HOW TO BRUSH?

Regular, thorough brushing is a very important step in preventing tooth decay and gum disease. Brushing removes the bacteria that promote tooth decay and the plaque that can cause gum disease.

Ideally, you should brush after every meal, because the bacterial attack on teeth begins minutes after eating. At the very least, brush once a day and always before you go to bed. Brushing your teeth isn't complicated, but there is a right and a wrong way. We do it every day without thinking too much, but there are some important points to remember when brushing your teeth.

Here are a few tips to help your brush better:
1. Squeeze some toothpaste onto a soft-bristled toothbrush. Your toothpaste should contain fluoride

2. Use short, back-and-forth brushing motions to clean the outside and inside surfaces of the teeth, as well as the chewing surfaces. Follow with up-and-down motions to clean the inside surfaces of the front teeth.

3. Clean every surface of every tooth.The chewing surface, the cheek side, and the tongue side.

4. Don't rush your brush. A thorough brushing should take at least two to three minutes. Try timing yourself.

5. Brush along the gum line. This is extremely important, as gum disease starts here. Brush gently to avoid damaging your gums.

6. Make sure to brush your back molars, where bacteria like to hide.

7. Brush your tongue to remove bacteria that cause bad breath.

8. Spit out the toothpaste and rinse your mouth with water or mouthwash.

9. Use a soft brush with rounded bristles. The right toothbrush cleans better. Choose a size and shape that allow you to reach all the way to your back teeth. There are many different types of brushes, so ask your dentist to suggest the best one for you. It is recommended you replace your toothbrush every three months.

10. Try to floss at least once a day, since most adult cavities occur between teeth. The most important time to floss is before going to bed. Floss before or after you brush'either is fine. Guide the floss between the teeth and use it to gently rub the side of each tooth.

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ORTHODONTICS

Orthodontics is the science of straightening and correcting teeth and any impaired (mismatched) growth of the jaws.

Who needs orthodontic treatment?
(1) Children as well as adults, are choosing to have orthodontic treatment for several reasons:
- Malocclusion
- Tooth Mal-alignment
- Unhappy with appearance of teeth

(2) During the preteen and teenage years, the jaws are growing and maturing; therefore it is easier to shift teeth at this stage rather than later on in adulthood.

(3) More adults are choosing to have orthodontic treatment in order to improve the appearance of their teeth. Since their jaws are no longer growing. Treatment may take a little longer.

What is Malocclusion?

Malocclusion is the improper positioning of the teeth and jaws. It is a variation of normal growth and development, which can affect the bite, the ability to clean teeth properly, gum tissue health, jaw growth, speech development and appearance.

Some Types of Malocclusion:
There are three basic categories of malocclusions:
(1) The first category consists of dental problems, in which the teeth (for various reasons) don’t have the correct position on their osseous base (dentoalveolus), and as a result they appear crowded, spaced or rotated. Usually these problems are not visible when the mouth is closed.
(2) The second category consists of skeletal problems, where the jaws have not grown harmoniously and that in turn has a negative effect on the function of the mouth and the esthetics of the face. In this category the goal of orthodontic treatment is to correct the position of the teeth and restore the balance of the face.
(3) Finally, in the third category the patient has a combination of dental and skeletal problems, which not only affect the oral cavity but also the esthetics of the face.

Why treat Malocclusion?

Orthodontics is not only used to improve your appearance. The main purpose of treatment is to get teeth into proper occlusion so as to improve the overall stability of your oral cavity.

Malocclusion or malaligned teeth can have long term effects, such as:
- Interference with normal growth and development of the jaws.
- Abnormal swallowing patterns
- Abnormal Facial Muscle function
- Impairment of chewing
- Speech defects
- Susceptibility to cavities due to the difficulty of removing plaque from crooked teeth.
- Vulnerability to accidents or fractured teeth (if your front teeth stick out, they may be more easily injured)

What are the goals of any orthodontic procedure?
To create:

What do the braces do to the teeth?

Teeth can slowly be moved and shifted into proper position by applying pressure in certain directions.

Bands, Wires and elastics are placed on the teeth to move them in the right direction. This takes place slowly and carefully over an extended period of time. Shifting teeth back into a functional position can take months to years, but eventually you will have a new and improved mouth and a longer lasting smile. Retainers are often used after the braces, to hold the teeth in their new position until they are stable.

It is important to wear the braces or an appliance for however long the dentist suggests. If you quit at any point during the treatment, the teeth can shift back into their old position.

Tips & Suggestions for maintaining your Braces
Braces collect food and dental plaque very easily. If proper oral hygiene is neglected during orthodontic treatment both tooth decay and periodontal disease can occur easily.

It is very important to maintain a daily plaque control program. Such a program may be as follows:
- A soft toothbrush should be used. A special orthodontic toothbrush can also be used to brush your teeth.
- Flossing with braces on takes more time than usual. Superfloss or floss threaders can aid in flossing, and make it more time efficient.
- An interdental brush can be used to fit between the wire and the tooth to remove hard-to-reach plaque and food debris.
- Oral irrigators can be used along with brushing and flossing. This helps remove food debris and plaque.
- A mouthwash containing fluoride can be used to help prevent cavities from occurring.
- Hard foods should be avoided since they can bend the wires, loosen the bands, or break the brackets (braces). Fruits and raw vegetables should be cut up into smaller pieces and chewed on the back teeth.
- Sticky foods such as chewing gum, hard candies, & toffees should be avoided as they can bend and break the wires and brackets.
- Foods high in sugar should also be avoided, since this will increase the chances of tooth decay.

Regular dental appointments are important to monitor the health of teeth and gums during orthodontic treatment.

Orthodontics is lot of work and taking care of the braces is not easy, but in the end, the results will be worthwhile when you have your new and improved smile....and remember, be proud to give a silver smile!

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ROOT CANAL TREATMENT

What is root canal treatment?

      

Common signs of pulp problems include:
- Pain when biting down on a tooth
- Sensitivity to hot or cold food or beverages
- Tooth discoloration
- Swollen gums around the infected tooth

Couldn’t I just have the tooth removed?
You could get it removed, but then adjoining teeth may shift and interfere with biting and chewing. You can have a replacement tooth implanted or attached to adjacent healthy teeth, but this can be expensive and require even more dental treatment. There is no real substitute for your own natural tooth, which is more efficient in chewing and biting than an artificial one.

What happens during root canal treatment?
An examination, including X-rays, will be performed. A local anesthetic will be given, if necessary. A sheet of rubber latex, called a “rubber dam,” will/may be placed around the tooth to isolate it and keep it clean and dry during treatment.

Complete root canal treatment usually consists of the following five basic steps:
Step 1. An opening is made in the crown of the tooth. Creating this access also relieves the pressure inside the tooth and can dramatically ease pain.

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GUM DISEASE

Stages Of Gingivitis And Periodontal Disease

Did you know?
Gum disease is a common dental problem that may result in tooth loss. Gingivitis and Periodontitis are the most common types of adult gum disease.

Healthy teeth and gums are maintained by daily plaque removal from all surfaces of the tooth (through tooth brushing and interdental cleaning)

The following features characterize healthy gums:
- Pink or coral pink color, (normal variations in color depend on race and complexion)
- Firm, resilient tissues
- 'Orange-peel' texture (known as stippling)
- Shape that follows the contour of the teeth and forms a scalloped edge
- No areas of redness, swelling or inflammation
- No bleeding during daily plaque removal

What Is Gingivitis?
Gingivitis is inflammation of the gum tissue. The gums are irritated and swollen due to a plaque or calculus (tartar) buildup along the gumline. The gums may be sore, bleed easily and appear puffy, soft and swollen. No bone structure is lost around the teeth at this stage of gum disease. Blood on the toothbrush or dental floss is one of the earliest and most common signs of gingivitis. Your gums should never bleed while brushing or flossing. The good news about gingivitis is that it is preventable and reversible through good brushing and flossing techniques (or other interdental tooth cleansing). On the other hand, if oral hygiene habits are poor, gingivitis may progress to Periodontitis.

What Is Periodontal Disease?
Periodontal disease is destruction of bone and the structures supporting the teeth. Unfortunately Periodontitis is irreversible, but you can stop its progression through good oral hygiene and visiting your dental professional.

Eight Warning Signs of Periodontal Disease:
- Gums that bleed when you brush or floss your teeth
- Gums that are red, swollen or tender
- Gums that have pulled away from teeth
- Infection including purulence (pus) between the teeth and gums when the gums are pressed
- Permanent teeth that are loose or separating
- Any changes in the way your teeth fit together when you bite
- Any changes in the fit of your partial denture
- Bad breath
- Itchy sensation

Early And Moderate Periodontitis:
- Periodontitis occurs when the inflammation of the gums progresses into the deeper underlying structures and bone.
- In the most common form of Periodontitis, plaque (and sometimes calculus) is found below the gumline.
- The gums may feel irritated, appear bright red, and bleed easily.
- The ligaments holding the tooth in its socket break down and the gums pull away from the teeth, resulting in a periodontal pocket or space between the tooth and gum.
- The periodontal pocket deepens and fills with more bacteria. Supportive ligaments and bone start to show damage.

Calculus and plaque do not have to be evident to the naked eye for periodontal disease to be present. You need regular examinations performed by your oral health professional to assess your periodontal health and determine if periodontal disease is active in your mouth.

After non-surgical periodontal therapy (i.e. scaling). The gums have been restored to health. Notice the gums have receded, exposing the root of the tooth. This is due to the irreversible bone loss as a result of previous periodontal disease. This can lead to tooth sensitivity.

Advanced Periodontitis:
- When Periodontitis progresses to the advanced stage, the gums severely recede (pull away from the tooth); pockets deepen and may be filled with pus.
- There may be swelling around the root and you may experience sensitivity to hot or cold or feel pain when brushing your teeth. This is due to the severely receding gums exposing the root surface.
- As bone loss increases, your teeth may lose so much support that they need to be removed to preserve the overall health of your mouth.

Advanced periodontal disease:
further progression of Periodontitis with major loss of bone support. The teeth may lose so much support that they may be loose

Adult gum disease is usually not painful. It can progress slowly. You may not even be aware of it until the advanced stages, when the tooth is in danger of being lost. Check your gums thoroughly and regularly. It is also important to go for regular checkups (at an interval schedule determined through collaboration with your oral health professional, based on your own personal needs). Your dental hygienist can detect the early stages of gum disease, when it is the easiest to treat.
Protecting your periodontal health brings many benefits. You can chew with more comfort. You can smile and speak with greater confidence. You can keep dental costs down by preventing further problems. A commitment to maintenance therapy is a commitment to better health.

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DENTAL IMPLANTS

The modern method of replacing missing teeth. Research shows that 85% of people who wear full or partial dentures experience some related discomfort and difficulty. Dental implants can eliminate those problems, restore self-confidence and improve the quality of life. From a single missing tooth to an entire set of teeth, dental implants can provide a permanent alternative to problem dentures, and help prevent the premature loss of remaining teeth. Dental implants can last a lifetime and are an excellent investment in oral health

Q: What are dental implants?
A: Dental implants are made of biocompatible materials that become directly attached to your jawbone. In dental terms, this is called “osseointegration.” Once anchored in place, your implants can be used to replace a missing tooth, support an entire set of teeth or retain an overdenture. The result is a natural type of tooth replacement that can restore the biting and chewing ability you once enjoyed, improve your appearance and renew your self-confidence.

                                          
                            Two-Stage Surgical Procedure       One-Stage Surgical Procedure

Q: What procedures are used to insert dental implants?
A: Placement of dental implants is a minor surgical procedure performed in one or two office visits. If you have one-stage implants, their metal tops will extend through the gums while your tissues heal, and you will not need a second surgery. If you have two-stage implants, they will be placed under the gums while the bone heals. You will need a second, simple surgery to uncover them and attach a post to support your replacement teeth. Your dentist’s decision to do a one- or two-stage surgical procedure depends on a number of clinical factors, such as the amount of available bone and location of the implants. After the implants are placed, the bone attaches to them and permanently anchors them within your jaw. In the meantime, your dentist may adjust your full denture or partial prosthesis for temporary use.

Restoration
Q: What restorations can dental implants provide?
                                          

WISDOM TEETH

What are wisdom teeth?
These are not extra teeth like most of us think. They are part of our normal set of teeth. Each one of us has 32 teeth. 28 would have erupted into the mouth by the time we are 13 years of age. The last four, one in each end of the upper and lower jaws are the wisdom teeth. There is a sequence of eruption and it just so happens that the wisdom teeth are the last ones to erupt at the age of 18 to 24 years of age. By then there is usually a lack of space for them to erupt properly and so most are always stuck(IMPACTED). So we always have this idea that they are extras!

Do we need to remove them?
There criteria most Dental Surgeons will have to determine whether that wisdom tooth of yours need to be removed. These are:
- They have given you gum pains before. These pains will usually subside after some medications and then will recur at a later date. No one can predict the frequency and severity of these recurring pains. They may or may not be accompanied by swelling and pustulent products.
- They have caused cavities in the teeth in front of them due to food trapping or they themselves have cavities from food trappings. These are usually determined by the dental surgeons after a check up or through x-rays results.
- They interfere with the treatment you are having. Usually this will happen in those who seek braces treatment.
- They are constant causes of food trapping and irritation.

What is an 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 loose teeth through decay as frequently as in the past, and our diet is such that our teeth do not wear down as much.

How are they removed?
There are two methods of removing wisdom teeth. They can be by simple extraction or they are removed by simple minor surgical procedures. These are determined by their degree of impaction. Removing wisdom teeth either by extraction or surgery can be performed under local anaesthesia or under general anaesthesia.
Local anaesthesia means that they can be done in the clinic when you are fully awake or sedated.
General anaesthesia will mean removing them while you are asleep and is usually done in a hospital environment under Day Surgery. i.e, you go home about four hours after the procedure is performed. These can be carried out either in the private hospitals or restructured hospitals. The surgeons can be private practitioners or from government service.
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, eventually filling in the socket completely, as illustrated here:
(note that there is a possibility of a swelling developing in the area which is normal and will reduce within a short time)

The Pro's and Con's of Wisdom Tooth Removal

Some Pro's 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 home care (brushing and flossing), bacteria and food debris remaining on the wisdom teeth may produce 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 to the 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 lays over the tooth may harbor food debris and bacteria that gets trapped under the gum, resulting in an infection in the gums.

Some Con's of Removing the Wisdom Teeth:
- 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/or bleeding. More complex extraction will require special treatment, which may result in more bruising, swelling and bleeding. However, your dental professional will provide you with post treatment instructions to minimize 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 dental professional.
- The longer you wait and the older you get, there is the potential for more problems to occur. This is because as you get older, the bone surrounding the tooth becomes more dense, making the tooth more difficult to remove. The healing process may also be slower.

Post Operative Care
- Do Not Disturb the Wound: In doing so you may invite irritation, infection and/or bleeding. Chew on the opposite side for the first 24 hours.
- Do Not Smoke for 12 Hours: Smoking will promote bleeding and interfere with healing.
- 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.
- 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.
- Control of Swelling: After surgery, some swelling usually expected mainly due to the reason that in some cases some bone covering that particular tooth may need to be removedwhich leads to swelling. This can be controlled through the use of cold packs (ice cube wrapped in a hand towel or kerchief.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 eight ounces of warm water).
- Medication for Pain Control: Anti-inflammatory medication such as Ibuprofen is used to control minor discomfort following oral surgery. The dentist may prescribe stronger analgesics if the patient is in extreme discomfort.
- Diet and Nutrition: A soft diet may be prescribed for the patient for a few days following surgery.

Following the removal of your wisdom teeth it is important that you call your dentist if any unusual bleeding, swelling or pain occurs. The first 6-8 hours after the extraction are typically the worst, but are manageable with ice packs and pain medication. You should also plan to see your dentist approximately one week later to ensure everything is healing well.

It is very important to talk to your dentist about extraction procedure, risks, possible complications and outcomes of the removal of these teeth. A dentist may do the actual extraction or it may be referred to an oral surgeon, who is a specialist in the field. This decision is based on the dentist’s preference and the unique features severity of each individual case.

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TOOTH WHITENING

Want Whiter, Brighter Teeth?

The best way to keep your teeth white is to brush twice a day, floss daily, see your dentist for regular checkups and professional cleanings, and limit stain-causing foods and habits. These include: tobacco, certain foods and beverages (such as coffee, tea and berries), some drugs (such as tetracycline), or trauma to a tooth. As well, your teeth may become stained or discoloured naturally as you age. Your dentist can give you the best advice about whitening your teeth.

HERE'S HOW IT'S DONE: Chairside bleaching - usually takes about 30 to 60 minutes and one to three visits to the dental office. A shield (or rubber dam) protects your gums from the bleaching agent (usually a form of hydrogen peroxide), which is "painted" onto your discolored teeth and activated with heat or high-intensity light.

Mouthguard Bleaching - is done by you at home. You wear a custom-made mouthguard with special bleaching gel (provided by your dentist) for a period of time each day, or overnight, over a number of weeks.

It's important to know that not everyone's teeth will "whiten" the same. It depends on the number of teeth involved and the severity of discoloration. Over-the-counter, at-home whiteners are not recommended because they may cause problems associated with over exposing gum tissues to the active whitening agent. Any bleaching treatment should be done under your dentist's supervision.

VENEERS

BEFORE                                        AFTER

Can I Improve My Smile?

Are you too self conscious to smile because your teeth are chipped, discolored, or poorly spaced? Cheer up, your dentist may be able to apply a porcelain laminate veneer to your teeth and give them a whole new appearance. Veneers are strong, thin pieces of porcelain that are bonded to the teeth. They are used to repair chipped, decayed or stained teeth and for closing gaps between teeth. With a bit of contouring, veneers can also rectify crowded or overlapping teeth. If your teeth have discolored with age, a veneer may improve their appearance. Veneers can also be used for cosmetic reasons instead of crowns, which are more often used for badly damaged or decayed teeth.

HERE'S HOW IT'S DONE: The tooth needs to be ground down and the veneer replaces the ground off surface. Veneer preparations frequently require the use of local anaesthetic and, depending on color and shade, may take two or more appointments to complete. Ask your dentist if veneers can help improve your smile.

The best way to keep your teeth white is to brush twice a day, floss daily, see your dentist for regular checkups and professional cleanings, and limit stain-causing foods and habits. These include: tobacco, certain foods and beverages (such as coffee, tea and berries), some drugs (such as tetracycline), or trauma to a tooth. As well, your teeth may become stained or discoloured naturally as you age. Your dentist can give you the best advice about whitening your teeth.

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COSMETIC BONDING

SPACE PRESENT                             SPACE CLOSED

As children reach their teen years, the appearance of their teeth can do much to promote a healthy self image and confidence.

Unfortunately, sometimes minor injuries occur, or cavities develop in front teeth, and in the past, the only solution was to fix or fill with typical amalgam, or go through an expensive capping or crowning process in order to restore the teeth to a more natural appearance.

Modern technology has changed this. Cosmetic bonding is basically the process of filling or fixing teeth with a tooth-colored filling material in order to maintain appearance by way of a beautiful and natural smile. Tooth-colored fillings are made from durable plastics called composite resins. Similar in color and texture to natural teeth, the fillings are much less noticeable and much more attractive than other types of fillings.

Your child can smile, talk, and eat with confidence. In addition, tooth-colored fillings are compatible with dental sealants, and a tooth can be filled and sealed at the same time to prevent further decay.

Tooth colored fillings may not work in every case, but for typical fillings and small restorations where appearance is important, can do wonders to provide a natural appearance and confident smile in your child.

Care for cosmetic fillings are the same as normal care, brushing, flossing, and regular dental visits. We will regularly check the fillings or repair for color change, leakage, or unusual wear and inform you of the need for repair or replacement.

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BRIDGES

A FIXED BRIDGE is a replacement that is cemented to the adjacent teeth and cannot be removed.

TOOTH JEWELLERY

Tooth Jewellery is the latest craze.

The latest fashion craze , this ready made tooth jewellery is available to everyone including the rich and famous. Fitting takes about 10 to 15 minutes is completely painless as there is no cutting of the tooth surface.

The jewellery is just cemented onto your tooth, the design can be changed several times if you want to change your smile, or even go back to your original smile.

Some designs include diamonds and also rubies, please specify which shape and if with diamond or ruby at time of ordering.

- No Drilling
- No Holes
- Painless Does Not Harm Tooth
- Temporary

Tooth Jewellery is the latest fashion accessory!

During a painless procedure, we fixe a jewel on the tooth surface. The jewel does not damage tooth tissues and has no side effects – except for the increased charm of your smile! Call it an oral fashion statement to stand out among ordinary mortals or simply an effort to blend in with the bold and the beautiful.

If somebody thinks he or she was better off without tooth jewellery, it can be easily removed without any side effects on the dental tooth structure as the procedure is non-invasive. What's more, tooth jewellery can be fixed again at a later stage.

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TOOTH LOSS & PREVENTION

Did you know that about 30% of adults over age 65 no longer have any natural teeth?! Tooth loss is more common in older folks who didn't have the benefit of growing up with fluoride (a mineral that helps keep teeth healthy and strong) in their water and other advances in dental care.

People usually need dentures because they've lost teeth due to:
- periodontal (say: per-ee-oh-dahn-tel) disease, or gum disease, which is caused by a buildup of plaque (a film that sticks to your teeth) and bacteria that attacks the gums.
- tooth decay (cavities), which happens in older adults more often because gums recede (become soft and worn down) as people age.
These problems get worse over time, especially if a person doesn't take care of his/her teeth, doesn't regularly see a dentist for cleanings and tooth care, or has health complications like diabetes or stroke. Some medications that older people may need to take every day can dry out the mouth and prevent good saliva flow, which is important in washing away food debris and keeping the mouth healthy.
So, what can you do to prevent anyone you know - as well as yourself - from needing dentures in the future? Take care of your teeth and urge other kids and adults you know to do so, too! Here's how:
- Carefully and gently brush your teeth twice a day with a toothpaste containing fluoride. Use a toothbrush with soft bristles, and try to remember not to brush too hard, which can cause gums to recede. If your toothbrush is all bent out of shape from the way you're brushing, then you're brushing too hard!
- Don't know how long to brush? Put on your favorite song. You should brush almost as long as the song.
- Be sure to floss your teeth at least once a day.
- Visit the dentist twice a year for a professional cleaning and checkup. Tell the dentist if you are experiencing gum pain or swollen gums or if your gums bleed when you brush.
- Don't drink or smoke. Smoking or chewing tobacco increases the risk of gum disease. Alone or paired with alcohol, tobacco increases the risk of throat and mouth cancers.

Drink plenty of water (six to eight glasses a day) and avoid sugary snacks and soft drinks between meals.

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COMPLETE DENTURES

What are Complete Dentures?

Complete dentures replace all of the natural teeth in the upper or lower jaw, or both, sitting on the soft (gum) tissue of the mouth that covers the bone ridge. Your dentist may use several different procedures to make sure your denture will fit the shape of your mouth, and provide the necessary support for your face. The design of the complete denture and position of the teeth will restore good speech and appearance.

Types of complete dentures:
A full denture, also called a complete denture, replaces natural teeth and provides support for cheeks and lips. Without support from the denture, facial muscles can sag, making a person look much older. There are the following types of complete dentures:
- Conventional full denture: after patient's remaining teeth are removed and the gum tissues have healed, this kind of denture is made and placed inside the mouth. The process for tissue healing may take months.
- Immediate full denture: The denture wearer does not have to wait during the healing period because after teeth removal, this kind of denture is made and inserted into patient's mouth.

How are dentures made?
Your dentist will take an impression of your jaw, along with measurements of how your jaws relate to one another and how much space is between them (bite relationship). The color (shade) of your teeth will also be determined either from your natural teeth or a denture you may already be wearing. The impression, bite and shade are given to the dental laboratory so a denture can be made just for you.

The dental laboratory makes a mold (model) of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a "wax try-in" of the denture will be done at the DENTAL CLINIC so any adjustments can be done before the denture is completed.

The denture is completed at the dental laboratory using the "lost wax" technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for the patient to wear.

Wearing Your Dentures
It usually takes a little while to get used to wearing a full denture. There may also be minor adjustments that your dentist will make to fine tune the fit of your denture. After a few weeks, you will be more at ease and your gums adapted to wearing a full denture.

It is very important that you wear your denture every day. If you don't wear your denture for an extended period of time, the denture may no longer fit as well as it should.

Over time, your mouth will change. The bone and gum areas may shrink or recede, causing the space between the jaws to change. Because your denture keeps its shape, adjustments will be needed to keep your denture fitting properly. Always consult your dentist rather than trying to fix the problem yourself. Trying to adjust them yourself will only cause more difficulties and what may have started out as a small problem could easily become a bigger one.

Getting Used to Your Denture
It will take a bit of time to get used to your new denture, particularly if it is your first. Unfortunately, a complete denture will not feel like your teeth did when you had them. They should, however, become comfortable and functional with time.

Speaking- At first you will have some difficulty with speaking and this is to be expected. Some people describe this as trying to talk with a "mouth full of marbles". Be patient; you will quickly adapt with practice and soon you will find you can not speak properly without your denture. There is no way to predict how long this will take, each patient adapts at a different rate.

Eating- Eating takes practice as well. The important thing to remember is that you do not chew with your denture as you did when you had teeth. Natural teeth chew in an up and down motion. Denture teeth, on the other hand, use a side to side motion to mash down the food. Always cut your food into small pieces for more effective denture chewing. It is unpredictable how well you will adapt to eating. Some patients can chew just about anything whereas others find they are limited in how well they can chew. All patients, however do improve with practice, time, and a bit of patience.

Denture Fit- Your denture will "settle in" in a short time and should fit well. The dentist will gladly adjust for any sore areas that may develop.do not stop wearing them if soreness develops,it needs adjustments. Report this to the dentist immediately. Upper dentures usually fit snugly and stay in with suction. The lower denture, however, does not develop this suction due to the different shape of the lower jaw. The lower tends to "float". You will learn with time how to help hold the lower stable by the way you use your mouth while eating, speaking, and resting. Once again, this takes time and it is not possible to predict how well each patient will adapt. Denture adhesives can help but it is recommended you not use them during the first few weeks of wearing your new denture.

How to Care for Your Denture?
- Keep your denture clean by brushing it with denture cleaning paste at least once a day. Do this over a sink filled with water to prevent breakage in case you drop the denture.
- Take your denture out every night when you go to sleep. Place it in some water in the box or cup with water Letting your denture dry out by not storing in a cup of water will slightly change it's shape enough to adversely effect the fit.
- Occasionally soak your denture in a commercial denture cleansing product which your dentist may prescribe to help disinfect it
- Rinse your mouth with mouthwash (without the denture) at least once a day to keep your mouth clean. This helps cut down on the amount of bacteria and fungus in the mouth which can lead to bad breath, denture sores, and infections.
- Make an appointment as soon as you develop any sores, change in fit, or any other problem you would like us to address.

The Life of your Dentures
Proper care and cleaning will increase the life of your dentures. Although they typically last five years, proper care and minimal jaw recession can extend the life of dentures up to 25 years. Dentures should be cleaned daily with a normal or specially-made denture toothpaste. In the case of tissue/bone shrinkage, worn down teeth, or breakage, dentures may come loose and need to be remade.

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COMMON MYTHS

Many decades ago unqualified dentists (quacks) provided certain dental treatment that was not based on scientific principles and along with this kind of assumption based treatment, myths developed which became imprinted in people's minds. Dentistry today is an advanced specialized branch of medical science based on scientific facts. Research in dental science has led to better understanding of oral diseases and a systematic approach to treatment based on facts became established. This advancement in dental science has only reduced the myths and not completely eliminated it from the minds of the people. In this article few of the myths, which still exist, are presented along with their related facts for people to understand.

- Myth - Removal of upper teeth affects vision.
- Fact - There is a myth among many people that removal of the upper teeth affects vision. This is a misconception. Vision is not affected in any way by undertaking treatment of the upper teeth including its extraction.

- Myth - An artificial set of teeth or complete denture that is made once is forever.
- Fact - While it is true that well fitting dentures are used by the patient for many years, it is a myth that it can be retained forever. The oral tissues that lie below the dentures change over a period of time. But the dentures are made of stiff materials that do not adapt according to the changing contours of the oral tissues. Thus even a well fitting denture may not fit well after a few years. If an ill-fitting denture is continued to be worn, it can cause damage to the underlying tissues. Thus most dentists’ advice changing of the dentures once in at least 5 years.

- Myth - Professional cleaning/scaling/removal of tartar loosens the teeth.
- Fact - Teeth are held firmly by the supporting tissues of the periodontium including bone. Bad oral hygiene results in the deposition of tartar /calculus on the tooth surface. These deposits irritate the gums and can cause inflammation and bleeding of the gums. If the tartar is not removed, the gums may recede and the supporting bone around the teeth gets destroyed. The tartar on the teeth thus causes great harm to the supporting tissues of the teeth. However, patients may experience slight mobility of the teeth after tartar is removed as it kind of binds the teeth together. Professional cleaning removes this tartar and arrests further destruction of supporting bone. Removal of tartar deposits only helps to recover the health of supporting structures. This chain of events does not take place in people who have dental checkup regularly.

- Myth - Dental procedures are always painful.
- Fact - Most dental procedures are carried out if the need arises under local anesthesia, which makes the procedures totally painless. In addition the modern day high-speed drills cause less vibrations and are more comfortable for the patients.

- Myth - Dental treatment should be avoided during pregnancy.
- Fact - The above notion is not true. Many a times dental treatment is provided even during late pregnancy. Routine dental procedures can be carried out without any fear. However, some major surgical procedure may require medical opinion before treatment. Dental X-rays are to be avoided during the first three months of pregnancy.

- Myth - Cleaning the teeth with finger & powder is better than with toothbrush.
- Fact – The use of a toothbrush with bristles is to clean plaque and food particles from almost all the surfaces of the teeth. The finger may not reach all the areas as well as a brush does. Hence, it is recommended to use a toothbrush with paste to clean the teeth and freshen the mouth. Finger can only be used to massage the gums after brushing is complete.

- Myth - Charcoal, salt, rice husk, tobacco, etc, in powder form is better than toothpaste in cleaning teeth.
- Fact - The objective of cleaning the teeth is to remove the plaque and food particles on and around the teeth by the bristles of a toothbrush with the help of a toothpaste or powder. A standard paste or powder contains proper sized particles, which are not harmful to the teeth. However, other powders are coarse and can erode the outer layer of the teeth and permanently damage them. Hence, only standard toothpaste or powder should be used with a toothbrush. Toothpaste is better than powder as it can easily be dispensed on the brush and it may contain fluorides, anti-tartar chemicals, etc. The foaming action of the toothpaste also helps to freshen the mouth. Tobacco should not be used. Users enjoy the euphoric effect of nicotine present in tobacco rather than cleaning of the teeth and slowly become addicted to it. Hence, it should never be used.

- Myth - Thumb sucking by children leads to forward placement of upper teeth.
- Fact - Thumb sucking is a normal infant habit, which makes the child feel secure and happy. It usually decreases after the age of 3 years. However, if the habit persists beyond the age of 4-5 years it can cause problems of the teeth including forward placement of the teeth. In these children, depending upon the frequency and severity of the habit an intervention of the habit by a dental surgeon may be required.

- Myth - A child never needs cleaning of milk teeth.
- Fact - It is a myth that we need not clean a child's teeth. Children are as much prone for dental decay or gum diseases as adults. In fact children tend to have sweet food including sweetened milk and juices, which can promote dental decay. So it is advisable to start the habit of cleaning the infant's teeth soon after they appear in the mouth. In fact it is advised to clean baby’s gum pads everyday by gentle massage even before the teeth erupt.

- Myth - Milk teeth need not be cared for because they last only for a few years, and these teeth will anyway be replaced by permanent teeth.
- Fact - Early loss of milk teeth will interfere with chewing and affect the child’s nutrition. Early loss of milk teeth leads to drifting of the adjacent teeth and closure of some of the space that is required for the succeeding permanent teeth to erupt into. Such a loss of space will cause the permanent teeth to erupt in irregular position and result in crowding. Therefore milk teeth need to be cared for as much as permanent teeth.

- Myth - When the gums bleed, it is better not to brush the teeth.
- Fact - Bleeding of gums is a sign that they are inflamed and are not healthy. This usually is a result of plaque and food particles accumulating around the teeth. Until this collection is removed, the gums continue to bleed. This is an indication that the individual needs to visit a dentist for opinion and treatment. Brushing the teeth with a soft toothbrush by the proper technique removes the plaque and helps the gums recover. Initial bleeding seen during brushing gradually reduces over a period of time.

- Myth - Keeping an aspirin tablet beside a painful tooth reduces the tooth pain.
- Fact - A toothache cannot be relieved by placing an aspirin tablet anywhere in the mouth. In fact this is a dangerous habit as it causes burns of the soft tissues around the area of placement. Hence, aspirin tablets should not be placed in mouth but swallowed after eating some food to relieve the pain.

- Myth - When an artificial set of teeth are worn, the upper denture logically has to fall down in the mouth and create problems, however the lower denture that should rest in place does not stay.
- Fact - Although the lower denture rests on the ridges of jaw, it does get easily dislodged because of the interference of the muscles of check, lips tongue and movement of the jaw during function. However, with time the muscles learn to co-ordinate with the lower denture and the patient overcomes this problem. The upper denture, on the other hand stays in its place due to creation of suction under the palate.

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WHAT TO DO IN EMBARRASSING DENTAL CONDITIONS?

Common Embarrassing Dental Problems Which You May Face Occasionally And Their Remedy

BREATH-BAD
* Brush your teeth after every meal with fluoride toothpaste
* Do not brush your tongue, use a tongue scraper to clean you tongue regularly and floss daily
* If you wear dentures take them out daily and clean them thoroughly and brush you teeth and/or gums thoroughly
* Use a dentist administered cleansing mouth rinse that neutralizes the sulfur compounds and kills the bacteria that contributes to bad breath.
* Make sure to drink at least eight cups of water a day.
* Keep a log of foods you eat to determine which foods are causing your problem
* Schedule regular dental checkups with professional cleanings
* Keep your mouth moist always,do not allow it to dry.
* Use a moisturizing nasal spray to control post-nasal drip, which can be a contribution factor
* Tobacco causes bad breath, ask your dentist/doctor for tips to kick the habit.

ORTHODONTIC PROBLEMS -Braces
* If a wire is causing an irritation, cover the end of the wire with a piece of gauze. See the Dentist immediately
* If a wire becomes embedded in the gum or cheek DO NOT remove it, go to the dentist immediately.
* If a Bracket (Brace) comes of visit the dentist and get it refixxed as soon as possible as these components are expensive & can potentially delay the treatment

CROWN COMES OFF
* Try to snap it back in to prevent losing it.
* Preserve it carefully and avoid dropping it
* Do NOT use ordinary household glue to fix it back
* Call the dentist as soon as possible to re-cement it properly

DENTAL INJURIES CAN BE PREVENTED:
* Child proof your home
* Make sure your children are belted safely in their stroller and car seat.
* Ensure that the whole family uses seat belts
* Wear a custom made mouth guard while in “school” sports and during weekend sports and activities
* If you are away from home, be sure to carry your doctor’s business card. So if you have a problem you can call for a telephone consultation so he can help you decide whether you need to seek immediate dental care.

BROKEN DENTURE, BRIDGE, OR PLATE
* Save all the parts of your broken denture, bridge or partial denture.
* Call your dentist
* If it is possible it may be repaired or it may need to be replaced as soon as possible the latter is always better.
* Temporary bridges, plates and dentures can keep you comfortable until the permanent one is repaired or replaced

DRY MOUTH
* Many medications such as antidepressants can cause this Consult with your Doctorr. to see if there are alternative medications that will not cause this symptom
* Put water in a spray bottle to keep your mouth moist. Try a little Lemon juice in the water to stimulate your saliva glands
* Chew sugarless gum to keep your mouth moist
* Use a moisturizing gel like oralbalance
* Use a saliva substitute such as glandosane.

BLEEDING AFTER AN EXTRACTION
* Slight bleeding after an extraction is normal. Clots usually form within one hour if you follow doctor’s post-op instructions.
* Place a thick gauze pad over the extraction site and apply pressure by biting on the gauze
* Avoid rinsing, drinking or eating for at least one hour following the extraction
* After 24 hours rinse the area with warm salt water(1/2 tsp. salt in 8 oz of water) after eating to keep the site clean
* Wet a tea bag and place it on the extraction site and bite on it
* Avoid sucking, spitting, and smoking

NUMBNESS CONTINUES AFTER EXTRACTION
* If a tooth has been extracted on the lower back area, it is possible that you may not regain full sensory feelings immediately
* After 24 hour contact your dentist to let him know your symptoms

STILL UNHEALED EXTRACTION SITE
* If you are still unhealed one week after an extraction you need to go to the dentist for an X-ray to see if a root tip or fragment is still embedded
* Do NOT wait to see your dentist

BROKEN/ FRACTURED /CHIPPED TOOTH OR FILLING
* If the tooth is broken/chipped/fractured and there is no other damage requiring hospital care go to the dentist within 2-3 hours. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. The dentist can smooth minor chips. The tooth may also need to be restored with a composite filling.
* Stop any bleeding by applying direct gentle pressure to the gums. If an upper tooth, apply pressure to the gums above the tooth. If a lower tooth, apply pressure to the gums below the tooth. Do NOT press directly on the broken tooth.
* Rinse the mouth with warm water and apply cold compresses to reduce swelling.
* Find the broken tooth fragments and bring the pieces with you; they may be able to be "cemented" back together
* Eat only soft foods. Avoid this side of your mouth when eating. Avoid food and drinks that are hot or cold, eat only lukewarm
* The more the tooth is bothering you before you go to the dentist the more difficult it is for the dentist to treat you comfortably.
* If the pulp is damaged it can mean a root canal.
* This tooth may need a full permanent crown to protect if from further breakage and tooth loss.

INJURY TO THE SOFT TISSUE INSIDE THE MOUTH
* These include tear, puncture wounds or lacerations to the check, lips or tongue.
* Clean the area right away with warm salt water
* Bleeding from the tongue can be reduced by pulling the tongue forward and using gauze to place pressure on the wound area
* Go to the doctor/hospital if it needs stitches

BURNING GUMS AND/OR ROOF OF MOUTH
* Ask your doctor for a prescription for anti-viral medications
* Use Doctor Prescribed Painkillers
* Try a topical application of prescribed local anaesthetic for the discomfort

SORE AFTER SCALING AND ROOT PLANNING
* Follow after care instructions given you properly by the dentist
* Use the prescribed mouth rinse
* Try eating soft foods
* Continue to gently brush and clean the area well

GUM SURGERY
* After the time determined by your dentist rinse with warm salt water (1/2 tsp. salt in 8 oz of water) to help with the discomfort.
* Try taking extract vitamin C to help quicken the healing period
* SMOKING WILL DELAY ALL HEALING. Stop smoking

FRACTURED JAW
* If your jaw hurts when it is moved or you cannot close your mouth in a normal manner, immobilize the jaw with a towel or tie.
* Go to the doctor/hospital. A blow to the head can be especially life threatening to a child. They can give you treatment and tell you if you need to see the dentist

SWOLLEN JAW
* Place a cold compress to the area swollen never use warm compress.
* Call the dentist immediately as you may have an infection and need to be on antibiotics