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Tell me about dentures

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Dentures & Partial Dentures

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue.  They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures – complete and partial dentures.  Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain.  A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

A Complete denture may be either “conventional” or “immediate.”  A conventional type is made after the teeth have been removed and the gum tissue has healed, usually taking 8 to 12 weeks.  During this time the patient will go without teeth.  Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process.  Once the tissues shrink and heal, adjustments will have to be made or the denture may need to be replaced entirely.

Dentures are very durable appliances and may last many years, but may have to be remade, repaired, or readjusted due to normal wear. They are however, probably the worst option for replacing missing teeth as they are bulky, are difficult to adapt to, have potential inherent stability problems and can interfere with speech initially.

Reasons for dentures:

  • Complete Denture – Loss of all teeth in an arch.
  • Partial Denture – Loss of several teeth in an arch.
  • Enhancing smile and facial tissues.
  • Improving chewing, speech, and digestion.

What does getting dentures involve?

The process of getting dentures requires several appointments, usually over several weeks.  Highly accurate impressions (moulds) and measurements are taken and used to create your custom denture.  Several “try-in” appointments may be necessary to ensure proper shape, color, and fit.  At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring as natural and comfortable a fit as possible.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will likely subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures.  Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures and is crucial in maintaining your oral health.

Cracked Tooth

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Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviours place the teeth under extra strain and render them more susceptible to cracking.

When tooth enamel is cracked, pain can become momentarily debilitating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack close back together, and pain subsides.

If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth. Other risks of non-treatment include extension of the crack resulting in eventual fracture of the tooth. The future prognosis of a fractured tooth is determined by the extent and location of the fracture.

Symptoms of a cracked tooth may include:

  • Unexplained pain when eating.
  • Sensitivity to warm and cold foods.
  • Pain with no obvious cause.
  • Difficulty pinpointing the location of the pain.

 

What kind of cracks can affect the teeth?

There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In many cases, if the crack is not too deep, root canal therapy and a crown can be performed and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction.

Here is a brief overview of some of the most common types of cracks:

Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.

Oblique supra-gingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will usually remain unaffected.

Oblique sub-gingival cracks – These cracks extend beyond the gum line, and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown), and endodontic treatment to place a crown or other restorative device.

Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can often save the tooth.

Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible; depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this classification of fracture.

Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.

How are cracks in the teeth treated?

There are many different types of cracked teeth. Some can only be seen using X-rays, while others are clearly visible to the naked eye. Some cracks cannot be detected on X-ray or visually and are diagnosed from the clinical symptoms.

In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth and it will continue to function as normal. Some teeth will need specialist referral to determine if they can be reasonably restored.

As a general rule, it is better to treat identified cracks at an early stage as their tendancy to extend often results in a need for more extensive treatment.

When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing and speaking functions.

If you have any questions or concerns about cracked teeth, please ask us.

 

Why do we have bad teeth?

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Why are our teeth so bad? Why do we get tooth decay and crooked teeth? It may have something to do with what we eat, not just today – but 10,000 years ago!
Unlike most animals, humans have undergone a rapid dietary change in a relatively short period of time.

As an oversimplification, take any animal species, and you’re looking at a creature that’s been eating the same general diet for the last million years or so.

Now, look at humans. Our diets have changed drastically in the past 20,000 years which in evolutionary terms is extremely fast. We’ve gone from diets heavy in fibrous plant materials, which are tough and require a lot of chewing, to being able to eat an entire meal through a straw!

Our early ancestors ate a lot of tough hard foods, and this required large jaws with teeth that could break down this material. The more the teeth can break down the food, the more energy can be potentially extracted from it by the body.

As our diets have gotten softer, our ancestors could get away with smaller jaws – which required less energy to grow and use. Using less energy to eat while acquiring the same energy in your diet as your large-jawed brethren = evolutionary advantage.

So humans have evolved much smaller jaws in a very short order of time. Having smaller jaws and the same number of teeth means that there is far less space, causing all manner of problems (think: wisdom teeth, cross-bites, malocclusion etc.).

Add to that the modern diet full of sugar, and you’ve got the perfect scenario for bad teeth!

Dealing with dental emergencies New Ross

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Dental emergencies can happen at any time, to any patient. While preventive dental care and the adoption of an effective at-home hygiene routine can go a long way in protecting your smile, routine wear and accidental trauma can take a toll on your teeth.

If you have experienced a dental emergency, seeking care as soon as possible can help prevent further damage.

Defining a Dental Emergency

For many patients, dental emergencies are often considered to be cases of extreme trauma to the mouth, such as a tooth being knocked out or a serious laceration occurring to the soft tissue. What many fail to recognize is that dental emergencies can also be relatively minor discomforts that, after careful examination, are indicative of larger, more serious dental conditions.

For example, while a toothache may initially seem like a problem that will quickly resolve itself, the associated pain that occurs may be a warning sign that the inner tooth structure is infected or has turned into an abscess, thereby requiring immediate treatment to protect the patient’s overall and oral health.

Similarly, patients experiencing more advanced cases of gum disease may begin to notice a change in gum color as well as bleeding when brushing or flossing. While not as dramatic as having a tooth knocked out, periodontal disease is still a serious problem that, if left untreated, can escalate and seriously compromise the patient’s dental function and health.

Ultimately, the term “dental emergency” can refer to any oral condition that has the potential to cause significant damage to the health and function of a dentition.

When Should I Seek Professional Dental Care?

Many of the seemingly minor dental emergencies, such as toothaches, minor cracks, temperature sensitivity, and gingival bleeding are often signals of a more serious oral health condition. As a result, it is especially important that patients seek care as soon as possible following the development of a dental emergency. By seeking restorative care early on, patients are able to limit the extent of damage caused by the oral condition and regain their oral health.

Emergency Dental Care in Wexford

If you are experiencing a dental emergency or discomfort, contact Quirke Dental Surgeons today on 051 421453 to schedule an urgent appointment. Our dentists are committed to helping patients protect their smiles through a number of preventive and restorative treatments. By using advanced technology and comprehensive solutions, our team can better understand the cause of your dental emergency and create an effective, lasting solution that contributes to your long-term oral health.

IV sedation for acute anxiety

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Did you know 50% of people admit to some form of anxiety visiting the dentist, with roughly 1 in 6 avoiding dental care altogether because of it? To ease anxiety dentistry has developed sedation methods that help patients relax during dental treatment.

Many can achieve relaxation with an oral sedative taken about an hour before a visit. Some with acute anxiety, though, may need deeper sedation through an intravenous (IV) injection of medication. Unlike general anesthesia which achieves complete unconsciousness to block pain, IV sedation reduces consciousness to a controllable level. Patients aren’t so much “asleep” as in a “semi-awake” state that’s safe and effective for reducing anxiety.

While there are a variety of IV medications, the most popular for dental use are the benzodiazepines, most often Midazolam. Benzodiazepines act quickly and wear off faster than similar drugs, and have a good amnesic effect (you won’t recall details while under its influence).

Other drugs or substances are often used in conjunction with IV sedation. Nitrous oxide (“laughing gas”) may be introduced initially to help with anxiety over the IV needle stick. Local anaesthetics will also be used to numb the teeth being treated.

If we recommend IV sedation for your dental treatment, there are some things you should do to help the procedure go smoothly and safely. Because the after effects of sedation may impair your driving ability, be sure you have someone with you to take you home. Consult with both your doctor and dentist about taking any prescription medication beforehand. Wear loose, comfortable clothing and don’t wear contact lenses, oral appliances like dentures or retainers, watches or other jewellery.

Our top priority is safety — we follow strict standards and protocols regarding IV sedation and you’ll be carefully monitored before, during and after your procedure. Performed with the utmost care, IV sedation could make your next dental procedure pleasant and uneventful, and impact your oral health for the better.

If you would like more information on IV and other forms of sedation, please contact us or schedule an appointment for a consultation.

What can I do about my loose denture?

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Lower dentures to replace missing teeth are normally the more difficult denture for people to get used to. Here are 3 of the main reasons they are often loose and uncomfortable.

  1. Your tongue is one of the strongest muscles in the body. It can easily flick a lower denture around.
  2. A lower denture only has a thin horseshoe shaped area of gum to sit on (unlike an upper denture which can rest on almost the whole surface area of your upper jaw & palate and also has suction). The lips are pushing the lower denture backwards and your tongue is pushing it forwards and lifting it.
  3. An older denture may not fit as snugly as when it was first made. Over time the jaw bone resorbs (or shrinks). This resorption happens the most during the first 6 months after a tooth has been removed but continues at a slower rate for the rest of your life.

Loose lower dentures – 5 potential solutions

  1. If you have an old denture that used to be comfortable and that you are happy with, appearance wise, but has become loose, an option may be to reline the fitting surface. This means putting a new layer of acrylic (pink plastic) on the fitting surface of the denture. This fills up any gaps between the denture and the gum and may help to re-stabilise it.
  2. Making a basic new acrylic denture.
  3. If there are teeth present making a cobalt chrome denture with clasps that clip around the remaining teeth to assist grip.
  4. If there are teeth present placing dental crowns on teeth adjacent to the denture with special precision attachments which the denture snugly clips onto. Special attachment crowns which also have milled parallel walls make for a very satisfactory solution – a secure denture and no visible clasps.
  5. Retaining the denture with dental implants.

If you would like to discuss potential options to make your denture more comfortable, give us a call on 051 421453 to arrange a consultation.

Ice cream hurts my teeth

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Does cold water make you wince?  Does ice cream hurt your front teeth?   Does cold air make you to cover your mouth with your hand…. and keep it there?

Sensitivity comes from deep within the tooth, in the dentin that lies beneath the enamel. Dentin contains tiny, water-filled tubules that connect to the nerve. When your enamel wears away and the dentin is exposed, it triggers pain. So people with damaged enamel — caused by excessive brushing, acid erosion and overly-abrasive toothpastes are more likely to have sensitive teeth. People who have their roots exposed due to recession or gum disease also experience the same sensitivity.  Whitening products, which temporarily dry out the teeth, also make it worse.

 

What can you do?  

1.  Brush gently with an extra soft toothbrush:  We have found that toothbrushes that are NOT extra soft/soft (or sensitive) can cause tooth abrasion over time.  Be thorough yet gentle and don’t scrub.  Please make sure plaque is removed because plaque makes acid and acid makes the teeth sensitive.

2.  Use a non abrasive toothpaste:   Generally toothpastes with extra ingredients such as tartar control are MORE abrasive.   Abrasives scratch the surface of your enamel and wear your teeth (and expose that sensitive dentin) over time.

3.  Avoid excess acidic foods:  Acidic foods can cause enamel erosion/destruction and expose sensitive dentin.  For example, sports drinks, lemons, and soft drinks are very acidic.

4.  Be aware of possible acid reflux:  Stomach acid can damage teeth if it pools while you sleep.  Do you wake up with a bad taste in your mouth?  Does your stomach bother you? Please let your dentist know if you experience these symptoms.

What can we do to help you?  

1. Prescription fluoride!   We can prescribe extra strength products such as Duraphat toothpaste and flouride gel or rinse.  The prescription strength fluoride hardens your enamel, making it more resistant to sensitivity.

2. MI paste:  This amazing paste is used after you have cleaned your teeth.  It uses an ingredient called amorphous calcium phosphate which slowly builds new enamel or repairs damaged enamel and ends sensitivity.

3.  In surgery desensitizing treatments.  We have easy paint on fluoride varnishes and treatments that can help your sensitive teeth feel better.  Your dentist or hygienist  can discuss these options with you.

Soon enough you can have your ice cream pain free!  Just don’t forget to brush!

 

Who needs antibiotics before a dental procedure?

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Did you know that for certain individuals it is recommended they take an antibiotic before (or immediately after) some dental procedures? This is because the mouth is full of bacteria which, if it gets into the bloodstream, can create an infection in other parts of the body.

Your immune system is normally able to fight off bacteria that enter the bloodstream, but those with heart conditions are more vulnerable to the infection it can cause. Individuals who should premedicate (which is called antibiotic prophylaxis) before a dental procedure are ones who have one of the following conditions:

  • Artificial heart valves or problems with the valves that developed during a heart transplant.
  • A history of endocarditis which is an infection in the heart.
  • Heart conditions such as palliative shunts or cyanotic congenital heart disease.

It used to be recommended that those with artificial joints also premedicate before a dental procedure, but this practice has been discontinued. It is only advised for those who also have a weakened immune system due to illnesses such as cancer.

Speak with your dentist about whether you should premedicate before a dental procedure. The procedures where antibiotic prophylaxis is recommended are the ones in which an incision is made to oral tissues. These procedures include tooth extractions, implant placement, and root canal treatment.