Tooth and Tips

Part of your routine dental care, along with having your teeth cleaned  includes having a complete dental exam performed by your dentist. It is important to be checked regularly by your dentist (at least every year or whatever is recommended based on the health of your mouth/ every six months).

Continue reading “Understanding the Dental Examination”

It’s the festive season packed with weddings , engagements , graduation ceremonies, religious gatherings and so on . Dental offices are booked for dental cleanings and whitening for these special occasions. I have been asked time and again these two valuable questions :

How to avoid staining the teeth? What can we do at home to keep the teeth white besides toothbrushing and flossing?

We should bear in mind that the tooth is made of minerals and is porous, therefore it will tend to get stained over time if left in staining agents.

Staining agents!? Yes! Tea and coffee are examples of staining foods. We so love our hot beverage in this cold weather, but too much of it does tarnish your whites. They are known as tannins. Other tannins are red wine, pomegranate, citrus fruits, smoked foods and vegetables.

Continue reading “Tips for clean bright teeth”

Hello!
Crown, Veneer Lumineer, those are strange terms that one can come across, or hear at the dental office. What are they?

They are actually methods of preserving / restoring a tooth.

A crown is a prosthetic restoration used to entirely cover or cap a damaged tooth. Besides strengthening a damaged tooth , a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth like shape and structure for function.

Your dentist may recommend a crown to

  • replace a large filling when there isnt enough tooth remaining.
  • protect a weak tooth from fracturing
  • restore a fractured tooth
  • attach a bridge
  • cover a dental implant
  • cover a tooth that has had a root canal treatment.

How a crown is fit

Visit 1. On your first visit to the dentist, the tooth is prepared and an impression is taken.

  1. step1 : After numbing the area the dentist trims some tooth structure ,just enough to provide space for the crown to fit in. This is also done to provide adequate strength and give room for proper shape.
  2. Step2: After the tooth is reshaped and impression is taken by the dentist.
  3. Step 3: Shade selection with your dentist, to make sure that it looks as natural as possible , similar to remaining teeth
  4. Step 4: A temporary tooth is made on the chair to replace the tooth while the impression is being sent to the laboratory.

Visit 2.

  1. On your second visit, the temporary tooth is removed.
  2. The permanent crown is fitted, and occlusion is tested using an articulation paper.
  3. Once both doctor and patient is satisfied, the crown is cemented tp the tooth.

Crowns can be of different materials such as metal , ceramic or ceramic over metal.

Veneers

Dental Veneer are tiny shells of porcelain that are custom made to fit over teeth providing a natural attractive look. they can be used to fix chipped stained misaligned worn down uneven or abnormally spaced teeth. Veneers are difficult to stain , making them popular for people seeking a perfect smile while keeping as much sound tooth structure as possible.

Procedure for getting a veneer

Getting a veneer usually takes 3 sittings with the dentist.

The first one is consultative where a dentist examines the teeth to make sure if it is appropriate and discuss the procedure and planning .

If a different shape is desired like the case I am working on at the moment, then at first appointment an impression is taken for study model and sent to the laboratory and a wax up is made.

At second appointment, if the patient validates the projected result, the dentist will shave a little bit of enamel from the tooth surface. This will be equal to the thickness of the veneer that will be added on the tooth.  Next an impression will be taken and sent to the dental laboratory where a the prosthesist will fabricate the veneer. The dentist will put a temporary veneer on your tooth. And you will be recalled in about a week time.

After a week, the temporary veneer is removed and the permanent veneer is cemented. The dentist will tell you a list of precautions to be taken.

Lumineers on the other hand are very very thin shell like structures placed on the teeth without the need of shaving the tooth. This is done in very specific cases. And very few laboratories do it in the Indian Ocean do it.

Personally the laboratory I send my works to do Emax Veneers.

IPS e.max Lithium Disilicate

Lithium disilicate (LS2) glass-ceramic is ideally suitable for the fabrication of monolithic restorations or veneered restorations in the anterior and posterior region. Due to its natural-looking tooth colouring and excellent light-optical properties, this material produces impressive results.

Years of clinical experience
The material is used in the dental laboratory in conjunction with either press or CAD/CAM technology. Years of clinical experience confirm the high strength of 500 MPa* for IPS e.max lithium disilicate. The outstanding performance of the material is based on a combination of excellent flexural strength and high fracture toughness adjusted to the given dental requirements. The clinical success of the material attests to its quality. Furthermore, these properties allow you to work according to the requirements of conservative dentistry. Depending on the patient situation, the restorations may be veneered in a highly esthetic manner or, if fabricated as monolithic restorations, they will be stained.

Patients with devitalized teeth
Even if the preparations demonstrate a dark shade (e.g. as a result of discolouration or titanium abutments), all-ceramic restorations may be used. In this case, it is important for you to inform your laboratory about the die shade, and the dental technicians then selects the IPS e.max lithium disilicate material in the required opacity in order to design the true-to-nature esthetic appearance.

Indications

  • Veneers (≥ 0.3 mm)
  • Inlays and onlays
  • Occlusal veneers, partial crowns
  • Minimally invasive crowns (≥ 1 mm)
  • Implant superstructures
  • Hybrid abutment solutions
  • Three-unit bridges up to the second premolar as the terminal abutment

Advantages

  • Excellent esthetics and high strength (500 MPa*)
  • Versatile applications and extensive indication range
  • Minimally invasive preparation and adhesive cementation of crowns with a layer thickness of 1 mm
  • Clinical long-term success and scientifically documented results
  • Natural-looking esthetics irrespective of the preparation shade
  • Adhesive, self-adhesive or conventional cementation depending on the indication

* Mean biaxial flexural strength (IPS e.max CAD 530 MPa, IPS e.max Press 470 MPa). Source: R&D Ivoclar Vivadent, Schaan, Liechtenstein

Below are more information about the materials used. Please do not hesitate to contact me if you have more questions.
Links:

Brochure for patient information.

Brochure for dentist 

Lab to dentist

Video of Crown fabrication at the lab

 

Hello dear readers!

How is December at your place? Here in tropical Mauritius it is hot!!! We all want to have chilled drinks and go to the beach!!! Please do so , and enjoy , because all work and no play makes John a dull person isn’t it? I myself can’t recall when was the last time I had proper holidays. But to be honest I love the view from the reception desk, I see palm trees, and part of Port-Louis Moka Range and the clear blue sky!

Today I will write something from a Dentist perspective. Please do not take any offence 😛

Don’ts and Do’s of patients at Dentists  Continue reading “Do’s and Don’ts at the dentist.”

Like all things dentist-related, dental anesthesia probably seems a little scary at first. We understand that gut reaction. If your dentist gives you a drug for a procedure, it probably means that procedure is really serious, right? You might even think that dentists only use anesthesia for risky or especially complicated procedures.

We’d like to show you why your fears are unfounded. Truthfully, dental anesthesia is safe, effective, helpful, and totally routine. Dentists use it every day, for all kinds of different procedures. Just because you have to have anesthesia for a dental procedure doesn’t mean there’s something seriously wrong with your teeth.

WHAT WE USE

Dentists use a variety of different anesthetics for different purposes. The type they use depends on what they need the specific anesthetic to do. Here are three pain control items we commonly use at dental offices, how they work, and what they’re for:

TOPICAL ANESTHETIC

Topical anesthesiaTopical anesthetic is applied to a specific area of soft tissue to numb it. It’s commonly referred to as numbing gel or jelly and even spray. Dentists usually apply it with a simple cotton swab or cotton roll. In order to work effectively, dentists let the gel sit on the surface it’s numbing for a few minutes.

Generally, dentists use topical anesthetic to numb the cheek or gums before an injection of local anesthetic in order to make the injection more comfortable. It works great on the surface of the mucosa or gums, but it can’t reach the nerves deep under the gums or within the teeth. Whenever dentists need to drill into teeth (like they do when placing fillings), they need to use more than just a topical anesthetic. It’s possible that your dentist won’t use topical anesthetic for every procedure. If your dentist doesn’t use numbing gel, don’t panic. If you are concerned about the anesthetics they’re applying, feel free to ask!

My patients love the gel, and mind you they are mostly adults! 🙂

LOCAL (INJECTED) ANESTHETIC

local anesthesticDentists use local anesthetic by injecting it directly into the area they want to numb. A local anesthetic temporarily deactivates the nerves in a specific part of the mouth. After administering it, dentists can perform a variety of procedures in that area without the patient feeling it. Dentists inject local anesthetics through a thin needle, usually after applying a topical anesthetic to the area. The patient seldom, if ever, feels pain from the prick of the needle used for the injection. At worst, they may feel a brief, slight pressure at the point of insertion.

Lidocaine is the most commonly used local anesthetic among dentists, but there are several other common varieties as well. Along with the anesthetic itself, injections often include a small amount of epinephrine (which your body already makes for itself in larger quantities) to constrict the blood vessels around the injection site and help the anesthetic work effectively and last longer. Dentists use local anesthetic for dental procedures that would be painful without it, like root canals, extractions, or fillings. Contemporary local anesthetics effectively numb any area that invasive dental procedures could affect.

NITROUS OXIDE (LAUGHING GAS)

NOT YET ALLOWED IN MAURITIUS- DEMAND HAS BEEN MADE

nitrous oxideNitrous oxide, or “laughing gas,” is a colorless, odorless gas commonly used to reduce anxiety in patients during dental procedures. Although it’s technically not an anesthetic, it does have some pain control properties. It’s called “laughing gas” for the euphoric state it imparts when it’s inhaled. Dentists administer it via a breathing mask that fits over the patient’s nose. The patient breathes in a mixture of the gases that’s usually around 30% nitrous oxide and 70% oxygen. The gas begins working within minutes. Dentists easily reverse the effect after treatment by switching to 100% oxygen.

Nitrous oxide doesn’t put patients to sleep, but it does have an effect on the nervous system. It’s used primarily as a means of relaxing anxious patients, but it also has some analgesic properties that help control pain. Nitrous oxide is considered reliable and safe because the effects are mild and easily reversed. It’s ideal for dental procedures because patients under its effects remain conscious and can respond to questions. Dentists can also easily control the amount of nitrous oxide administered to the patient. Dentists use Nitrous oxide in conjunction with, not instead of, local anesthetics.

WHY WE USE IT (anesthesia) ?

Procedures like fillings, crowns, and root canals involve drilling into a tooth to remove decayed tooth material. In the case of root canals, dentists even have to remove inflamed or diseased pulp tissue and nerves. Fortunately, anesthetics allow dentists to perform these procedures safely and effectively in the controlled environment of the dental office while your body doesn’t know that’s what’s happening.

Without anesthetics, many dental procedures would be quite painful, even though they’re being performed perfectly correctly. Anesthetics numb your mouth’s nerves to keep them from transmitting pain signals to your brain. You don’t interpret the procedure as painful. After the dentist finishes the procedure, your mouth won’t either! Many dental procedures may cause minor aches and pains for a couple days after they’re completed, and sometimes injection sites can be sore as well. This discomfort is also natural, and is usually the result of the needle penetrating through gums or mouth muscles during the injection.

 

Still feel a little scared of dental procedures? That’s ok! You can always ask me about any and all concerns you have. We’re always happy to walk you through our process and put your mind at ease.

Hello all!!

Sometimes we can write a lot, but in the end a picture speaks louder, and easier to explain whatever is happening.

In this post I will put some pictures to illustrate progression of caries, to illustrate gum disease hence importance of prophylaxis treatment, the tooth eruption chart, so that parents know what to expect and at about what period etc.

 

old amalgam fillings vs tooth coloured restorations

 How to replace tooth/teeth

1. If the root is still present and can be restored, then a crown can be made. (1st picture)
2. second picture illustrates the use of post and core under a crown if the tooth structure remaining is not very strong.

 

if a tooth has been extracted then
a. a bridge of at least 3 units can be used as fixed option
b. an implant
or
c. a removable denture

 

 

  

When the gums start to become red and bleed , it is one of the signs that gum diseases have begun. We can at the office do prophylaxis treatment, through scaling/ root planning.

At home to maintain the hygiene, brushing and flossing should be continued.

 

  

 

Deep caries in Primary teeth should be treated too

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Happy  Divali Friends

I hope you had a great one!! We can have a good Divali and healthy teeth if we follow the following tips :

  • Sweets and chocolates are an integral part of our celebrations. Enjoy your Divali cakes, but just ensure to brush twice a day, in the morning and at bedtime. Make it a habit to floss as well.
  • Use fluoridated toothpaste as they prevent bacteria buildup in your mouth and help prevent cavities.
  • During the day, if you cannot brush, have a glass of water after eating sweets. Having a glass of water helps wash away the sticky sweets. Not to forget, drinking water even helps you control weight.
  • You may chew upon Sugar free gums after eating sweets as the sugar free gum helps in cleaning the mouth and increase saliva flow. Increased saliva flow increases our ability to fight bacteria and avoid cavities.
  • Avoid fizzy drinks; they are  bad for our health.
  • Avoid sweets just before bedtime.
  • Take special care of your kids as they tend to skip brushing during festivities. Remind them to brush and floss at morning and bedtime. Ask them to rinse after eating sweets. Get them a tooth brush of their favorite character to motivate them to brush.

Toothache is the worst thing to happen during Diwali time and especially when others are savoring on Diwali sweets.

Have a fun filled, prosperous and safe Diwali!!!!!

Found this post informative, please feel free to share

As you could guess, I have recently been promoted to mummy status.

Being a mum brought a lot of changes and my dear friend Pretty who works in the UK in the dental field too told me it is actually a good subject for my blog.

How has becoming a mummy helped me and how do I manage?

The thing is  I live with my husband and we are in different fields. He is in the IT sector . We have different work hours and with the baby it is not quite easy.

I was working in Quatre Bornes, and was becoming a slave of work and was stressing if I could attend to baby needs etc. I suddenly became mom, business owner, driver, cook , cleaner , daughter and wife. People talk about equality and stuff, but for women like myself who work on our own it is not very easy. We do not get paid maternity leaves, au contraire we have to keep paying loans, keep paying rent and so on and so forth.

So then I made the decision to move EBENE, home based. If I have free time, I can do things for the house or baby . I can book the appointments in such a way that it won’t interfere with the little one or home . Career is something but the little baby will grow fast and these days it is not about working 9 to 5 , 5 days a week, but working efficiently. No matter how much effort the doctor would do, patients would want to come after hours, or late in weekends, forgetting that we too got a family and life. But I understand. So this is why now I am more flexible and take patients on appointment basis. On weekends , my husband stays with the little one, or if he is busy , my parents graciously look after my little prince.

In summary I have more time for my baby, my family and at the same time my business without compromising.

Look up, laugh loud, talk big, keep the color in your cheek and the fire in your eye, adorn your person, maintain your health, your beauty and your animal spirits. William Hazlitt

Hello!! I hope October started on a good note for you dear readers! Over here it was great! We were graced by the presence of two very knowledgeable specialists in pediatric dentistry ( Specialist for Children) and for two beautiful days we had the pleasure to learn from them. The event was organised by the MDA at the Labourdonnais Hotel Caudan Waterfront Port Louis Mauritius.

All colleagues present including me are eager to put the techniques in practice soon.

There is a couple of things I can share, please see attached photos. Also to all teachers , coaches, assistants or people around accident prone areas , please look for the app TOOTHSOS, . It is specially made by the International Association of Dental Traumatology and made available free to inform public about dental traumas on both IOS or Android platforms. Together with the right information we can save a smile.

Have a great day!

Cheers Dr Tunesha