Dr Hardeep Bhatta & Dr Allen Friesen
Suite 205 - 1465 Salisbury Ave
Port Coquitlam, BC V3B 6J3
(604) 239-5954

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Posts for: August, 2014

By Smiling Creek Dental
August 29, 2014
Category: Dental Procedures
Tags: bridgework  
AFixedBridgeRemainsanEffectiveOptionforToothReplacement

If at all possible, we want to save a tooth — it’s the best outcome for your overall dental health. In many cases, we can achieve this by filling the tooth or installing a crown over it.

Unfortunately, preservation isn’t always possible if the natural tooth has been irreparably weakened by decay or trauma. Replacing the natural tooth with a life-like artificial one is the next best option: the replacement will help you regain lost function and reinvigorate your smile. Filling the missing tooth’s space also prevents neighboring teeth from drifting into it, causing further problems with function and appearance.

Dental implants are widely recognized as the best choice for tooth replacement because of their life-like qualities, durability and positive effect on bone health. Even their biggest drawback, their cost, isn’t that great an issue if you factor in their longevity — they may actually result in less dental expense over the long-term.

A dental implant, however, isn’t always a viable option. Some patients may not have enough bone mass to support an implant. Those with certain systemic diseases like uncontrolled diabetes or a weakened immune system may not be able to undergo dental implant surgery.

Fortunately, many of these patients can benefit from a fixed bridge, a restoration option that’s been used for decades. A bridge is a series of life-like crowns permanently joined like pickets in a fence. The middle crown known as the “pontic” fills the empty space left by the missing tooth. The crowns on either side of the pontic are permanently attached to the natural teeth that border the missing tooth space. Known also as “abutment” teeth, they serve as the support for the bridge.

Bridges do have one downside — the abutment teeth must be prepared by filing them down so the new crowns fit over them properly. This will permanently alter and possibly weaken the teeth. Dental implants, on the other hand, have little to no effect on adjacent teeth.

Still, a bridge remains an effective option for many people. Properly cared for, a bridge can restore function as well as enhance your smile for many years to come.

If you would like more information on bridgework as a restorative option, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”


AntibacterialSolutionscanHelpFightAdvancedGumDiseaseInfections

Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.

A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.

If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.

The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.

Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.

These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.

If you would like more information on treatments for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Difficult Areas of Periodontal Disease.”


TakingPrecautionsBeforeDuringandAfterImplantsWillHelpEnsureSuccess

One of the many reasons for dental implant popularity is their reliability — studies have shown 95% of implants still function well after ten years. Still, on rare occasions an implant will fail. We can minimize this risk by taking precautions before, during and after installation.

Long-term success begins with careful planning before surgery. We thoroughly examine your teeth and jaws, using x-rays or CT scanning to map out the exact location of nerves, sinus cavities and other anatomical structures. Along with your medical history, this data will help us develop a precise guide to use during implant surgery.

We’ll also assess bone quality at the intended implant site. The implant needs an adequate amount of bone for support — without it the implant will not be able to withstand the biting force of normal chewing. It may be possible in some cases to use bone grafting or similar techniques to stimulate growth at the site, but sometimes other restoration options may need to be considered.

The surgery can also impact future reliability. By precisely following the surgical guide developed during the planning stage, the oral surgeon can increase the chances of success. Still, there may be an unseen variable in play — a pre-existing or post-operative infection, for example, that interferes with the integration of the implant with the bone. By carefully monitoring the healing process, we can detect if this has taken place; if so, the implant is removed, the area cleansed and the implant (or a wider implant) re-installed.

Even if all goes well with the implantation, there’s still a chance of future failure due to gum disease. Caused mainly by bacterial plaque, gum disease infects and inflames the supporting tissues around the teeth; in the case of implants it could eventually infect and weaken the surrounding bone, a condition known as peri-implantitis. This calls for aggressive treatment, including plaque and infected tissue removal, and possible surgery to repair the bone’s attachment to the implant. Without treatment, the implant could eventually detach from the weakened bone.

Maintaining your implants with good oral hygiene and regular dental checkups is the best insurance for long-term reliability. Taking care of them as you would natural teeth will help ensure a long, happy life for your “third set” of teeth.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants.”


By Smiling Creek Dental
August 04, 2014
Category: Oral Health
Tags: tooth decay  
WarningSugarCanBeDangeroustoyourHealth

Look around and you’ll find warning labels on lots of household items: alcoholic beverages, drain uncloggers, pesticides and pool toys (not to mention cigarettes and chainsaws). Now, California lawmakers are proposing to add one more item to the list: sugary soft drinks. A bill to that effect recently passed the California state Senate, and is presently headed to the Assembly. If approved by both houses and signed by the governor, it would require sugary beverages to carry a warning label.

The proposed label would read: “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.” It would appear on drink packaging and vending machines. While some may feel it’s an infringement on personal choice, recent polling seems to show that the tide of public opinion may have turned toward recognizing the potential health dangers of sugary drinks.

How real are those dangers? The medical groups sponsoring the bill (including the California Medical Association) point to numerous scientific studies showing, among other things, that:

  • Drinking one soda per day increases an adult’s likelihood of being overweight by 27 percent — and for a child, the likelihood is doubled!
  • Drinking one or two sodas per day increases the risk of developing type II diabetes by 26 percent.
  • People who drink two to three sodas per day are 2.75 times more likely to have a heart attack.
  • Drinking sugary beverages daily for only two weeks increases LDL (“bad”) cholesterol and triglyceride levels by 20 percent; over a longer period, it has even worse effects.
  • Children who consume sugary beverages are much more likely to develop tooth decay.

No matter where you stand on the debate over warning labels, you should understand the potential dangers of consuming foods and beverages with added sugar. For years, dentists have been cautioning people to limit their intake of sugary treats, including sodas and other sweets. Initially, our warnings came from the standpoint of oral health. Now, we have evidence that many other health problems have the same cause. We want to share this information with you because we’re concerned about your overall health — not just your oral health. You can learn more by reading the Dear Doctor magazine article “Think Before You Drink.”


VeneersareaVersatileMeanstoAchievingaConfidentSmile

Nothing says confidence like a bright, beautiful smile. But problems with your teeth’s appearance — discoloration, abnormal shapes, or gaps — may be giving you reasons not to smile. If so, you may be a candidate for porcelain veneers.

A veneer is a thin covering of porcelain or other dental material permanently attached to the face of a tooth to improve its appearance. Veneers help resolve a variety of aesthetic issues: their life-like color can brighten dull, stained teeth; they can “lengthen” shortened teeth caused by wear or normalize congenitally misshapen teeth; they’re also helpful in reducing small gaps or used in conjunction with orthodontics for more serious misalignments.

The first step to a better smile with veneers is to assess your teeth’s current condition and develop a treatment plan. Your input is extremely important at this stage — what changes you believe would improve your smile. We would also offer valuable insight, based on our knowledge and experience, into what is realistically possible and aesthetically appealing regarding porcelain veneers.

Once you have decided to go forward, the next step is to prepare the teeth for attaching the veneers. Depending on their size and location, this preparation can range from no tooth structure removal to a relatively small amount of structure. If the latter is needed, we remove only what’s necessary to achieve the aesthetic result since structural reduction isn’t reversible.

After preparing an impression of your teeth, we would send it and other instructions to a dental technician to create the permanent veneers. In the meantime, we’ll install a temporary set for you to wear while the permanent set is under construction.

Once we attach the permanent veneers, they will adhere so securely a drill or laser would be needed to remove them. We achieve this attachment by creating microscopic pores on the face of the teeth and the inside of the veneer with a mild acid solution. The bonding cement seeps into these pores and creates a strong bond that virtually unites the tooth and veneer into one.

Although your new veneers are made to last, you’ll need to maintain them like your other teeth, with a little added caution when biting and chewing. All in all, though, you’ll be able to smile again with confidence — for many years to come.

If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers.”