activity and exercise, but not in the first 24 hours after a tooth extraction.
Physiotherapy, osteopathy, chiropractic treatment, massage and acupuncture.
Distraction and relaxation techniques.
Alcohol is not recommended.

What to Expect After Dental Hygienist Treatment

Sun, 29 Dec 2019 07:32:08 GMT

A typical hygienist appointment will involve ‘debridement and prophylaxis’, the removal of a plaque and calculus from the surfaces of your teeth. If you are suffering from periodontal disease then this may include tooth surfaces both above and below the gum.

Possible problems and what to do

Sensitivity to hot and cold – As damaging as tartar can be to the gums, it does have an insulating effect on the tooth underneath. Removal may expose the root surface, opening the ‘tubules’ or pores in the teeth that transmit temperature through to the nerve. Usually this will settle down within 3-4 days as the teeth remineralise and the healing gum tightens up. If sensitivity persists, treatment is the same as for sensitive teeth, with daily use of Tooth Mousse and/or’ ‘Sensodyne’/’Colgate Rapid’ toothpastes.

Sore gums – After all the irritants have been removed (plaque, tartar and food remnants), gums may have a raw sensation. Placing a teaspoon of salt in a cup of warm water makes a very effective salt water mouthwash. Rinsing several times a day as needed will help sooth the gums, reduce inflammation and speed up healing. Over the counter mouthwashes can be used, following the advice of your dentist or hygienist. You can also take normal painkillers as required, according to the directions on the packet.

Bleeding – Healthy gums don’t bleed. Inflamed gums bleed very easily, often just with the touch of a tooth brush or floss. You will sometimes get a small amount of gum bleeding during and after hygienist treatment. This will usually stop within a few minutes. Prolonged bleeding is very rare. If you do get lots of blood in your mouth after treatment, follow the instructions as for an extracted tooth and contact us for further advice.

Gum recession – Tartar and plaque may cause gums to become very swollen and inflamed. As the gums recover from this damage, they tighten up against the teeth and may shrink back. Once your gums are at their correct and healthy height, your teeth will be much easier to keep clean. Unfortunately, once recession has occurred, the gum at the necks of the teeth will rarely grow back. The only solution is gum surgery with a periodontist (gum specialist). This is why preventing and maintaining gum disease is so important.

Enlarged gaps between teeth – Removal of large amounts of tartar and the healing of inflamed gums may also leave gaps between your teeth. Again, these areas will be much easier to keep clean and maintain. Sometimes as the gums continue to recover, they will slowly grow back to fill in the spaces between teeth, but this is unpredictable.

Mobile or loose teeth – Gum disease causes the destruction of the tissues that hold your teeth firm in your jaw bone. As the tartar grows and the gums become inflamed, everything becomes very tight, and teeth can appear more stable than they really are. Sometimes we even see teeth stuck together with tartar. Once the tartar is removed and the swelling resolves, there may be more movement in the teeth. This usually improves as the healing gums tighten up against the teeth again.

Keep up the good work!

It is important to continue diligent homecare, brushing twice for 2 minutes and flossing daily. Your mouth will often be a bit tender, so initially brush and floss gently. Remember that perseverance with home care is essential to stop the bacteria growing back and gum problems getting re-established.

If you have any questions or persistent symptoms which fail to improve or get worse, please don’t hesitate to contact us .

What to Expect After a Root Canal

Sun, 29 Dec 2019 07:32:01 GMT

After a root canal dressing

In order to clear up in the infection and stop the pain from your tooth, at the first visit we have remove the main part of the nerve and place an antibacterial dressing. This is designed to kill the bacteria that have grown in the tooth and cause any discomfort. As it takes time for this dressing to start working and the tooth is very inflamed, you may still have some pain after the initial treatment. We recommend that you take painkillers such as paracetamol as you need them. Any discomfort should be significantly improving by the following day. If it is not, please contact us and we will arrange to dress the tooth again.

So the antibacterial dressing has time to kill all the bacteria and sterilise the tooth, we normally leave it sealed in place for two to three weeks. Then we bring you back and complete the root filling and the filling on top. If you decide to leave the tooth for longer than a few weeks before a second appointment, there is a risk the active ingredients in dressing may run out and the tooth may get sore again.

After root canal completion

To seal your tooth and stop bacteria from growing inside it, we removed the antibacterial dressing and place an inert root filling material. This fills up the whole inside of the tooth so there is no room for any bacteria to grow. It is now up to your body to heal and to remove any remaining infection outside the tooth. For this reason, you may still have some discomfort after the final treatment. We recommend that you take painkillers such as paracetamol as you need them. Any discomfort should be significantly improving in the next few days. If it fails to keep improving or gets worse please contact us.

The success of root canal treatment depends mainly on how well the tooth is sealed from saliva and the bacteria in your mouth. Research has shown the best seal is obtained by placing a protective crown or onlay on the tooth. For this reason we highly recommend placing a permanent restoration as soon as we are sure the root canal treatment has healed. Usually we allow 6-12 months and will contact you for a review appointment.

If you have any questions or persistent symptoms which fail to improve or get worse, please don’t hesitate to contact us .

Laserbrite In-Surgery Tooth Whitening

Sun, 29 Dec 2019 07:31:57 GMT

General information

Tooth whitening is a procedure that is designed to lighten the colour of your teeth. When done properly, whitening will not harm your teeth or gums. Significant lightening can be achieved in the majority of cases but the results cannot be guaranteed. Whitening, like any other treatment, has some inherent risks and limitations. These are seldom serious enough to discourage you from having your teeth whitened, but should be considered in making an informed decision to have the treatment.

Risks and side effects

A small percentage of people may experience side effects. These may include tooth sensitivity, a burning sensation in the gums, soft tissue ulcers, nausea, temporary changes in the bite and temporary jaw joint soreness. In the unlikely event of swallowing any whitening solution, you may experience some throat irritation. If you have any symptoms or questions about these symptoms, please discuss them with the clinician.

Completion of treatment

Level of lightening: There is no reliable way to predict how light your teeth will whiten. With Laserbrite tooth whitening, one session is sufficient to significantly lighten the teeth. This is followed by ‘maintenance’ home whitening which we recommend you use for no more than 2-4 weeks unless you have tetracycline staining.

Relapse: Once whitening is complete there may be gradual relapse back to the original colour. To reverse this relapse a repeat treatment may be necessary after 6-12 months, however wearing the home whitening tray once a month will help prevent this from occurring.

Diabetes and Dental Health

Sun, 29 Dec 2019 07:31:53 GMT

Diabetes is a chronic disease which can be controlled but not cured. However for people at risk of developing the disease, it can be prevented by leading a healthy lifestyle.

There are several forms of Diabetes. Type 2 diabetes affects the majority of diabetics. For those with the disease it can be managed with healthy food choices, medication and exercise. Type 1 affects about 10% of diabetics and cannot be prevented but can be managed the same way. Gestational diabetes is a third type that occurs during pregnancy. It will usually resolve at the end of the pregnancy. Unfortunately these mothers are more at risk of developing type 2 diabetes in the future.

Dental complications of diabetes

Increased risk of gum disease.
Risk of hypoglycaemia (decreased blood sugar) and hyperglycaemia (elevated blood sugar) during dental appointments.
Impaired healing, especially when diabetes is uncontrolled. This can lead to complications after gum therapy, tooth extractions and other mouth surgery.
Increased fungal infections in the mouth (thrush), especially if you wear dentures.
Dry mouth
Impaired taste

Diabetes and gum disease

People with diabetes have twice the risk of developing gum disease.
The risk level is higher if the diabetes is not controlled.
The risk level is higher the longer the diabetes has been present.
Gum disease is more severe in people with diabetes and progresses twice as fast.
Gum disease is worse in people with diabetes who smoke.
Diabetes and gum disease are related in children and adolescents as well.
The relationship works both ways. People may have more difficulty controlling their diabetes if they have periodontal disease.

Important information before dental visits

Tell your dentist you have diabetes, any medications you are taking and how well your diabetes is controlled.
Take all your medications as normal.
Book appointments when you know your blood sugar levels will be normal. Usually this means eating before your visit.
If you take insulin, appointments in the morning after breakfast are ideal.
Continue to eat normal meals after your dental visit.

How to keep your mouth and body health

Have a healthy lifestyle by:

Quitting smoking
Controlling your blood sugar levels
Taking medications as directed by your doctor
Reducing your intake of salt and sugar
Drinking lots of water and avoiding sugared soft drinks and fruit juices
Eating breakfast lunch and dinner everyday
Reducing your intake of high cholesterol and saturated fat containing foods
Controlling your weight by reducing calorie intake and exercising regularly
Eating the correct quantities of food

Prevent gum disease by:

Brushing your teeth twice a day with a fluoride toothpaste
Cleaning in between your teeth daily with floss or other dental aids
Having regular dentist visits at least once per year
Having regular hygienist treatments and following their advice

Not only will eating less sugar decrease your risk of tooth decay but leading a healthy life style will benefit you in multiple ways. Many of the risk factors for diabetes, heart disease and periodontal disease are shared. The risk of developing all three diseases can be reduced by making healthy choices.

For further information visit diabetes.org.nz

Heart Disease and Dental Health

Sun, 29 Dec 2019 07:31:49 GMT

Heart diseases account for 30 % of all deaths annually and are the main cause of death in New Zealand.

Periodontal disease and heart disease both have multiple risk factors, many of which are shared. For this reason it is difficult to study the association between them. However they are both chronic inflammatory diseases. Recently, this inflammation is thought to be the link between the two. Neither have been proven to cause the other, however having periodontal disease may increase your risk of heart disease. Treating periodontal disease will simply decrease the inflammatory load that your body has to cope with.

The shared risk factors for gum disease and heart disease that can be modified include:

tobacco smoking
diabetes mellitus
stress
obesity

How to reduce your risk of gum disease and heart disease

Quit smoking
Reduce your intake of salt and sugar
Reduce your intake of high cholesterol and saturated fat containing foods
Control your weight by reducing calorie intake and exercising regularly
Try and minimise stress if possible
Brush your teeth twice a day with a fluoride toothpaste
Clean in between your teeth daily with floss or other dental aids
Have regular dentist visits at least once per year
Have regular hygienist treatment and follow their advice

Smoking and Dental Health

Sun, 29 Dec 2019 07:31:45 GMT

Does Smoking affect Dental Health?

Tobacco is used to deliver the highly addictive drug nicotine. It may be chewed, snuffed or smoked. In New Zealand it’s most common use is in cigarettes. Smoking.

The cold, hard facts

In New Zealand 5000 people die each year from smoking, 4200-4700 from smoking themselves and the rest from second hand smoke exposure.
Half of all long-term smokers will die from a smoking related disease.
Long-term smokers who die from a smoking related disease, die 15 years earlier than non-smokers.
One in four cancer deaths in New Zealand are caused by smoking.
Children are three times more likely to smoke if their parents are smokers.

Smoking has a negative effect on nearly all of parts of the human body. The health problems it causes include:

Lung disease (including 80% of lung cancers)
Heart disease and heart attacks
Strokes
Poor pregnancy outcomes
Infertility
Impotence
Blindness
Diseases of the mouth and throat

Diseases of the mouth include oral cancer, periodontal disease, smoker’s melanosis, black hairy tongue, tooth abrasion and gum recession.

Smoking effects in the mouth

Smoking reduces the blood supply and oxygen to all areas of your mouth. This impairs the ability of the gums and supporting tissues to heal and to fight bacteria.

These bacteria include the ones causing gum disease (periodontal disease). Because of the decreased blood supply, smokers often have less redness or gum swelling. Smoking masks the warning signs and how severe gum disease really is. A smoker has 2-3 times more risk of gum disease than a non-smoker. The more you smoke and the longer you smoke the greater the risk. Smokers have deeper pockets, more gum recession and more bone loss. Smokers lose more teeth than non-smokers.

Smoking reduces healing after mouth surgery including tooth extractions and gum therapy. Post treatment complications are much more likely.

Smoking stains teeth, fillings and dentures. It causes bad breath and loss of taste.

In patients requiring dental implant treatment, smoking decreases the success rate by 20%.

Smoking is one of the main risk factors for mouth, throat and oesophageal cancers. When compared to non-smokers:

People who smoke less than 15 cigarettes per day are 5.3 times more likely to get mouth cancer.
People who smoke more than 25 cigarettes per day are 14.3 times more likely to get mouth cancer.
When combining smoking with alcohol use, mouth cancer risk jumps even higher. Heavy alcohol and cigarette users have a 38 fold increase in developing mouth cancer.

The good news

There is a relationship between the number of cigarettes smoked, the length of time you have been smoking and the risks of and gum disease and mouth cancer. The more you smoke the greater the risk of disease but the less you smoke the less the risk. You can prevent further damage and stop the progress of the gum disease by quitting smoking. After quitting smoking, the risk of mouth cancer reduces immediately.

Don’t smoke. If you do smoke, the less you smoke the better. Better still, quit.

Quitting smoking

It is hard work, but you can quit smoking! Help to stop smoking may be found at the following websites:

smokefree.org.nz

quit.org.nz

cancernz.org.nz

Remember, nicotine in cigarettes is powerfully addictive. Quitting usually takes two or more attempts. If you don’t make it first time, be prepared try again.

What You Need to Know About Dental X-Rays

Sun, 29 Dec 2019 07:31:41 GMT

Dental x-rays are now an essential part of modern dentistry. They provide us with a huge amount of diagnostic information. They allow us to see what is going on under the gum, inside the tooth and in the surrounding bone. X-rays are very safe.

An x-ray works in much the same way as a camera. The difference is that it uses a small dose of radiation instead of light. This shines through your jaw and records an image on a film which we can then view. The radiation dose with conventional films is very small. It has been compared to the same quantity of radiation you receive while flying on an international flight. Using the latest digital equipment we can further reduce your radiation exposure to 10% of conventional x-rays.

The advantages of digital x-rays include:

Reduced radiation exposure to 10% of conventional x-rays.
X-rays can be viewed on computer immediately.
Better for the environment as no chemicals are needed to develop films.
Safer for staff as they are not exposed to poisonous chemicals.
Images are in digital format so we easily send them to specialists or to patients who require copies.

Intraoral x-rays

These x-rays are placed inside your mouth and show us detailed images of the tooth and its surrounding structures. They very helpful for diagnosing the following:

Tooth decay

Images show if decay is present, where it is and how deep it is. By comparing successive x-rays we can also see how fast decay is progressing. Sometimes it is not advancing at all and if the surface of the tooth is still intact, we can watch and repair it with careful home care and fluoride application. Routine ‘bite-wing’ x-rays of your back teeth should be taken every 2 years for a healthy individual, more frequently if your teeth are assessed as being at increased risk of decay.

Problems with existing fillings

X-rays allow us to see in between teeth and under existing dental work. We can see filling overhangs, poor fitting crowns and bridges and leaking or broken fillings that may need repair or replacement.

Gum disease

We can accurately see bone levels around each tooth and where bone has been lost due to gum disease. Again we can compare successive x-rays to tailor treatment and make sure the disease is under control. In some people the calculus (hardened plaque) is so thick on their teeth you can see it on an x-ray.

Root canal treatment

After 10 days of dental infection, early abscesses can become visible in the bone as a shadow on x-ray. Well established dental infections are usually more obvious. These indicate the nerve of a tooth is dying and root canal treatment is needed. During root canal treatment x-rays are used to measure the length of the root and make sure all the infected nerve is removed. Finally, review x-rays are taken after completion, to make sure the site is healing and treatment is a success.

Accidents

X-rays are a vital part of assessing teeth after accidents. We look for cracks and fractures, teeth knocked out of position, damage to adult teeth below and infections. They are also used in future reviews to make sure growth is normal and injuries are healing correctly.

Panoramic x-rays

The jaw is a curved shape, similar to a horse shoe. A panoramic x-ray provides a flat, two dimensional image of this half circle. The film does not go inside your mouth but sits inside the machine instead. To minimise radiation exposure and provide an instant computer image, our panoramic x-ray machine is also completely digital.

It captures all the upper and lower jaw and provides information on:

impacted teeth (teeth which haven’t come through into the mouth)
extra and missing teeth
bone loss from gum disease
accident assessment including broken jaws
dental implant assessment
denture assessment
orthodontic assessment
the jaw joint (TMJ)
the sinuses and nasal cavities
cysts
cancers and tumours
calcifications in the carotid arteries (indicating atherosclerosis and increased risk of heart attack)
diagnosis of dental abnormalities

Panoramic x-rays are excellent at showing us the ‘big picture.’ However intra-oral x-rays are still needed to see fine detail such as tooth decay. Panoramic x-rays are routinely taken as part of our ‘New Patient Examination’ and in other cases when indicated.

Safety: lead shields and pregnancy

When using the older x-ray machines small amounts of the main x-ray beam used to bounce off and ‘scatter’ sideways, potentially exposing the other parts of the body. In the past some dentists used lead shields to protect you from this radiation. Our modern equipment uses filters, collimators and a decreased exposure time, so scattered radiation is almost completely eliminated. There is also a theory that lead neck shields can bounce the scatter radiation back to your body. For these reasons we do not routinely use them.

As a precaution, to give unborn babies the best protection, we do avoid x-rays for pregnant mothers unless absolutely necessary. The early embryo is such a small group of developing of cells we do not want to risk any radiation exposure at all. We do have a full body lead shield to protect in utero babies if needed. It is important to tell us if you think you might be pregnant before we take any x-rays.

Caring For Dentures

Sun, 29 Dec 2019 07:31:33 GMT

Why clean your dentures?

Plaque forms on dentures the same way as it does on natural teeth. While your dentures will not decay, plaque growth may cause problems with bad breath and staining, not to mention an unpleasant feel. If left, plaque will mineralise and form calculus (tartar), a hard, chalky deposit which is very difficult to remove.

Staining may be caused by smoking, tea, coffee, and certain coloured foods and drinks. Plaque and calculus are particularly susceptible to taking up discolouration. Plaque and stains are easily removed from a clean denture, but calculus is much more difficult.

Poor oral hygiene and plaque formation can also cause ‘oral thrush’ under your denture. This is caused by the ‘candida’ organism. Again, it is prevented by keeping your denture clean.

The three steps to denture care

1. Brushing

Dentures should be removed and brushed with a soft toothbrush and a mild soap. It is best to avoid using toothpaste on your denture as most toothpastes are too abrasive and will slowly wear your denture away. Brushing removes plaque and food debris.

It is a good idea to clean your denture over a soft surface or basin of water to prevent damage if it is dropped.

If you are wearing a partial denture, it is equally important to clean your remaining natural teeth with a fluoride toothpaste. This is best achieved by removing your denture first to access as many surfaces of your teeth as possible. If you have a full denture simply rinse your mouth thoroughly with water while your dentures are out.

2. Overnight Soaking

Dentures should be soaked in a sterilising solution once a day. Ideally they should be removed and soaked overnight. This thoroughly cleans your dentures but also gives the gums time to rest. We recommend using ‘Polident’ denture cleanser, following the manufacturers instructions. Alternatively use a teaspoon of hypochlorite bleach (‘Janola’ or ‘Chlorogene’) diluted in a glass of water. We do not recommend using ‘Steradent’ as have found it bleaches the pink colour out of some denture base materials.

If you have a metal partial denture or metal clasps on your denture do not use bleach solutions as they will corrode the metal. Only soak your denture in ‘Polident’ cleansing solution. ‘Polident’ is available in most chemists and supermarkets.

If you decide not to take your dentures out at night, treat them like your natural teeth and clean them before bed and when you get up in the morning.

3. Rinsing

Before placing your dentures back in your mouth, rinse them with water to remove any sterilising solution.

Problems with your dentures

Sore Spots and Ulcers

Sore spots are very common, especially with new dentures. If these persist for more than a couple of days, please call us. Usually your denture will simply need minor adjustment in the problem area.

Speech Problems

Speech may initially be difficult, especially for the new denture wearer. Perseverance and practice are the key to success. Reading aloud is a good exercise. Usually speech will become more natural within 1-2 days.

Eating

Eating may be awkward at first as the technique is different from eating with natural teeth. Your denture teeth are not anchored into the jawbone like natural ones, but are joined together for stability. It is often easier to chew with your side teeth than your front ones to avoid the denture tipping.

It may also be easier to start with soft, less sticky foods, cutting them into smaller pieces. The muscles of your tongue and cheeks will quickly adapt to your new eating habits, and eating will become easier each day.

Stubborn stains and deposits

Some stains and calculus cannot be removed by brushing. It is necessary to see a dentist to remove these.

If you have any other problems or questions regarding your new dentures and their care, please don’t hesitate to contact us .

What You Need to Know About Nitrous Oxide Sedation

Sun, 29 Dec 2019 03:44:09 GMT

Nitrous oxide (sometimes referred to as ‘laughing gas’) is a mild sedative which is used to help relax and calm patients during dental treatment. It often causes a feeling of euphoria and laughing with decreased pain sensation and occasionally some memory loss.

Nitrous oxide is a colourless, sweet smelling gas which is inhaled through a mask that covers only your nose. It is very short acting and its effects are only felt while you are breathing in the gas. As soon as you start breathing oxygen or normal air again, it wears off rapidly. This means it is very easy for you and your dentist to control.

There are no prolonged side effects when using nitrous oxide and normal activity can be resumed after the dental procedure.

Alternative treatment options

The purpose of nitrous oxide is to make it more comfortable for you or your child to receive the necessary dental care with less pain and less anxiety. Alternative treatment options are:

No treatment.
No nitrous oxide sedation, with the necessary procedure being performed under local anesthesia only (being awake for an injection).
Referral to hospital for dental treatment under general anaesthesia (being put to sleep by an anaesthetist).

What to expect

Patients are fully awake thoughout the procedure.
Patients are fully aware of their surroundings and are able to respond rationally to inquiries and directions.
Nitrous oxide provides good pain relief. However, we do not rely on this alone, but use it to prevent the patient from feeling the local anaesthetic injection.

Effects may include:

tingling in the fingers, toes, cheeks, lips, tongue, head or neck area
heaviness in the thighs/or legs, followed by a lighter floating feeling
resonation in the voice or presence of a hyper-nasal tone
warm feeling throughout body, with flushed cheeks
episodes of laughter
a feeling of detachment or disassociation from the environment
lightweight or floating sensation with an accompanying “out of body” sensation
sluggish movement

Possible side effects:

Some patients may not like the sedation sensation, but it can be quickly reversed by simply breathing air through your mouth. The possible complications from nitrous oxide sedation are rare and temporary. They include:

slurring and /or repetition of words
intense and uncomfortable warm and/or hot feeling throughout body
excessive sweating
giddiness
feeling of nausea
agitation
hallucination
vomiting

Contraindications

Woman who are pregnant, think they may be pregnant or are trying to conceive (including IVF), should avoid exposure to nitrous oxide. Research has shown an association between high levels of nitrous oxide exposure and an increased risk of miscarriage of the baby.

Nitrous oxide restrictions

You may have a light meal up to 2 hours prior to surgery (toast, bagel, fruit, muffin).
You may have clear liquids up to the time of surgery (juice, water, black coffee, tea).
There are no driving restrictions.

Consent for treatment

Please download the nitrous oxide consent form here

What to Expect After Local Anaesthetic at Your Dentist

Sat, 28 Dec 2019 23:21:13 GMT

To make the dental procedures as comfortable as possible we may place local anaesthetic (an injection) beside your tooth. You will have a numb lip, tooth, gums and sometimes tongue for about three hours. It is important not to bite, burn or hurt your lip or tongue while it is asleep.

It is not uncommon to have some discomfort around the injection site. In the lower jaw the anaesthetic is placed deeper and there is sometimes bruising in the area. When the jaw is opened, the previously relaxed muscles are stretched flat against each other. Any bruising is squashed between the muscles and may be sore. This will usually improve within 2 weeks.

In very rare cases, the numbness may last longer. If you have numbness lasting longer than 12 hours, or if you have any questions, please don’t hesitate to contact us .

What to Expect After Laser Treatment

Sat, 28 Dec 2019 23:16:15 GMT

What to Expect After Laser Treatment

If your gum requires reshaping due to a deep filling or crown that extends below the gum, you may receive treatment with a soft tissue laser. This gently trims the excess gum away. Because the laser uses intense light with no heat, there is no damage to the adjacent tissue. It makes a sterile cut with no bleeding, forming an immediate scab with very little swelling. Healing is much faster than conventional surgery.

Initially the scab appears white. The scab is fragile and should not be removed so we recommend you avoid brushing the area for 3-4 days. Alcohol free, colourless mouthwashes can be used. Alternatively place a teaspoon of baking soda in a cup of water to make a sodium bicarbonate mouthwash. When you start brushing, go very gently. It is helpful to run your brush under warm water to soften the bristles.

If you have received laser treatment for an ulcer, you should have no extra discomfort afterwards as it uses a very low power setting.

If you have any questions or persistent symptoms which fail to improve or get worse, please don’t hesitate to contact us .

What to Expect After a Filling or Crown

Sat, 28 Dec 2019 23:12:06 GMT

What to expect...

After a crown preparation

Temporary crown care

So that your tooth is protected, we have placed a temporary crown until your permanent crown is completed. We will be removing your temporary crown at your next visit, so it is only glued with temporary cement. It is designed to come off. It is very important that you treat this tooth care, avoid sticky foods, and when flossing pull the floss out sideways by one end only.

The temporary crown might feel a little rough, and the colour may not match exactly. However at your next visit we will replace this temporary with a permanent crown which will be a perfect fit and have an excellent colour match.

Lost temporary crown

If your temporary crown comes off, it is important that you contact us to get it put back on. If you have lost, broken or swallowed your crown, don’t worry, we can quickly and easily make a new one. If the crown is not replaced, the tooth may move and your finished crown may not fit.

After a filling or final crown fitting

Sensitivity

It is not uncommon to get temporary sensitivity to biting, hot or cold. Normally this will settle down in the next few days. If necessary, post-treatment sensitivity can be treated the same way as dentine sensitivity.

In rare cases sensitivity may last longer. This usually occurs with deep fillings where there is only a thin layer of tooth protecting the pulp (nerve) underneath. Luckily the cells in the pulp are very clever and can lay down more dentine on inside of the tooth. In effect the pulp recedes back into the root as the tooth heals itself. Tooth tissue is very hard, much harder than bone. A broken bone may heal in a matter of weeks whereas an injured tooth can take weeks or months to settle.

If the tooth fails to keep improving or gets worse, please contact us.

High spots

We carefully check your restoration to make sure it is not too high. However sometimes when you are lying back with your jaw in a different position, or after local anaesthetic, it is difficult to get you to bite together normally. If your tooth feels high please contact us, as you risk damaging the restoration or hurting the tooth. It is very easy to adjust and usually takes no more than five minutes. Of course there is never any fee for these adjustments.

White fillings

For the best aesthetics and to save the maximum amount of tooth, the most commonly used fillings are tooth coloured, composite resin. Composite is a plastic type filling material that is bonded to the tooth. The bonding procedure uses a mild acid to prepare the tooth. This opens the pores or tubules in the tooth so the glue layer has something to grip on too. These tubules can transmit temperature and pressure to the nerve in the center of the tooth. This is the reason you may experience some sensitivity, especially in deeper fillings.

Composite fillings are set with a bright blue light during your appointment. You can bite on them straight away. You can brush and floss normally.

Amalgam fillings

Amalgam (metal) fillings are one of the strongest fillings placed directly into your tooth. However they take 24 hours to harden and reach their full strength. Try to avoid biting or chewing on that tooth until the following day. It is alright to eat and drink, simply try and chew on the other side. You can brush and floss normally.

We are unable to bond amalgam fillings to your tooth. The filling has to be held in by undercuts and sometimes pins. As amalgam and the pins are metal they will conduct temperature very well. For this reason amalgam fillings are often hot and cold sensitive after placement. This may last for several days but should keep steadily improving. Remember if the tooth fails to keep improving or gets worse, please contact us.

Home care

All fillings and crowns can be brushed and flossed daily from the time they are placed. As meticulous as we are, the join between a filling and a tooth will never be as smooth as a natural tooth surface. We highly recommend using a fluoride toothpaste. This will help keep the tooth and filling margin free from plaque and as resistant to decay as possible.

Complications

Fillings are never placed in healthy teeth. They are always placed in teeth compromised by decay, cracks, fractures, previous restoration or combinations of these problems. Every time a tooth is treated the nerve is stressed. Sometimes the tooth will not recover from the stress or trauma of a filling and may start to die. When this occurs, the tooth can usually be saved by performing root canal treatment.

If you have any questions or persistent symptoms which fail to improve or get worse, please don’t hesitate to contact us .

What to Do After an Extraction

Sun, 01 Dec 2019 09:53:55 GMT

Rest

For the remainder of the day, avoid strenuous exercise or any activities which increase your heart rate and blood pressure. Such increases may cause bleeding.

Rinsing

DO NOT RINSE YOUR MOUTH UNTIL THE FOLLOWING DAY. This includes cleaning your teeth. Rinsing your mouth may dislodge the blood clot and cause bleeding. If you get blood in your mouth, simply spit it out.

The following day, start rinsing with a mouthwash, swishing it around the affected area for at least one minute. Repeat this at least 5 times a day, ideally every time after eating. Continue this for the next six days. A simple and effective mouthwash uses ½ a teaspoon of salt dissolved in a glass of very warm water. Alternatively, use a capful of ‘Savacol’ antibacterial mouthwash if instructed. Continued use of ‘Savacol’ mouthwash may cause staining of your teeth or tongue, so use it for only 3-4 days unless advised otherwise.

Eating, Drinking and Smoking

AVOID HOT DRINKS. Drink normal cold and warm drinks. Eat soft food, but try to avoid eating on the side of the extraction. It is important to maintain a diet of soft nutritious foods to aid the healing process.

DO NOT SMOKE FOR AT LEAST 24 HOURS. The longer you refrain from smoking, the faster the gum will heal. Smoking seriously slows the healing process. Avoid alcohol for 24 hours.

Pain

Unfortunately most extractions are uncomfortable afterwards. Taking a painkiller (analgesic) before the anaesthetic wears off will help. Then take painkillers as required for discomfort, following the manufacturer’s instructions on dosages. Paracetamol (‘Panadol’) is usually sufficient, however you may be prescribed something stronger if required. You may find our guidelines on managing dental pain are helpful.

Bleeding

A slight ooze of blood is normal for the first 24 hours. If there is more bleeding, roll up a piece of gauze or cotton and bite firmly on this for at least 15 minutes. Sit up. Don’t lie down as this will make the blood go to your head. If there is excessive bleeding, please call us.

Healing

The initial healing period takes one to two weeks depending on the difficulty of the extraction. Expect some swelling and bleeding in the first 24 hours. During this period the tooth socket will fill up with blood forming a clot. The bone and gum will slowly grow back as the socket heals over. It is important not to dislodge this blood clot as this will impair the healing and may cause complications.

Complications

Please contact us if excessive bleeding continues or if you have a fever, severe swelling or severe pain.