Fearing the dentist is a thing of the past!Article
12. 07. 2021 Dentistry
THE MODERN DENTISTS SHOULDN’T BE ASSOSCIATED WITH PAIN! THEY SAVE MORE TEETH THAN THEY PULL OUT, USE STATE-OF-THE-ART TECHNOLOGY AND METHODS THAT WERE EXPENSIVE OR UNAVAILABLE TEN YEARS AGO BUT ARE A ARE A NECESSITY TODAY. "EVERY PATIENT IS THE MAIN PART OF PREVENTION," says JITKA KÁRNÍKOVÁ, CHIEF DENTIST AT CANADIAN MEDICAL.
To be scared of going to the dentist is practically ingrained in us. How do you work around this fear during your day-to-day practice?
It’s true that a lot of people that take a seat in the dentist’s chair experience fear. This is understandable, especially if they have a dentist associated with an unpleasant experience from the past. Nowadays, when anaesthetics are widely used in dental procedures, there is no objective reason to be scared. People stress unnecessarily. It is crucial that the dentist always acquaints the patient with the method of treatment and that they build rapport and trust. It is also necessary to start early on in childhood.
It is very important that a child’s first experience with a dentist is positive. This can be greatly influenced by the parents, who we recommend should bring their child for their first preventive examination right after teething. These first visits are a matter of getting acquainted with the dentist rather than for the purpose of treatment. The child perceives it positively and visiting a dentist will never be an unpleasant experience for them. We know from experience that if a certain intervention is needed later on, whether it is a filling or tooth extraction, the child will handle this situation much better.
And when it comes to anaesthetics, can drilling of tooth decay and other dreaded treatments be done without pain nowadays?
We try to perform all treatments in a quality manner and at the same time quickly and painlessly. Currently, most procedures are performed under local anaesthesia, whether it is surgery, aesthetic dentistry, periodontology, or prosthetics. Local anaesthetics are available for all procedures. Analgesic sedation can also be used in patients who do not tolerate or are afraid of dental treatment. We use Entonox or laughing gas and, if necessary, general anaesthesia- mostly in children, but sometimes in adults who do not cope well with dental treatment.
What dental treatment is available today that wasn’t conceivable ten years ago?
Most of the treatments I will mention were available ten years ago, but to a much lesser extent, but today they are a necessity that every modern dental practice should offer. Modern trends certainly include tooth replacements using implants. Furthermore, new procedures for whitening or treatment in dental hygiene are particularly interesting. We also rely heavily on expert technology- from microscopes needed for the treatment of root canals or the application of aesthetic fillings, dental scanners for quality prosthetic work, or 3D X-rays to improve diagnostics. At our clinic, for example, it is possible to use CBCT - a three-dimensional X-ray examination of the bone structure of the head and teeth. And the quality and scope of additional services is increasing- catering for patients who themselves are becoming increasingly demanding in this regard- and rightly so.
You mentioned teeth whitening. I thought the only way to whiten teeth was using hydrogen peroxide. What are the new procedures?
The differences are in the possibilities offered by modern technology. For in-clinic whitening, we have a special Philips Zoom whitening lamp, which speeds up whitening and increases the effect of the whitening gel. At the same time, our technology does not cause problems with tooth sensitivity after treatment, which is a drawback of a lot of other methods.
How do we damage our teeth, what harms them the most from our lifestyle?
Sipping on sweet drinks, lemonades, teas with honey, concentrated juices and, of course, excessive consumption of sweet foods. These cause enamel damage, erosion, and tooth sensitivity. They create environmental conditions in the oral cavity for the development of dental caries. Prevention includes proper brushing of teeth, especially in the evening. Just remember what you’ve been told since before you can remember- before going to bed, brush your teeth thoroughly and then eat nothing and drink no sugary drinks. Just water. And if we do eat something, it is necessary to go back and brush our teeth again.
When do you save a decayed tooth and when is it necessary to pull it out?
We must always assess the degree of damage to the tooth and evaluate which treatment is appropriate on a case-by-case basis. Whether to make a filling or to solve the defect with a crown, or if the problem goes all the way down to the dental canal. The treatment of dental canals or endodontics can be of great importance for the future of the tooth. It is a key treatment that can leave a tooth in the mouth that has died because of too much caries, inflammation, or injury. Sometimes surgery is needed to save a tooth.
Of course, there are cases when it is not possible to treat a tooth so that it can continue to function in the oral cavity, and we must pull it out. After the wound has healed, we solve the defect, most often with the use of implants.
Are amalgam fillings still used today?
Nowadays, most of the fillings we do are white. Although amalgam fillings are still available in several qualities because they contain varying amounts of precious metals, their properties have been significantly improved. However, when making them, more of the tooth must be drilled out to create a quality filling of the correct shape. On the other hand, white or composite dental fillings are made from a material called photocomposite, which is made of synthetic resin, and does not require such extensive preparation as it binds to the tooth chemically. It usually solidifies under light, which is also an advantage. And then of course there is the aesthetic factor. Composite fillings are very easy to polish, they blend into the tooth well, and if done correctly, no one will even notice that caries have been drilled from your tooth.
What can you do with dental implants?
In some extreme cases, we can use implantology to reconstruct the entire dental cavity. The dental implant can serve not only as an artificial root to which the crown is attached, but also as a basis for attaching a bridge or prosthesis. The implant also functions as the tooth's own root in other respects because it naturally transmits pressure to the jaw and prevents the loss of the jawbone, which occurs when the tooth is lost.
Do implants have a limited lifespan?
With proper care, implants usually last a lifetime. However, it is important to visit a dental hygienist who, with special tools designed exclusively for the bodies of implants, professionally removes plaque and stone deposited under the gums around them. This keeps the implant site clean and prevents inflammation.
Everybody should visit their dental hygienist. How often?
Yes, I perceive it as the basis of all dental care and I recommend undergoing dental hygiene at least once or twice a year as part of the prevention of dental caries and periodontal diseases. The ideal model is to undergo dental hygiene treatment every six months and then a preventive examination in dentistry. Dental hygiene removes tartar above the gum surface. Sandblasting eliminates its residues as well as pigment. Furthermore, the removal of tartar is also performed under the edge of the gums or deep cleaning in the treatment of periodontitis.
What are the main causes of periodontitis? Is it mainly due to poor dental hygiene?
Periodontitis is a severe gum infection, the cause of which is usually poor dental hygiene. Dental plaque that is not removed leads to gingivitis. Subsequently, the gums are damaged, accompanied by bone loss in the affected area, which leads to the loss of teeth. The only method to prevent this disease is having good dental hygiene, which must be performed daily. In other words, proper tooth cleaning. Dentists specialising in periodontology can treat periodontitis.
Many people suffer from having sensitive teeth. What is the cause of this problem?
We must distinguish whether it is the sensitivity of one tooth, for example when biting into something, or all your teeth. If it’s just one particularly sensitive tooth, there is something wrong with the tooth, and it is necessary to visit your dentist and solve these problems in the clinic. When it comes to the sensitivity of your whole denture, where the teeth are generally sensitive and the patient feels severe pain when drinking a cold drink or biting into an extremely sweet or sour meal, a change in eating habits may be necessary. These problems are very often caused by citrus fruits, strawberries, or fizzy drinks, as well as some whitening or abrasive toothpastes.
Sometimes, the neck of the tooth can become sensitive (the part where the enamel turns into cementum, which covers the root of the teeth). A bad brushing technique can lead to the exposure of the tooth necks causing sensitivity- again, these issues are most often solved in the dentist’s office, most often by impregnating the sensitive areas.
What does it mean for a tooth neck to become exposed?
This problem most often arises after gingivitis, when the soft tissues recede and the neck part of the teeth, which was previously hidden, is exposed. This process can be prevented with good dental hygiene, which prevents gingivitis.
Even someone with perfect dental hygiene and healthy teeth can suddenly become tormented with growing wisdom teeth. What is your approach?
Wisdom teeth usually grow as the last set of teeth, at a time when there is very little space in the mouth. That is why we often face their difficult growing. If this process is accompanied by pain, inflammation or swelling, then it is necessary to pull the tooth out. Sometimes a cyst forms around the tooth in the bone, in which case extraction is also necessary. And the same is true if, for example, a patient intends to get braces to straighten their teeth, and we find out that they have hidden wisdom teeth on the X-ray, then we must also first extract the tooth prior to the application of orthodontics. But it is also not the case that we need to extract every single wisdom tooth we see.
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