Category: General Dentistry

It’s quite obvious right now in the radiology field that old-school, analog image acquisition and processing using films are about as inefficient as imaging can get. Most people also know that there are multiple ways to take your imaging into the digital age. Digital X-ray replaces the use of film and computed radiography (CR) plates with a direct digital transfer of X-ray images into the PACS.

Digital radiography is a mode of X-ray imaging that uses digital X-ray sensors instead of film or computed radiography. Some reasons for preference of Digital Radiography (X-ray) includes time efficiency as it bypasses chemical processing and can transfer and enhance images digitally. Also, less radiation can be used to project an image of similar contrast to conventional radiography. Instead of an X-ray film, digital radiography uses a digital image capture device. This gives advantages of immediate image preview and availability; elimination of costly film processing steps; a wider dynamic range, which makes it more tolerable to over- and under-exposure; as well as the capacity to apply special image processing techniques to enhance the overall display quality of the image.

Digital radiography provides so many advantages over the conventional film that it’s easy to see why practices are drifting towards digital dental X-ray systems in their numbers. It’s telling that dentists without digital X-ray imaging who plan to sell their dental practices are finding it difficult. Also, your patients expect to see modern technology in your office. When you go digital with DMC, you provide  top-class, expert treatment to your patients while improving the rating and efficiency of your office, saving time and money.

Advantage of Digital X-ray

1. Better quality of care: The equipment you use determines the way your patients perceive your practice. These days, patients are concerned about exposure to radiation, and conventional radiography can put you at a disadvantage. Digital X-ray reduces radiation exposure by 75% or more.
2. X-ray image enhancement: Digital X-ray systems allow you control the exposure of each image in real time, so you can make pictures darker or lighter on demand. You can also enlarge images, make enhancements to color and superimpose textures.
3. Improved X-ray image quality: Clarity and precision detail are crucial to dental imaging. Digital X-ray equipment provides image quality that supersedes traditional film, bringing out tiny fractures and imperfections that could have been missed on film.
4. More comfortable use than conventional radiography: With just a small amount of training, the practitioner and their staff can quickly adapt to digital radiography equipment.
5. Quick image sharing: Digital radiography gives your practice the ability to send images to other practitioners in just moments. Send digital X-rays while you’re talking on the phone or even while a patient is being treated.
6. No chemical developers: No patient or even practitioner likes dealing with harmful developing chemicals and fixing solutions. Digital radiography eliminates the use of automatic film processors.
7. No more lost images: Digital X-ray removes the risk of losing essential radiographs since they safely store your X-rays image with no worries.

Disadvantage of Digital X-ray

The disadvantage of digital X-ray is mostly related to the sensor. The sensors are expensive to buy, and also in the case of damage of the sensor, it requires high cost for replacements.

Even after regular brushing and flossing, there could still be the accumulation of tartar, plaque, and biofilm from both the tooth surface and underneath the gum line. Also, Tobacco, caffeine, wine and other such foods tend to stain teeth over time, and the counter teeth whitening products can only do a temporary job. The accumulation of plaque is quite unsightly and can spoil the appearance of your pearly whites. Bacteria and germs can grow in the plaque that accumulates around teeth, and this can cause dental complications such as gingivitis.

Due to this, it is essential to schedule a visit to a qualified dentist to get your teeth cleaned by scaling and polishing not only for aesthetic purposes but also for health purpose.

Scaling and polishing, also commonly known as teeth cleaning is one of the most fundamental dental treatment.

“Scaling” is the process of removing hardened plaque and tartar (calculus) stuck to your teeth using our ultrasonic scalers. This instrument removes unwanted dirt by knocking them out using its ultrasonic vibrations. It can remove tartar way faster than just using manual hand scaler in the past. “Polishing” on the other hand is the use of a spinning polishing cup/brush to remove plaque and stains on the surface of your teeth.

After the scaling and polishing session, the dentist may apply a concentrated fluoridated gel on the teeth, if required. This gel comes in various flavors such as raspberry, and the purpose of this gel is to help in the prevention of tooth decay by making the tooth more resistant to acid attacks from bacteria in our mouth.

In the past, many people avoid scaling and polishing because they believe that scraping the teeth is bad, or because they experienced sensitivity or receding gums after treatment. However, these are just ordinary misconceptions. There is no cause for worries when you are in the hands of qualified professionals who are trained to perform this task without causing any harm to your teeth.

Why do we need Scaling and Polishing

1. To remove stains caused by food (coffee/tea) or tobacco.
2. To remove tartar or calculus – this helps prevent gum diseases which are the leading cause of gum recession, loose teeth and subsequently, tooth loss.
3. To allow screening for any oral disease, decay, and any cavities.
4. To learn about how best to keep your teeth and gums clean and healthy.

Frequency for Scaling and Polishing of The Tooth

Many factors determine how often you should have your teeth cleaned, and the most crucial element will be the condition of your oral hygiene. Length of dental maintenance intervals is customized according to each’s oral health.  Remember, your dentist can only help you when you come for your appointment. Early intervention and preventive treatment is the best option to protect your teeth. Although the most common answer to the big question of how often we should visit the dentist for scaling and polishing, will be once every 4-6 months, this may not always be true.

Dental phobia can also be termed dental fear or odontophobia, dentophobia and dental anxiety. Dental phobia is the fear of dentistry and of receiving dental care. However a distinction has been made between dental anxiety, dental fear, and dental phobia.

Dental anxiety is a reaction usually made to an unknown danger. Anxiety is extremely common, and most people have been known to experience some degree of dental anxiety especially if they’re about to experience something which they’ve never experienced before. Basically, it all boils down to being fear of the unknown.

Dental fear is generally a reaction to a danger already known which involves a fight-or-flight response when confronted with the stimulus threatening the subject matter or person.

Dental phobia is basically the same as fear, the only difference is that it is much stronger. Here, the fight-or-flight response actually occurs when the individual just thinks about or gets reminded of the threatening situation. In other words, someone with a dental phobia will avoid dental care at every turn until either a physical problem or the psychological burden of the phobia becomes overwhelming.

The most common causes of dental phobia are bad experience, a history of abuse, uncaring dentists, vicarious learning and humiliation to mention but a few. The good news is that there are ways to overcome such phobia. The few ways to overcome one’s fear of visiting the dentist includes :

 

1. You can go to your very first visit with someone you trust, such as a close relative who has no fear of dentists. It is encouraged that friends and relatives should sit with the patient during treatment.
2. Another way you can help yourself is by seeking distraction while in the dentist’s chair. This you can do by listening to your own music on headphones preferably not one you’ve heard a lot, so you’ll be a little more interested in it. Also, you can find a dentist with a TV or other distractions available in the treatment room.
3. Another good way is you can try relaxation techniques. Sometimes controlled breathing which involves taking a big breath, holding it, and letting it out very slowly, like you are a leaky tire; helps a lot . This is because your heartbeat gets slowed down and you can easily relax your muscles. Another technique is progressive muscle relaxation, which involves tensing and relaxing different muscle groups in turn.
4. You can review with your dentist to know which sedatives are available or appropriate for the treatment . Options include local anesthetic, nitrous oxide (“laughing gas”), oral sedatives, and intravenous sedation. While oversedation can be dangerous, too many dentists are uncomfortable using any oral sedation.
5. Lastly, If you can’t bring yourself to go to any dentist, you might try seeing a psychologist first. The most “tried and true approach” to treating dental phobia (and other phobias) is what is called “direct therapeutic exposure.” It involves introducing the patient to feared items like a needle which is done in a gradual and controlled manner.

Tooth extraction is the removal of a tooth from its socket in the bone.
If a tooth has been broken or damaged by decay, a dentist will try to fix it with a filling, crown or other treatment. However, sometimes, there’s too much damage for the tooth to be repaired. In this case, the tooth will need to be extracted. A very loose tooth usually requires extraction if it can’t be saved, even with bone replacement surgery.

It has been known that permanent teeth were meant to last a lifetime, however there are a number of reasons why tooth extraction may come into play. A very common reason involves a tooth too badly damaged either from trauma or decay, to be repaired. Other reasons may also include:

 

 

1. A crowded mouth:

Most times, dentists pull teeth to prepare the mouth for orthodontia. The goal of this orthodontia is to align the teeth as much as possible, which may not be possible if your teeth are too large for your mouth. In the same manner, if a tooth cannot break through the gum because there is not enough room in the mouth for it, your dentist may recommend pulling it.

2. Infection:

If tooth decay or damage extends to the pulp, bacteria in the mouth can enter it leading to infection. The good news is that often times this can be corrected with root canal therapy. However if the infection is very severe in that antibiotics or root canal therapy do not cure it, then extraction may be needed to prevent the spread of infection.

Here are other reasons:

 

1. Some people may have extra teeth which block other teeth from coming in.
2. Sometimes baby teeth don’t fall out in time to allow the permanent teeth to come in.
3. People who use braces may need some teeth to be extracted to create room for the teeth that are being moved into place.
4. People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
5. People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
6. Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
7.  Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly come in during the late teens or early 20s. They need to be removed if they are decayed, cause pain or have a cyst or infection. These teeth often get stuck in the jaw and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually taken out at the same time.

Tooth filling is a treatment to restore the function, integrity, and morphology of missing tooth structure which results from caries or external trauma as well as to the replacement of such structure supported by dental implants. Tooth fillings are most commonly used to treat cavities, and they are also used to repair cracked tooth, broken tooth or tooth that has been worn down over time.

Usually, when patients develop cavities, the dentist removes some parts of the natural teeth that are infected. Dental supplements are used to fill in this space and maintain the structural integrity of the tooth. Patients can choose to have their cavities filled with a silver amalgam or composite bonding solution. Silver amalgam fillings have been used for decades, are less expensive, and usually last longer than composite fillings.

The dental filling treatment covers two stages: firstly, your dentist will have to clean out the infected tooth, thereby removing all signs of decay and damage; the next step is that your dentist will bond the filling material to the tooth to provide additional strength and support. The tooth fillings treatment is ideal because it can be completed in one dentist appointment, is relatively inexpensive, and results in few side effects.

 

 

There are lots of benefits of tooth fillings which includes:

1. Quick procedure:

When only one tooth is affected by decay, the fillings treatment can be completed in as little as one hour. Wonderful right?

2. Long lasting:

Tooth-colored fillings tend to last about five to seven years, while silver fillings tend to last nearly 12 years. This is cost effective.

3. Cost:

Treatment is frequently covered by dental insurance which you can quickly get.

4. Appearance:

Tooth-colored filling restorations produce a natural appearance; often used to replace old silver amalgam fillings.

 

Although tooth fillings have a lot of benefits, there are still have some risks and side effects attached to the treatment. You should know that both silver amalgam and composite tooth-colored fillings are associated with the following risks and side effects:

A. Sensitivity: Some patients experience sensitivity to hot and cold in the weeks following the procedure.

B. Pain: Some patients experience pain when biting down or applying pressure to the teeth in the days following the procedure.

C. Re-treatment: The dentist will permanently remove damaged areas of your natural teeth and fill it in with a synthetic material. Eventually, the composite bonding material or silver amalgam that is used to fill in this space will wear down and need to be replaced. Dentists expect composite fillings to last five to seven years and silver amalgam fillings to last about 12 years.

 

Silver amalgam fillings are associated with additional risks. Over time, silver amalgam fillings can expand and contract due to changes in the temperature. This can eventually damage and weaken the surrounding tooth structure. Silver amalgam fillings contain elements like mercury, which can be toxic. However, several studies have been conducted to determine if silver amalgam fillings cause any health risks, and no conclusive evidence has been found.

Maintaining your oral hygiene is crucial, not only for the beauty but because we all want to keep our teeth healthy. Many people unfortunately experience some form of tooth decay or cavities, maybe even more significant problems such as dental caries. With modern technology, there is barely need worry as there are methods to save the troubled tooth. Dental cavities are usually resolved by engaging a dentist in Singapore to apply tooth fillings on and around the affected tooth.

Dental fillings are used to restore a tooth that has been damaged by decay back to its normal function and shape. In tooth filling, the decayed tooth material is first removed, then the affected area is cleaned, and then a suitable filling material is placed and shaped to form the tooth. Fillings essentially restore the form and shape of a tooth and especially closing off spaces where bacteria can enter. Hence fillers can also help prevent further decay. The cavity is filled with a dental restorative material. And these Fillings materials may be metal or alloys of metals, or non-metal.

For Metal Fillings, examples are gold and amalgam (Amalgam is an alloy of silver, tin, copper, and mercury). While for Non-Metal Fillings, examples are composites, glass ionomers, and porcelain. Tooth coloured fillings are usually composites or glass ionomers. They consist of powdered glass dispersed in a plastic resin. In certain circumstances, composites can be alternatives to amalgam fillings for better aesthetics, and for better bonding.

In general, there are four different types of tooth fillings that are widely available. The tooth-colored (composite) fillings are the most commonly used fillings by dentists in Singapore.

Factors that Affects the Choice of Filling Material

The type of tooth filling that’s most suitable for you depends primarily on these factors:

1. Where the filling is needed
2. How much repair is required for the decay?
3. Your preference for how visible the filling is

 

Cost of Tooth Filling in Singapore

This costs of tooth filling is an estimated cost per tooth, and it varies for each of the fillings material.

• For Gold Fillings – SGD 700 and above
• Amalgam / Silver Fillings – SGD 60 – 150
• Porcelain / Ceramic Fillings – SGD 250 and above
• Tooth Colored / Composite Fillings – SGD 80 – 160

 

Importance of Tooth Fillings

• Restore healthy tooth functiond
• Relieve sensitivity by insulating otherwise exposed inner tooth structure
• Restore dental appearance (aesthetics)
• Prevent further decay by sealing off space from bacterial entry

 

Processes for Tooth Filling

1. A local anesthetic is applied to the tooth that needs filling to numb the area
2. An air abrasion instrument (a drill) is used to remove any existing decayed tooth material
3. After removing all the decayed material, the cavity will be cleaned using a water/air jet
4. Lastly, the tooth is filled with the fillings and polished

 

Fluoride is a natural mineral that can be found in many kinds of food and also in water. It is an important mineral that keeps tooth decay at bay. Fluoride, also the calcium in our teeth is lost through a process known as demineralisation where the enamel layer of the tooth is attacked by acids (formed from plaque bacteria and sugars) in the food and drinks that we consume and gradually eroding the tooth.

From the food and drinks that we eat or drink, minerals are also replenished in the form of fluoride, calcium and phosphate in a process known as remineralisation.

Fluoride treatments offered by our clinic can help to strengthen the bonding of calcium in our tooth enamel, hence preventing and reversing tooth decay. The fluoride, usually either in the form of a gel, cream or varnish, is spread on your teeth and left there to be absorbed.

Benefits of Fluoride Treatment

Fluoride helps to prevent the tooth from decaying by making the tooth more resistant to acid attack from plaque and sugars. Fluoride is especially important for children under the age of six as it forms the foundation for the development of permanent teeth. Fluoride helps to speed up remineralisation process and also prevents acid from attacking the teeth.

Treatment Process

Fluoride can easily be found in most food and water. It may also be directly applied through the use of fluoridated toothpaste and mouthwash. Over-the-counter mouthwash contains lower amounts of fluoride. However, if you require stronger concentrations of fluoride, you would require a dentist’s prescription.

A dentist can also apply fluoride directly to the teeth in the form of a gel, foam or varnish. This method allows for a much higher amount of fluoride to be applied to your teeth than toothpastes and mouthwashes. Fluoride supplements are available in liquid or tablet forms and must be prescribed by the dentist, family doctor or pediatrician.

FAQs on Fluoride Treatment

What is Fluoride Varnish?

Fluoride varnish is a topical fluoride used to prevent tooth decay. Fluoridated toothpaste is another type of topical fluoride. Both are used on the surface of teeth.

 

How is Fluoride Varnish applied?

A small piece of gauze is used to clean and dry the teeth. The varnish is painted onto the front and back, top and bottom of the teeth with a tiny brush. It forms a sticky covering over the tooth and becomes hard as soon as saliva in the mouth touches it. It takes less than 2 minutes to varnish the teeth.

 

How does Fluoride Varnish work?

Fluoride in varnish enters the tooth enamel and makes the tooth hard. It prevents new cavities and slows down or stops decay from getting worse. If tooth decay is just starting, it repairs the tooth.

 

Is Fluoride Varnish safe?

Fluoride varnish is safe. It is used on babies from the time they have their first tooth. Because the varnish is painted onto teeth and only a very small amount is used, almost no fluoride is swallowed.

Recently, people have considered the value of working with a dentist to manage their sleep-breathing problems, even though dental sleep medicine has been around for over three decades. It was first pursued in conjunction with other treatments (namely continuous positive airway pressure, or CPAP) for obstructive sleep apnea (OSA). Because dental technology has advanced in effectiveness and comfort for snoring mouthpieces and oral devices, dentists now find themselves at the forefront of sleep medicine, especially in support of alternatives, like oral appliance therapy (OAT), for patients with OSA who are unhappy with CPAP. Despite this, many patients (and even dentists and physicians) still don’t recognize the relationship between oral health and sleep-breathing disorders. This recent mainstream emergence of dental sleep medicine stands to change that.

What is Dental Sleep Medicine?

Dental sleep medicine is a branch of specialty dentistry which focuses on the use of oral appliance therapy, COAT (Continuous Open Airway Therapy) to treat sleep-disordered breathing, including snoring and obstructive sleep apnea (OSA). Dentists work together with sleep physicians to identify the best treatment for each patient. Although people misplace Dental Sleep Medicine with Sleep dentistry, Dental Sleep Medicine is not sleep dentistry. Sleep dentistry refers to the use of sedation to perform dental work.

Dentists and COAT (Continuous Open Airway Therapy)

An oral appliance is a device worn in the mouth only during sleep. It fits like a sports mouth guard or orthodontic retainer. The oral device is an effective treatment that prevents the airway from collapsing by supporting the jaw in a forward position, resulting in COAT.

Snoring or Obstructive Sleep Apnea

Snoring is a universal warning sign for obstructive sleep apnea. Before treatment, you should be diagnosed by a board-certified sleep medicine physician. If you have to snore without sleep apnea, your doctor should give you a prescription for an oral sleep appliance. If you have sleep apnea, your doctor will discuss treatment options with you.

The most general form of treatment for sleep apnea is continuous positive airway pressure (CPAP) therapy. The CPAP machine keeps your airway open by forcing air through flexible tubing. CPAP therapy requires you wearing a mask while sleeping. Although CPAP therapy offers superb results, some people are unable to adhere to it. Your doctor may consider offering you a different prescription for a sleep apnea appliance if you are unable to comply with CPAP therapy or prefer an alternative treatment effectively. Many people like an oral appliance because it is comfortable, quiet, portable and easy to wear.

The Roles of Dentel Practitioners in Dental Sleep Medicine

1. Recognize oral signs and symptoms of OSA
2. Identify and screen patients who snore or may suffer from OSA
3. Educate patients on potential sleep-disordered breathing issues
4. Promote potential patients to be tested (PSG/HST)
5. Provide alternative treatment to CPAP and Surgery
6. Selection, fitting, adjustments, and follow-up care of the oral devices
7. Be a part of the treatment team, along with physicians, dedicated to improving your patient’s quality of life through better sleep