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All posts by Maurice Quirke

Invisalign, step by step

By | Treatment information | No Comments

If you’re interested in Invisalign braces you’re probably keen to know more about what your treatment will involve. Invisalign sounds great, but will you need to undergo long and arduous appointments with your dentist to achieve a straighter smile?

The short answer is ‘no’.

From the very beginning treatment is comfortable and convenient. To give you an idea of what to expect, here is a step-by-step guide to the typical Invisalign patient experience:

1. Invisalign consultation

Come and see us for a free consultation to find out if an Invisalign treatment is suitable for you. This appointment is very relaxed and will include a brief examination of your teeth and the opportunity to ask lots of questions. We’ll also go through the cost of your treatment and our payment options (we can also offer a payment plan with Flexi-Fi).

2. ClinCheck®

At your next appointment we’ll take impressions (moulds) of your teeth, which we send off to the Invisalign team. They’ll then use these impressions to create a digital model of your teeth and, based on your dentist’s recommendations, they’ll plan your treatment using special ClinCheck software.

Invisalign ClinCheck

Invisalign ClinCheck

3. Virtual treatment plan

Your virtual treatment plan is then sent back to your dentist so we can make sure we’re happy with your end result and the way your teeth are going to move throughout your treatment (we can anticipate how your teeth will look at every stage!). We can send this virtual treatment plan to your email address so that you can view it at home later.

4. Your Invisalign braces

Once your ClinCheck has been approved by you and your dentist, Invisalign will make the custom aligners that will be used to straighten your teeth. The number of aligners that you’ll need will depend on how complex your treatment plan is. Usually you’ll have one aligner for every 10-14 days of treatment. It’s important to wear your retainers for 22 hours every day, removing them only for eating, brushing and flossing.

5. Check-ups

Your dentist will give you a few aligners at a time and see you every four to six weeks to check your progress and hand over the next set of aligners. Usually this is a quick routine appointment to make sure everything is moving as planned. Occasionally we may need to make small adjustments to your teeth or Invisalign braces. For example, it might be necessary to fit small tooth-coloured buttons, to your teeth to help your aligners move them in a particular direction. These are called Invisalign attachments – you can see an example of an attachment in the below photo.

Invisalign attachments

Invisalign attachment

6. Refinements

As you reach the end of your treatment we may need to make some extra refinements to give you the very best results. These would be included in the cost of your treatment and might involve taking another set of impressions, from which Invisalign can make you some extra aligners to refine your results.

7. Retainers

Once your treatment is complete you’ll be given retainers. Before you stop wearing your Invisalign braces we can fit a discreet fixed retainer behind your teeth, which will hold them in place for the longterm. At the same time we’ll take impressions for a removable retainer, which will arrive back from our lab the following week. Your removable retainer will be very similar to your Invisalign aligners, but you will only need to wear it at night.

8. Follow-up care

Included in cost of your treatment are two years of orthodontic follow-up care, so for the next 24 months we’ll see you for regular check-ups and you can also get in touch if you have any problems.

Easy payment terms for treatment

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Spread the cost of your treatment

We know how stressful it can trying to budget for your dental treatments, especially if you are investing in orthodontics, implants etc. So we have partnered with Flexi-Fi to help make life a little easier for you. Flexi-Fi is a payment plan facility allowing you to spread the cost of your treatments over a term that suits your budget. You can apply for Flexi-Fi online and receive a decision in minutes.

Check out our ‘Financing your treatment’ page for more details and for links to the quotation and application process.

Tips when starting Invisalign

By | Treatment information | No Comments

Adult Front Top & Bottom on White-Small

The choice of Invisalign is a big step for new patients beginning their journey from crooked or spaced teeth to a new smile.

Just like  traditional braces, Invisalign improves your smile and is an effective treatment adults. You’ll enjoy the convenience of Invisalign and get the results you want by maintaining your aligners in good condition and staying on schedule.

When beginning Invisalign treatment, you should consider the following tips.

Remember to Always Wear Your Aligners

Invisalign trays are removable, but we recommend wearing your aligners as much as possible to stay on track with your treatment schedule.

Your Invisalign trays should be worn for a minimum 22 hours each day, and should only be taken out when eating or brushing and flossing.

Change Aligners on Time and In the Right Order

Staying on top of aligner changes ensures treatment goes according to plan.

Changing aligners regularly, and in the right order, will help you stay on schedule and finish treatment on time.

Attending regular monitoring appointments and following instructions from our dentists will ensure that you continue making steady progress toward a new smile.

Keep all of your old aligners until treatment is complete.

Brush and Floss Every Day While Continuing Regular Hygiene Visits

Brushing and flossing regularly is a must during Invisalign treatment. Especially after eating and drinking.

Failing to clean your teeth properly can cause bacteria from your mouth to become trapped inside your Invisalign trays. This can increase the risk of damage due to gum disease or decay.

If you are unable to brush and floss during the day, be sure to rinse your mouth thoroughly after eating and drinking before putting your trays back in. Keep floss and a toothbrush with you during the day if possible.

Attending regular hygienist appointments also helps your teeth stay clean and healthy during treatment. Most patients should attend the hygienist twice a year, but in some cases more regular visits may be required. Check with your dentist and schedule appointments accordingly.

Make Sure Your Aligners Are Cleaned Regularly

Keeping your aligners clean helps keep your teeth clean. Trays will not collect debris and plaque if your teeth are regularly cleaned.

In addition to cleaning aligners after eating and drinking, we also recommend cleaning them after you wake up. Bacteria can build up in your aligners overnight during sleep.

To clean your aligners, simply brush them and rinse with cold water. Avoid soaking them in mouthwash or boiling them as this can cause damage, distortion and discoloration. Keeping your trays clean helps maintain an attractive look when wearing aligners at school or work.

Keep Track of Your Aligners and Store Them Properly

Invisalign trays can be costly to replace and losing them may delay your treatment process. Keep a close eye on your aligners when you aren’t wearing them.

Avoid leaving aligners out and exposed. Be sure to put keep them in your storage case when you they aren’t being worn. This will prevent bacteria buildup and keep you from misplacing your trays. If you leave your aligners out by accident, rinse and soak them before putting them back in.

Take Time to Adjust to Invisalign

When you first begin each new Invisalign tray, give yourself time to adjust to any discomfort. It’s important to wear your aligners for the recommended amount of time each day, even if they are uncomfortable at first.

Your speech may also be affected temporarily when beginning Invisalign treatment. The more often you wear your aligners, the faster you will adjust.

Download the My Invisalign App

The My Invisalign App is available to Quirke Dental Surgeons patients on both iPhone and Android devices and makes tracking the process of your treatment simple.

The app helps guide you through treatment by providing a platform to share your experience with others, find answers to common questions, and receive reminders when it’s time to change your aligners.

Ask us about the My Invisalign App during your free consultation or next appointment.

Your Smile is Just the Start

At Quirke Dental Surgeons, we’ll help you achieve a healthy, lasting smile. Are you ready to get started with Invisalign?

Contact us today to request a free consultation!

Invisalign clear aligner braces are here!

By | Hi-tech Dentistry, Treatment information | No Comments

We are delighted to announce that we are now certified providers of Invisalign clear aligners.

This high tech solution to crooked smiles has already been successfully used to treat over 6 million patients worldwide and we are pleased to make it available to our patients in New Ross.

These braces offer a clear alternative to traditional braces and we will offer as a potential solution to adults with crooked, crowded or spaced teeth and who may have shied away from traditional orthodontic solutions because of the appearance of brackets and wires or because they would have interfered with their lifestyle.

There are no brackets or wires in the Invisalign system and it works by using a series of different thin plastic trays to gradually move the teeth into the desired position.

If you feel that your smile could benefit from a clear Invisalign makeover, you can use our simulation software here to generate a photo of yourself with a proposed new smile. Just follow the instructions on the screen;-)

After that, call us on 051 421453 to arrange a consultation.

Invisalign Provider-JPG                       Adult Front Top & Bottom on White-Small

Finalists!!

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We are delighted to announce that Quirke Dental Surgeons has been named as finalist in 2 categories at the Irish Beauty Industry awards 2018 to take place in Dublin in December. We have been shortlisted for Best Dental Practice South and Best Overall Dental Team. We are very pleased to have been recognised for the high levels of service we provide. Well done team!!

Snoring – not my problem?

By | Diseases, Preventative | No Comments

Sleep Apnoea is a sleep breathing disorder that is characterised by repetitive pauses in breathing during sleep. Pauses occur several times per hour and last for over 10 seconds. As the blood-oxygen levels decrease, the brain awakens the individual which often leads to a loud gasp or snort. Sleep apnoea is associated with snoring, witnessed pauses in breathing, and excessive daytime sleepiness.

Sleep apnoea is usually a chronic condition with most people having sleep apnoea for years before being diagnosed. When breathing appears to stop or becomes shallow, the sleeper comes out of a deep sleep and moves to a light sleep or awakens. This results in poor quality sleep, resulting in excessive daytime sleepiness.

Sleep Apnoea can be very serious when untreated because –

There’s an increased risk of heart attack, high blood pressure, obesity, stroke, and diabetes;

It makes irregular heartbeats, or arrhythmias, much more likely;

It increases the risk of heart failure; and

There’s a greater risk of having a driving incident, or work-related accident.

There are several treatment options for sleep apnoea. One of the options is the oral appliance. Currently, there are approximately 200 different oral appliances available worldwide. We concentrate on using 3 of these appliances to give an effective range of treatments at a level of cost to suit most patients.

Also called Mandibular Advancement Devices (MAD), these sleep apnoea mouth pieces are custom made by us to conform to the specific shape of the patient’s teeth and mouth. Not only do they work against sleep apnoea, they are also effective in treating snoring.

If you, or your partner, suffer from apnoea or snoring, give us a call on 051 421453 to arrange a consultation about your treatment options.

How to Properly Brush and Floss

By | Preventative | No Comments

Brushing and flossing are of paramount importance to oral hygiene.  Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent homecare methods are equally valuable.  Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle and prevent serious diseases.

Reasons why proper brushing and flossing are essential:

  • Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures.  Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth.  This phenomenon can easily be prevented by using proper home hygiene methods.
  • Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession.  Periodontal disease is caused by the toxins found in plaque, and can lead to serious health problems in other parts of the body.  Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
  • Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth.  These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.
  • Prevention of staining – Staining or the yellowing of teeth can be caused by a wide variety of factors such as smoking, coffee and tea.  The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.

The Proper Way to Brush

The teeth should be brushed at least twice a day; ideally in the morning and before bed.  The perfect toothbrush is small in size with soft, rounded-end bristles and no more than three months old.  The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue.  The American Dental Association (ADA) has given electric toothbrushes their seal of approval; stating that those with rotating or oscillating heads are more effective than other toothbrushes.

Here is a basic guide to proper brushing:

  1. Place the toothbrush at a 45-degree angle where the gums and teeth meet.
  2. Use small circular motions to gently brush the gumline and teeth.
  3. Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
  4. Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
  5. Use back and forth strokes to brush the chewing surfaces.
  6. Brush the tongue to remove fungi, food and debris.

The Proper Way to Floss

Flossing is a great way to remove plaque from the interdental regions (between the teeth).  Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets.  The interdental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis.  The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.

Here is a basic guide to proper flossing:

  1. Cut a piece of floss to around 18 inches long.
  2. Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
  3. Work the floss gently between the teeth toward the gum line.
  4. Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
  5. Carefully move the floss up and down several times to remove interdental plaque and debris.
  6. Do not pop the floss in and out between the teeth as this will inflame and cut the gums.

If you have any questions about the correct way to brush or floss, please ask your dentist or dental hygienist.

 

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.

Do I have gum disease?

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Signs & Symptoms of Periodontal Disease

Periodontal disease (also known as periodontitis and gum disease) is a progressive condition and the leading cause of tooth loss amongst adults in the developed world.  Periodontal disease occurs when the toxins found in plaque begin to irritate or inflame the gingiva (gum tissue).  The resulting bacterial infection, often known as gingivitis, will eventually lead to the destruction of the gum tissue and underlying bone.  If periodontal disease is not treated, it can also lead to loose teeth or tooth loss.

There are many common types of periodontal disease including aggressive, chronic, necrotizing periodontitis, and periodontitis associated with systemic diseases.  Each of these types of periodontal disease has its own distinct characteristics and symptoms, and all require prompt treatment by a dentist to halt subsequent bone and tissue loss.

Common Signs & Symptoms

It is extremely important to note that periodontal disease can progress without any signs or symptoms such as pain.  This is why regular dental health checks are exceptionally important so that disease can be identified at as early a stage as possible. Described below are some of the most common signs and symptoms of periodontitis.

If you have any of these signs or symptoms, the advice of a your dentist should be sought as soon as possible:

  • Unexplained bleeding – Bleeding when brushing, flossing or eating food is one of the most common symptoms of a periodontal infection.  The toxins in plaque cause a bacterial infection which makes the tissues prone to bleeding.
  • Pain, redness or swelling – A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason.  It is essential to halt the progression of the infection before the gum tissue and jaw bone have been affected.  It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body.
  • Longer-looking teeth – Periodontal disease can lead to gum recession.  The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”
  • Bad breath/halitosis – Although breath odor can originate from back of the tongue, the lungs and stomach, from the food we consume, or from tobacco use, bad breath may be caused by old food particles which sit between the teeth and underneath the gumline.  The deeper gum pockets are able to house more debris and bacteria, causing a foul odor.
  • Loose teeth/change in bite pattern – A sign of rapidly progressing periodontitis is the loosening or shifting of the teeth in the affected area.  As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.
  • Pus – Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress.  The pus is a result of the body trying to fight the bacterial infection.

Treatment of Periodontal Disease

It is of paramount importance to halt the progression of periodontal disease before it causes further damage to the gum tissues and jawbone.  The dentist will initially assess the whole mouth in order to ascertain the progress of the disease.  When a diagnosis has been made, the dentist may treat the bacterial infection with antibiotics in conjunction with nonsurgical or surgical treatment or both.

In the case of moderate periodontal disease, the pockets (under the gumline) of the teeth will be completely cleared of debris using a procedure called scaling and root planing.  The pockets may be filled with antibiotics to promote good healing and kill any bacteria that remain.

Severe periodontitis can be treated in several different ways, such as:

  • Laser treatment – This can be used to reduce the size of the pockets between the teeth and the gums.
  • Tissue & bone grafting – Where a considerable amount of bone or gum tissue has been destroyed, the dentist may elect to graft new tissue by inserting a membrane to stimulate tissue growth.
  • Pocket elimination surgery – The dentist may choose to perform “flap surgery” to directly reduce the size of the gum pockets.

If you have any further questions about the signs and symptoms of periodontal disease, please ask your dentist.

Cracked Tooth

By | Diseases, Preventative, Treatment information | No Comments

 

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.