02
Say Cheese!
DID YOU KNOW? The use of toothpaste dates back to 500BC, with records of it being used in both India and China
I have long been a fan of Cheryl Cole’s pearly whites and, having been a survivor of teenage braces, understand the importance of dental care and the benefits of having a beautiful set of teeth. There really is nothing quite like the ‘perfect’ smile. Today, I’m happy to report, dental care has greatly evolved since the days of the dentist’s drills and awful extractions, when having a tooth pulled was the only solution to dental pain. So, cast your preconceived notions aside, because it’s time to visit your dentist again. There is no discounting the importance of oral hygiene and the benefits that it has on your overall health. In fact, a recent study carried out by experts from University College London found that people who never or rarely brush their teeth are 70 per cent more likely to suffer from heart disease than those who brush twice a day, establishing a clear link between poor dental hygiene and increased risk of heart problems. Good oral health is a combination of the teeth and mouth being healthy, feeling comfortable, functioning well, and having an acceptable appearance. Dentists recommend you brush twice daily as, through regular brushing and good oral practices, you can combat plaque and tartar which, in turn, fights tooth decay and oral disease. Regular checkups with your dentist – at least once every six months – are also recommended. And now, because of the huge advancements and developments in Irish dental care, the solution to a toothache is no longer just an extraction, and the growth of cosmetic dentistry means we can all achieve our perfect set of pearly whites. Better still, DID YOU KNOW? many clinics have based their design on boutique Teeth are the hardest hotels, so now you can enjoy TV in the waiting substance in the room and music and massage in the dentist’s chair. human body We’ve certainly come a long way! Healthy teeth are a sign of a healthy, happy and confident you. So invest in your smile again and be proud to say ‘cheese’! Nuala Ryan, Editor
Contents
DID YOU KNOW? Eating and drinking sugary foods and drinks regularly is the biggest cause of tooth decay
03 04 05 06 07 08 10 11
Oral disease prevention Think before you travel Nine facts your dentist wants you to know Get the perfect smile – your guide to orthodontics Dental phobias Dentist profiles Healthy teeth, happy kids Understanding dental implants, plus a guide to dentures 12 Cosmetic dentistry explained 14 In case of emergency 15 The changing face of dentistry – a look at emerging dental treatments and technologies A BeCreative Editorial Production www.becreative.ie Editor Nuala Ryan – Nuala@becreative.ie Contributors Tara Leigh, Emma Hill, Ben Murnane Photography Original photography by Nic Mac Innes – nicmac@eircom.net Advertising Keith Gildea – kgildea@independent.ie (01) 7055469 Design INM Design Studio – studio@production.ie Repro Independent Newspapers (Ireland) Ltd, 27-32 Talbot Street, Dublin 1 D E N T A L
C A R E
I R I S H
I N D E P E N D E N T
03
Prevention is better than cure
Maintaining good oral health and practising proper oral hygiene can greatly reduce your risk of developing oral disease, says NUALA RYAN
A
ccording to the experts, brushing teeth twice daily is key to reducing the levels of bacteria in the mouth, which will, in turn, reduce your risk of developing oral disease. If you do not brush your teeth regularly, you can end up with increased levels of bacteria leading to inflammation and the build-up of plaque. To maintain good oral health there are a number of important factors to consider. Not only is eating healthily vital – frequent consumption of sugary foods and drinks is the biggest cause of tooth decay – but smoking and excessive alcohol consumption, which are major risk factors for cardiovascular disease, cancers and oral diseases, should be avoided. Gum disease can be easily prevented and treated. However, to maintain good oral health, you should visit your dentist regularly and carry out the proper oral hygiene practices at home. This means eating healthily, cutting back on alcohol, quitting smoking and brushing the teeth at least twice a day. In doing so, your teeth should last you a lifetime.
Gum Disease Periodontal disease, or gum disease, is a very common condition that can occur as gingivitis, which is inflammation of the gum distinguished by redness, swelling and bleeding on brushing; or as periodontitis, which is inflammation of the bone and tissues of the teeth. If left untreated, these conditions can result in the loss of gum and bone tissue or loosening and loss of teeth. As is the case with most oral diseases, prevention is key. To reduce your risk I R I S H
I N D E P E N D E N T
of developing oral disease, practise regular brushing and plaque control. As brushing is the best plaque control method, ensure you brush your teeth correctly (a gentle scrub technique is most effective) and invest in a good toothbrush. Mouthwash, dental floss and plaque disclosing agents are also useful aids in the fight against plaque. Sensitive Teeth Sensitive teeth, or cervical dentine sensitivity, is caused by exposure of the root surface at the gum margin due to gum disease or over-vigorous brushing with a hard toothbrush. To prevent tooth sensitivity, you should follow the same oral hygiene practices as set out to prevent gum disease. If your sensitivity is severe, however, consult your dentist, who will determine the cause of the sensitivity and may recommend a protective filling be placed over the sensitive area. Or why not try a ‘sensitive’ toothpaste? Growing evidence shows that these can help ease the pain of sensitive teeth in certain cases. Halitosis Halitosis or bad breath is an embarrassing condition caused by excessive amounts of volatile sulphur compounds being produced by bacteria in the mouth, and can be affected by food, drink, oral hygiene practices and sleep. Many people find that the plaque control and oral hygiene products aimed at fighting gum disease can also help combat bad breath. Some products, however, only mask the problem and are not a long-term solution. In this instance, sufferers of halitosis should try antimicrobial mouthwashes, which have proven effects, or tonguecleaning devices.
04
Think before you travel
Sometimes travelling abroad for dental treatment can seem like a good idea – but there are a number of factors to consider before you go
A
recent survey carried out for the Irish Dental Association found that an astonishing three out of every four Irish dentists are treating patients for problems with treatment received abroad. In recent times, the phenomenon of ‘dental tourism’ has grown, with many Irish people going abroad to receive treatment. However, before you travel, there are some important things you should take into account. Many patients opt to get a lot of work done while abroad in order to save time and money. However, such ‘overtreatment’ can create significant problems. Complex dental treatment is not a quick fix. It’s a combination of advice, communication, prevention, care,
problem solving, health, function and maintenance. One of the keys to dental health is regular visits with your dentist; dental work often requires follow-up appointments or treatment to be carried out over a number of visits. With dental implants, insufficient stages of treatment (enough appointments) may reduce success rates. Follow-up by the dentist who did the restoration work is recommended and the continued aftercare is as critical as the treatment. It’s also vital to remember that implants cannot be moved – there is one chance to get it right. Responsibility and accountability are so important in any aspect of healthcare. When you have treatment done, you want to know that you can return to the same dentist with any problems and if you have a complaint that you can get redress. Reduced costs can be achieved by
using different materials, components and technical services, to give a different aesthetic result – but, at the end of the day, this is your mouth. If a dentist needs to address emergencies, it’s helpful for him or her to know your treatment history – what happened during previous procedures and what materials and techniques were used. In Ireland you have a wealth of specialists from all disciplines, working together, so you will be referred to the specialist you need to see.
“
Of course, it is possible to receive good treatment outside of Ireland, but when it comes to follow-up, regular dental care and peace of mind, regular appointments with your own dentist are the key. With such an important, irreversible aspect of your health, long-term care is as important as the treatment itself. ‘Every tooth in a man’s head is more valuable than a diamond’ – Miguel de Cervantes, ‘Don Quixote’, 1605
FOLLOW-UP BY THE DENTIST WHO PERFORMED THE TREATMENT IS RECOMMENDED AND CONTINUED AFTERCARE IS AS IMPORTANT AS THE TREATMENT ITSELF”
AD
D E N T A L
C A R E
I R I S H
I N D E P E N D E N T
05
9 Facts Your Dentist Wants You to Know
DR ROBERT MOLLOY of Redmond Molloy Dental Clinics dispels your dental myths
1
Dental checkups are extremely important and include oral cancer screenings Going to the dentist for regular checkups and cleanings is one of the most important factors in maintaining good oral health. Regular checkups can prevent cavities, root canals, gum disease, oral cancer, and other dental conditions.
2
Gum (periodontal) disease influences your overall health Gum disease is one of the main causes of tooth loss in adults. It is also linked to heart disease, strokes and diabetes. In the early stages, the disease (gingivitis) can be easily treated and reversed. If treatment is not received, it becomes more serious and advanced and is called periodontitis. Bone loss occurs at this stage. Brushing twice a day for two minutes, daily flossing, and regular dental checkups and cleanings are the best prevention against gum disease.
3
Help keep the cavities away by brushing twice a day Brushing your teeth properly, twice a day, removes the plaque that causes cavities. Plaque is the soft and sticky substance that accumulates on the teeth from food debris and bacteria. Flossing removes the plaque from between the teeth where the toothbrush cannot reach and should be done prior to brushing. A mouthwash can help but is not a substitute for brushing.
4
Bad breath may be due to a dental problem Roughly 85 per cent of people with bad breath have a dental condition that is to blame. If a dental condition is the cause of bad breath, mouthwash will only mask the odour. A simple scale and polish with your dentist or hygienist can help rectify the problem along with daily flossing and brushing. Remember to brush both your teeth and tongue twice a day as this can greatly reduce and possibly eliminate bad breath in between your dental visits.
5
Proper diet is important for good dental health Sugars in soft drinks and non-nutritional foods feed the bacteria in our mouth; these produce acids that attack tooth enamel which can lead to cavities and gum disease. As a nation we are eating a lot more acid containing food than in decades gone by and this is leading to the phenomenon of enamel erosion. The main sources of dietary acids are fruit derived foods or drinks, fizzy drinks and wine. One important tip is not to brush directly after an acidic food or drink, the I R I S H
I N D E P E N D E N T
tooth surface is at its softest immediately after anything acidic, the saliva hardens the surface within 30 mins, so it is best to brush after this period. Limiting the amount of high sugar drinks and foods can greatly help to maintain good dental health.
AD
6
Dental problems never get better or go away without treatment If your dentist gives you a treatment plan for dental work, you should focus on getting your teeth fixed as soon as you can. Cavities will continue to get bigger and if they reach the nerve in your tooth, your only option would be to have a root canal or have the tooth extracted. Also, the longer a problem persists, generally the more expensive it becomes to fix. Prevention or early intervention is both better and more economical than cure.
7
Root canal treatments are usually painless In the past, when a root canal treatment was suggested, "Oh, just pull the tooth, I've heard root canals are agony!" was generally the response. However, with today's technology and anaesthetics a root canal should be as painless as having a filling done.
8
Change your toothbrush regularly Manual toothbrushes become worn out after about three months and no longer work as well as they once did. A soft toothbrush is also recommended as this causes less wear on the enamel of your teeth.
9
Maintaining good dental health is not time consuming Brushing for two minutes twice a day plus flossing totals about eight minutes per day! An easy way to brush for two minutes or get your kids to brush for two minutes is to put a song on and brush for the duration. Seeing your dentist for regular checkups and cleanings only lasts about 30 minutes twice yearly! D E N T A L
C A R E
06 Get the perfect smile in three months
Does straight teeth in three months sound too good to be true? TARA LEIGH explores the area of orthodontistry and talks to Dr Robert Molloy of Redmond Molloy Dental Clinics about alternative treatments available today
I
n this day and age, we all want that attractive Hollywood smile and straight teeth play a key role in this. For many of us, however, braces may not be a viable option. They can be costly, unsightly, and have to be
worn for approximately two years. Today, there is an alternative to traditional train tracks which is becoming increasingly popular throughout Ireland. Orthodontics is a particular area of dentistry that deals with the correction of teeth. Crooked teeth can result from numerous factors, such as the premature loss of baby teeth, finger sucking and
genetics. Dentists have long used braces in the treatment of crooked teeth and there are a wide variety available, the most common being train tracks, a brace made of small brackets glued to the teeth. Today, there are also invisible braces, clear, fixed six-month braces and more recently the Inman Aligner. The Inman Aligner is a removable, non-invasive, retainer-like piece that relies on ‘push’ and ‘pull’ motion to move or straighten teeth. “Because the brace is fitted with the full force initially, unlike other types of braces, it isn’t uncomfortable,” says Dr Molloy. Still, it shouldn’t be viewed as a onesize-fits-all solution, warns Dr Molloy. “The Inman Aligner is perfect for people who want to straighten three or four teeth at the front but it is not a complete replacement for train tracks, and there are people it will just not suit.” For this reason, it is advisable to visit your dentist, who will assess the best course of action for you. And if your dentist does prescribe this treatment, there are some great advantages, the most obvious being the ability to remove the aligner. “If you have a presentation or a date you can take it out but,” Dr Molloy warns, “if you want to see realistic results, you have to wear it for 20 hours a day.” Another great advantage of the Inman Aligner is its relatively low cost in comparison to traditional braces. The Inman Aligner costs approximately €1,700 per arch, whereas conventional braces can range between €4,000 and €6,000. In real terms, this expense can actually be a lot less as all orthodontic treatments carry a tax relief of 20 per cent, reducing the cost of the Inman Aligner to €1,385.
An orthodontist may suggest braces if the patient has the following: • Crowding Crowding occurs when a person has too many teeth for their mouth space. • Overbite An overbite is the term used to describe a situation where the upper teeth overlap the lower teeth significantly. • Underbite Conversely, an underbite occurs when the lower front teeth overlap the upper front teeth. • Crossbite A crossbite is the term used to describe a situation where the upper teeth don’t quite fit over the bottom teeth
Dr Robert Molloy
FOOD FOR THOUGHT Braces should not impede your lifestyle; they are there to enhance your smile. However, there are certain foods which should be avoided if you are wearing the traditional train track brace, sticky foods being the most obvious. Foods such as caramel and chewing gum can get stuck to the braces, causing discomfort and making them difficult to keep clean, while hard foods like candy, carrots and apples can cause the brace to break and should, therefore, be avoided. If you opt for a removable brace, this can be taken off during mealtimes, but you must be careful to put it back on once you have finished. D E N T A L
C A R E
I R I S H
I N D E P E N D E N T
07
Fighting your dental demons
Don’t let your dental fears affect your oral health
D
id you know that according to some studies, between 6 and 14 per cent of people avoid attending the dentist because of dental phobia? Did you know that almost half of those that do attend are anxious in this dental environment? Well, fear no more because there are ways of fighting your dental fears. Whether you are afraid of the dentist, the pain associated with dental treatments, or the embarrassment of having missed appointments or not maintaining good oral health practices, there are coping mechanisms that can help you to conquer your dental phobias. Remember, nothing is
ever as bad as you imagine! When you book your dental appointment, tell the receptionist about your anxieties. He or she may be able to offer you advice, reassurance and make sure that, on the day of your appointment, you are as comfortable as possible. If it is the sights, sounds and smells of the surgery that set you quaking, put your preconceived notions of dental surgeries aside. Today, many clinics have invested in making the waiting rooms, and the surgery itself, as comfortable as possible, with some even modelling themselves on boutique hotels. With televisions in the waiting room, music in the dentist’s chair, and even massage chairs in some cases, there are plenty of distractions to help make your
dental experience more pleasant. If you are afraid of the dentist, tell him or her! Voicing your anxiety will give you immediate relief, and allow the dentist to address your concerns. Being open and honest with your dentist will help create a good, professional relationship, making you feel more comfortable and at your ease each time you visit. Similarly, if you are nervous about dental procedures, whether it is a routine checkup or a specific treatment, ask your dentist to give you an overview of what to expect. Knowing what the dentist is doing and why he is doing it can provide reassurance for patients. Worried about the pain involved in dental treatments? Why not ask the dentist
about pain relief? You may be able to request an anaesthetic so that the procedure can be carried out completely painlessly. And if you are finding it difficult to cope while in the surgery, don’t be afraid to ask the dentist if you can take a break. If your fear is particularly bad, some clinics offer dental sedation, leaving you drowsy and unaware of any treatment, while still enabling you to co-operate with the dentist. And remember, attending the dentist regularly is not only good for your oral health, it also helps you overcome your dental fears. Not only will you become more familiar with the process at each visit, you are also likely to need less serious work done.
AD
I R I S H
I N D E P E N D E N T
D E N T A L
C A R E
08
Dentist Profiles Dr Annette O’Donovan BDS MFD RCSI Education: University of Manchester Qualification: Bachelor of Dental Science 2001; Member of the Royal College of Surgeons, 2004 Special Interests: Cosmetic and sedation dentistry Practises at: Alexandra Dental Practice, 6 Alexandra Tce, O'Connell St, Limerick t: (061) 315228 e: info@limerickdentist.com w: www.limerickdentist.com
Anna Zwolinska MD Education: Medical University in Wroclaw, Poland Qualification: Dentist (2007) Special Interests: General dentistry Practises at: KBM Medics, Unit 14, Belgard Square West, Tallaght, Dublin 24 t: (01) 414 0616 e: info@kbmmedics.ie w: www.kbmmedics.ie
Dr Miriam Quilty BDS NUI Education: University College Cork Qualification: Bachelor of Dental Science, 2003 Special Interests: General and preventative dentistry, cosmetic dentistry Practises at: Alexandra Dental Practice, 6 Alexandra Tce, O'Connell St, Limerick t: (061) 315228 e: info@limerickdentist.com w: www.limerickdentist.com
Ewa Dudarewicz DMD Education: Medical University in Gdansk, Poland Qualification: Dentist (1980), Dentistry & Orthodontics (1997), Orthodontics (2000) Special Interests: Orthodontics Practises at: KBM Medics, Unit 14, Belgard Square West, Tallaght, Dublin 24 t: (01) 414 0616 e: info@kbmmedics.ie w: www.kbmmedics.ie
Dr David Casey Education: University of Birmingham Dental School Qualification: BDS (Bachelor of Dental Surgery) Special Interests: General practice and aesthetic dentistry Practises at: Beechwood Dental, 9 Dunville Avenue, Ranelagh, Dublin (beside Beechwood Luas stop) t: (01) 496 7526 e: info@beechwooddental.ie w: www.beechwooddental.ie Dr Peter Casey Education: University of Birmingham Dental School Qualification: BDS (Bachelor of Dental Surgery) Special Interests: General practice and implant dentistry Practises at: Beechwood Dental, 9 Dunville Avenue, Ranelagh, Dublin (beside Beechwood Luas stop) t: (01) 496 7526 e: info@beechwooddental.ie w: www.beechwooddental.ie Brian C Mahon Education: City & Guilds of London, George Brown College of Health Sciences Canada, Royal College of Surgeons (UK) and Royal College of Surgeons Ireland Qualification: Clinical Denturist registered with the Irish Dental Council Special Interests: Custom-made dentures Practises at: Dentaltech ltd, Whitehall House, Whitehall Close, Terenure, Dublin 6 t: (01) 455 1866 f: (01) 408 7935 e: info@dentaltech.ie w: www.dentaltech.ie Dr Jim Griffin Education: Trinity College Dublin; The London Hospital, Whitechapel; Southampton University Hospital; Oregon Health Sciences University; Regional Orthodontic Unit, St James Hospital Qualification: BDentSc, Cert Orth (US) Special Interests: Orthodontics Practises at: East Coast Orthodontics, Wicklow, Gorey Town and Stillorgan, Co Dublin t: (01) 283 2046 e: info@eastcoastorthodontics.ie w: www.eastcoastorthodontics.ie
D E N T A L
C A R E
Krzysztof Samborski DDS DMD OMS Education: Medical University in Krakow and Warsaw, Poland Qualification: Dentist (1981), Oral Surgery (1987), Maxillofacial Surgery (1991) Special Interests: Oral/dental surgery Practises at: KBM Medics, Unit 14, Belgard Square West, Tallaght, Dublin 24 t: (01) 414 0616 e: info@kbmmedics.ie w: www.kbmmedics.ie Dr Eamonn Noonan Education: University of Birmingham Qualification: BDS Special Interests: Emergency dentistry, restorative dentistry, tooth whitening, minor oral surgery Practises at: 17 Ellen Street, Limerick t: 1800 230 230, (061) 468 765, Emergency Mobile: 087 989 5381 w: www.toothache.ie Dr Rona Leith BA BDentSc, MFD (RCSI), DChDent (UDubl) Education: Trinity College Dublin, Royal College of Surgeons Ireland Qualification: Dental Surgeon, Doc in Paediatric Dentistry Special Interests: Paediatric dentistry Practises at: The Park Clinic, Cabinteely, Dublin 18 t: (01) 285 1937 e: reception2@parkclinic.ie w: www.parkclinicdental.com Dr Ebrahim Al Awadhi BDentSc(TCD), MSc(ULond), MOrth(RCSI), MOrth(RCSEng), BA Education: Trinity College Dublin, Eastman Dental Institute, Royal College of Surgeons England Qualification: Masters in Orthodontics, MOrth Special Interests: Orthodontics Practises at: The Park Clinic, Cabinteely, Dublin 18 t: (01) 285 1937 e: reception2@parkclinic.ie w: www.parkclinicdental.com Dr Altona Myers BDentSC (TCD) Education: Trinity College Dublin Qualification: Bachelor of Dental Science Degree Special Interests: General dentistry and orthodontics Practises at: The Seapoint Clinic, 23 Seapoint Avenue, Blackrock, Co Dublin t: (01) 284 2570 e: info@seapointclinic.ie w: www.seapointclinic.ie
I R I S H
I N D E P E N D E N T
Dr Aidan Redahan BA, BDentSc, MFD (RCSI), MChDent (UDubl) MOrth (RCSEdin) Education: Trinity College Dublin, Royal College of Surgeons in Edinburgh Qualification: Dental Surgeon, Member of the Faculty of Dentistry, Member of the Royal College of Surgeons Edinburgh (Orthodontics) Special Interests: Orthodontics Practises at: The Park Clinic, Cabinteely, Dublin 18 and the Dublin Dental School and Hospital t: (01) 285 1937 e: reception2@parkclinic.ie w: www.parkclinicdental.com Dr Edmond O’Flaherty BA BDentSc (Hons) Education: Trinity College Dublin, University of Warwick Qualification: Bachelor of Dental Science Degree, Certificate in Implant Dentistry Special Interests: Dental implants and cosmetic dentistry Practises at: The Seapoint Clinic, 23 Seapoint Avenue, Blackrock, Co Dublin t: (01) 284 2570 e: info@seapointclinic.ie w: www.seapointclinic.ie
09
Dr Eavan Lawlor BA, BDentSc (Hons) Education: Trinity College Dublin Qualification: Degree in Bachelor of Science & Bachelor of Arts Special Interests: Cosmetic dentistry Practises at: Bray Town Dental, Suite 1, Town Hall Court, Main Street, Bray, Co Wicklow t: (01) 274 5111 e: bray@towndental.ie w: www.smiles.ie
Dr Sean Murray BA BDentSc MSc Implant Dentistry Education: Trinity College Dublin Qualification: Bachelor of Dental Science, Masters in Implant Dentistry, Cert in Conscious Sedation Special Interests: Cosmetic dentistry, implant dentistry Practises at: Smile Design Dental, 16 Mainstreet, Baldoyle, Dublin 13 and 63 Northstrand Road, Northstrand, Dublin 3 t: (01) 839 6520 (Baldoyle) or (01) 834 9663 (Northstrand) e: info@smiledesign-dental.com w: www.smiledesign-dental.com
Dr Huw Anthony BDS (Hons) (U Cardiff) Education: University of Cardiff Qualification: Bachelor of Dental Science Degree Special Interests: Orthodontics Practises at: The Seapoint Clinic, 23 Seapoint Avenue, Blackrock, Co Dublin t: (01) 284 2570 e: info@seapointclinic.ie w: www.seapointclinic.ie
Dr Tony Brady BDS MBBch Education: University College Cork Qualification: Bachelor of Dental Science, Bachelor of Medicine Special Interests: All aspects of dentistry and sedation Practises at: Smile Design Dental, 16 Mainstreet, Baldoyle, Dublin 13 and 63 Northstrand Road, Northstrand, Dublin 3 t: (01) 839 6520 (Baldoyle) or (01) 834 9663 (Northstrand) e: info@smiledesign-dental.com w: www.smiledesign-dental.com
Dr Kevin Murphy BDentSc (TCD) MFDS (RCSEd) Education: Trinity College Dublin, Royal College of Surgeons in Edinburgh Qualification: Bachelor of Dental Science Degree, Member of the Faculty of Dental Surgery (RDCEd) Special Interests: General dentistry, orthodontics and surgical extractions Practises at: The Seapoint Clinic, 23 Seapoint Avenue, Blackrock, Co Dublin t: (01) 284 2570 e: info@seapointclinic.ie w: www.seapointclinic.ie
Dr Derek Lombard BDS (UGlasg) MFDS RCPS (Glasg) Education: University of Glasgow Qualification: Bachelor of Dental Surgery, BAHons applied psychology, membership of the Royal College of Physicians and Surgeons of Glasgow Special Interests: All aspects of dentistry, especially gentle care dentistry Practises at: Smile Design Dental, 16 Mainstreet, Baldoyle, Dublin 13 and 63 Northstrand Road, Northstrand, Dublin 3 t: (01) 839 6520 (Baldoyle) or (01) 834 9663 (Northstrand) e: info@smiledesign-dental.com w: www.smiledesign-dental.com
Dr Thomas Linehan BA BDentSc (Hons) Education: Trinity College Dublin, University of Warwick Qualification: Bachelor of Dental Science Degree, Certificate in Implant Dentistry Special Interests: Dental implants and cosmetic dentistry Practises at: The Seapoint Clinic, 23 Seapoint Avenue, Blackrock, Co Dublin t: (01) 284 2570 e: info@seapointclinic.ie w: www.seapointclinic.ie Ali-Reza Afrasiabi BA BDentSc Education: Trinity College Dublin Qualification: Degree in Bachelor of Science and Degree in Bachelor of Arts Special Interests: Restorative, endodontic and cosmetic dentistry Practises at: Smiles Dental: 4 South Anne Street, Dublin 2 t: (01) 672 8939 e: appointments@smiles.ie w: www.smiles.ie
Dr Jean Louis Salmon BDS UOF EPGETcertif Education: France Qualification: Bachelor of Dental Surgery, Stomatology college certificate (Creteil), Skull Osteopath certificate (CDB,Paris), UNIODF member (France), ADDIBO President Special Interests: Practice limited to orthodontics Practises at: Smile Design Dental, 16 Mainstreet, Baldoyle, Dublin 13 and 63 Northstrand Road, Northstrand, Dublin 3 t: (01) 839 6520 (Baldoyle) or (01) 834 9663 (Northstrand) e: info@smiledesign-dental.com w: www.smiledesign-dental.com Michael Maguire Education: Trinity College Dublin Qualifications: BA BDentSc Special Interests: Covers all aspects of dental treatment Practises at: Perfect Smile, Mullingar Medical Park, Marketpoint, Co Westmeath t: (044) 934 7911 w: www.perfectsmile.ie
Philip Christie MDent Sc Education: Trinity College Dublin Qualification: Masters Programme in Dental Science Special Interests: Periodontology, occlusion and TMJ Practises at: Waterford Town Dental, 3 Neptune House, Canada Street, Waterford t: (053) 912 2008 e: waterford@towndental.ie w: www.smiles.ie
I R I S H
I N D E P E N D E N T
D E N T A L
C A R E
10 O
Healthy teeth, happy kids Good and bad dental health habits can be formed at a young age. Here’s how to make sure your kids are picking up the good ones!
ur front teeth – two on the top and two on the bottom – are the very first to appear, when we are only about six months old. By the time we are two and a half, most of our baby teeth have usually erupted, and adult teeth begin appearing at the back of the mouth when we are around six years of age. As a child grows his or her dental needs are growing and developing too – and it’s crucial that you and your child take good care of his or her teeth in these early stages. A child’s baby teeth are not simply a precursor to adult teeth – they help a child develop speech, and are important for your child’s self-confidence and smile. Baby teeth also act as a guide for adult teeth, as some baby teeth are not lost until 11 or 12 years of age. Brushing You should start cleaning your baby’s teeth as soon as the first tooth appears, using a small soft toothbrush and tap water. Toothpaste isn’t recommended for children under two. Children over two should use a pea-sized amount of fluoride toothpaste. Brushing should be done last thing at night and on one other occasion. Always supervise children up to seven years of age when they are brushing their teeth, and change your child’s toothbrush every three months or as soon as the bristles become worn.
Tooth decay Tooth decay is caused by bacteria in our mouths which act on the sugars in food and attack the teeth. When fizzy drinks, juice, milk or even breast milk are in constant contact with a baby’s teeth, this can lead to tooth decay. Any sign of tooth decay in a child under the age of three is described as Severe Early Childhood Caries (S-ECC) and should be brought to the attention of a dentist. There are several simple steps you can follow to help avoid tooth decay: Don’t let your child sleep with a bottle or feeder in his/her mouth; from your child’s first birthday, encourage him/her to drink from a beaker or cup; never dip a soother in sugar, honey or anything sweet before giving it to your child; always brush teeth after the last feed of the day. Diet One of the most important aspects to consider when looking after your child’s teeth is diet. Recent studies have shown that 40 per cent of children in the 9-17-year age group are eating sugary and high-fat foods like fizzy drinks, sweets and biscuits three or more times a day. The best snacks to help keep your child’s teeth healthy are fruit, vegetables, yoghurts, cheese, plain popcorn and bread. For drinks stick to water, milk or sugar-free squashes. Milk is a great source of calcium, needed for the development of teeth and bones. Keep sugary foods and drinks to meal times only. If you are giving your child a fizzy drink, using a straw helps
direct the drink to the back of the mouth, avoiding sugary contact with the teeth. Sugary foods that dissolve slowly in the mouth are particularly bad – for example, hard-boiled sweets or lollipops. These bathe the teeth in sugar for longer and increase your risk of decay and erosion. Remember that ‘low sugar’ or ‘no added sugar’ labels do not mean the food or drink is sugar-free. Choose sugar-free medicines where possible. Each time we eat or drink, we increase the acid levels in our mouth and thus increase our risk of damaging our teeth. The Irish Nutrition and Dietetic Institute recommends that eating be limited to around six times a day. Regular trips to the dentist are also important to ensure your child’s teeth are healthy and developing normally. Sources: The HSE, Irish Nutrition and Dietetic Institute (www.indi.ie), Oral Health Services Research Centre and the Dental Health Foundation (www.dentalhealth.ie) THUMB SUCKING Babies and children often like to suck their thumbs or a soother for comfort; long-term thumb or soother sucking, however, can affect the position of the teeth, so kids should be encouraged to stop sucking their thumbs by school age.
AD
D E N T A L
C A R E
I R I S H
I N D E P E N D E N T
Ask the Dentist sponsored by
11
Keep smiling! t: (01) 839 6520 e: info@askthedentist.ie w: www.askthedentist.ie
D
Understanding Dental Implants
What you need to know when considering dentures
entures help you keep your smile; they support your face and help boost your confidence. If you’re missing all of your teeth (edentulous), you should have well-fitting, comfortable dentures. If you are missing several teeth, dentures may also be a good option for you – especially if financial constraints mean you cannot go down the route of crown/bridge or implant work. According to Bevin Mahon, manager of Dentaltech in Terenure, Dublin, there are some key things to consider if you are thinking about getting dentures: Lifespan: Dentures do deteriorate over time, and your mouth changes shape as well. If your dentures are five years old or more, you should consider getting new ones. Retention: The design of the denture depends on the requirements of the
patient (i.e. the number of teeth), and retention is a key focus. There are two methods to retaining dentures: a full palate and suction, or clasps and rests on natural teeth.
Aesthetics: You need something that looks good and is a natural-looking replacement for your own teeth; dentures aren’t one-size-fits-all but are matched in shape and colour to the appearance of the patient and his or her original smile. Function: Dentures shouldn’t move or slip when you eat; they must be able to function well. Comfort: You should be able to wear your dentures with comfort. It takes about six weeks for the muscles in the mouth to adapt to new dentures. “It’s like getting used to a new pair of shoes,” says Bevin. Helping patients through this bedding-in period is vital, and aftercare is important too.
NUALA RYAN consults the experts at Smile Design Dental Clinic
A
re you missing teeth and want a beautiful smile again? Perhaps you have trouble eating certain foods? Maybe you want to provide additional support for a denture, making it more secure and comfortable? If so, dental implants could be the solution. A dental implant is an artificial tooth root that is placed into your jawbone to accommodate a replacement tooth or bridge. One of the biggest advantages of implants is that they do not rely on neighbouring teeth for support, which means you can replace one or more teeth without having to affect the adjacent teeth. A dental implant will leave you with a tooth that looks and feels just like your own. In fact, they are so naturallooking and feeling, you may even forget that you ever lost a tooth! But, like your own teeth, implants require the same level of care. Regular checkups with your dentist will also ensure that your teeth, and implant, remain healthy. If you maintain good oral health, there is no reason why your implant(s) cannot last a lifetime. Don’t believe me? Here is what the experts at Smile Design Dental Clinic say!
I R I S H
I N D E P E N D E N T
Q. What are dental implants? A. Dental implants are used to replace the root structure of a tooth. They are made of titanium which the body easily accepts and the bone consequently grows around the implant. Once the implant has been accepted, crowns are placed on the head of the implant leaving you with a new tooth that looks, feels and functions like your own natural teeth. Q. Are dental implants safe? A. Implants are a well-established treatment option and have been scientifically tested and documented for over 30 years. They have a longterm success rate of over 95 per cent as shown in clinical studies. Not only are dental implants a permanent solution, they won’t compromise any healthy adjacent teeth. They can also preserve the jawbone, which maintains the shape of the face.
AD
Q. How do dental implants rate alongside other treatments in value for money? A. Dental implants are extremely costeffective as they have a 95 per cent success rate, which is far better than other more traditional treatments. Most other treatments would need to be redone every five to seven years. So in the long run, dental implants work out much cheaper.
D E N T A L
C A R E
12
Smile like you mean it
NUALA RYAN speaks with Limerick dentist Dr Annette O’Donovan about the growing popularity of cosmetic dentistry and why so many Irish people are now investing in their smiles
A
There is something powerful about a flash of perfect pearly whites. From Julie Roberts’ Hollywood smile to George Clooney’s gleaming gnashers, more and more people are becoming aware of the importance of a winning smile and of how they can achieve it. Today, thanks to the growth of cosmetic dentistry, beautiful teeth are no longer confined to A-list celebrities.
AD
D E N T A L
C A R E
Now we can all ‘Say Cheese’ with confidence. More and more people are visiting their dentists for cosmetic dentistry treatments, not just for pain relief. People are more aware of their teeth, they want to improve their smile, and they know that improvements can be made very easily. Cosmetic dentistry is focussed on keeping things minimal – minimal pain, minimal invasion – but with maximum results. And as long as you are in good all-round oral and general health, the perfect smile is possible.
“Some studies show that the first thing you see in a person is their smile, then their eyes,” explains Dr Annette O’Donovan of Alexandra Dental Practice, Limerick. “Being confident in your smile can empower you; however, many people are afraid to smile and don’t want to show their teeth. “Having a nice, healthy smile not only gives you confidence, it gives the person you are talking to confidence – people trust in what you are saying.” From a medical viewpoint, healthy oral
tissue is very important. “There have been a lot of studies in the last 10 years that show a huge correlation between poor oral hygiene and cardiac disease,” Dr O’Donovan notes. “Even if you do not need to have cosmetic treatment, it pays to maintain a healthy mouth.” With cosmetic dentistry, each case is taken individually. Some people might just want to freshen up their smile, in which case tooth whitening is the ideal option. Others may be looking for a complete revamp – this
AD
I R I S H
I N D E P E N D E N T
13
Implants are growing in popularity as they cause little damage to adjacent teeth
could involve veneers. Any treatment, Dr O’Donovan explains, is dependent on the patient. Similarly, the length of time a procedure takes is also dependent on the individual. As the tooth is a living tissue, treatment times can vary depending on the tooth and the patient’s wishes. Dr O’Donovan advises you consult your dentist before undertaking any cosmetic dentistry. “Get to know your dentist first so you are happy with the treatment they are carrying out. A good dentist should be able to give you an accurate outline of the treatment so that you
know what to expect, exactly what is happening, and what the finish line should be.” And when it comes to specific dental treatments, most dentists would recommend you visit them rather than a beauty clinic. “A dentist knows what they are putting on your teeth, and will be sure to avoid any treatment that will damage the teeth.” However, regardless of what treatment or procedure you undertake, it is vital that you look after your teeth and follow up any treatments with regular checkups, ideally once every six months. If you take good care of your teeth, there is no reason why your cosmetic dentistry treatment will not last you a long, long time.
COSMETIC DENTISTRY EXPLAINED BEFORE YOU BEGIN YOUR COSMETIC DENTISTRY TREATMENT, IT IS IMPORTANT TO KNOW WHAT IS INVOLVED Teeth Whitening Teeth whitening, whether using a takehome kit or power bleaching, is the most popular cosmetic dentistry procedure as it is an affordable, minimally invasive treatment and both techniques can provide excellent results for people wishing to brighten the colour of their smile. The take-home kit involves custom-made trays that the patient wears at night over a number of weeks to deliver bleach to the teeth, and is a very gentle way of whitening the teeth with good results. Power bleaching is done in the surgery over an hour and a half. It gives fast results, but uses a more concentrated form of peroxide. Bleaching your teeth can be most effective. It’s a great service which improves people’s smiles and, in turn, their confidence. However, it is important to remember that your teeth are precious. You can improve their colour with bleaching but it is vital that you do it with care and with a reputable dentist. Composite Bonding Composite bonding is used to add on to the teeth to give a nicer shape and fill in gaps. It is an inexpensive and minimally invasive treatment, as you don’t have to cut down the tooth. Although it is not suitable for all patients, where it is suitable it is very effective. ‘No Prep’ Veneers ‘No prep’ veneers are another minimally invasive treatment, whereby very thin veneers are used to change the shape and colour of the teeth, with little or no preparation of the teeth. A veneer is almost like putting on a false fingernail – it is very thin, approximately 1mm, and is added to the front of the tooth. However, because they use laboratory I R I S H
I N D E P E N D E N T
technology, no prep veneers are generally more expensive and time-consuming than bonding. However, although it is better to use no prep veneers due to their minimally invasive nature, it is not always possible. In this instance, dentists may suggest conventional or traditional veneers, which involve cutting back the tooth to get the right effect.
AD
Crown A crown wraps around the back of the tooth and is used when the tooth is already quite broken down, chipped or very badly discoloured. Bridging Bridging is used to replace missing teeth. Conventional bridging involves cutting back the tooth structure; however, implants are now becoming a popular alternative to bridging as they cause little disruption to adjacent teeth. Implants An implant is used to replace missing teeth and involves a titanium screw being inserted into the jawbone and eventually fusing with the surrounding bone to become one unit. Other Options Many people are now opting for adult braces, which take significantly less time to straighten teeth than the ‘train tracks’ of old – sometimes teeth can be straightened in just six months. This treatment often helps patients avoid extractions, and the wires are discreet or invisible. Similarly, more and more people are choosing white fillings over the traditional silver, mercury variety, leaving patients with natural-looking teeth. D E N T A L
C A R E
14
In case of emergency Some tips for dealing with dental accidents and emergencies
C
liché though it may sound, the best way to avoid needing emergency dental treatment is to take great care of your oral health. Eating healthily, avoiding sugary drinks and snacks, brushing twice daily and flossing will all help keep you in your dentist’s good books and help you avoid gum disease. It is also important to get regular checkups with your dentist so any potential problem areas can be spotted. What’s more, if you know you need treatment and are planning to go on holiday, make sure you get the treatment before you head away. That said, no matter how well you treat your teeth, dental emergencies can still occur. Accidents happen on the sports field, or while kids are at play – teeth can be damaged or knocked out; this is known as dental trauma.
Wearing a helmet while cycling helps protect your teeth as well as your head
Prevention and management Most traumatic injuries to teeth arise from accidents during normal, everyday activities, and obviously prevention in these circumstances is difficult. Such injuries can be complicated to treat and can have long-term financial, aesthetic and functional problems for the patient. According to the Dental Health Foundation, the most common teeth to be damaged during an accident are the upper central incisors – these are the sharp biting teeth at the front of the mouth. Primary (baby) incisors can be damaged
AD
“
especially when infants are learning to walk. Approximately 1 in 11 children in Ireland will have broken one or more of their permanent teeth before they reach the age of 15. Wearing a mouth guard or a helmet with face shields during contact sports reduces the likelihood of fracturing a tooth. Wearing safety helmets when cycling, skate boarding, and so on – and always wearing your seatbelt – is also advised. When a tooth is accidentally damaged, it is important that professional advice from a dentist is sought immediately.
APPROXIMATELY 1 IN 11 CHILDREN IN IRELAND WILL HAVE BROKEN ONE OR MORE OF THEIR PERMANENT TEETH BEFORE THEY REACH THE AGE OF 15”
WHAT TO DO IF A TOOTH IS KNOCKED OUT If a primary (baby) tooth is knocked out completely: • Parents/carers should make no attempt to reinsert a primary (baby) tooth that is knocked out as they could damage the permanent (adult) tooth that is developing under the gum – the child should be brought to a dentist to be checked. If a permanent tooth is knocked out completely: • Find the tooth and pick it up by the crown (the white part). Avoid touching the root. • If the tooth is dirty, wash it briefly (10 seconds) under cold running water and reposition it. Try to encourage the patient to replant the tooth him/herself, using the shape of the teeth at either side of the gap as a guide to positioning. • Bite on a handkerchief to hold the tooth in position for 15-20 minutes as you make your way to a dentist. • If this is not possible, place the tooth in a glass of milk or it can also be transported in the mouth, keeping it beside the back teeth and the inside of the cheek. Avoid storage in water. • Seek emergency dental treatment immediately; phone ahead to tell your dentist you are on your way. Source: Oral Health Services Research Centre and the Dental Health Foundation (www.dentalhealth.ie)
D E N T A L
C A R E
I R I S H
I N D E P E N D E N T
The changing face of dentistry NUALA RYAN speaks with Dr Edmond O’Flaherty of Seapoint Dental Clinic about how dentistry, and its associated technology and treatments, has evolved
O
nce upon a time, dentistry’s main function was to relieve pain. You visited your dentist when the pain became unbearable and had teeth extracted because that was the only treatment available. Dentures were the future and everyone was going to end up wearing them. Now, according to Dr Edmond O'Flaherty of Seapoint Dental Clinic, Blackrock, Co Dublin, dentistry has changed. Today, the focus is on rebuilding. “We see patients who lost their teeth when they were in their teens. With their teeth missing, they consequently lost a lot of jawbone and the support this offers, in a similar way to how you lose muscle in your leg if you have worn a cast for a considerable length of time. Now, however, people are electing to have implants carried out as replacements for missing teeth – they are the way forward.” To carry out such procedures, the CAT scanner is a vital piece of technology. “We can place implants in areas where they would have once been impossible because you did not know exactly where the nerve or bone was. The CAT scanner gives a three-dimensional view of the jaw and you can place an implant into it right on the screen. Using this technology, you can choose exactly the right size and exactly the
right spacing. You can even get an identical 3D model made of the jaw and do the surgery on that first before you undertake the real procedure. With CAT scans, things are a lot more predictable and reliable.” Adult braces have also grown in popularity. Instead of the two years of treatment previously needed, which involved extracting pre-molars, now it only takes six months to straighten the teeth in many cases. Extractions can be avoided, which saves on the pain, and the wires are discreet and sometimes even invisible. Fillings have also benefited from advancing technology. Instead of the unsightly mercury fillings of old, patients can choose white fillings that give the teeth a natural-looking finish. This is the positive move that dentistry is taking. However, even though dentistry has come a long way, there are still further advancements and new treatments in the pipeline. Bone regeneration, for example, is a key area of potential advancement, which could make it easier and faster to grow teeth back. Tooth buds could be a similarly exciting development. “A lot of research is going into planting tooth buds,” explains Dr O’Flaherty. “Instead of having an implant, which is a man-made root, you could potentially re-grow a tooth. This treatment is still a few years away, but it is exciting to think that you could grow your own tooth back in exactly the right shape and colour.”
15 Advanced technology and emerging treatments mean that the focus of dentistry is now on rebuilding, says Dr Edmond O'Flaherty
TECHNOLOGICAL ADVANCEMENTS THANKS TO TECHNOLOGY, DENTISTRY CAN NOW ACHIEVE RESULTS WITH INCREASED ACCURACY AND PREDICTABILITY Cerec – A three-dimensional intraoral scanner allowing customised porcelain restorations in one visit. Used for crowns, veneers and ‘inlays’ (porcelain fillings) to give enamel-like fillings that blend into the natural tooth structure, providing a durable bonded filling which holds the remaining tooth structure together. This can be accurate to within 45 microns – less than the width of a human hair. CAT scan – This allows undistorted imagery of the jaw for precise virtual implant planning that can be used as a template for predictable surgery to maximise the predictability of the implants. It can also be used for assessment of wisdom teeth to ensure safe removal without damage to nearby nerves and vital structures. Photospectrometers – These are used by the dentist to identify the correct colour balance and transluscency so that your natural tooth colour can be documented and the information transfered to the technician for replication of the tooth colour. For futher information on current and emerging technology, visit Ire-Scd (Irish Society for Computerised Dentistry) www.ire-scd.com
AD AD
I R I S H
I N D E P E N D E N T
D E N T A L
C A R E
AD
D E N T A L
C A R E
I R I S H
I N D E P E N D E N T