Teeth grinding during sleep may affect up to 10 % people; more if the grinding is keeping our partner awake at night. It can be both a symptom of a problem and problem in its own right. We might grind our teeth in times of stress and frustration, and if we are lucky this might resolve itself over time before we suffer any serious damage. Else, teeth grinding might be an ongoing problem. There are some suspicious signs of tooth grinding, such as a saw jaw in the morning, unexplained headaches or a complaining partner. But serious tooth grinding may occur without any of these symptoms appearing. If teeth show signs of unexplained wear it is quite possible that the individual is grinding their teeth at night. This damage can be quite serious. There is fairly good evidence to link grinding with stress and frustration, but this quickly gets complicated, and is affected by many factors. Some people suffer stress, yet show other symptoms rather than teeth grinding. Others grind their teeth during difficult phases of their life, and stop grinding one the problem is resolved. It seems that the predisposition to teeth grinding is genetic. Everybody suffers stress from time to time; some people experiences teeth grinding as a symptom of this, others do not. Early theories about grinding being caused by physical problems in the jaw look to be false, though grinding certainly can cause problems by wearing away teeth and causing sore gums. There appears to be no simple cure for teeth grinding. Resolving the cause of stress can help, but some individuals grind their teeth despite a lack of any apparent stress. Instead, grinding treatment concentrates on preventing damage. Wearing a mouth guard will prevent the teeth from being worn away, which is a major concern. Unfortunately, tooth grinding can strain jaw muscles and severely compromise hearing. Mouthguards do very little to reduce this damage. Behavioural therapy, biofeedback and improved diet have a limited benefit for jaw grinding. The situation is very frustrating for patients as the habit is quite involuntary. Despite knowing about the issue the patient is unable to stop their night time behaviour. At least the fitting of a mouthguard will prevent most of the damage done to the mouth.
When a new form of technology becomes common in society many different people find many different ways to apply it. Some recent examples that apply to dentistry include;
There have been more than a few medical applications for 3-D printing; it has been used to print body organs. Dental researchers have used 3-D printing to create replacement teeth, which is no longer recent news. But this have taken this further so that 3-D printing has been used to recreate the patients mouth, allowing better replacement teeth to be produced. In some extreme cases a patient cannot open their mouth sufficiently for a mould to be made. But 3-D scanning can produce a very accurate model of the patient’s mouth, and this is used to make the prosthetic or replacement teeth. In at least one case an entire upper jaw has been made by this method. If nothing else patients will have to spend less time having moulds made of their mouth.
Laser Cavity Repair.
Lasers ceased to be science fiction more than two generations ago. We are used to them in CD players and as novelty pointers for lecturers. Attempts to use them to regrow hair have only anecdotal evidence, but Harvard research has used them to regrow dentin and reverse tooth decay. So far the method has only been used on animals, but the technique looks very promising.
The laser used is extremely bright but fairly low powered. It encourages stem cells in the mouth to reform dentine, the substance inside the tooth. Teeth can normally only form new dentine at their centre where the stem cells are, and not near the surface of the tooth. The laser treatment allows dentine to be reformed right up to the surface of the tooth, though the surrounding surface enamel presently cannot be regenerated.
As lasers are already used for many medical procedures there does not appear to be too many obstacles to prevent the introduction of this new laser treatment.
Stem cells have also been used to regrow significant parts of a patient’s jawline. We expect there will be a great deal of many other applications for stem cells in dental work.
The basic brushing instructions we were given in school taught us to brush in small circles or back and forth. Some believe a modified method is better.
For the outside of the teeth the brush should be horizontal with the bristles angles up to 45 degrees. Brush in small circles and flick the brush downward when each section is finished.
For the inside teeth the brush should be vertical, and moved up end down. If the brush head is sufficiently small it is possible to clean the inside in the same manner as the outer teeth, angling the brush at 45 degrees,
Some Common Mistakes:
- Replace the brush after about three months, or when the bristles cease to be straight.
- Wait 30 minutes after eating before brushing. If the food is acidic it will soften the tooth enamel, so your brushing will damage the teeth.
- Completely avoid hard bristle toothbrushes. These are far too abrasive on gums, and many pensioners have found a lifetime of hard brushes has damaged their tooth enamel. Complementary toothbrushes in hotels and planes are mostly too hard. Save these for cleaning jewellery and teacups.
- Brush for at least 2 minutes. Most people tend to brush for less than half this. Use a timer or watch. The fluoride in the toothpaste needs about two minutes to work effectively.
- Don’t rinse with water after brushing. This washes away the fluoride in the paste, making it much less effective. Use a mouthwash rather than water.
- Don’t store toothbrushes out in the open, especially in the bathroom. Toothbrushes attract all sorts of filth from the air. A cover for the brush helps slightly, but this prevents the bristles form drying, and wet bristles will breed bacteria. Find somewhere clean and dry to store the brush.
- It makes a significant difference.
- Scrape your tongue. Either buy a tongue cleaner or buy a brush with a tongue scraper on the back. Some people with bad breath find that cleaning the tongue almost completely eliminates the problem.
- Electric toothbrushes tend to be good, but use a manual toothbrush on occasions so you don’t lose the basic brushing skills.
Preventative dentistry looks to treat teeth and gums so that problems don’t develop. This may now be extended so that problems are revered when first detected, prevent the need for expensive and awkward treatments.
It has been knows for a while that the outer surface of a tooth can re-calcify when kept clean and treated with fluoride. Dentists encourage this approach when the first signs of decay appear. But it is now understood that decay does not progress as rapidly as previously thought, and that there may be a wider window for preventative measures.
Till recently the tooth showing moderately early signs of decay was thought to be a risk. If the surface could not re-calcify within a few months it was quickly drilled and filled. Dental authorities believed that failure to deal with the problem would lead to rapidly progressing decay, with the whole tooth, not just the surface, being threatened. It is now believed that decay takes several years before being an irreversible threat. During this time is should be possible to detect and treat problems on the tooth surface.
If the decayed tooth surface is detected the damaged areas can be treated with highly concentrated fluoride. Repeated fluoride treatment, and long term removal of unhealthy food products, appears to restore decayed tooth surfaces. As long as there is no physical hole in the tooth the problem should be treatable without resorting to drills and filling material.
Recent trials have seen the need for filling reduce by 30 to 50%.
Coconut oil has received a lot of press over the past few years. It was considered a bad food for several generations due to the high level of saturated fat. But recently this has been questioned due to the possibility that not all saturated fats are unhealthy.
Many of the uses of coconut oil are topical, so its saturated fat and high caloric count need not be a health issue. It has been effectively used as an ingredient in soap and deodorant for many years, with its anti-bacterial properties preventing many fungal problems and other infections. It has also proved useful as a skin moisturizer.
The anti-bacterial function of coconut oil may extent to tooth decay. Enzyme modified coconut oil has been found to be very effective at fighting the bacteria (Streptococcus mutan) that is part of the tooth decay process. The enzyme modification performed on the oil was designed to be similar to the process of food digestion in the human digestive system. This same modified oil was also found to be effective against other bacteria problems including thrush and other skin infections.
Before people start gargling coconut oil it must be remembered that it is the enzyme modified version of the oil that has proved effective against tooth decay; regular coconut oil may have little or no benefit. None the less, any products developed from this look to be more organic, more environmentally friendly that some of the chemicals we have used for fighting bacteria in the past.
The last generation has seen many links drawn between oral hygiene and other health issues. The connection between dental plaque and heart disease is probably the most publicized example, though it is now believed that 90% of all health issues have some connection to our teeth, gums and mouth. Sometimes this connection is an initial cause, sometimes it is an increased risk factor, more often it is a symptom that allows early diagnosis.
A study of patients having suffered a stroke has shown a strong association with the oral bacteria (cnm-positive Streptococcus mutans). The association seems strongest with Haemorrhagic strokes rather than intracerebral strokes.
Haemorrhagic stroke is the term for blood vessels in the brain that rupture. It is thought that the presence of cnm-positive Streptococcus mutans bacteria in the person’s blood may be increasing the risk of a stroke; the bacteria seem to bind to blood vessels weakened by age and high pressure and increase the risk of rupture. The bacteria are not the sole cause of the stroke, but it increases the chance of stroke if the other risk factors are already there. Only 10 % on the population have these type of bacteria in their body, but this level is measured at more than 26% in stroke victims
If the theory about the bacteria binding to blood vessels is accurate there may be further health implications; the same binding properties would affect dementia, and could well provide the link between dental hygiene and heart problems.
Previously, there had been speculation that heart, stroke and dental issues occurred because individuals were negligent in all aspects of their health – people who didn’t brush their teeth were also people who didn’t exercise or eat well. Now it appears the link is more direct, and is physiological rather than psychological. Poor dental health compromises our overall health.
Toddler’s non-spill cups, sometimes known as Sippy cups, do prevent spilt drinks; however, they can also cause dental decay and injuries if not used safely.
The decay issues with sugary liquids in well known; sugar reacts with the bacteria in the mouth and steadily damages teeth. Sippy cups make this problem worse. When using such a cup the front teeth are constantly exposed to the liquid being consumed, increasing the decay. Furthermore, children using these Sippy cups tend to sip liquids steadily over a long period of time; this constant exposure also increases the decay. Individuals drinking from a regular cup tend to consume the beverage in one sitting, meaning only a brief exposure to the liquid. Children with Sippy cups have increased decay on the front teeth due to these teeth being constantly exposed to sugary liquids.
This issue does not apply to children when drinking water. Decent quality water will not harm the teeth. Problems only occur when the children drink sugary substances, or with some milk of baby formulas.
Safe Cup use
It is unfortunately common for children to trip while running with a Sippy cup. Tripping over is bad enough, but the child can severely damage teeth if they have something in their mouth. Instruct children to only drink when sitting or standing still. Most accidents can be avoided.
The choice of cup makes a significant difference. Children’s drinking cups with soft silicon tops will cause much less damage if the child falls over. Children’s cups that incorporate a straw are reasonably spill-proof and expose the child’s teeth to much less liquid. It can be a good idea to replace the type of drinking cup as the child’s physical skills develop.
Only use water in the children’s non-spill cups, where possible. When a child needs to drink other liquids make sure they consume the whole drink in one sitting; small portions are advisable. Drinking through a straw reduces the teeth’s exposure to the liquid.
Use a non-spill cup that has a soft silicone top or a cup with an inbuilt straw. This prevents the child from injuring themselves if they fall with a cup in their mouth. Do not let the child run around while drinking from a cup.
Fluoride in water has always been the subject of some controversy. Fluoride was originally added to drinking water because populations drinking naturally fluoridated water suffered fewer dental cavities. But is has been known for a while that very high levels of fluoride can compromise health. The controversy debates where the safe fluoride level lies. Treated water should have far less fluoride than the amount needed to cause issues.
Both New Zealand and Israel have seen this debate resurface recently: Israel actually suspended fluoridisation for about two years before reintroducing it in mid-2016. New Zealand television has been running an anti-fluoridation campaign, strongly criticized for giving misleading information.
According to its critics the fluoride in water can cause kidney strain, child development problems and (ironically) dental issues. It is known that these issues have some connection to fluoride, but only under extremely high levels of exposure. The human kidneys should be more than able to deal with the minute amount than most individuals are exposed to. And the dental issues from fluoride consist of white patches on teeth that are only of aesthetic importance. The effects on child brain development do not seem to be an issue in developed countries with regulated fluoride, only in unregulated, extremely high level supplies; and even then there is suspicion that the problem might be caused by other pollutants. Low levels of fluoride seem to pose no threat.
The cost of water fluoridisation in many developed countries is about $1.oo per person. This is much less than the cost of fixing the dental problems that would exist without fluoridisation. Many studies support the idea that this practice is justified.
The human body needs many trace elements to survive. These same elements can sometimes be toxic in higher doses. Copper is one example of this; deficiencies are a health issue, but toxicity occurs beyond a very small dose. Fluoride is probably similar. It is useful in small doses, but causes problems in human when consumed in extremely high doses.
Anaesthesia can completely numb part of the body or produce unconsciousness. Some types of Anaesthesia reduce anxiety without putting the patient to sleep or relieving pain. These have been used to calm patients, particularity children, who are anxious about surgery.
In the past sedatives were given orally. They were effective provided that the right dose was administrated. But the right dose was hard to estimate and took time to work. Use of a new nasally administrated sedative looks promising, especially for children. The nasal sedative intranasal midazolam is rapidly absorbed into the bloodstream, making it fast acting. As a result there is no need for an estimated dose, the sedative is simply administered till effective.
There appears to be no issues regarding larger or smaller doses of the sedative. Trials in Africa have only revealed one issue- people complained of a burning sensation in the nose when the drug is administrated. This can be prevented with a nasal anaesthesia applied a few minutes before the sedative.
At the moment this sedative spray is not available in Australia. Its status is unclear when it comes to administration, apparently requiring a professional sedation qualification. The nasal application is more convenient that other application methods, but it still requires a professional for administration.
For Dundas dental patients, Newington dental patients and Oatlands dental patients there are already several ways to deal with the discomfort and anxiety associated with dental procedures. Talk to Dentist on Victoria about what is best for you situation.
Our wisdom teeth are the last to develop. They are the third molars that appear at the back of our mouth. Our first set of teeth develop when we are about 1 year old. Our adult teeth come through by about the age of 12. But the wisdom teeth at the back of our mouth do not emerge until our very late teens or early twenties.
Wisdom teeth are notorious for causing problems. It is almost rare for all four wisdom teeth to emerge without some issues. Most individuals find that there is not enough room in their mouth for the wisdom teeth to emerge correctly; teeth either do not fully emerge or emerge to push other teeth out of alignment. This can lead to several problems.
Widespread problems with wisdom teeth include:
-Swelling in the jaw and lower face
-Red inflamed gum near the partially / full covered molar
-Gum and jaw pain
-Infections and pus from the gum
-Sore lymph glands beneath the jaw
-Difficulty swallowing or opening the mouth
-Hard Impaction – the wisdom tooth pushes other teeth out of alignment
-Soft impaction – the wisdom tooth causes the gum to be misshapen
-The wisdom tooth emerges at an odd angle, no good for chewing
-The patient finds it hard not to continually bite their jaw.
These problems will stay or reoccur unless the wisdom tooth is removed or otherwise treated. Infection will reoccur if the wisdom tooth is not removed, and individuals with pre-existing health problems or otherwise compromised immune function will find that dental infections can cause severe complications.
Wisdom tooth extraction
Many individuals find they need at least some of their wisdom teeth extracted. An earlier extraction is almost always better than a latter one.
A general dental examination, and possibly an X-ray, will show if an extraction is required.
Sometimes several wisdom teeth are removed in one session.
After a Wisdom tooth extraction
You gum and jaw will be sore and swollen after the wisdom teeth are removed. This will continue for several days. Painkillers will help with the discomfort. Gargling salty water (wait 24 hours) will also help healthy healing of the wound.
Please talk to Dentist on Victoria for:
-wisdom teeth Denistone
-wisdom teeth Dundas
-wisdom teeth Ermington
-wisdom teeth Oatlands
-wisdom teeth Rydalmere
-wisdom teeth Telopea