tag:blogger.com,1999:blog-10895802656724016292024-03-13T22:15:23.876-07:00Dental Treatment UK BlogAdivices, links and infos for a shining smile!healthcarehttp://www.blogger.com/profile/08616671434100738332noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-1089580265672401629.post-70511749138912556072008-11-20T02:50:00.000-08:002011-04-21T07:22:17.492-07:00Better dental care promised for kids next year<span style="TEXT-TRANSFORM: uppercase" id="ctl00_ContentPlaceHolder_article_NavWebPart_Article_ctl00___Credit1__">Queen's Park Bureau</span><br /><br /><br /><p>Ontario's underprivileged children should receive better access to dental care in 2009, Health Minister <strong>David Caplan</strong> said yesterday.</p><br /><br /><p>Complications from <strong>tooth decay</strong>, a disease affecting 6 to 10 per cent of all pre-schoolers, are an urgent problem that requires immediate preventive action, according to a new report from the <strong>Ontario Dental Association</strong>, the group representing 7,000 dentists. </p><br /><br /><p>Those most at risk for suffering from <strong>rotting teeth</strong> are low-income children who do not have access to dental care. For 10 years, the association has pressed the government to improve the <strong>Children in Need of Treatment</strong> program, which they say addresses only catastrophic dental needs for kids. Coverage kicks in only when the damage is already done, they say.</p><br /><br /><p>The government is aware of the program's limitations and is working to "<strong>expand the eligibility</strong>," Caplan told reporters.</p><br /><br /><p>"<em>Although I haven't read the report from the (dental association) ... I do understand they make the case it is not just treatment but prevention that does need to be taken into account and we certainly agree. We do want to extend treatment and support for prevention."</em></p><br /><br /><p>In addition, the Liberal government's anti-poverty strategy, to be unveiled in December, will include a $135 million dental package promised earlier in the budget. </p><br /><br /><p>The dental association's report pointed out that tooth decay is the most common chronic childhood disease.</p><br /><br /><p><strong>Dr. Larry Levin</strong>, president of the association, said there has been talk of increasing to 18 the age limit of kids covered under the Children in Need of Treatment program but that needs to be done in conjunction with <strong>improving preventive care</strong>.</p><em>"The preventative piece we feel is a key element to improve the lives of kids in Ontario," he said. "We can't keep repairing."</em>Unknownnoreply@blogger.com3tag:blogger.com,1999:blog-1089580265672401629.post-44821713202153506122008-11-15T02:28:00.001-08:002011-04-21T07:22:29.165-07:00Dental treatment plan to be scrappedA scheme to help low income earners get dental treatment is to be scrapped despite an outcry from dentists.<br /><br />The Government claims not enough people have shown an interest in the scheme which offers financial help.<br /><br />But Association for <strong>Oral Health Chairman Hans Zoellner</strong> says the Government has been doing its best to make sure they don't even know about it.<br /><br />“<em>Most of the 2 million Australians who are eligible don’t know about it and anybody who did know about it and was using the scheme got a letter incorrectly saying that the scheme was closed and threatening that if the scheme was halfway through a course of care medicare might just not pay</em>.”Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-67993274297993241362008-11-10T02:50:00.000-08:002011-04-21T07:22:53.119-07:00The relationship between oral healthExcerpt from<br /><a href="http://alessiobel.mizar5.hop.clickbank.net/?tid=CHOLLYMI">The relationship between oral health<br />and life expectancy</a><br /><br /><br />Many people may not understand how oral health may affect life expectancy. So the first step would be to recognise the mouth as a major gateway into the human body. It is the<br />upper part of the digestive system and has a structure that prepares food for the first phase of digestion.<br /><br />The mouth contains the tongue, teeth, hard and soft palate, and gum, salivary glands and the mucosa.<br /><br />The body has various inter-connected systems of organs. This means that if there is a problem with one part of the body, it may affect other parts. A disease of any part of the mouth<br />may be associated with some other organs in other parts of the body.<br /><br />A person with gum infection may suffer from general body malaise and loss of appetite. A person with tooth ache may<br />also suffer from severe headache and earache.<br /><br />Several diseases affecting the general health of the body have been linked to the health of the parts of the mouth.Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-1089580265672401629.post-24126711276730118562008-09-12T02:39:00.000-07:002011-04-21T07:23:15.718-07:00Tips for Choosing the Right Dental ProductsWith so many dental products available, it can be overwhelming trying to choose which ones to buy.<br /><br />Brushing twice a day, flossing daily and regular dental check ups are the key factors in maintaining a healthy mouth and avoiding dental problems.<br /><br />The tips listed here will help you in choosing important dental products.<br /><br />Choosing a Toothbrush<br /><br />Any toothbrush that you choose should have soft bristles and feel comfortable in your hand. Choosing between a manual and an electric toothbrush is a decision that you can make depending on your lifestyle and situation.<br /><br /># Manual Toothbrushes<br /><br />If you prefer a manual toothbrush, make sure that the tip is small enough to reach all areas of your mouth easily. For children, be sure to choose a child size toothbrush with soft bristles. A manual toothbrush works just fine using the recommended back and forth brushing motion.<br /><br /># Electric Toothbrushes<br /><br />People with arthritis or arm and shoulder problems might prefer an electric toothbrush for convenience as well as comfort.<br /><br />If purchasing an electric toothbrush, be sure that the head is soft and the bristles move in a back and forth motion.<br /><br />Dental Floss<br /><br />Whether you choose regular dental floss or dental flossers depends on your personal convenience and comfort. They are both designed to remove cavity causing plaque and food debris from in between your teeth.<br /><br />When flossing with either product, be sure to gently insert the floss in between the teeth, without snapping, which could damage the gum tissue. Gently move the floss up and down into the spaces between the gum and teeth moving towards the gumline. Floss each side of your tooth, even if there isn't a tooth next to it.<br /><br /># Dental Flossers<br /><br />I personally prefer to use a dental flosser because it seems to make flossing so much easier than conventional dental floss.<br /><br /># Conventional Dental Floss<br /><br />If you decide to use regular dental floss, tear off a piece at least 18 inches long and wind it around your two index fingers. Hold the floss tightly between your index fingers and thumbs and guide the floss softly in between your teeth.<br /><br /># Floss Threader<br /><br />If you have a fixed dental bridge in your mouth, you can floss underneath it using a floss threader. Floss threaders also work great for people who wear braces.<br /><br />Toothpaste<br /><br />In June of 2007, the FDA issued a poisonous toothpaste alert for any toothpaste made in China. A week after this alert was issued, counterfeit tubes of Colgate toothpaste that possibly contain the deadly chemical Diethylene Glycol, were found in the United States. If you live in the United States, you can check dental products to make sure that they contain the seal of acceptance from the American Dental Association (ADA), which ensures that they have been tested and found to be safe. If you live outside of the United States, make sure that Diethylene Glycol is not listed in the ingredients of any toothpaste products that you are considering purchasing or using.<br /><br />Choosing a toothpaste that contains fluoride, will help to prevent cavities. Some factors of choosing toothpastes are usually personal preferences, such as flavor, whitening, tartar control and price. If you have small children, you might want to try some fun flavored children's fluoride toothpaste. When applying toothpaste to your toothbrush, you only need to use about a pea size amount.<br /><br />Mouthwash<br /><br />Mouthwash can be beneficial to kill germs and fight bacteria that can lead to cavities. A mouthwash containing fluoride can even help protect your teeth from cavities. Ingredients, flavor and price are factors to considering in choosing a mouthwash. Many mouthwashes contain alcohol, which can dry up the protective saliva in your mouth, so you may want to ask your dentist to recommend one for you. A mouthwash is a great dental product, but it cannot replace flossing and brushing. If you decide to use a mouthwash, be sure to use it in conjunction with brushing and flossing.<br /><br />The Bottom Line<br /><br />There are many dental products available to make brushing and flossing easier, but the bottom line is that you don't have to spend a lot of money to have good oral hygiene. Be sure to have regular check ups with your dentist and ask him / her for any personal recommendations on dental products if you have special conditions. Most dentists will also provide you with samples of various dental products. This is a great way to find out if you like a certain dental product before investing in it.Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-1089580265672401629.post-21671014654657795582008-08-28T00:04:00.001-07:002011-04-21T07:23:41.434-07:00Do you need to find a dentist in LondonDo you need to find a dentist in London<br /><br />Due to difficulty of finding dentists in London and the surrounds of London, londondentist.co.uk has been developed.<br /><br />The aim of londondentist.co.uk is to provide members of the public in the London area, and General Dental Practitioners in London, with a list of London Dentists.<br /><br />Whether you are looking for an NHS London dentist, Private London dentist, London Cosmetic Dentist or even a London Emergency Dentist<br />london dentist<br /><br />Each of the dentists in the London area listed on londondentist.co.uk have a web site, and a link is provided through to their web site.<br /><br />If you are a London dentist working in a London dental practice and would like to be listed on Londondentist.co.uk then please complete the form at the top of the page .<br /><br />Londondentist.co.uk can take no responsibility for any content, statements or offers made on the web sites of the various London Dentists.<br />London Dental Practice<br />Ravenscourt Dental Practice W6 0SL Holistic dental care in Ravenscourt near Hammersmith London holistic dentist<br />AllClear Dental Practice CR0 1UX All Clear general dentist in Whitgift Shopping Centre Croydon dentists<br />Linda Greenwall's Dental Practice NW3 2LL Linda Greenwall's Dental Practice at Heath Health Care - Hampstead London<br />Park View Dental NW10 implant dentist London NW10 cosmetic dentist North London dentist NW10<br />Brokley Dentist SE4 2AQ SE4 dentist London Cosmetic Dentist Brokley SE4 London dentist Brokley<br />Barbican Dental Care EC14 9ET<br />Dentist London, barbican dental care located in canary wharf, London<br />Barry Blooms Dental Practice W1G OPN<br />London dentist, Dental Practice in Cavendish Square, London<br />Battersea Dental Care SW11 4LY<br />dentist battersea, dentist london: Battersea Dental Care, Battersea<br />Cambridge Court Dental Practice W2 1UL<br />London dentist: The Cambridge Court Dental Centre in W2, London<br />Camden Dental Surgery NW1 7JL<br />Camden dentist Camden Dental Centre dentist Camden, London<br />Carnaby Street Dental Practice W1V 1PQ<br />Mercury Free Dentist. 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Cosmetic dentist in Harley St. London<br />Finchley Road Medical Centre NW11 7RX<br />London Medical Centre: Finchley Road Medical Centre in Golders Green.<br />Harcourt House Dental Practice W1G 0PN<br />zoom tooth whitening dentist Harley Street London<br />HK Dental Practice W1G 8YA<br />central london implant dentist implant dentist London dental implants<br />Holford Partners Dental Practice W1G 0PL<br />London implant dentist in Cavendish Square near Harley Street, W1<br />Jenny Pinders Dental Practice SE26 4DJ<br />nervous of the dentist? Jenny Pinder, a dentist for phobics in London<br />Knightshill Dental Practice SE27 0SR<br />Dentist West Norwood : dentist South London : dentists London<br />London-dentist.com W1G 0PL<br />West End dentist Central London W1 dentist West End London<br />Medenta SW11 1TH<br />Cosmetic Dentist London Dentist Battersea SW11 and SW17 SW18<br />Millbank Dental Care SW1P 4PR<br />Pimlico Dentist, Westminster Dentist, SW1 dentist, London Dentist<br />Oracare Dental Practice HA8 6LD<br />Edgware dentist, Middlesex dentists, cosmetic dentist Edgware London<br />Phillip Davies W1N 1AF<br />Dentist harley street, London providing high quality dentistry in London<br />Sarah Burns Orthodontics TW9 3NL<br />Orthodontics Notting Hill orthodontist Notting Hill, London<br />Scarsdale Implant Clinic W8 6EF<br />dentist Kensington, implant dentist Kensington, implant dentist London<br />Southern Dental SE15 5RS<br />Maidstone dentist at Maidstone Dental Practice, dentist London<br />James Street W1U 1EQ The James Street Dental Practice, London<br />North Kensington W10 5NR NHS dentists, North Kensington,London<br />Implant and Cosmetic Dental Centre W1G 0PN Dental Implants and Cosmetic Dentistry for London<br />Tooth Implant Centre<br />SW6 6BS Dental Implants using BioHorizons Implant Systems in London<br />dentalsmiledesign<br />W8 4DB London Dentist in Kensington London<br />London Emergency Dentist London emergency dentist providing 24 emergency cover in London<br />Dr Forest & Ray<br />W1G 9PP Affordable London dentist in Harley Street, London save up to 70%.<br />My Local Dentists My Local Dentists is the leading Dental Directory for London Dentists<br />Church Hill Dentistry SM3 8NA Quality Dentistry at affordable Prices from a London Dentist in Cheam<br />Leather Lane Dental Practice EC1N 7TP The Leather Lane Dental Practice- 50 Leather Lane, London, EC1N<br />Chelsea dental and dermal clinic SW3 3NR Chelsea dental and dermal clinic, London, SW3 3NR<br />NW1 DentalCare NW1 Dentist Camden dentist at NW1 Dental Care 0207 485 4626<br />Nick & Polly Patsias BR3 2JE Polly Patsias Dental Practice a beckenham dentist in Kent, nr London<br />Family Dental Care E2 0QY Family dental care in Bethnal Green, E2 provided by Dr Karim Ali, E2 dentist<br />Century Dental Clinic SW15 6AW Putney Dentist SW15 London dentist in Century Dental Clinic in Ravenna Road<br />Contact London Dentist .co.uk<br /><br />If you'd like to have a link placed on LondonDentist.co.uk to your web site, please complete the form below and click on the submit button, one of our team will then contact you:-Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-1089580265672401629.post-9490400803578084692008-01-12T01:09:00.001-08:002011-04-21T07:26:40.952-07:00Homeopathy and Mercury-free dentistryHomeopathy<br />The uses of homeopathy in dentistry are manyfold. It is essential that the remedies used are provided by a qualified practitioner and that the remedies themselves are supplied by a bespoke manufacturer. Unfortunately, remedies from the high-street chains are can be less effective due to their lower strengths.<br />Homeopathic treatments in dentistry can help with fear, anxiety, surgical healing, pain, bruising and swelling. There are also remedies to help with periodontitis , teething babies, oral infection, and many other common oral conditions.<br />After a consultation and detailed discussion involving many aspects of the individual case history, remedies can be prescribed to treat the symptoms.Remedies are as equally effective in the old as the young and have no side effects.<br />Remedies are also used during mercury removal, along with other measures, to decrease the toxicity of mercury amalgam.<br /><strong>Mercury-free dentistry<br /></strong>The safety of the mercury contained within dental amalgam has been debated for many years. The use of dental amalgam is now prohibited in Sweden and Germany. Although no scientific evidence has yet conclusively proved the risk to health, it would seem sensible not to place a known poison into the mouth and leave it there for twenty years. It may also be worth noting that after placing an amalgam filling, the residual material cannot simply be disposed of in the normal bin-the residual amalgam must be disposed of in a special poisons container and then collected by a specialist removal company. The very same material that has just been placed into a person's mouth!<br />There are now many alternatives to the use of dental amalgam which are cosmetically superior and can be equally durable. At the Clock Tower Dental Clinic existing amalgam is removed carefully under rubber dam isolation and copious water irrigation. High-bore suction dramatically cuts down the emission of mercury vapour.<br />Homeopathic remedies are also used to decrease any toxicity.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-61142060191394520822007-12-26T08:21:00.001-08:002007-12-26T08:21:56.501-08:00Management of acute dental pain: a practical approach for primary health care providers<p class="authorsText">John Wetherell, Senior Lecturer, Lindsay Richards, Associate Professor, Paul Sambrook, Senior Lecturer, and Grant Townsend, Professor of Dental Science, University of Adelaide, Adelaide </p> <p class="summaryTitle">Summary</p> <p class="summaryText"> A detailed history and examination will identify the cause of dentally-related pain in most emergency situations. Sharp, shooting pain can be caused by inflammation in the pulp or exposure of the dentine. Dull throbbing pain has several causes including ulcerative gingivitis, dental caries and food impaction. Simple treatment will usually alleviate the symptoms until patients can be seen by a dentist. Prescription of antibiotics is usually not indicated. </p><p> Key words: dental infections, sinusitis, temporomandibular joint.</p> <p class="citationsText"> (Aust Prescr 2001;24:144-8)</p> <p align="right"><a class="consumerComment" href="http://www.australianprescriber.com/cc/115">There is a comment for consumers on this article</a></p> <p><b>Introduction</b> </p> <p> General medical practitioners are often called upon to manage acute dental pain in emergency situations, for example, out of hours or in rural Australia, where it may not be possible for a dentist to provide immediate treatment. Common acute oral problems are usually easy to diagnose. Simple management can alleviate pain and further discomfort until a dentist can be called upon. </p> <p>Most problems can be identified by the history and examination. Several dental conditions have typical symptoms with different types of pain. </p> <p><b>History and examination </b> </p> <p> When investigating acute dental pain, the history should focus on the pain's: </p> <ul><li>location </li><li>type </li><li>frequency and duration </li><li>onset </li><li>exacerbation and remission (for example the response to heat or cold) </li><li>severity </li><li>area of radiation. </li></ul> <p>Associated pathology and referred pain should also be considered. </p> <p>The following structures need to be examined carefully in order to be sure that the pain is of dental origin: </p> <ul><li>tongue </li><li>buccal mucosa </li><li>floor of the mouth </li><li>hard palate </li><li>teeth and periodontal tissues (see <a href="http://www.australianprescriber.com/magazine/24/6/144/8/#f1">Fig. 1</a>) </li><li>tonsils </li><li>temporomandibular joints </li><li>airway </li><li>ears </li><li>salivary glands </li><li>lymph nodes. </li></ul> <p><b>Which tests can assist in diagnosis?</b> </p> <p> There are several simple tests that may assist in diagnosis of dental pain. </p> <p><b><i>Pulp sensitivity test </i></b></p> <p>Dry ice, or an ordinary ice stick (made in a plastic or glass tube), is placed on the cervical third (neck region) of the tooth crown. A response to the stimulus indicates that the pulpal tissue is capable of transmitting nerve impulses. No response may indicate pulp necrosis. </p> <a name="f1"></a> <table border="1" cellpadding="2" cellspacing="2" width="100%"> <tbody><tr> <td bgcolor="#ffcccc"> <p>Fig. 1 </p> <p> Diagram of a lower molar tooth </p> <p><img src="http://www.australianprescriber.com/upload/issue_files/2406_dental_f1.gif" height="211" width="257" /></p> </td> </tr> </tbody></table> <p><b><i>Percussion test </i></b></p> <p>Using an instrument handle, the tooth is tapped in the longitudinal axis. A painful response suggests possible periapical inflammation. </p> <p><b><i>Probing</i></b> </p> <p>Placing a fine, blunt probe gently into the gingival sulcus surrounding the tooth enables the health of the gingival tissues to be assessed. Bleeding and/or sulcus depths greater than 3-4 mm indicate gum disease. </p> <p><b><i>Mobility test </i></b></p> <p>Holding a tooth firmly on the buccal (cheek) and lingual sides between the fingers enables mobility to be assessed. All teeth have a small amount of mobility (<0.5> <p><b><i>Palpation</i></b> </p> <p>Careful palpation around the area of concern may reveal tenderness and the type and extent of swelling. </p> <p><b><i>Radiographic examination </i></b></p> <p>If it is possible to obtain a screening radiograph, such as an orthopantomograph (OPG), this may assist in the diagnosis and localisation of the cause of the pain. The radiograph should show clearly the apical and periapical structures of teeth and associated tissues. The relationship of the maxillary molars and premolars to the floor of the maxillary sinus can be examined, and radiographs may reveal recurrent caries or periapical radiolucencies associated with an established infection (<a href="http://www.australianprescriber.com/magazine/24/6/144/8/#f2">Fig. 2</a>). </p> <p><b>What are the common types of dental pain?</b> </p> <p> Common types of oro-facial pain likely to cause a patient to seek emergency care are categorised in <a href="http://www.australianprescriber.com/magazine/24/6/144/8/#f3">Figure 3</a>. The character of the pain can point to a diagnosis. </p> <p><b><i>Short, sharp, shooting pain </i></b></p> <p>This type of pain can be generalised or confined to one region of the mouth. The pain may be due to fluid movement through open tubules in the dentine or there may be some initial inflammatory changes in the dental pulp. It can be caused by caries, dentine exposure on root surfaces, split cusp, lost or fractured restoration or a fractured tooth. </p> <p>Patients complain commonly of a sharp pain associated with hot, cold or sweet stimuli. The pain is only present when a stimulus is applied. In the case of a cracked cusp, grainy bread or hard food may create a sharp pain, that may be spasmodic, on biting or chewing. </p> <p>With gingival recession, recent scaling, or tooth wear due to a high acid diet or gastric reflux, there may be generalised dentine sensitivity. However, with caries, fractured fillings and cracked cusps, the pain tends to be localised to the affected tooth. </p> <p>Intermittent sharp, shooting pains are also symptomatic of trigeminal neuralgia, so care must be taken not to mistakenly label toothache as neuralgia. </p> <p><i>Treatment</i> </p> <p>For root sensitivity the use of a desensitising toothpaste and a reduction in acid in the diet will help resolve the symptoms. The use of a fluoride mouth-rinse may also help. In the case of caries, a lost filling or fractured tooth, coverage of the exposed dentine with a temporary restoration will usually relieve the symptoms. </p> <a name="f2"></a> <table border="1" cellpadding="2" cellspacing="2" width="100%"> <tbody><tr> <td bgcolor="#ffcccc"> <p>Fig. 2 </p> <p> An orthopantomograph (OPG) showing extensive dental caries (radiolucent areas) affecting the crowns of several teeth, and abscess formation (radiolucent areas) around the periapical regions of the roots. Arrows show caries and abscess formation on two mandibular teeth. </p> <p><img src="http://www.australianprescriber.com/upload/issue_files/2406_dental_f2.jpg" height="314" width="566" /></p> </td> </tr> </tbody></table><br /><a name="f3"></a> <table border="1" cellpadding="2" cellspacing="2" width="100%"> <tbody><tr> <td bgcolor="#ffcccc"> <p>Fig. 3 </p> <p> Causes of common types of dental pain </p> <p><img src="http://www.australianprescriber.com/upload/issue_files/2406_dental_f3.gif" height="227" width="535" /></p> </td> </tr> </tbody></table> <p><b><i>Dull, throbbing, persistent pain </i></b></p> <p>This type of pain may have several causes. These include tooth problems, food impaction, pericoronitis, acute necrotising ulcerative gingivitis, temporomandibular disorder, or even maxillary sinusitus. </p> <p><i>Painful tooth problems </i></p> <p>The most common dental cause of dull, throbbing persistent pain is caries. In many cases this is recurrent and associated with an existing restoration. Where the pulp is affected irreversibly, necrosis may follow with possible development of a periapical infection. A fractured cusp involving the pulp, or a large deep restoration may also be associated with this type of pain. Affected teeth may be tender to percussion in the later stages of periapical inflammation. </p> <p>There is considerable variation in the pain reported by patients, but it commonly starts as a sharp stabbing pain that becomes progressively dull and throbbing. At first the pain may be caused by a stimulus, but it then becomes spontaneous and remains for a considerable time after removal of the stimulus. The pain may radiate and be referred to other areas of the mouth. This type of pain tends to cause the patient to have difficulty sleeping and may be exacerbated by lying down. Heat may make the pain worse whereas cold may alleviate it. The pain may be intermittent with no regular pattern and may have occurred over months or years. If there is periapical infection present, patients may no longer complain of pain in response to a thermal stimulus, but rather of sensitivity on biting. </p> <p>Treatment </p> <p>Treatment of affected teeth will involve either root canal therapy or tooth removal. In some patients, periapical inflammation can lead to a cellulitis of the face characterised by a rapid spread of bacteria and their breakdown products into the surrounding tissues causing extensive oedema and pain. If systemic signs of infection are present, for example, fever and malaise, as well as swelling and possibly trismus (limitation of mouth opening), this is a surgical emergency. Antibiotic treatment alone is not suitable or recommended (see <a href="http://www.australianprescriber.com/magazine/24/6/144/8/#box">box</a>).</p> <p> <a name="box"></a> </p> <table border="1" cellpadding="2" cellspacing="2" width="100%"> <tbody><tr> <td bgcolor="#ffcccc"><b>Should antibiotics be prescribed?</b> </td> </tr> <tr> <td bgcolor="#ffcccc"> <p>While antibiotics are appropriate in the management of certain dental infections, they are not indicated if the pain results from inflammatory (non-infective) or neuropathic mechanisms. The degree of pain is not a reliable indicator of acute infection. </p> <p>There is evidence that Australian dentists and doctors are using antibiotics empirically for dental pain, rather than making careful diagnoses of the causes of the pain.<sup><a href="http://www.australianprescriber.com/magazine/24/6/144/8/#1">1</a></sup><a href="http://www.australianprescriber.com/magazine/24/6/144/8/#1"> </a>Most dental emergency situations involve patients with acute inflammation of the dental pulp or the periapical tissues. Prescribing antibiotics for these conditions will not remove the cause of the problem nor destroy the bacteria within the tooth. </p> <p>Antibiotics should be limited to patients with malaise, fever, lymph node involvement, a suppressed or compromised immune system, cellulitis or a spreading infection, or a rapid onset of severe infection. </p> </td> </tr> </tbody></table> <p>If pus is present, it needs to be drained, the cause eliminated, and host defences augmented with antibiotics. The microbial spectrum is mainly gram positive including anaerobes. Appropriate antibiotics would include a penicillin or a `first generation' cephalosporin, combined with metronidazole in more severe cases. </p> <p>Paracetamol or a non-steroidal anti-inflammatory drug is the recommended analgesic in the initial treatment of dental pain. </p> <p><i>Food impaction and pericoronitis </i></p> <p>Soft tissue problems that may cause dull, throbbing, persistent pain include local inflammation (acute gingivitis associated with food impaction) or pericoronitis. </p> <p>Chronic periodontitis with gradual bone loss, rarely causes pain and patients may be unaware of the disorder until tooth mobility is evident. There is quite often bleeding from the gums and sometimes an unpleasant taste. This is usually a generalised condition, however, deep pocketing with extreme bone loss can occur around isolated teeth. Food impaction in these areas can cause localised gingival pain. Poor contact between adjacent teeth and the presence of an occluding cusp forcing food into this gap can also cause a build-up of food debris and result in gingival inflammation. </p> <p>Acute pericoronitis involves bacterial infection around an unerupted or partially erupted tooth and usually affects the lower third molar (wisdom tooth). The condition is often aggravated by the upper molar impacting on the swollen flap of soft tissue covering the unerupted tooth. There may be trismus. </p> <p>Treatment </p> <p>Food debris should be removed and drainage established, if pus is present. Irrigation with chlorhexidine and rinsing the mouth with hot salty water is recommended. Early referral to a dentist is indicated. Cellulitis can develop, requiring urgent referral to a surgeon. </p> <p><i>Acute necrotising ulcerative gingivitis </i></p> <p>Acute necrotising ulcerative gingivitis is a rapidly progressive infection of the gingival tissues that causes ulceration of the interdental gingival papillae. It can lead to extensive destruction. Usually young to middle-aged people with reduced resistance to infection are affected. Males are more likely to be affected than females, with stress, smoking and poor oral hygiene being predisposing factors. Halitosis, spontaneous gingival bleeding, and a `punched-out' appearance of the interdental papillae are all important signs. </p> <p>The patients quite often complain of severe gingival tenderness with pain on eating and tooth brushing. The pain is dull, deep-seated and constant. The gums can bleed spontaneously and there is also an unpleasant taste in the mouth. </p> <p>Treatment </p> <p>As there is an acute infection with mainly anaerobic bacteria, treatment follows surgical principles and includes superficial debridement, use of chlorhexidine mouthwashes and a course of metronidazole tablets. Treating the contributing factors should prevent a recurrence. </p> <p><i>Dry socket </i></p> <p>A dull throbbing pain develops two to four days after a mandibular tooth extraction. It rarely occurs in the maxilla. Smoking is a major predisposing factor as it reduces the blood supply. The tissue around the socket is very tender and white necrotic bone is exposed in the socket. Halitosis is very common. </p> <p>Treatment </p> <p>The area should be irrigated thoroughly with warm saline solution. If loose bone is present, local anaesthesia may be necessary to allow thorough cleaning of the socket. Patients should be shown how to irrigate the area and told to do this regularly. Analgesics are indicated, but pain may persist for several days. Although opinion is divided as to whether or not dry socket is an infective condition, we do not recommend the use of antibiotics in its management (see <a href="http://www.australianprescriber.com/magazine/24/6/144/8/#box">box</a>). </p> <p><i>Temporomandibular disorders </i></p> <p>Temporomandibular disorders may lead to pain that is confused with toothache. Patients usually complain of unilateral vague pain occurring in the joint area and in the surrounding muscles of mastication. If the patient bruxes (clenches or grinds) at night, then pain in the temporal area on waking is common. Patients who clench during the day may find they get symptoms at the end of the day. The symptoms are often cyclical, resolving then recurring again. On questioning, patients will frequently be able to reveal stressful incidents that may have triggered this process.<i> </i>Palpation of the muscles of mastication will elicit tenderness, usually unilaterally. There may also be tenderness around the temporomandibular joints, limitation in mouth opening and obvious wear of the teeth. This wear may contribute to dentine sensitivity, as the enamel is worn away by the tooth grinding. Wear facets will be seen on restorations as well as natural teeth. Quite often, neck and shoulder muscles are tender to palpation. There may be joint pain with clicking and grating. </p> <p>Treatment </p> <p>Reassurance about the self-limiting nature of the problem and its reversibility may be all that is needed. Anti-inflammatory drugs and muscle relaxants can also help. Construction of a night-guard and muscle exercises may be indicated subsequently. These exercises may include gentle passive stretching, or resistance and clenching exercises.<sup><a href="http://www.australianprescriber.com/magazine/24/6/144/8/#2">2</a></sup> </p> <p><i>Sinusitis</i> </p> <p>This is caused by infection of the maxillary sinus, usually following an upper respiratory tract infection. However, there can be a history of recent tooth extraction leading to an oro-antral fistula. Patients usually complain of unilateral dull pain in all posterior upper teeth. All these teeth may be tender to percussion, but they will respond to a pulp sensitivity test. There are usually no other dental signs. </p> <p>The pain tends to be increased on lying down or bending over. There is often a feeling of `fullness' on the affected side. The pain is usually unilateral, dull, throbbing and continuous. Quite often the patient feels unwell generally and feverish.</p> <p>Treatment</p> <p>Pain originating from the sinus arises mainly from pressure. Decongestants can help sinus drainage. Antibiotics probably have only a minor role in mild cases. Referral to an otorhinolaryngologist for endoscopic sinus surgery may be indicated in chronic cases.<sup><a href="http://www.australianprescriber.com/magazine/24/6/144/8/#3">3</a></sup> </p> <p><b>Managing dental trauma</b> </p> <p> <i><b>Avulsed tooth </b></i></p> <p>Avulsed deciduous (baby) teeth are generally not reimplanted, as they may become fused to the alveolar bone and impede subsequent emergence of the permanent successor. </p> <p>It is essential to reimplant permanent teeth as soon as possible. However, while the tooth is out of the alveolus it should be stored in a physiological medium, for example, normal saline, milk, or the vestibule of the mouth. </p> <p>Before reimplantation, the root surface should be cleaned gently with normal saline to remove debris, but the root should not be touched with the fingers. The tooth socket should be irrigated gently with normal saline to remove any blood clot that has formed. The tooth should then be replaced into the socket using minimal pressure, and splinted to the adjacent teeth with a flexible splint (e.g. aluminium foil, bluetack). </p> <p>When a tooth is reimplanted, an antibiotic is prescribed for five days and a tetanus booster is given if immunisation is not up to date. </p> <p><b><i>Fractured tooth </i></b></p> <p>If the crown of a tooth is fractured by trauma and the broken fragment is available, it should be stored in a physiological medium until a dentist can assess the patient. Coverage of exposed dentine on the fractured crown with a temporary restoration is desirable to protect the underlying pulp tissue. </p> <p><b>Placement of temporary restorations</b> </p> <p> Although it is unlikely that many general medical practitioners will have temporary filling materials available in their surgeries, dentine that has been exposed by caries, a lost filling or tooth fracture can be covered relatively easily with glass ionomer cement (GIC) or zinc oxide eugenol (ZOE) materials. Most GIC materials are dispensed in capsules but a hand-mixed material is available, consisting of a powder, liquid and conditioner. The surface of the cavity is painted with the conditioner, then rinsed and dried, before placement of the filling. Zinc oxide eugenol materials consist of a powder and liquid (oil of cloves) that are mixed to a putty-like consistency before placement in the tooth. </p> <p>E-mail: <a href="mailto:grant.townsend@adelaide.edu.au">grant.townsend@adelaide.edu.au</a> </p> <p>R E F E R E N C E S </p> <ol><li> <a name="1"></a>Abbott PV. Selective and intelligent use of antibiotics in endodontics. Aust End J 2000;26:30-9. </li><li> <a name="2"></a>Okeson JP. Management of temporomandibular disorders and occlusion. 4th ed. St. Louis: Mosby; 1998. </li><li><a name="3"></a> Wormald PJ. Treating acute sinusitis. <a href="http://www.australianprescriber.com/magazine/23/2/39/42/">Aust Prescr 2000;23:39-42</a>. </li></ol>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-74601016990574060762007-12-26T08:17:00.000-08:002007-12-26T08:20:54.745-08:00Dental Treatment Pain - Book reviewTherapeutic Guidelines: Endocrinology. Version 2. North Melbourne: Therapeutic Guidelines Limited; 2001. 227 pages. Price (postage not included): $31.90 (2001), $33 (2002); students $25.30. David Mills, General Practitioner, Port Lincoln, South Australia This latest version of Therapeutic Guidelines: Endocrinology is an excellent reference source for busy general practitioners. Given the rise in many endocrine-related conditions, this is timely. The layout is simple and easy to follow with more space devoted to common conditions such as diabetes and osteoporosis, although a large number of conditions are still covered. There is a concise and succinct drug summary at the start of the book called ‘Getting to know your drugs’ allowing easy cross-referencing from the text. There are also some brief appendices on endocrine emergencies, pregnancy and breastfeeding, and for those interested in searching further, related web sites. The diabetes sections are well set out and reinforce the current diagnostic criteria based on American Diabetes Association/ World Health Organization guidelines. Treatment targets are up to date as is the advice on treating difficult complications such as neuropathy. Current drug therapies are outlined logically, but some drugs such as the ‘glitazones’ are not available on the Pharmaceutical Benefits Scheme. Osteoporosis is now high on the agenda of many general practitioners and this section is excellent with clear, current principles on diagnosis, prevention and management. All of the drugs described are available and well known to general practitioners, making the reading very practical. Under the sections on contraception there is good coverage of topical issues such as depot medroxyprogesterone, the etonogestrel implant and the levonorgestrel intrauterine devices. Similarly there is a comprehensive and easy to read discussion on hormone replacement therapy addressing most of the well-known controversies. Overall this book reads extremely well and fulfils the general practitioner’s need for evidence-based guidelines, in a short but easily understood form. It compares well with other general practice guidelines such as Evidence Based Medicine. David Mills has been in rural general practice for 15 years. He is a clinical lecturer at the Department of General Practice at the University of Adelaide and sits on the South Australian Diabetes Advisory Group.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-73481917413568248972007-12-16T05:07:00.001-08:002007-12-16T05:07:48.803-08:00What should I look for when choosing a dentist?<strong></strong>You may wish to consider several dentists before making your decision. During your first visit, you should be able to determine if this is the right dentist for you. Consider the following: <ul><ul><li>Is the appointment schedule convenient for you?<br /> <br /> </li><li> Is the office easy to get to from your home or job?<br /> <br /> </li><li> Does the office appear to be <a href="http://www.ada.org/public/topics/infection_control.asp">clean</a>, neat and orderly?<br /> <br /> </li><li> Was your medical and dental history recorded and placed in a permanent file?<br /> <br /> </li><li> Does the dentist explain techniques that will help you prevent dental health problems? Is dental health instruction provided?<br /> <br /> </li><li> Are special arrangements made for handling emergencies outside of office hours? (Most dentists make arrangements with a colleague or emergency referral service if they are unable to tend to emergencies.)<br /> <br /> </li><li> Is information provided about fees and payment plans before treatment is scheduled?<br /> <br /> </li><li> Is your dentist a member of the ADA? All ADA member dentists voluntarily agree to abide by the high ethical standards reflected in the <a href="http://www.ada.org/prof/prac/law/code/index.asp">ADA Principles of Ethics and Code of Professional Conduct</a> as a condition of their membership.</li></ul></ul> <p> You and your dentist are partners in maintaining your oral health. Take time to ask questions and take notes if that will help you remember your dentist's advice.</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-39521240260660543352007-04-14T13:35:00.000-07:002007-04-14T13:36:59.555-07:00Caring for my teethQuestion: <br />Why are my teeth so important?<br />Answer: <br />Your teeth vary in shape and size depending on their position within your mouth. These differences allow the teeth to do many different jobs. Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly. Finally, teeth help to give our face its shape. A healthy smile can be a great asset and because this is so important, it makes sense to give your teeth the best care possible.<br />Back to top <br /> <br />Question: <br />What can go wrong?<br />Answer: <br />Tooth decay can lead to fillings, crowns or inlays. If tooth decay is not treated, the nerve of the tooth can become infected and die, causing an abscess. This may then need root canal treatment. Gum disease is the largest cause of tooth loss in adults. Gum disease is a treatable, preventable condition and can be kept under control with regular check-ups, preventing further problems. If teeth are lost, it may be necessary to fill the gaps with bridges, dentures or implants.<br />Back to top <br /> <br />Question: <br />How do I keep my teeth and gums healthy?<br />Answer: <br />It is easy to get your mouth clean and healthy, and keep it that way. A simple routine of brushing and cleaning between the teeth, good eating habits and regular dental check-ups can help prevent most dental problems. Although most people brush regularly, many don’t clean between their teeth and some people don’t have dental check-ups. A few small changes in your daily routine can make a big difference in the long run. Your dentist or dental hygienist can remove any build-up on your teeth and treat any gum disease that has already appeared. But daily dental care is up to you, and the main weapons are the toothbrush and interdental cleaning. (Cleaning between the teeth).<br />Back to top <br /> <br />Question: <br />What is plaque?<br />Answer: <br />Plaque is a thin, sticky film of bacteria that constantly forms on your teeth. The plaque reacts with food, turning sugar into acid, which then dissolves the enamel on your teeth.<br />Back to top <br /> <br />Question: <br />How can plaque cause decay?<br />Answer: <br />When you eat foods containing sugars and starches, the bacteria in plaque produce acids, which attack tooth enamel. The stickiness of the plaque keeps these acids in contact with teeth. After the teeth are attacked in this way many times, the tooth enamel breaks down forming a hole or cavity.<br />Back to top <br /> <br />Question: <br />How can plaque cause gum disease?<br />Answer: <br />Plaque can harden into something called calculus (another name for it is ‘tartar’). As calculus forms near the gumline, the plaque underneath releases poisons causing the gums to become irritated and inflamed. The gums begin to pull away from the teeth and the gaps become infected. If gum disease is not treated promptly, the bone supporting the teeth is destroyed and healthy teeth may be lost. Gum disease is the biggest cause of tooth loss in adults and can lead to dentures, bridges or implants.<br />Back to top <br /> <br />Question: <br />How can I prevent gum disease?<br />Answer: <br />It is important to remove plaque and food debris from around your teeth as this will stop your gums from swelling and becoming infected. If you leave plaque on your teeth it can develop into tartar, which can only be removed by the dentist or hygienist. It is important to keep up your regular appointments so that your teeth can have a thorough cleaning if they need it.<br />Back to top <br /> <br />Question: <br />How do I know if I have gum disease?<br />Answer: <br />Gum disease (gingivitis) will show itself as red, swollen gums that bleed when brushed or flossed. Many people are alarmed when they notice this bleeding and will then brush more gently, if at all. It is important that you continue to clean regularly and firmly in order to fight the condition.<br />Back to top <br /> <br />Question: <br />Why is brushing important?<br />Answer: <br />Daily brushing and cleaning between your teeth is important because it removes plaque. If the plaque isn’t removed, it continues to build up, feeding on the food debris left behind and causing tooth decay and gum disease<br />Back to top <br /> <br />Question: <br />Which type of toothbrush should I use?<br />Answer: <br />Your dentist or dental hygienist will be able to recommend a toothbrush to you. However, adults should choose a small to medium size brush with soft to medium multi-tufted, round-ended nylon bristles or ‘filaments’. The head should be small enough to get into all parts of the mouth: especially the back of the mouth where cleaning can be difficult. Children need to use smaller brushes but with the same type of filaments.<br /><br />You can now get more specialised toothbrushes. For instance, people with sensitive teeth can now use softer bristled brushes. There are also smaller headed toothbrushes for those people with crooked or irregular teeth.<br /><br />Some people find it difficult to hold a toothbrush, for example because they have Parkinson’s disease or a physical disability. There are now toothbrushes, which have large handles and angled heads to make them easier to use.<br />Back to top <br /> <br />Question: <br />How should I brush?<br />Answer: <br />Brushing removes plaque and food particles from the inner, outer and biting surfaces of your teeth.<br /><br />Here is one method of removing plaque:<br />1. Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45 degree angle against the gumline. Move the brush in small circular movements, several times, on all the surfaces of every tooth.<br />2. Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gumline.<br />3. Use the same method on the inside surfaces of all your teeth.<br />4. Brush the chewing surfaces of the teeth.<br />5. To clean the inside surfaces of the front teeth, tilt the brush vertically and make several small circular strokes with the toe (the front part) of the brush.<br />6. Brushing your tongue will help freshen your breath and will clean your mouth by removing bacteria.<br />Back to top <br />Hold the brush at a 45 degree angle<br /> <br />Question: <br />How often should I brush my teeth?<br />Answer: <br />Be sure to brush thoroughly with a fluoride toothpaste at least twice a day, more often if your dentist recommends it. If you keep getting discomfort or bleeding after brushing go to see your dentist about it.<br />Back to top <br /> <br />Question: <br />How often should I change my toothbrush?<br />Answer: <br />Worn-out toothbrushes cannot clean your teeth properly and may damage your gums. It is important to change your toothbrush every two to three months, or sooner if the filaments become worn. When bristles become splayed, they do not clean properly.<br />Back to top <br /> <br />Question: <br />How do electric toothbrushes work?<br />Answer: <br />An electric brush often has rotating or vibrating head, which provides a large amount of cleaning action with very little movement needed from the user.<br />Back to top <br /> <br />Question: <br />Do electric toothbrushes clean better?<br />Answer: <br />Tests have proved that certain electric toothbrushes are better at removing plaque. They are particularly useful for people with limited movement, such as disabled or elderly people, who often find that using a normal toothbrush does not allow them to clean thoroughly. Electric toothbrushes can also be better for children as they may be more inclined to brush regularly because of the novelty of using an electric toothbrush. Discuss the idea with your dentist or hygienist to find out if you would benefit from using an electric toothbrush.<br />Back to top <br /> <br />Question: <br />What sort of toothpaste should I use?<br />Answer: <br />As well as regular family toothpastes, there are many specialist toothpastes. These include tartar control for people who are prone to tartar build-up, and ones for people with sensitive teeth. Total care toothpastes include ingredients to help fight gum disease, freshen breath and help reduce plaque build-up. Whitening toothpastes are good at removing staining, but are not strong enough to change the natural shade of the teeth.<br /><br />Children’s toothpastes have about half the level of fluoride that adult toothpastes have. They still provide extra protection for the teeth, but as children have a tendency to ‘eat’ their toothpaste, there is less risk of them taking in too much fluoride.<br /><br />To have a clean and healthy mouth you need to use the correct dental care products. Ask your dentist or hygienist to tell you the options and give their recommendations.<br />Back to top <br /> <br />Question: <br />Should I use a fluoride toothpaste?<br />Answer: <br />Yes. Fluoride helps to strengthen and protect teeth, which can reduce tooth decay in adults and children.<br />Back to top <br /> <br />Question: <br />How much toothpaste should I use?<br />Answer: <br />You do not need to cover the head of your brush in toothpaste. A pea-sized amount is enough. Children should use a small scraping of toothpaste<br />Back to top <br /> <br />Question: <br />How should I clean between my teeth?<br />Answer: <br />One way to clean between your teeth is with dental floss or tape. Flossing removes plaque and food particles from between your teeth and under the gumline, areas a toothbrush can’t reach. Your dentist or hygienist can show you proper flossing techniques.<br /><br />The following suggestions may help:<br />1. Break off about 18 inches of floss, and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the other hand. As you use the floss, you will take up the used section with this finger.<br />2. Hold the floss tightly between your thumb and forefingers, with about an inch of floss between them, leaving no slack. Use a gentle ‘rocking’ motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.<br />3. When the floss reaches the gumline, curve it into a C-shape against one tooth until you feel resistance.<br />4. Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum. Repeat on the other side of the gap, along the side of the next tooth.<br />5. Don’t forget the back of your last tooth.<br /><br />When flossing, keep to a regular pattern. Start at the top and work from left to right, then move to the bottom and again work from the left to right. This way you’re less likely to miss any teeth.<br /><br />It is also very important to clean around the edges of any crowns, bridges or implants. This can be difficult to do effectively using traditional floss and there are now specialist flosses to do the job thoroughly (such as super floss and specialist floss threaders). Ask your dentist or hygienist on how to use these properly and which method you should use.<br />Back to top <br />Floss between all of your teeth<br /> <br />Question: <br />Should my gums bleed when I floss?<br />Answer: <br />Your gums may bleed or be sore for the first five or six days that you floss. This should stop once the plaque is broken up and the bacteria has gone. If the bleeding does not stop, tell your dentist. It may be that you are not flossing correctly or your teeth and gums need a more thorough clean by your dentist or hygienist.<br />Back to top <br /> <br />Question: <br />What do I do if I have difficulty using floss?<br />Answer: <br />If you have trouble using floss you can use a floss holder or an interdental cleaning aid. Interdental cleaning aids include woodsticks or small interdental brushes used to remove plaque from between the teeth. Your dentist or hygienist can explain how to use these properly.<br />Back to top <br /> <br />Question: <br />Are oral irrigators useful?<br />Answer: <br />Oral irrigation devices use a stream of water to remove food particles from around the teeth. These devices can be particularly helpful for people wearing orthodontic appliances or fixed bridges.<br />Back to top <br /> <br />Question: <br />Should I use a mouthwash?<br />Answer: <br />Mouthwashes are mainly used to freshen breath. If you have to keep using a breath freshener to hide any bad breath, see your dentist. Bad breath can be a sign of poor general health as well as unhealthy teeth and gums. A fluoride mouthwash can help prevent tooth decay. Your dentist may recommend an antibacterial mouthwash to help control plaque and reduce gingivitis (gum disease).<br />Back to top <br /> <br />Question: <br />Can watching my diet help?<br />Answer: <br />Many people think that it is a high level of sugar in your diet that causes decay, but this is not so. It is how often you have sugar in your diet, not the amount, that causes problems. It takes an average of 40 minutes for the mouth to cancel out the acid caused by eating and drinking sugar. It is therefore important to limit the number of attacks by keeping sugary foods and drinks to mealtimes.<br />Back to top <br /> <br />Question: <br />What do I do if I have dentures?<br />Answer: <br />It is just as important to clean dentures as it is to clean your natural teeth. Food can become caught around the edges of dentures and clasps, and can rot if not cleaned thoroughly.<br /><br />Clean your dentures using a denture brush and plain soap. Always clean dentures over a bowl of water or folded towel to stop them breaking if you drop them.<br />Back to top <br /> <br />Question: <br />I have implants, do I have to do anything special?<br />Answer: <br />Your dentist or oral surgeon will tell you how to care for your implants after surgery. It is very important to make sure you clean them regularly and thoroughly to prevent gum disease and possible infection.<br />Back to top <br /> <br />Question: <br />Why should I visit the dentist regularly?<br />Answer: <br />Prevention is always better than cure. If you visit your dentist regularly, you will need less and your dentist will spot any problems earlier. It will also be easier to put these problems right.<br />Back to top <br /> <br />Question: <br />Are accredited products better?<br />Answer: <br />Look for products carrying the British Dental Health Foundation 'Approved' symbol on the packet. These products have been clinically and scientifically proven to the satisfaction of a panel of experts. The claims made on the labels must be accurate in what they say and what they imply.<br />Back to top <br /> <br />Question: <br />What should I do regularly to care for my teeth?<br />Answer: <br />Good dental health begins with you. By following this simple routine, you can keep your mouth clean and healthy:<br />· Brush your teeth twice a day using fluoride toothpaste.<br />· Have sugary drinks and snacks less often.<br />· Use a small to medium size toothbrush.<br />· Use a toothbrush with soft to medium multi-tufted, round-ended nylon bristles.<br />· Use a pea-sized amount of toothpaste.<br />· Use small circular movements to clean your teeth.<br />· Change your toothbrush regularly.<br />· Clean between your teeth using dental floss or wood sticks.<br />· Visit your dentist at least once a year.<br />· Look out for products with the 'British Dental Health Foundation Approved' symbol.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-6920516973894154712007-04-01T03:29:00.000-07:002007-04-01T03:31:14.921-07:00What is tooth whitening - Common QuestionsWhat is tooth whitening?<br />Answer: <br />Tooth whitening can be a highly effective way of lightening the natural colour of your teeth without removing any of the tooth surface. It cannot make a complete colour change; but it will lighten the existing shade.<br /><br /> <br />Question: <br />Why would I need my teeth whitened?<br />Answer: <br />There are a number of reasons why you might get your teeth whitened. Everyone is different; and just as our hair and skin colour vary, so do our teeth. Very few people have brilliant-white teeth, and our teeth can also become more discoloured as we get older.<br /><br />Your teeth can also be stained on the surface through food and drinks such as tea, coffee, red wine and blackcurrant. Smoking can also stain teeth.<br /><br />Calculus or tartar can also affect the colour of teeth. Some people may have staining under the surface, which can be caused by certain antibiotics or tiny cracks in the teeth which take up stains.<br /> <br />Question: <br />What does tooth whitening involve?<br />Answer: <br />Professional bleaching is the most common form of tooth whitening. Your dentist will be able to tell you if you are suitable for the treatment, and will supervise it if you are. First the dentist will put a rubber shield or a gel on your gums to protect the soft tissue. They will then apply the whitening product to your teeth, using a specially made tray which fits into your mouth like a gum-shield.<br /><br />The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, oxygen gets into the enamel on the teeth and the tooth colour is made lighter.<br />Back to top <br />After tooth whitening treatment<br /> <br />Question: <br />How long does this take?<br />Answer: <br />The total treatment can usually be done within three to four weeks. First, you will need two or three visits to the dentist. Your dentist will need to make a mouthguard and will take impressions for this at the first appointment. Once your dentist has started the treatment, you will need to continue the treatment at home. This means regularly applying the whitening product over two to four weeks, for 30 minutes to one hour at a time.<br /><br />However, there are now some new products which can be applied for up to eight hours at a time. This means a satisfactory result can be achieved in as little as one week.<br /> <br />Question: <br />What other procedures are there?<br />Answer: <br />There is now laser whitening or ‘power whitening’. During this procedure a rubber dam is put over your teeth to protect the gums, and a bleaching product is painted onto your teeth. Then a light or laser is shone on the teeth to activate the chemical. The light speeds up the chemical reaction of the whitening product and the colour change can be achieved more quickly using this procedure. Laser whitening can make teeth up to five or six shades lighter.<br /> <br />Question: <br />How long does this take?<br />Answer: <br />Your dentist will need to assess your teeth to make sure that you are suitable for the treatment. Once it has been agreed, this procedure usually takes about one hour.<br /> <br />Question: <br />How much does tooth whitening cost?<br />Answer: <br />You cannot get whitening treatments on the NHS. Private charges will vary from practice to practice and region to region. Laser or power whitening will be more expensive than professional bleaching. We recommend you get a written estimate of the cost before you start any treatment.<br /> <br />Question: <br />How long will my teeth stay whiter?<br />Answer: <br />The effects of whitening can last up to three years. However, this will vary from person to person. The effect is less likely to last as long if you smoke, or eat or drink products that can stain your teeth. Ask your dentist for their opinion before you start the treatment.<br /> <br />Question: <br />What are the side effects?<br />Answer: <br />Some people may find that their teeth become sensitive to cold during or after the treatment. Others report discomfort in the gums, a sore throat or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days of the treatment finishing.<br /><br />If any of these side effects continue you should go to your dentist.<br /> <br />Question: <br />What about home kits?<br />Answer: <br />Home kits are cheaper. But because tooth whitening is a complicated procedure you should only have it done by a dentist, after a thorough examination and assessment of your teeth.<br /><br />Over-the-counter kits sold in the UK are not recommended as they usually contain only a small concentration of hydrogen peroxide (the whitening product). The legal limit in the UK is 0.1% of hydrogen peroxide and effective bleaching products need to have about 3.6%. So home kits will not be able to lighten your teeth noticeably. Also, some contain mild acids and others are abrasive. This can cause ulcers and damage to the gums if the product is not used properly<br /> <br />Question: <br />What about whitening toothpastes?<br />Answer: <br />There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining and therefore may improve the overall appearance of your teeth. Whitening toothpaste may also help the effect last, once your teeth have been professionally whitened.<br /><br />We recommend that you look for our accreditation symbol on the packaging of oral care products. This is a guarantee that the claims made about the product have been scientifically and clinically checked by an independent panel of experts.<br /> <br />Question: <br />Can a single tooth which has been root filled be whitened?<br />Answer: <br />Yes. Many dead teeth go discoloured after a root filling. If the tooth has been root treated, the canal (which previously contained the nerve) may be reopened. The whitening product is applied working from the inside to whiten the tooth.<br /> <br />Question: <br />When might tooth whitening not work?<br />Answer: <br />Tooth whitening can only lighten your existing tooth colour. Also it only works on natural teeth. It will not work on any types of ‘false’ teeth such as dentures, crowns and veneers.<br /><br />If your dentures are stained or discoloured visit your dentist and ask for them to be cleaned. Stained veneers, crowns or dentures may need replacing; again ask your dentist.<br /> <br />Question: <br />How can I look after my teeth once they have been whitened?<br />Answer: <br />You can help to keep your teeth white by cutting down on the amount of food and drink you have that can stain teeth. Don’t forget, stopping smoking can also help prevent discolouring and staining.<br /><br />We recommend the following tips to care for your teeth:<br />· brush your teeth twice a day with a fluoride toothpaste<br />· cut down on how often you have sugary snacks and drinks<br />· visit your dentist at least once a year.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-69085981073336930662007-03-20T01:29:00.000-07:002007-03-20T01:30:32.762-07:00Where can people with special needs obtain dental care?The ADA Council on Access, Prevention and Interprofessional Relations suggests the following tips:<br /><br /> * Inform the dentist about your special health or financial conditions.<br /><br /> * Ask if the dentist has training and/or experience in treating patients with your specific condition.<br /><br /> * Ask if the dentist has an interest in treating patients with your specific condition.<br /><br /> * Find out if the dentist participates in your dental benefit plan (dental insurance program.)<br /><br /> * Ask if the dental facility is accessible to the disabled.<br /><br />In addition, the Council suggests that patients with special needs<br /><br /> * Call or write the dental director at your state department of public health.<br /><br /> * Contact the nearest dental school clinic or hospital dental department, especially if it is affiliated with a major university.<br /><br /> * Contact the Special Care Dentistry (Formerly Federation of Special Care Organizations in Dentistry, the Academy of General Dentistry and the American Academy of Pediatric Dentistry for a referral.<br /><br /> * Also, the National Oral Health Information Clearinghouse may have useful information.<br /><br /> * Contact the National Foundation of Dentistry for the Handicapped (NFDH), a charitable affiliate of the American Dental Association since 1988. The NFDH, via several programs, facilitates the provision of comprehensive dental care for needy disabled, elderly, and medically compromised individuals.<br /><br /> * Dentists and dental institutions organizing or participating in voluntary projects that care for uninsured and underserved patients will find information, and grant opportunities through Volunteers in Health Care (VIH). VIH Program staff are available to assist you at the toll-free number 1-877-844-8442.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-25132212441722578052007-03-19T05:35:00.001-07:002007-03-19T05:35:48.117-07:00Paying for dental treatmentPaying for dental treatment<br /> <br />Question: <br />How do I pay for my dental treatment under the National Health Service?<br />Answer: <br />Many people are concerned about the cost of their dental treatment and how they will pay for it. There are several different ways of paying for dental treatment today.<br /><br />NHS charges are set by the government and are standard for all NHS patients. The charges are assessed each year and usually change every April. Some people do not have to pay, including those receiving benefit, children, pregnant women and nursing mothers.<br />Back to top <br /> <br />Question: <br />How do I pay for my dental treatment privately?<br />Answer: <br />Private fees are set by the dentist or practice concerned and can therefore vary quite a lot from practice to practice. The dentist will either charge a fee based on the work being done or on the time taken.<br />Back to top <br /> <br />Question: <br />When will I have to pay?<br />Answer: <br />Your dentist is entitled to ask for full payment at any time, including at the start, during the treatment or when it is finished. Many people still pay this way, but in some cases the practice will accept instalments as they go.<br />Back to top <br /> <br />Question: <br />What types of payment plans are there?<br />Answer: <br />There are several different types of payment plans, ranging from cash payment plans to individual practice plans. Some allow you to spread your payment over a period of time, while others offer fixed cash payments depending on the treatment. Others allow you to make a monthly payment depending on your dental health and treatment needs.<br /><br />Some practices offer membership to a particular company plan which they are part of. These are usually run by a separate organisation that will process your payments and pay the dentist for any treatment you need. Your dentist will be able to tell you which plan the practice uses.<br />Back to top <br /> <br />Question: <br />How do cash payment plans work?<br />Answer: <br />Cash payment plans are the most popular health care plans in the country with plans covering several million people. Many organisations offer these plans to their employees, who have their payment stopped from their pay. These plans will pay you cash towards a range of health benefits including NHS and private dental charges. These cash plans are specifically tailored to the lifestyles of individuals and their families.<br />Back to top <br /> <br />Question: <br />How do other payment plans operate?<br />Answer: <br />Different company and practice plans work in different ways and cover various treatment options. It is important to find out what is covered by your particular plan.<br /><br />Some plans cover treatment up to a yearly limit, based on the amount of the monthly payment. Routine treatment is often covered, and allowances may be made for certain treatments including check ups, scale and polishes and a number of small fillings. Other schemes pay for all the treatment needed throughout the year in return for a monthly fee.<br /><br />Some plans also cover emergency treatment, hospital in-patient treatment and worldwide emergency cover.<br />Back to top <br /> <br />Question: <br />Will there be anything else to pay?<br />Answer: <br />Some plans charge separately for any treatment that involves laboratory costs. For example: you may have to pay the laboratory fee for a crown, or you may have to pay for the entire crown. This should be explained when you join the plan to avoid confusion.<br />Back to top <br /> <br />Question: <br />How can I join a payment plan?<br />Answer: <br />Some companies offer employee-based plans. These are usually offered as part of a staff benefits package and may either be partly or fully paid for by the employer.<br /><br />Or you can join a plan as an individual, just as if you were taking out any other kind of insurance plan. These plans can often be tailored to your needs and you can choose which areas of treatment to cover and the amount of monthly payment to make. If your dentist is linked to a particular plan they will be able to help you join.<br />Back to top <br /> <br />Question: <br />How much will it cost me?<br />Answer: <br />Costs usually depend on the level of cover you want. Some plans will base the costs on the condition of your mouth. Your dentist will assess you and set your monthly fee dependent on, for example, the number of fillings you have, the condition of your gums and how many natural teeth you have. In some cases it may be cheaper to join as a family or with a partner.<br />Back to top <br /> <br />Question: <br />Can I join at any time?<br />Answer: <br />With many payment plans you have to be dentally healthy before they will accept you as a client. Your dentist will usually be responsible for making sure your teeth and gums are healthy. Preventive care is aimed at keeping teeth for life. To be in some plans you have to go for regular check ups and preventive care. A payment plan is really a way of maintaining your mouth, not repairing it.<br />Back to top <br /> <br />Question: <br />Can I get a loan for expensive dental treatment?<br />Answer: <br />Yes. In some cases it is possible for your bank or building society to offer special rates on loans for dental treatment. It is worth checking with several banks to find the best rate for you personally.<br />Back to top <br /> <br />Question: <br />What if I’m not happy?<br />Answer: <br />As is the case with most dental complaints, the ideal solution is to talk to your dentist and try to solve the problem there and then. However, if you feel that you are unable to discuss the problem, or if it is more serious, you will probably find that the plan you have joined will have its own complaints procedure and will have a department you can contact to complain. Most plans work like a credit card and include a kind of insurance as part of your premium.<br /><br />If your plan does not offer this service, you will need to follow up the problem in the same way you would as a private patient. First discuss the matter with your dentist to see if it can be easily solved. If this doesn’t work, write to the practice asking them to investigate the matter. If this still does not solve the problem, you may consider legal advice.<br />Back to top <br /> <br />Question: <br />What if I want to change dentists?<br />Answer: <br />Each type of plan will work differently. Under most dental plans you have to tell them if you change your dentist. If you join a plan run by your dentist and need to change for some reason, your dentist should be able to tell the company and have your records and treatment transferred to another dentist, as long as they are running the same kind of plan.<br /><br />If you change dentists under the NHS, you will need to re-register with another dentist. If you are under an individual plan, again you should be able to take it with you when you go.<br /><br />In some cases, you may need to tell the company why you are changing dentists. If you have started treatment with a particular dentist, you may have to complete the treatment with them, unless there are very strong reasons not to.<br /><br /><br />Back to top <br /> <br />Question: <br />What if I have two different opinions?<br />Answer: <br />If you decide to change dentists, it may be an idea to have a final appointment and ask if there is still any treatment you need. Under some plans your treatment will have to be finished, and you must be ‘dentally fit’, before you can join. This may be difficult in some cases, as what one dentist may see as being dentally fit may not be the same as another. It does not mean that one of the dentists is wrong, just that their opinions differ.<br />Back to top <br /> <br />Question: <br />Which plan should I choose?<br />Answer: <br />Payment plans are often tailored to the individual as much as possible, so it is difficult to recommend any one plan. Discuss the matter with your dentist, who may be able to provide one for you. Or compare one or two different plans to see which would suit you best. Your dentist may be able to help you make a decision.<br />Back to top <br /> <br />Question: <br />Does my private medical insurance cover me?<br />Answer: <br />Some medical insurance covers certain dental surgical treatments. It is important to check your insurance documents, or ask the company concerned, to see exactly what you are entitled to. It is also important to remember that medical insurance covers only oral surgical procedures which are carried out by a consultant oral surgeon, usually in hospital, and not routine dental treatment.<br />Back to top <br /> <br />Question: <br />Is anything else covered?<br />Answer: <br />Almost all NHS treatment is guaranteed for one year, and should be replaced free of charge during that period if needed. Privately, it is worth checking with the dentist before committing to treatment. Ask your dentist for a written guarantee if possible, which some practices are happy to supply with their work. Some plans will also offer specific treatment guarantees.<br />Back to top <br /> <br />Question: <br />What if I have a dental emergency?<br />Answer: <br />Many private plans include an emergency service for registered patients. If you have toothache and are not able to visit your dentist it may be possible for another practice within your plan to be able to see you. You may be given a card, which will include a free phone number to call if you have an emergency out of your area. Some plans even cover you for foreign countries. Again check these details with your chosen plan.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1089580265672401629.post-23481932061000326632007-03-19T05:28:00.000-07:002007-03-19T05:29:05.173-07:00NHS dentistryNHS dentistry<br /><br />On 1 April 2006, the most significant reforms to NHS dentistry (since its inception in 1948) were introduced.<br /><br />These changes are benefitting patients by commissioning better access to local services and a new, simpler charging system.<br /><br />These pages have information about what the changes mean for you and answer some common questions about NHS dentistry.<br /><br />Simpler charging<br />There are now three standard charges for all National Health Service (NHS) dental treatment. This makes it easier to know how much you may need to pay and also helps ensure that you are being charged for NHS care (rather than private care).<br /><br />The maximum charge for a complex course of treatment has been reduced from £384 to £189. Most courses of treatment cost £15.50 or £42.40.<br /><br />You still receive free NHS dental treatment if you meet the exemption criteria.<br /><br />Find out more about the new patient charges.<br /><br />Better access to local services<br />Your Primary Care Trust (PCT) is now responsible for local NHS dental services and:<br /><br /> * has money that must be used for local dental services<br /> * agrees contracts with NHS dentists for services that best meet local needs<br /> * can influence where new practices are established<br /> * is responsible for urgent and out-of-hours care in your area<br /><br />If a dentist moves, closes down a practice or reduces the amount of NHS dentistry he or she provides, the money to provide this service now remains with your PCT for reinvestment in NHS dentistry for the local community.<br /><br />Over time this is helping PCTs ensure that NHS dental services better meet the needs of people in your area.Unknownnoreply@blogger.com0