Saturday, 28 September 2013
If you are an adult in your 70s and you have all your own teeth, then you are in the minority. According to the American Association of Oral and Maxillofacial Surgeons 69% of adults between 35 and 44 have lost at least one permanent tooth due to an accident, gum disease or tooth decay. According to the same research 26% of 74 year-olds have lost all their permanent teeth (source: http://www.aaoms.org/conditions-and-treatments/dental-implants/). It is not to be doubted that the figures are very similar for the UK and other countries in Europe.
Thus, most of us will have to make a decision sooner or later about how we want to replace a missing permanent tooth. The traditional methods were to use a fixed bridge or a removable denture. Neither of these options is ideal. Removable dentures can slip in the mouth and cause clicking sounds. Both can lead to bone damage and gum disease. It is for this reason that fixed bridges and removable dentures need to be replaced every 15 years to prevent damage to the remaining teeth and the gums.
The better option is dental implants. Fixed bridges are anchored on adjacent teeth. Removable dentures sit on the gum line. Dental implants are different they are put in the bone. Through accident scientists in the 1950s discovered that titanium embedded in the bone actually fuses with the bone. This means the bone grows around the titanium and effectively becomes part of the bone. It is for this reason that dental implants use titanium to anchor the tooth in the jawbone. The implant becomes very firmly fixed because of the fusing between the titanium and the bone. This fusing is called “osseointegration”. It is, excuse the pun, at the root of modern dentistry.
Normally a dental implant will last for the life time of a patient. Although implants cost a lot more than bridges and dentures, if you factor in the maintenance of bridges and dentures the price difference becomes considerably less.
Dental implants are now becoming the norm especially for those that can afford them. In the UK dental labs account for 2 billion pounds of the economy. Of that sum half is in the private sector. Even though the NHS doesn’t cover most dental implant lab fees or dental surgery costs people can see the obvious advantages of replacing missing teeth with implants rather than fixed bridges and removable dentures. The video above shows a dental surgeon in India perform implant surgery.
Wednesday, 25 September 2013
The Wikipedia entry on dentistry defines the subject as “the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, the maxillofacial area and the adjacent and associated structures, and their impact on the human body.” It seems a long-winded definition, but it covers all the bases – dentistry involves not only teeth but also gums and the whole oral cavity region.
With this definition in place it is possible to look back through historical records to discover the history of early dentistry. The earliest recorded evidence of dental work is found in the Indus Valley Civilization (7000 BC). They treated tooth problems with a basic tool called a bow drill that was also used to start fires and drill holes in hard stones. It is not surprising that some of the earliest records of human civilization contain details about treating teeth; after all, toothache is painful and persistent if not treated. More surprising is that reconstructions of these early dental procedures show they were effective.
A Sumerian text dated at 5000 BC mentions ‘tooth worms’ as the cause of dental caries or dental cavity. The belief that worms destroyed teeth persisted until the Fourteenth Century.
In Slovenia, a manuscript dating to 4500 BC details the earliest cavity filling using beeswax.
Records have come to light showing during the Pharaonic period (3200 BC to 30 BC) dental prosthetics and surgery was performed These procedures were also attempted by the Greeks and the Romans.
The ancient Greeks were marvelous scientists: Aristotle and Hippocrates write about tooth decay and gum disease. It is the Etruscans in 700 BC who are credited with making the first bridges.
In the Far East there is a manuscript dating to the Tang Dynasty credited to Su Kung (659 AD) describing dental amalgams. An amalgam is a mixture of mercury and other metals to fill in a dental cavity.
During the Middle Ages dentistry was often carried out by barbers, especially tooth extraction. In 1530 the first book dedicated to dentistry was circulated – ‘Artzney Buchelin’.
It was between 1650 and 1800 that modern dentistry can be said to have developed although all the above precedents no doubt had an impact on subsequent breakthroughs and misconceptions.
Pierre Fauchard in the 17th Century is credited as being “the father of modern dentistry’. He developed techniques for dealing with dental caries; he introduced fillings; and also dental prosthesis.
Since Fauchard, dentistry quickly became recognized as a distinct form of medicine requiring specialist training. It is from this beginning that we can trace the development of European and American dentistry. However, that is not to say that at the dawn of human civilization they hadn’t already found methods of treating dental problems. Such is the ingenuity of mankind and his relentless desire to master the natural world through science.
Saturday, 21 September 2013
A tooth is not made of a single material; rather it is made of three main layers of material. They are enamel, dentin and pulp. This post will take a closer look at these three layers and discuss these layers in relation to pain.
The outside layer of healthy teeth, as most people know, is enamel. This is a very hard and glassy substance that forms the outer protective layer to our teeth. It is what gives the teeth their natural shine, and it is also what gets stained by tobacco smoking and tobacco chewing. Enamel is resistant to chemicals and abrasion.
Below the enamel layer in a tooth is a layer of dentin. This layer contains tubes that hold nerve endings. This means that the dentin layer of a tooth feels pain. It is thus essential to make sure that the outer layer of enamel is not broken.
The innermost layer of a tooth is called pulp. When a dentist performs a root canal operation it is the pulp that he or she is dealing with. Pulp consists of nerves and blood vessels. This is the most delicate part of the tooth. The enamel and dentin layers make up about a quarter of an inch of the entire tooth.
Enamel doesn’t have any nerve endings and this feels no pain. This is why it doesn’t hurt when people with healthy teeth eat hot or cold food or chew food. By brushing your teeth regularly and by dental cleaning we can protect the enamel layer and avoid pain.
However, the enamel layer can get worn down by abrasion. This is caused by people grinding their teeth and also by eating coarse foods such as grains and foods with a husk. Other causes of eroded enamel are stomach acid and gum erosion.
Dentists can help patients with exposed dentine with a variety of bonding agents and tooth pastes. It is also possible to use Sensodyne toothpaste. This works by blocking off the dentine tubes. The best way to use Sensodyne is to rub it into the sore spot and leave it to do its magic. However, don’t use Sensodyne instead of seeing a dentist! Another method is to rinse with high fluoride mouth wash and not rinse with water.
If the trouble is more serious then the dentist will fill the hole with a filling or a crown.
When the tooth is damaged all the way to the pulp as is the case if it is knocked by a cricket ball then the dentine layer has been breached and the pulp layer is affected. This is what causes the most pain. This type of pain cannot be relieved by any home remedies: immediate dental work is necessary. The dentist will have to perform root canal surgery.
The danger with surgery on the pulp is that infection is a serious issue. If the pulp becomes infected with a virus often the only course of action is extraction.
In less extreme situations the pulp can be filled with an artificial substance. This means there are less nerve endings and less pain.
With tooth restorations where the original pulp is kept pain can occur after dental surgery while the tooth nerve endings are still mending themselves. With gold fillings the conductive nature of the metal can increase the heat on the tooth and cause pain. The same is true of the dentist’s drill that rotates very fast and causes frictional heat.
When the pulp layer is partly replaced with composite pain can occur when the composite sets and shrinks. This is why restorations are done in layers to reduce this type of pain.
The only good thing about tooth pain is that it tells a person that something is initially wrong with the tooth. The pain is a warning that something must be done to restore the tooth otherwise infection could set in and cause even worse and more painful complications.
Wednesday, 18 September 2013
Beauty might only be skin deep and we should judge people's characters rather than their appearance. These are truisms. But it is also a truism that first impressions matter. One of the strongest impressions people give is connected to the state of their teeth. If your teeth are brown and stained; with gaps or missing teeth people naturally feel repulsed. They feel they are beholding someone who has not looked after him or her self or their teeth. The bad impression is made even stronger if that person has bad breath.
In nature the life span of many animals is determined by how long they keep their teeth. Once they lose their teeth they can no longer chew their food. Without the nourishment from chewed food the animal dies.
The ingenuity of people means that we have managed to extend our lives beyond the life span of our teeth. Some people look after their teeth well and die at a ripe old age with most of the same adult teeth. Others have a bridge or implants to add artificial teeth to their mouth. In this way they can continue to eat food and live a healthy life.
For people with shinny and clean teeth it is possible to have a great smile. A smile deflates tension and stress and signals to other people to relax. A beautiful smile is a wonderful thing that shouldn't be underestimated. When you smile, the world smiles back at you.
Going regularly to a dentist for a check up helps to guide you in good oral hygiene; it makes sure that any problem with your teeth is dealt with swiftly and not allowed to get worse.
A dentist can make sure that teeth develop properly in young people; that the teeth do not end up crooked or that there aren't too many teeth. A dentist doesn't just help with people's aesthetics; he also helps to stop tooth ache. If a dental problem is not seen to it can become a continuous source of pain for a person. Tooth ache is not something that is easy to live with.
A good dentist works in connection with a good dental lab. Today's dentistry relies upon a lab that can make crowns, bridges, implants and do a wide variety of dental lab work. Those who work in dental labs are not given the recognition they deserve in helping to preserve the dental health of people.
Finally, it should be mentioned, that for many people teeth take second place to other health concerns. People are more likely to go and see a doctor than a dentist. Indeed, the common perception is that a visit to the dentist is something to be feared, as it is sure to lead to pain. Moreover, whereas benefits may cover health costs, they often do not extend to dental matters. This is a failing in public policy; but, this failing shouldn't deter people from looking after their teeth.
Look after your teeth!