As we have moved through the last few decades there have been massive advances in many aspects of life. Look at phones, televisions and cars to mention a few but if you think back with regards to the way your teeth have been checked and reviewed few things appear to have changed. Maybe the x-rays are digital and the anaesthetics are less painful but in reality these are very minimal change for the same period of time. There have been massive changes in Dentistry especially in the diagnosis of caries, the bacterial infection which causes the holes in your teeth and the recognition of subtle changes on the tooth surface which indicate that decay or other damage that is present even if not causing pain or visible on x-rays.
In medicine, it is common to embrace the notion of early intervention like the idea of removing a mole to avoid treating it later as cancer. We accept that using cameras, lasers and magnification to aid this detection is sensible and possibly lifesaving yet in Dentistry things remain the same. Many Dentists still only use x-ray’s (some not even digital), a probe and their eyes. Would you be happy with this for your other medical conditions?
Here at Incity Dental in Rotorua we like to follow the leaders of Dentistry to allow us to provide you with the best Dentistry possible, not just the latest trend which in a few years may appear to be less than successful. We have changed what you can expect from us when you’re present for your routine dental examination.
We will continue to use our eyes to look for areas of damage in your teeth and to get a good look at previous restorations. Any areas of hidden decay we will still take regular x-rays, however we have other new diagnostic tools which will find decay, that have previously gone unchecked in the past.
Where needed we will examine your teeth under magnification of up to 6x with bright illumination both from the top and the sides. This allows us to see subtle fractures and very small areas of decay on the surface and sides of teeth. As professional dentists we have looked at issues in teeth for many years and not realized what we have been looking at. But once you have the knowledge you cannot fail to see the problems that have always been there.
The Diagnodent is one of the must haves of Dental Diagnosis. For the past 10 years it has been developed and refined to the point that it is an ideal tool to help aid in the diagnosis of very small areas of decay within pits and grooves of the teeth. Diagnodent works simply by emitting a beam of light at 655nm wavelength. In healthy teeth nothing happens, but in teeth with damage to the enamel or areas where the bacteria that cause tooth decay are present the tooth will fluoresce and the Diagnodent is able to measure this fluorescence. This indicates the presence of something which requires further investigation and possible treatment depending on various other factors. This has also allowed us a very accurate way to evaluate and diagnose possible decayed areas on the occlusal surface. Occlusal decay has always been very difficult to diagnose from x-rays and up to 70% has been missed using older probing techniques. Because of this difficulty to diagnose there have been two outcomes.In the older generations there are large numbers of silver fillings which were placed to block these fissures by cutting them out and placing a filling.
The long term results of this are now only becoming apparent with the discovery of new issues such as Cracked Tooth Syndrome and Occlusal Effect Caries. By fixing a problem that may not have existed, a new and more serious problem was created.
In the younger generations this may have been done but another technique is also used called Fissure Sealing. This involves placing a seal over the fissure or pit without cutting it away. The idea is to completely seal the area and prevent any bacteria from being able to get in and cause damage.This is a valid preventative technique but requires a way of very accurately ensuring that you are not sealing bacteria into that area and then providing it shelter which it is able to destroy the tooth while being protected from detection by the very restoration that was placed to stop it. There are many documented cases of teeth having to be root treated or extracted in teenagers as a result of exactly this problem. By the use of the Diagnodent and its ability to detect extremely small amounts of bacteria and minute changes within the enamel, we are able to check for these presence of problems. If detected we use air abrasion remove these bacterial and damaged areas without the need for drilling or injections prior to sealing the fissures and pits and securing the future of the tooth.
By using photographs of both your face and smile and also magnified photographs of teeth we are able to review the issues that are going on with you and help you see what we can see. Advances in knowledge of what subtle changes on the surface of the tooth can mean inside the tooth allow us to predict changes which will happen and hopefully intervene before these result in much more invasive and expensive operative procedures.
This system allows us to take an x-ray of you which shows us many areas of your face and jaw that we are not normally able to review with standard x-ray techniques. We are able to review the roots and bone structure of all the teeth the joints of your jaw and also the sinus areas.
In 2012 on a routine x-rays of a new patient to the practice we discovered a highly invasive cancer which unfortunately was not able to be treated successfully. This was discovered by chance by taking a Panoramic X-ray. After this we decided that we should implement a regular program for checking these more unusual areas. We will now take a Panoramic X-ray every 5 years.
The hygienist is the centre of our practice. A dental practice without a hygienist is like a car dealer without a service centre. Once you have bought your smile it is very important to know how to look after it and to be given regular maintenance to ensure the money you have spent is not wasted and will last as long as possible. Our hygienist will provide you with on-going maintenance as well helping you understand the way your care can greatly minimize the cost of your teeth.
Many people living with bleeding gums feel this is a normal thing. Generally though this means an underlying condition in the gums which left unchecked will result in the loss of bone supporting your teeth and finally the teeth themselves. Do not ignore the tell-tale signs of problems in your mouth, after all if the emergency warning light came on in your car you would be a fool to continue to drive.