The objective of ‘modern dentistry’ is to help people maintain their ‘teeth for life’. However, a lot of people prematurely lose their teeth. Why?
Dental Failure
How often did you ask yourself?:
- Are my teeth worse than they were twenty years ago despite the efforts?
- Am I born with weak teeth?
- Am I going to lose all my own teeth in my old age?
- Why is it that after fillings after fillings they still seem to be failing?
- What went wrong?
At the Beginning
"Nobody is born with bad teeth"
Most of us were given a set of sound teeth right from the beginning.
When we were young with deciduous teeth (baby teeth), if our parents were not advised to keep the syrupy drink or honey on the dummy away from us before bed, our new teeth soon developed decay. Brushing our baby teeth is important to keep them healthy.
Then our milk teeth (baby teeth) were replaced by adult teeth. This transition takes place as early as five and continues till our mid teens. Proper cleaning techniques must be taught and flossing should also be encouraged. The gum must be massaged during teeth brushing.
How many of us only brush our teeth and not our gums? Regular maintenance visits to the dentist should begin early in life. This allows the dental team to monitor the growing pattern of young teeth and provide direction in taking responsibility towards life managing their only set of teeth.
Decay will set in when food and plaque are not removed thoroughly and the acid produced demineralises the enamel and cavities (holes) develop. The grooves on the molars, if deep, now need sealing to prevent the retention of plaque and reduce the potential cavities from developing.
How many of us have managed to this stage without decay?
Young Adult
If you have decay setting in, fillings will be a new experience for you. The fillings placed by the dentist will affect the future of these teeth. All the decay has to be removed before they are biologically sealed and properly contoured with the filling material. If this is not achieved, food and plaque will soon break down the margin and recurrent decay will follow.
Also, sometimes being young and feeling invincible, you have a higher dietary sugar in- take and may lack a disciplined tooth brushing routine allowing unchecked faulty fillings to continue to decay rapidly. This recurrent decay under the filling can cause massive destruction to the tooth structure.
Adulthood
- The next decay will invade further towards the pulp, making the cavity larger and deeper.
- If you are lucky, the tooth will fracture, the result of the decay undermining the enamel shell, and will prompt you to seek dental treatment immediately.
Even if you seek dental treatment promptly, the damage is done. The tooth is now weakened. A large filling will only serve as an interim treatment. Over time, continuous chewing will further weaken the filled tooth and cause further problems later in life.
If you noticed a “hole” in the mouth and chose to ignore it, it will “catch up” with you at the end. How many of you have “hoped the problem will go away?”
- If you are not lucky, the decay will quietly invade towards the pulp, and you will suddenly experience severe pain: the dreaded toothache. This is where your problem begins to escalate.
You will then face with a few options.
- If you want to “keep the tooth”, root canal therapy followed by a crown is one of your choices.
- Or you will choose to extract the tooth and perhaps to replace it with a bridge or an implant.
All of these procedures are technique sensitive and expensive. Therefore, it is paramount to make an informed decision and the procedures are expertly carried out by an experienced and competent dentist.
Later in Life
All the heavily filled teeth will ultimately require strengthening if they are to last. If not, then we are simply “asking a boy to do a man’s job”, which is a good way to describe the situation.
The weakened heavily filled teeth will need to be strengthened and protected by crowns. If the break down of the teeth continues and unresolved, more teeth may be lost and if you have sound financial standing, you will require the advanced restorative procedures such as extraction followed by dental implants as mentioned above. If finance is a problem to you, then partial dentures will be your only practical solution to help you chew and look respectable.
At this stage you may think that there is no need to go for your regular check-up and maintenance with a dentist, and this could be the beginning of the end for the remainder of your teeth.
How to keep your teeth for life
Our teeth are meant to last for life if we observe the following:
- Establish early personal oral hygiene habits
- Maintain regular preventative dentistry
- Get early detection and treatment if decay and gum disease
- Sound restorations provided and maintained
- Protect heavily restored teeth ( large fillings)
What went Wrong?
If you have chronic dental problems and are not getting any good solutions, you may want to know: “What went wrong?”
Supervised neglect from dental professionals- Who gives inadequate or wrong opinions to the public
- Who only provides short term and bandage treatment, but ignores the “big picture”
- Who do not recognize and manage the chronic clinical conditions
- Who performs without knowing the limitations of their skill and ability
- You do not maintain good oral hygiene
- You do not seek regular maintenance
- You maintain a poor diet
- You do not seek prompt treatment when problems first appear
SUMMARY
These comments should answer some of the questions posted in the beginning of this article. There are so many things that can go wrong in your lifetime that will affect the survival of the teeth. Good personal discipline, plus the care of a good dental team will ensure your teeth are maintained healthy for life.
If you think your teeth are worse than ten or twenty years ago despite all the efforts put in, I hope, from reading this article, you identify and understand your dental problems and start to modify your thinking and take appropriate action towards improving your dental health.
It is your teeth after all
Examples of Supervised Neglect:
Case Studies by Dr Andrew Sih:
Case 1
This is the case of a sixty five-year old man with poorly managed mouth. Over the years, he sought dental treatments from different dental practices, spending a lot of time and money trying to get his teeth fixed. The first photo showed the condition of his teeth when he came in for a consultation.
His teeth were severely worn. The crowns placed over a period of years are of the wrong bite and the wrong shape, resulting in the patient’s severe pain and chewing difficulties. This patient also had badly worn and missing back teeth which had not been addressed.
Full mouth reconstruction option was discussed and accepted.
Treatments included replacing all existing crowns, root canal therapies for infected teeth and implant crowns and bridges were prescribed.
The case took two years to complete and the patient looks completely ‘different’ and feels great.
Case 2
The above are photos of a 32-year old lady who came with cosmetic issues regarding the appearance of her front teeth.
Three veneers and crown were done four years ago and appear uneven both in shape and color. The arch looks narrow. She was not happy with the results.
Treatments provided to her included replacing the old crowns (which was of the wrong colour and shape) and old veneers with four laminated composite veneers giving her teeth a broader and more even arch.
She is very happy with the result. Her teeth now look balanced and natural.
Do you want to have ‘teeth for life’?
When your teeth were maintained and properly protected from your early age, you can expect to have your teeth for life. However, due to continual neglect and mismanagement in the past you may now become dentally compromised. Depending on the extent of damage, dental restorations required may be extensive.
Full mouth reconstruction
Modern dental technology allows the dental profession to prescribe treatments that were not available 30 years ago. We can now offer patients “full mouth reconstruction” to a very broken down mouth with predictable and amazing results.
To restore a broken down mouth is like renovating an old house. The extent of the damage is recorded by using radiographs and study models. Decision by the dentist to remove any non strategic and severely broken down teeth is essential. This will create a healthier mouth and allow new implants and prosthesis introduced with a more predictable and favorable prognosis. A final treatment plan is then drawn up, with associated fees explained.
The aim is to “Wind back the Clock” for the patient, to give him a healthy and fully functional mouth again. From then on, with proper regular maintenance program in place, you should again be able to enjoy your TEETH FOR LIFE.
If you have any major unsolved chronic dental problems, please contact Bondi Dental for a personal analysis with Dr Andrew SIH. His knowledge and clinical experience will give you the advice you need and enable you to see “Light at the end of the Tunnel”.
If you have any doubts or concerns about the condition of your mouth, please contact Bondi Dental and make an appointment with Dr. Andrew Sih at (02) 9365 3988.