Few things have greater impact on dental health and appearance than loss of a tooth.  When teeth are lost the remaining teeth can drift out of position, cause a change in the bite, develop decay or gum disease and have a higher risk of fracture.  At Riverside Dental we offer options for replacement of missing teeth these being a Denture, Dental Bridge, Dental Implant or leave the gap.

Dentures

These are removable appliances that can be used to replace one tooth or a full set of teeth. Generally they are constructed out of a type of plastic called acrylic. Plastic teeth are set into pink acrylic to mimic a tooth and gum and are a cost effective option for the replacement of missing teeth. Dentures can also be made out of metal with acrylic teeth and gum attached and these can prove better accepted by patients as they are not as bulky. Over time they do become looser as the gum shrinks and the denture can wear away.

Dental Bridges

The teeth either side of where the tooth was removed can be used for anchorage of a fixed bridge. The teeth either side of the gap are prepared for crowns and the false tooth is constructed by the technician to attach to the two crowns. These types of restorations were extremely popular before the invention and general use of the dental implant. They still have their place in modern dentistry today but are less favoured due to the loss of tooth structure caused by the crown preparation on the teeth either side of the gap. They tend to have a lifetime of approx 5-10 years though this can depend on a number of different factors

Dental Implants

Dental implants are an ideal way to replace missing teeth. Whether it’s to replace a single tooth, or to create a full mouth of secure stable new teeth, implants are a proven, long lasting alternative to bridges and dentures! Replacing the root of your natural teeth, implants bond with the bone to form a stable foundation for permanent replacement teeth that look, feel and function like natural teeth.

The implant is placed in one visit and is left for a period of 3-6 months to allow it to bond to the bone. It is then can be checked that it has intergrated or bonded to the bone before the new tooth is screwed down into place.

Dental implant costs $4000-$6000 each case is different and it variance depends on the number and complexity of the case.

 For more information please use the link below or call us at riverside dental on 07 5455 5066

http://www.riversidedental.com.au/

Though I have known about aligner technology for many years I thought I would do a quick blog on what is currently available to straightening crooked teeth. This is not an exhaustive list but gives you a good start.

Two main ways of making teeth straight are through removable appliances or fixed appliances.

Invisible or aligner braces.

These are a series of removable , clear plastic trays that snap onto the teeth and move the teeth little by little,  week by week, until they are in their final position. They are difficult to see that you are wearing them and take 8-18 months to work. They must be worn 22 hours per day and you don’t drink or eat with them.

Costs of clear braces vary from $3000-$9000 depending on the system.

Inman Aligner.

The Inman Aligner is a removable appliance that utilizes a lingual coil spring that puts pressure on the teeth that need repositioning and a labial bar that reverses the same pressure.

These components work together to “squeeze” teeth together by pushing and pulling them into alignment

Inman Aligner treatment typically takes 6-16 weeks. Simple cases can complete in a little over 1 month and more complex cases might take 4 months or so. At Riverside Dental as an inman aligner provider we will give you a realistic guide of what to expect once we do a full thorough examination. Normally lower front teeth move a little faster than uppers.

Inman Aligner cost expect to pay $2000- $3500 depending on the number of visits required

For more info see the link below.

http://www.riversidedental.com.au/inman-aligner/

Fixed Braces.

Your dentist or orthodontist places small brackets on the teeth followed by a a wire and elastics to move the teeth into a more favourable and pleaseing position for aesthetics and also function. The tretament time can be anywhere from 6 months to sometimes 3 years depending on the complexity of the case.

Orthodontics costs from $3500 -$10,000 depending on the complexity and the length of time it takes.  

For more information follow the link below or call riverside dental 07 5455 5066

http://www.riversidedental.com.au/treatment-products/orthodontics-clear-aligners/

Whitening we addressed in the last artcle but what are the other options to having a great smile.

Enamel Re-contouring.

This is ideal for small chips, uneven edges of a tooth or a sharp looking vampire tooth. These areas can be re-countoured to a softer, rounder and more pleasing look. We use a little sandpaper disc and no need for anaesthetic.

Enamelplasty or re-contouring cost usually $50-$100 per tooth.

This is permanent and once enamel is gone it is gone.

Bonding.

This is a great way to change the shape and colour and contour of the teeth. Bonding is what alot of dentist these days use to fill teeth it is the white filling material. It can also be used to fix chips, broken or crocked teeth and fill in gaps in the smile. It can be done in a single visit and the results are immediate.

Bonding Cost Expect to pay $300-$600 per tooth

Bonding can stain, chip and break it is repairable but has a limited cosmetic life expectancy.

Veneers.

Are thin coverings like false fingernails that are placed and stuck over the teeth. They are great for making major changes to the smile and are great for covering defects and can make crooked teeth straight without having orthodontics. The teeth are usually re shaped to allow the dentist room to fit the veneer and to what extent depends on the posisiton of the original tooth.

Dental Veneers cost $900- $2500  depending on who makes the veneers and how great you want the aesthetics. Life expectancy usually from 7-10 years but this can vary.  

Crowns 

Teeth that have been heavily restored, badly broken down, fractured, traumatized or root filled can require a tooth crown. At Riverside Dental we take great care in the preparation of your tooth for a crown using the latest electric motor handpieces, diamond coated tipped burs and sensational strong anaesthetics as well as enhanced magnification including the latest Seiler Evolution XR6 Dental microscope.  Tooth crowns strengthen and protect the remaining tooth structure by completely surrounding the remaining tooth and can improve your smile. A dental crown is available in different materials from aesthetic all porcelain crowns to all gold crowns. At Riverside Dental we will help to make the decision of which crown will best suit your situation.

The procedure for a crown to be placed onto a tooth usually requires two visits. First appointment Dr. Patrick will remove any disease or decay from the tooth ensure that the foundation is strong and then shape the tooth ready for an impression or mould to be taken. A temporary crown made of plastic is constructed and placed over the tooth until the next visit. The moulds are then dispatched to the dental technician whom constructs the crown to fit precisely to the mould. At Riverside Dental we use a number of different technicians depending on different factors this can be discussed in more detail at your initial tooth crown consultation.

At the second visit the temporary crown is removed and the final crown is tried in and checked for its fit and how it looks and feels to you the patient. Minor adjustments are made and once the patient has accepted the feel and the look of the crown it is cemented into place.

Dental crowns have lifetime of approximately 7-10 years with some lasting a lot longer. At Riverside Dental we offer up to 5 years warranty on some of our crowns so you have the peace of mind that we stand by what we produce. Details are available on this site.

To find out more and make an appointment see the link below or call riverside dental 07 54555066

http://www.riversidedental.com.au/treatment-products/cosmetic-dentistry/

People want their teeth to be white and bright below are a couple of options that can help you achieve those results.

Whitening

A great way to start getting brighter smile is through whitening, either an in office or a take home kit.

Take home kits are professional made from individual impressions of your mouth and custom made thin mouth-guard like trays that fit exactly over your teeth. The gel or bleach is placed in the tray and and then in the mouth  and then the stains are lifted out of the teeth over a period of few days to weeks depending on the extent of colour change required. Your dentist needs to decide if your a good candidate. If you have gum disease or dental decay that needs to be taken care of first. Almost all systems provided by your dentist work. Maintenece is essential and using the trays with gel once or twice a month is usually sufficient to maintain the look.  Expect to pay $300-$700 depending on the system.

Upside: Will efectively whiten the teeth by a number of shades and look fantastic. Cost effective when compared to other treatment options

Downside: The individual has to spend the time at home doing the whitening. It will not whiten crowns,bridges, veneers or fillings. Can create sensitivity for 24-48hrs after the whitening treatment.

In office Whitening

In the chair at the dentist. The teeth are usually isolated using a liquid dam that is painted onto the gum. The gel usually a higher concentration of carbemide/hydrogen peroxide is applied to the teeth for periods of 10-30 minutes(depending on the system) sessions two or three times. This treatment will ussually lift the colour of the teeth immediately, but with any system it is essential to maintain the colour with a at home kit at least once or twice a month application. Otherwise the results will quickly fade. Expect to pay $800-$1800 for a full system.

Upside. The teeth are whitened in about an hour.

Downside: Lasting effects are mixed.  Continued maintenece and possibly looking at another session in 12-18 months. Costs more than the take home kits.

For a consultation call Riverside Dental 07 54555066

At Riverside Dental Noosa we totally understand that these events cannot be planned whether it is a toothache, lost filling fractured tooth or lost tooth .

We have a dedicated weekend telephone service emergency number

0432 907559

• Please call and if not answered please leave a message and one of our team will return your call.
• We have dedicated emergency appointments everyday to accommodate unforeseen happenings. Please ring us as early as possible in the morning and hopefully we will be able to accommodate you for that day.

Riverside Dental surgery is located on Thomas Street in Noosaville.

We also offer personal finance options through GE to make Cosmetic Dentistry affordable for everyone. Our extensive payment options mean that everyone has the opportunity to enhance their smile, making those desired and often necessary changes available today.

At Riverside Dental payment of dental treatment is required on the day of your treatment and we appreciate your courtesy on this matter.

Cancellation Policy

Notice of Cancellation Requirements and Cancellation Fees:

For appointments of an hour or more we would normally require a deposit to secure the time with our team.

• If you need to cancel an appointment of 1 hour or less in duration we require at least a couple of days notice in order to have a chance to schedule that time to another patient and avoid the cancellation fee of $100.00 per hour booked in.

 Your Commitment to Riverside Dental

Exceptional dentistry takes commitment from both you and our dental team. This relationship involves teamwork, just as we place high standards on ourselves; we ask the same from our patients.

Before every appointment you will receive a courtesy email and text message from us reminding you of your appointment. As a courtesy to us we ask in return that if you are unable to attend an appointment to please notify us as soon as possible in accordance with our notice for cancellation policy.

1. Do not eat anything or drink hot fluids until the numbness has worn off to avoid injury from accidental biting or burning.
2. No vigorous rinsing, drinking through a straw, or spitting for 3 days so the blood clot will not be disturbed.
3. Today, rest as much as possible with your head elevated. No vigorous exercising for 3 days.
4. Slight bleeding is normal for several hours following surgery. If persistent bleeding occurs place a wet teabag on the involved area and apply direct pressure for 15-20 continuous minutes. Repeat as necessary.
5. Do not pull back the lips or cheeks to look at the area as this can disturb the surgical site and increase complications.
6. Do not eat by the surgical area for 1 week. Soft nutritious foods will be necessary for the first few days.

Avoid acidic and crunchy foods. Drink plenty of fluids.

7. Do not use tobacco or drink alcohol as these will delay healing.
8. Swelling can be lessened by placing a cold compress on the face alternating on and off for 20 minutes during
the first 72 hours.
9. Take all medications the doctor has prescribed for you according to directions.
10. Starting 24 hours after surgery, gently rinse your mouth with ¼ teaspoon salt in warm water three times a day.
11. After the periodontal treatment, proper oral hygiene must be maintained in the surgical area to aid in healing.

After one week, carefully brush the teeth while avoiding the gums in the area of surgery. The gums and lower parts of the teeth should be cleaned with a dampened piece of cotton. Gentle flossing can be resumed in 2-3 weeks. Regular brushing can be resumed after 3 weeks.

12. After periodontal surgery, sensitivity of the teeth may occur. This is remedied by maintaining proper oral hygiene and by the use of specially formulated sensitive toothpaste, such as, Sensodyne.
13. If a periodontal pack has been placed in your mouth, do not remove it. The pack should remain in place for one week. If the pack comes off before this time, it is not an emergency, but the doctor should be notified.
14. Return for your appointment to have the periodontal pack and any sutures removed. If the sutures loosen or come out within 3 days, please inform the office.
15. If you have any questions, please feel free to call us on 5455 5066

After your surgery, you will want to eat nourishing food that can be eaten comfortably. Temperature of the food does not matter, but avoid extremely hot foods and liquid. We recommend that you only consume soft foods during the first 6 days to avoid food particles contaminating the wound.

After each meal, the mouth should be thoroughly rinsed with warm saline solution (1/2 teaspoon of salt in a glass of warm water) or mouthwash containing chlorhexidine (available at your local pharmacy).

Managing Swelling

We recommend covered ice packs or a cold compress applied for a period of half hour to the face over the surgery site to reduce any chance of swelling resulting from the surgery. We suggest that you apply 30 minutes on and 30 minutes off. If possible, elevate the head with an extra pillow during the first 2 nights after surgery to reduce swelling.

Managing Bleeding

We’ve placed a gauze pack on the surgical site(s) to limit bleeding while clotting takes place. The gauze packs should be left in place for 30 to 40 minutes after you leave the practice.

Bite down softly on the gauze, making sure they remain in place. Continue to change the gauze packs every 30-40 minutes if there is continual bleeding.

To replace gauze, fold a clean piece into a pad thick enough to bite on. Dampen the pad and place it directly on the surgical site. Bleeding should never be severe. If bleeding remains uncontrolled, please call us.

Managing Pain

The length of time you experience numbness varies, depending on the type of anaesthetic you’ve received. While your mouth is numb you’ll want to be careful not to bite on your cheek, lip or tongue. The numbness should subside within a few hours. Tablets for pain relief should be taken as necessary and according to instructions. If pain persists, please call us.

Managing Infection

The mouth should be thoroughly rinsed with warm saline solution or mouthwash containing chlorhexidine after each meal to reduce the chance of infection. Place the solution in your mouth and gently rotate your head from side to side. Please do not swish aggressively.

It is essential that you complete the course of antibiotics prescribed.

Healing

After an implant placement, a blood clot forms in the surgical area. This is an important part of the normal healing process. You should therefore avoid activities that might disturb the surgical area. Do not rinse your mouth vigorously or probe the area with any objects or your fingers.

Do not smoke or drink through a straw for 72 hours following your surgery. These activities create suction in the mouth, which could dislodge the clot and delay healing.

If you do not care for the taste in your mouth, drink some fluids or use a wet washcloth and wipe your tongue, but please stay away from the surgical area. Avoid strenuous activity for the first 24 hours after your procedure. This will reduce bleeding and help the blood clot to form.

Dentures

Dentures will be refitted as soon as possible after the implant placement. However, inserting the dentures too early may jeopardise a successful healing process.

Dry, Cracked Lips

We recommend applying Vaseline or lanolin to the lips for the first two days to prevent lips from drying or cracking.

Oral Hygiene

Begin your normal oral hygiene routine as soon as possible on day 2 or 3 after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.

Contact Us

If you are concerned over any matter regarding the surgery or recovery, please call us on 5455 5066

It is important that you carefully read and adhere to the following postoperative instructions.

• Leave the gauze pack(s) in place for 15 minutes after you leave the surgery.
• If after removing the gauze pack(s) there is still some bleeding, replace with the fresh gauze pack(s) and bite down firmly for a further 20 minutes. Repeat if necessary.
• It is quite normal to have a little blood in your saliva in the first few hours following surgery. If however you are concerned that there is excessive bleeding that has not been controlled by biting on the gauze packs provided please contact the surgery.
• You should have nothing to eat or drink for the first 2 hours following surgery.
• On the day of surgery avoid vigorous rinsing of your mouth.
• On the day following surgery you should gently rinse your mouth with warm salty water. You should do this first thing in the morning, last thing of an evening and after any meals. Continue this until healing has occurred.
• Avoid excessively hot/cold foods for the next couple of days.
• It is important to rest for the remainder of the day. If you lie down keep your head elevated with a couple of pillows. If you require a certificate for time away from work/school please ask.
• Use ice packs as frequently as possible in the first 24 hours to help minimise swelling.
• If you have been given a prescription for antibiotics it is important that you take them as directed. If you have any queries ask your pharmacist.
• Avoid smoking. Smoking adversely affects healing.

Dr Patrick O’Rourke

The canals inside the roots have been cleaned, irrigated, medicated and permanently sealed. The opening in the tooth through which root canal treatment was done has been sealed with a filling.

Delay in obtaining final restoration (crown) may result in fracture and/or possible loss of the tooth

What to Expect

• It is not uncommon for a tooth to be uncomfortable or even exhibit a dull ache immediately after receiving root-canal therapy. This should subside within a few days (or even weeks)
• This occurs because of conditions, which existed before treatment was started. Experience shows that if there was pain prior to treatment there maybe a degree of pain that will continue for a few days after the procedure. Remember that pain radiates. You may feel sensations of discomfort that are not related to the treated area during the healing process. This can be created by inflammation in this area and/or due to increase in blood volume that natural occurs in the healing process.
• Your tooth will be sensitive to biting pressure and may even appear to feel loose. This feeling is a result of the sensitivity of nerve-ending in the tissue just outside the end of the root, where we cleaned, irrigated and placed filler and sealer material. Discomfort in this area for a few days to a couple of weeks is common. Warm salt-water rinses for the next two days will help, and avoid chewing on this side until all tenderness is gone.
• Occasionally, a small “bubble” or “pimple” will appear on the gum tissue within a few days after completion of a root canal. This represents the release of pressure and bacteria which no longer can be sustained around the tooth. This should disappear within a few days.
• The gums may be sore and the tooth may be tender when biting or chewing. These conditions exist because the nerves around the tooth have been inflamed because of the conditions that existed before treatment was started and due to the manipulation of the tooth during treatment.

A crown is now needed to protect this tooth

What to Do

• Please do not chew or attempt to eat on the side of your mouth that has been worked on while this area is still numb.
• You may want to put an ice pack over area where the procedure was done for 1/2 hour when you first get home to minimize swelling. Apply the ice pack (or use frozen vegetables like peas) every hour for 10-15 minutes during the first 4-6 minutes.
• Sleep with your head in an elevated position for the first few nights if you do not have any physical limitations.
• Eat a soft diet for at least two days and remember not to chew on the treated side. Avoid very hot or cold foods during the healing process.
• We recommend you take something for pain-relief within one hour of leaving our office, to get the medication into your blood system before the anesthesia we administered begins to subside. Generally, only one dose is needed. We recommend ibuprofen (Nuprin, Advil, Motrin)-800 mg (four tablets). Two to four tables may be taken four times a day for the next 3-4 days to help control the sensitivity in this area. If you have a medical condition or gastrointestinal disorder which precludes ibuprofen, acetaminophen (Tylenol, Excedrin) is a substitute, although it does not contain anti-inflammatory properties, Aspirin and aspirin-containing products are NOT advisable, as they tend to increase bleeding from the area that was treated.
• Please take prescribed medication (antibiotics and /or pain medication) as directed. If you are given PenicillinVK take 2 pills every 4 hours for 48-72 hours, then complete prescription taking 1 pill very 6 hours. Please take the full course of antibiotic medication. If you were given a prescription for pain, it is meant to help you with more serious discomfort only for a couple of days. Refer to pain control article
• Whenever possible, try to chew on the opposite side from the tooth we have just treated, until you have a crown place. Until that time, your tooth still is weakened and could fracture.
• Do not smoke during the first 24 hours and minimize the number of times you smoke during the remaining healing process because smoking delays the healing process. Avoid drinking alcoholic beverages. Avoid strenuous exercise for 24 hours.
• Please avoid crunchy or hard foods which could cause the tooth without a crown to fracture.
• Frequent rinsing with warm salt water for the next two days
• We recommend you take something for the increased sensitivity in this area within one hour of leaving our office, to get the medication into your blood system before the anesthesia we administered begins to subside. Generally, only one dose is needed. We recommend ibuprofen (Nuprin, Advil, Motrin)-two to four tablets, which may be taken four times a day if needed. If you have a medical condition or gastrointestinal disorder, which precludes ibuprofen, acetaminophen (Tylenol, Excedrin) can be a good substitute, although it does not contain anti-inflammatory properties.

Delay in obtaining final restoration (crown) may result in fracture and/or possible loss of the tooth

What to do for non-healing after Endodontic Treatment

Fortunately for everyone, most root canals heal with about a 95% success rate. When they don’t heal, we would prefer to call this “non-healing”. Be aware that this is not mere carpentry — it is a medical procedure and all medical procedures do not heal 100% of the time, including root canals. Generally speaking, the non-healing takes one of two avenues:

1. Pain (mild too severe) with or without swelling, or
2. No symptoms at all, but rather changes on the x-ray suggestive of non-healing (i.e.: bone dissolving around the root tips).

Typically, the non-healing is caused by one of two things:

1. Inflammation-The inflammation may be from the tooth being inflamed prior to treatment, or the treatment itself may elicit more inflammation. Usually time, and medication like Advil, or steroids can resolve this.
2. Infection can be from three main causes:

1. The original infection persists
2. There is a crack in the tooth,
3. There is leakage through the top of the tooth (i.e.: the filling) that re-infected the root canal filling.

If the non-healing is due to infection, usually time and antibiotics will resolve this. If signs or symptoms persist, there are three options:

1. Retreat the root canal, or
2. Surgically clean the bone that surrounds the root tip and seal the tip of the root, or
3. Extract the tooth.

Obviously, every case is different and careful evaluation is paramount to resolving any conditions of non-healing.

We will contact you by mail and/or phone in six months for a re-examination to determine that healing is progressing normally. We may take a x-ray to ensure that the tooth and surrounding tissues are healed. There will be no additional fee for this service.

If you ever have any questions, or should difficulties arise as a consequence of your endodontic treatment, please do not hesitate to call us on: 5455 5066