What is biofilm?

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This will be the first in a number of posts about biofilms. This is not about cinematic experiences involving Richard Attenborough and lovely furry animals but about something you encounter every day of your life.

What Is Biofilm?

You may not be familiar with the term biofilm, but it is something that you come into contact with every day. The plaque that forms on your teeth and causes tooth decay and periodontal disease is a type of biofilm. Clogged drains also are caused by biofilm, and you may have encountered biofilm-coated rocks when walking into a river or stream.

Biofilms form when bacteria stick to surfaces in some form of watery environment and begin to excrete a slimy, gluelike substance that can stick to all kinds of materials–metals, plastics, soil particles, medical implant materials, biological tissues.

Biofilms can be formed by a single bacterial species, but biofilms more often consist of many species of bacteria, as well as fungi, algae, protozoa, debris, and corrosion products. Essentially, a biofilm may form on any surface exposed to bacteria and some amount of water.1

Dental plaque is a yellowish biofilm that builds up on the teeth. Biofilms contain communities of disease-causing bacteria and their uncontrolled accumulation is associated with cavities and gum disease (both gingivitis and periodontitis).

In the past, scientists studied bacteria by looking through a microscope at cells suspended in a water droplet. Today, scientists believe that the disease-causing bacteria do not exist as isolated cells, such as in the water droplet, but rather they stick to various wetted surfaces in organized colonies that form diverse communities–biofilms.

Think of biofilm as a teeming city of bacteria, the foods they live on, the waste products they create and a glue which sticks the whole mess to a surface.

Next time we will look at how biofilms are created.

QI facts in dentistry

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If you’re in the mood to expand your knowledge when it comes to teeth and oral health, we’ve got some interesting bits of trivia for you!

  1. Did you know that tooth decay in children is a new concept? Kids in prehistoric times didn’t have to worry about it because their diets were free of sugar!
  2.  The only organ that’s fully developed at birth in a human baby is the tongue
  3.  Women smile an average of 62 times a day
  4.  Before modern toothbrushes, humans in ancient history would clean their teeth with twigs and roots.
  5.  Of every 2,000 babies born, one will have a tooth already in their mouth.
  6.  The strongest substance in the human body is tooth enamel
  7.  The Chinese celebrate a holiday called ‘Love your Teeth’ day
  8.  Snails have thousands of teeth all lined up in rows
  9.  Some people in medieval Germany believed kissing a donkey would cure a toothache
  10.  The ancient Romans used to make toothpaste out of honey and eggshells
  11.  Much like a fingerprint, everyone’s tongue print is unique too

My oral health routine

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Maintaining healthy habits when it comes to taking care of your teeth is absolutely necessary. We often only think about the short-term consequences of our actions, which leads to poor dental health from accumulated lack of care in the long run. Therefore, greater awareness of the long-term disadvantages of poor oral health can help people make smarter choices in the present and avoid costly visits to the dentist.

Bad oral hygiene leads to plaque, which accumulates around your teeth and gums, leading to inflammation of the gums. This can be very painful. Another effect of plaque is tooth decay, which can worsen over time and result in the need for dentures.

You can evaluate your dental health by a number of methods. Although it is difficult to be certain about your symptoms, a visit a dentist for a dental health check is key. For instance, you should make sure your gums are pink, which indicates that they are healthy. Furthermore, they should not bleed when you floss or brush your teeth. You should not be suffering from bad breath at all times. Finally, your teeth should not only feel, but look clean as well.

Having preventive oral care measures takes time to begin feeling natural to you. Therefore, follow these steps without hurrying through them, and remain committed to the whole process keeping the long-term benefits in mind.

You must brush your teeth for two minutes, twice a day. Make sure your brush reaches all sides of all teeth, in a gentle circular manner. At night, after brushing, you must floss your teeth properly, at least once a day. The floss string should reach all your teeth, and it should follow the tooth line so that your gums are not harmed. The space between the teeth and the gum should also be gently reached by the floss.

Additionally, after brushing and flossing, you can use a mouthwash and swish it in your mouth for at least thirty seconds before spitting it out. It is also very important to clean your tongue to prevent mucus and bacteria from building up and being detrimental to your teeth. To do so, you can put a little bit of toothpaste on your toothbrush and gently clean the tongue, or you can use dental floss to scrape bits off your tongue. You can also simply invest in a tongue cleaner and use it at least once a day, preferably before bedtime.

As a final piece of advice, even if you include the steps above into your daily oral health regimen, make sure you visit us at the intervals we recommend for a dental health check. For more information on the wide range of best available dental services at Quirke Dental Surgeons, please contact our friendly team at (051) 421453.

What is an inlay?

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Inlays and onlays are dental restorations that are used by dentists in order to repair the back teeth that are suffering from mild to moderate decay. They can also be used to repair fractured or cracked teeth that are decaying, but are not damaged enough to warrant a crown.

Inlays and onlays are usually used for patients suffering from enough damage in their oral cavity that the tooth structure cannot be treated using a filling, but have enough healthy tooth remaining that there is no need for a crown. In essence, inlays and onlays can be used for patients suffering from a midlevel of tooth decay. Inlays and onlays allow us to conserve more of the original tooth structure of the patient.

While some people consider inlays and onlays to be more of a cosmetic procedure, this cannot be further from the truth. There are several different types of benefits of using inlays and onlays compared to using metal fillings including:

  • Inlays and onlays help to strengthen the damaged teeth by nearly up to 75 percent. In case of traditional metal fillings, they are known to reduce the strength of the teeth by nearly up to 50 percent.
  • Inlays and onlays are known to prolong the life of the tooth and therefore help to prevent the need for further dental treatment somewhere in the future.
  • Inlays and onlays are known to be more durable as they are made up of hard-wearing and tough materials that are known to last up to 20 years in some cases.

Much like fillings, dental inlays and onlays require local anaesthesia as well. However, this is mainly to remove the old fillings. Basically, inlays and onlays will be used in cases where old fillings are no longer useful and need to be replaced or removed. Much like a filling, dental inlay will fit inside the top edges, or the cusp tips of the teeth, while fitting dental onlays is an extensive procedure that needs to extend over the cusp of the tooth that has been treated.

For both inlays and onlays, once the filling has been removed, we will take an scan of the tooth with our CEREC scanner.  The new Inlay and onlay can be made from this scan and porcelain or composite resin materials can be used in the final restoration. Then, the new Inlay or onlay is cemented into place and it blends with the treated tooth in order to give the patient a more natural and uniform appearance.  For more information on the wide range of dental services at Quirke Dental Surgeons, please contact our friendly team at (051) 421453.

Caring for your denture

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If you’ve recently started wearing dentures, you know how important they are for maintaining your facial structure and helping you enjoy your favorite meals. Wearing dentures shouldn’t cause you extra work, in fact, they should be taken care of similarly to your original teeth! Teeth in a denture can be made of porcelain or acrylic, but they build up plaque and tartar just like natural teeth. To keep great oral health with your new dentures, it starts by making sure they’re clean and properly fitted. Here are some helpful hints:

  • Thoroughly clean your dentures every day.
  • Remove and rinse your dentures after eating.
  • Soak them in a cleaning solution for about 30 minutes before brushing to loosen tartar and plaque.
  • Rinse your dentures before putting them back in your mouth, especially after using a denture-soaking solution.
  • Brush your dentures every day with a denture brush and liquid soap or foam cleaner.
  • Use non abrasive products to prevent scratching.
  • Leave your dentures out overnight to let your gums rest and to prevent inflammation.
  • Soak your dentures overnight.
  • Clean the cup you store your dentures in at least once a week.
  • Replace your denture brush on a yearly basis.
  • Avoid contact with abrasive cleaning materials, whitening toothpastes, products with bleach, and hot water.

Each day you should remove your dentures and brush your mouth, tongue, cheeks, and palate. You should also inspect your denture for any broken or cracked areas that may attract a buildup of plaque. At Quirke Dental Surgeons, we’ll monitor your dentures for fit and comfort and will also replace them over time for proper jaw alignment. We will want to see you regularly to monitor your oral tissues and overall health for any changes. To learn more about how to properly care for your dentures, contact us today!

5 ways poor oral hygiene is making you sick

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Here we’ve put together five of the more common ways poor dental hygiene can negatively affect your health. We strongly advise that if you are suffering from any of the problems below, or you are experiencing gum inflammation or tooth pain, that you seek medical attention immediately.

1.     Poor oral hygiene can make you depressed

Researchers at Deakin University recently linked poor dental health to depression. Their research, based on a survey of more than 10,000 Americans, found not only a connection between dental health and depression but also that the worse your dental health became the more your depressive state was intensified.  “Not only did we find a connection between dental health and depression, we also demonstrated that a dose-response exists between the two conditions, meaning that the more dental conditions one had the greater the severity of their depression,” said Deakin’s Adrienne O’Neil, M.D.

This relationship remained even when tested against other factors such as high body mass index (BMI) or an elevated level of CRP, a protein found in blood plasma, that when elevated is used as a general marker of inflammation in the body.

The relationship between poor dental health and depression is a complicated one. Typically, depression is seen as a precursor to poor dental health. Those suffering from mental illness are often at an increased risk of substance abuse or face limited economic resources making dental health care problematic. Stress related disorders, such as teeth grinding or dry mouth, also result in damage to your jaw and enamel.

“The relationship between dental health and depression is not well understood, with previous studies investigating poor dental health as a by-product of depression, rather than a precursor,” Dr O’Neil said.

“Although the results of this study provide only a snapshot of this association, they add to emerging theories around the importance of oral health and bacteria in mental health … if poor dental health is a risk factor for depression, this may have implications for depression management, as well as depression prevention from a public health perspective.”

From a self-esteem perspective though, poor dental hygiene could cause you to shy away from social situations; inhibit you in the pursuit of your career; and cause pain and sleeplessness that can negatively affect your mood.

The US department of Health and Human Services  notes that both: “a tendency to avoid social contact as a result of concerns over facial appearance… [and]… persistent pain has similar isolating and depressing effects.”

2.     Poor dental health could cause your heart to suffer

Researchers aren’t sure why but people with gum disease are twice as likely to suffer from coronary artery disease. Some hypothesise that the inflammation could increase your risk of blood clots that can trigger heart attacks.

A 2013 study published in the Journal of the Royal Society of Medicine warned that excessive sugar – not just fat and salt – could cause heart disease. The article stated that a link between poor oral health and cardiovascular disease (CVD) had been demonstrated to have a “convincing evidence base”.

Gum disease, often prompted by excessive sugar consumption, can cause an inflammatory response leading to CVD through a process called atherosclerosis, the hardening of the arteries, the paper says.

3.     Poor oral health could affect your diet

The National Survey of Adult Heath (2004-6) found that 17.4 per cent of the population avoided foods because of dental problems. Besides causing potential damage to your social life, this could cause sufferers to avoid healthy grains and proteins necessary for good nutrition. The kind of pain that sufferers report is varied with everything from minor tooth decay to sinus infections being capable of resulting in pain either during or after eating. While it’s not uncommon for people to report some pain after excessive sugar consumption or to experience sensitivity to hot or cold foods, prolonged or sharp pain when chewing is not normal. If you’re experiencing this kind of pain you could be suffering from tooth decay, a loose filling and physical damage to your tooth (like a fracture), nerve damage, or the inflammation/infection of pulp tissue inside the tooth.

4.     Poor oral health can worsen your diabetes

Studies have found very strong connections between diabetes and your oral health. But there’s some evidence to suggest gum disease could prevent you from regulating your blood sugar levels, exacerbating your existing condition. More prevalent is research showing a heightened risk of oral health problems for diabetes sufferers. The higher your blood sugar level, the greater the supply of sugars and starches – every tooth’s worst enemy. This heightened supply can initially result in cavities, but diabetes sufferers also more prone to infection – resulting in a higher rate of gingivitis and advanced gum disease (periodontitis).

5.     Pregnant women could be at risk of poor oral hygiene

A study from the Journal of Natural Science, Biology and Medicine found links between periodontitis (a serious gum infection) and both premature pregnancy and low birth weight. Due to hormonal changes, pregnancy itself can result in an increased risk of gingivitis with over 70% of pregnant women having some instance of the condition during the gestational period. If left untreated gingivitis can become periodontitis (a serious gum infection), which increases the risks of premature birth, low birth weight, pre-eclampsia and gestational diabetes. Regular morning sickness and frequent snacking during pregnancy could place you at higher risk. It’s advised that you closely watch your oral health during pregnancy taking special care to avoid high-sugar foods and drinks. If morning sickness is a problem, it’s advised that you don’t brush your teeth immediately after bouts of illness as this can wear away at the enamel. Alternatively, rinse your mouth out with water and wait 30 minutes before grabbing the toothpaste and toothbrush.

Sleep Apnoea

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Laboured breathing during sleep

Excessive sweatiness and/or restlessness during sleep

Excessive day time sleepiness and/or morning tiredness or head aches

Pauses in breathing and/or choking/gasping/snorting during sleep


Awakening due to bad dreams and/or sleep walking

Positions (sleeping in unusual positions; eg. extended neck, sitting up)

Nasal obstruction and mouth breathing

Overweight or underweight

Enuresis (bed wetting)

Attention/learning/behavioural problems

The above handy check list is a great tool you can use for a physical examination to judge the potential your child could be at risk of obstructive sleep apnoea.

Children may stop breathing 40 to 50 times an hour every hour during sleep which can then cause the brain to starve of oxygen, which can than lead to difficulty concentrating at school.

Obstructive sleep apnoea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnoea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnoea is a combination of the two. With each apnoea event, the brain briefly arouses people with sleep apnoea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.

Dental health and pregnancy

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Being pregnant is incredibly exciting. And it’s a time when you need to pay particular attention to looking after your teeth, especially your gums, with regular dental checkups and cleans.

During pregnancy your body will go through massive hormonal changes and an increase in blood flow. Due to these changes your gums are more likely to become inflamed, or even infected and bleed, if not being cared for correctly. Many pregnant women experience some bleeding of their gums, especially when brushing or flossing their teeth. This is one of the first signs of gingivitis (inflammation), which may turn into periodontal disease (infection) if left untreated. These infections, along with tooth decay, may harm your baby. So it is recommended that every pregnant woman to have a dental examination to check for any signs of gingivitis, periodontal disease or tooth decay.

A checklist of what you can do

    • Keep your teeth and gums clean, which means brushing twice daily for a minimum of 2 minutes and flossing once daily.
    • Be gentle with your teeth and gums and always use a soft-bristled toothbrush, a gentle brushing technique and a fluoride toothpaste.
    • If you have extreme gum sensitivity, try using a sensitive toothpaste or talk with your dentist about what you can use.
    • Cut down on sweets and candy. Try to make healthy snack choices such as fruit, vegie sticks or nuts.
    • Have a dental checkup. Ideally it is best to do this before you fall pregnant, or in the early stages of pregnancy, then again throughout the pregnancy and afterwards. It is best to see your dentist more regularly while you are pregnant.
    • Don’t put off dental work until after delivery as decaying teeth, gingivitis or periodontal disease might cause infection that could harm your baby.
    • Always tell your dentist when you are pregnant and how far along you are.

Enjoy this special time in your life. It is a precious journey in which you will want to stay healthy and keep your baby healthy. So look after yourself, your body, your teeth and your gums, and have a dental checkup and clean when pregnant.

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!