Dentiste Wigger Tasman

Dental hypnosis: The best way to overcome your fear of the dentist.

Our practice offers care in all areas of dentistry, except orthodontics:

• Dental hygiene and prophylaxis
• Dental care for children
• Conservative care and cosmetic treatments
• Periodontal care
• Surgery
• Implants
• Fixed and removable prostheses
• Dental hypnosis

 

Should amalgam fillings be replaced?

Although the controversy has died down considerably, a few years ago there were heated and highly publicized discussions about the alleged harmful effects of dental amalgam. The issue is complex, and even professionals find it difficult to form a balanced opinion. The fact that, on both sides, some opinions sometimes take on an almost ideological tone does not help in this regard. The conclusion is that there is currently no single doctrine accepted by all.

The alternative material to amalgam is composite resin (known as "composite"). This material, which is the same color as teeth, does not have the same biological and biomechanical properties, and therefore does not have the same advantages and disadvantages as amalgam.

The main points of comparison between amalgam and composite are as follows:

Amalgam nbsp;                         Composite

1) unsightly1) Aesthetic1) Aesthetics

2) better wear resistancenbsp;                2) less wear resistance

3) Contains potentially toxic mercury 3) Does not contain mercury

4) may cause electric currents in the mouth 4) does not cause any phenomena

                                                                                     electrical

5) does not adhere to the toothnbsp;                          5) adheres to the tooth

6) inhibits bacterial growth6) does not inhibit bacterial growth

7) expands over timenbsp;                        7) contracts when the material is taken

8) associated with lichen planus (a disease of the mucous membrane) 8) not associated with diseases of the mucous membranes

9) may cause allergies in some cases (?) 9) may cause allergies

10) Easier to handle in the mouth 10) More delicate handling in the mouth

A health hazard?

A large percentage of the population has had dental amalgam in their mouths for many years without experiencing any problems. We can therefore consider that, biologically speaking, this material has proven to be well tolerated by the majority of people. It is in this sense that the US Food and Drug Administration (FDA) considers that, to date, there is insufficient scientific evidence to advise against the use of amalgam in general. It maintains this opinion even for pregnant women and children. (www.fda.gov/cdrh/consumer/amalgams.html )

Although they are very much in the minority, there are cases where amalgam causes health problems. This has prompted the health authorities in Norway to ask dentists to stop recommending amalgam to their patients. In Sweden, amalgam has even been banned for children and adolescents.

Here we see two contradictory attitudes, each reflecting its own assessment. In cases of lichen planus (a disease of the mucous membrane) in contact with dental amalgam, removal of this material is recommended.

As for mercury poisoning, all possible symptoms are non-specific and could also have other causes. It is therefore impossible to know in advance whether amalgam is to blame. Only after removing the amalgam fillings can an assessment be made as to whether there has been any improvement.

A wide variety of health problems have been associated with mercury poisoning from dental amalgams, ranging from chronic fatigue and mood swings to sleep disorders, various neurological, immunological, and cardiovascular disorders, as well as gastrointestinal and respiratory conditions (asthma). In children, hyperactivity, neuropsychological delays, and even autism have been reported. It should be noted that these assumptions are not unanimously accepted by the scientific community. If health problems of the types described cannot be explained otherwise, the removal of amalgam fillings may be worth discussing.

Chewing on a rock

Apart from its lack of aesthetics, which hardly needs commenting on, dental amalgam has another major disadvantage in practice, which is less often mentioned.

Amalgam does not adhere to the tooth surface at all. It only stays in place because it has been shaped to fit. When you bite down on an amalgam filling, it's a bit like biting on a small pebble, which separates the two halves of the tooth without holding them together. This explains why small or large cracks can be detected in most teeth from which old amalgam fillings are removed. And it is indeed relatively common for a tooth that has been repaired with amalgam to break after some time.

Unlike amalgam, composite bonds strongly to the tooth. This means that it simultaneously holds the different parts of the tooth together by gluing them together. It is much rarer for a tooth repaired with composite to break than a tooth with amalgam. And even in these rare cases, the fracture is generally much less dramatic. These findings regularly lead us to recommend replacing amalgam fillings with composite to prevent tooth fractures.

The wear resistance of composite resins has improved significantly in recent years. As a result, composite is now tending to replace dental amalgam. In certain specific cases—which are becoming increasingly rare—amalgam may still be used.

At our practice, we do not recommend the systematic removal of all old amalgam fillings. It should also be noted that exposure to mercury is much higher when amalgam is removed than when it is in the mouth. However, when an amalgam filling needs to be replaced, composite resin is generally the preferred replacement material. We sometimes recommend replacing an amalgam with a composite to prevent tooth fracture. In certain cases of health problems—which are much rarer—the systematic removal of all amalgams may be discussed.

 

Sensitive teeth: summary of advice

- Consult a dentist to rule out tooth decay or other problems that may require treatment.

- Adopt a proper brushing technique and use a soft toothbrush.

- If your enamel is worn, any teeth grinding should be treated

- If you experience acid reflux from the stomach, consult your family doctor

- Avoid consuming acidic foods and drinks on a regular basis

- Do not brush your teeth immediately after consuming acids; rinse with water, or better still, with milk; wait at least 30 minutes before brushing

- If you have very sensitive teeth, apply a slightly acidic fluoride gel (Elmex® gel) to the affected tooth before consuming acidic foods

- Use a soft toothbrush and special toothpaste, and possibly a mouthwash for sensitive teeth

Why can teeth be sensitive?

Tooth sensitivity to hot and cold, when sucking in air, or even to sweet foods, is a relatively common phenomenon. It can be caused by tooth decay, gum recession, enamel wear, or hypersensitivity of the tooth nerve for other reasons.

It is therefore recommended that you consult a dentist if you experience tooth sensitivity, if only to rule out the presence of tooth decay or other lesions that may require treatment.

The part of the tooth that is normally visible in the mouth, the crown, is covered with a layerof enamel. Under the enamel is another hard tissue called dentin. At the center of the dentin is the pulp of the tooth. The pulp contains nerve fibers and blood vessels, among other things. Dentin also makes up most of the root, which anchors the tooth in the jaw.

While tooth enamel is relatively impermeable, dentin is porous. There are small microscopic channels ( dentin tubules ) that run through the dentin from the inside to the outer surface. The nerve cells in the pulp inside the tooth have extensions that enter these channels. If the dentin is exposed, the nerve can communicate directly with the surface of the tooth, which explains why the tooth may be sensitive.

However, it should be noted that even in the case of one of these lesions, teeth do not always become sensitive. The absence of pain or sensitivity is therefore no guarantee of good dental health.

Find and treat the cause

If a tooth is sensitive, it is most often because the dentin is exposed. Once the presence of decay has been ruled out, the first step is to stop the process that is causing the dentin to become exposed.

Gum recession

As the years go by, the gums tend to recede. However, this process can be greatly accelerated by improper tooth brushing techniques. In particular, avoid using a hard toothbrush and brushing back and forth horizontally on the gums. Once the gums have receded, they will not return to their original level. Ask your dentist or hygienist to show you the correct brushing technique.

Enamel wear

If sensitivity is caused by enamel wear, the cause may be erosion due to acidity in the mouth, teeth grinding, or a combination of both.

Tootherosion is caused by acids from food and drinks, or from the stomach in cases of acid reflux or frequent vomiting. To prevent this, follow the advice on the next page.

People who grind their teeth are usually unaware of it. It is an unconscious activity, most often performed during sleep. When grinding your teeth, you can apply forces that far exceed the maximum forces of chewing, which can cause muscle and joint problems, as well as fractures and tooth wear.

There are two possible strategies to prevent teeth grinding:

- Have a mouth guard made to wear at night, which prevents the upper and lower teeth from touching

- In some cases, hypnosis can produce good results

 

Avoiding sensitivity

Tooth sensitivity often varies over time. This is because the pores in the dentin on the surface of the tooth can be more or less open or closed. To reduce sensitivity, it is important to avoid demineralization (opening of the pores) and promote remineralization (closing of the pores).

Teeth are demineralized by acids. These acids come from food and drinks, or from the stomach in cases of gastric reflux or frequent vomiting. If the acidity comes from the stomach, consult your family doctor so that appropriate treatment can be recommended.

In terms of diet, it is recommended that you reduce your consumption of acids in particular. These acids are typically found in vinegar, fruit, and fruit juices. The consumption of certain fruits and their juices (especially grapefruit) requires particular vigilance, as their residues remain acidic in the mouth for a very long time. Avoid consuming these foods repeatedly.

After consuming foods or drinks with high acid content, it is not recommended to brush your teeth immediately. Acids weaken the surface of the teeth, and brushing at this time can cause erosion and increased sensitivity. It is better to rinse your mouth with water, or even better with milk, and brush your teeth only after about 30 minutes.

The most effective way to prevent sensitivity is to use a slightly acidic fluoride gel, such as Elmex® gel. Apply this gel with your finger to the affected teeth just before consuming acidic foods. Thanks to its slight acidity, this gel binds with saliva to form a protective layer that sticks to the teeth like a blanket. The acids in food will then be unable to reach the sensitive areas. As this method is relatively inconvenient, it is generally reserved for cases of very pronounced sensitivity.

In general, but especially in cases of tooth sensitivity, it is preferable to use a soft toothbrush. The brush can also be placed in warm water for one or two minutes just before brushing to soften the bristles even more. It is advisable to use a low-abrasive toothpaste. Several brands of toothpaste are available on the market that are specially designed for sensitive teeth. Various mouthwashes for sensitive teeth can also be beneficial.

Remedying sensitivity

If proper preventive measures are taken, tooth sensitivity often decreases spontaneously after a while.

There are a variety of products that dentists or hygienists can apply to tooth surfaces to reduce sensitivity. In our experience, most of these products have variable results and are more or less effective. In general, we apply a fluoride varnish, which is very often effective. Sometimes a laser can also be used to reduce the sensitivity of tooth surfaces.

If the sensitive surface also shows a loss of substance due to erosion, filling this defect with composite resin may be considered. This resin covers the tooth tightly and can thus remedy the sensitivity.

In some cases, a gum graft may also be used to cover a sensitive root surface. This treatment is usually chosen if the removal of the gum also poses an aesthetic problem. Often, the coverage of the exposed surface remains more or less incomplete when this method is used.

In very rare cases, particularly after periodontal treatment, it may be necessary to decide to devitalize a tooth due to its sensitivity. This option will only be considered if all other attempts to remedy the problem have failed.

 

Why should baby teeth be treated?

"Why treat baby teeth if they are going to fall out anyway?" This is a question we are often asked.

There are several reasons why it is important for baby teeth to remain in place and in good condition until they are ready to fall out naturally:

- To maintain space so that permanent teeth can grow in the right place.

- to prevent damage to permanent teeth

- to avoid pain and the risk of infection

- to maintain chewing function and allow language learning

Maintain space so that permanent teeth can grow in the right place

In general, teeth always tend to move forward if nothing prevents them from doing so. If a baby tooth on the side—which should normally fall out at the age of 10 or 11—has to be extracted prematurely, the first permanent molar, which has already grown in around the age of 6, moves forward into this empty space. This prevents the tooth that should replace the extracted tooth from coming in correctly. To remedy this situation, complicated, lengthy, and expensive orthodontic corrections will be necessary.

Avoiding damage to permanent teeth

The buds of permanent teeth are located very close to the roots of baby teeth. If a cavity in a baby tooth develops into an infection, it can cause irreparable damage to the permanent tooth.

Avoiding pain and the risk of infection

If cavities in baby teeth are left untreated, they can eventually reach the nerve of the tooth. This does not always cause discomfort, but the child may also experience severe pain. Treatment of the tooth itself is more complex at this stage, and it is obviously difficult, if not impossible, to perform it properly on a child who is in pain and often exhausted by the pain.

If the decay reaches the nerve of the tooth, the child often feels no pain at all. However, a tooth in this condition becomes infected. It can cause an abscess in the mouth, which can sometimes be dangerous. In any case, it provides an entry point for bacteria to enter the body. This can cause health problems even in a completely different part of the body.

Maintaining chewing function and enabling language learning

Our teeth are used for chewing. Chewing not only breaks down food, but also mixes it with saliva. This is an important first step in digestion. Saliva contains substances (enzymes) that begin to break down the chemical structure of food in the mouth, allowing the body to absorb it properly afterwards. If you are unable to chew properly, you will tend to swallow food "whole," which is harmful to the body.

In young children, baby teeth are also important for language development.