Occlusal Splints/Bite Plates

Occlusal Splints are custom fitted plastic appliances that are usually worn through the night to prevent over usage and damage of jaw muscles and the jaw joint

They are also ideal to prevent damage to the teeth as they are relatively small and comfortable to wear

See Bruxism and Temporo Mandibular Joint Disorder

Oral Health

Oral health can affect our overall health and therefore is extremely important.

The aim here is regular removal of bacteria from the mouth.

Plaque is mostly made of bacteria (approx.. 70%)

The average time for bacteria to reproduce is from 15 to 20 minutes.

Offspring increase exponentially expressed as 2x.

Given this, one bacterial cell can turn into one million cells in 7 hours.

The best way to attain oral health is to physically remove them. The best brushes have soft bristles that are not compacted together and vary in height; small heads and large handles.

Our favourite brush for some years now is the Supreme by TePe (Sweden). They have all the ideal features and only cost $3. The only problem is they are hard to find.

Remember that teeth have five surfaces and we must clean between them. The two best ways are: 1. Floss. Especially good is Reach “Clean Paste” by Johnson and Johnson

2. Interdental Brushes. These come in different sizes. The best of them are made by Colgate, TePe and Caredent (Proxabrush).

Tongues are also a site for bacterial colonisation especially bacteria involved in bad breath (halitosis) and should be scraped once a day.

The regular use of antibacterial mouth rinses is not recommended and in fact can result [n poor oral health if used to replace the mechanical removal of bacteria.

How long should I brush?

Proper brushing should take two to three minutes.
Remember that it is not how long or how frequent you brush but how well you brush that will protect from disease.

How often should I brush?

You should brush your teeth at least twice a day. Remember it is important to have the right brushing technique as poor brushing techniques can cause harm to the teeth and gums.

How often should I floss?

You should floss every day.

What should I do if brushing or flossing makes my gums bleed?

If your gums bleed or become sore after flossing, do not panic. If you have not been flossing regularly then the gums will be inflamed and will bleed more easily. If the bleeding persists — see your dentist.

What is the best toothbrush?

The best toothbrush is one with a small head and soft bristles. Electric toothbrushes can also be very good, particularly for people who find proper brushing techniques difficult to master.

What toothpaste should I use?

Always use a toothpaste containing fluoride. Fluoride combines with minerals in your saliva to toughen your tooth enamel and help stop decay.

Oral Hygiene

ITS GOOD TO BE FANATICAL ABOUT ORAL HEALTH

Don’t forget to scrape your tongue

• Oral hygiene refers to the use of cleaning techniques that allow us to achieve oral health by removing the main cause of problems in the mouth - microorganisms or germs
• Tooth decay is the most common global disease affecting every family
• Severe gum disease causes at least one-third of adult tooth loss. Oral hygiene is probably more effective at preventing gum disease than tooth decay
• In fact, oral health can affect our overall health see systemic link
• Our prehistoric ancestors developed a variety of oral hygiene measures such as chew sticks, tree twigs, plant spikes, bird feathers, animal bones and porcupine quills.
• Ayurveda or Indian Medicine uses the neem tree or datun chewing one end till it resembles the bristles of a toothbrush.
• Islam uses the miswak or siwak made from roots or twigs of the Salvadora persica tree (aka as arak or peelu tree) It has been shown to have some antiseptic properties and features in Islamic hygienical jurisprudence. “miswak should be one hand span in length when selected. If it becomes dry, it should be soaked in rose water + to ensure the end is soft. The end should be cut afresh to ensure hygiene, and should never be stored near a toilet or sink“ Wikipedia quote
• Our ancestors also used baking soda and chalk
• Here is what you’ll need for a charcoal paste which claims not only to kill germs and polish the teeth but also to deodorize:
  • 2 ounces of cuttle fish bone
  • 5 ounces of Areca nut charcoal
  • 1 ounce of pounded Areca nuts
  • Oil of Cassia
  • Meat tenderizer
  • Newspaper or heavy plastic bag

I. Place the fish bone, charcoal, and Areca nuts under the newspaper and begin pounding with a meat tenderizer…..
Read more: http://www.ehow.com/how_4471346_use-powder-charcoal-brush-teeth.html#ixzz19a5VPLHd

Modern methods of Oral Hygiene involve:

• Daily use of a toothbrush
• Daily use of floss or interdental brushes
• Daily tongue cleaning
• Low level use of fluoride
• Occasional mouth rinsing
• Check ups ranging from 3 to 24 months
• Eating healthy - see diet
• Avoiding bad habits such as smoking, grinding or bruxism, nail biting, tongue and lip piercing
• Attention to systemic conditions such GORD, bulimia, diabetes, osteoporosis, cardio vascular disease, medication side effects (such as dry mouth)

Sometimes electrical appliances such oral irrigators and electric tooth brushes may be recommended.

Sometimes custom made trays are used to deliver medicine to the teeth and gums such as Tooth Mousse, Clinpro Tooth Crème and peroxide

Stimulation of saliva by moderate use of chewing gum may also be useful

Oral Irrigation

Oral irrigators reach 3–4 mm under the gum line. Oral irrigators use a pressured, directed stream of water to disrupt plaque and bacteria.

Oral Pathology

Oral pathology / oral medicine is a specialty area of dentistry that is concerned with the health of the mouth and the diagnosis and management of diseases of the oral region. It may also include the oral and dental treatment of patients who are medically compromised, that is, those that have serious medical problems

• Pathology is the study and diagnosis of disease.
• Dental decay and periodontal disease are by far the most common diseases in the oral cavity, but there are other important diseases can affect the mouth and surrounding structures. Here is a list of a few:
• Abfraction
• Abrasion
• Acute necrotizing ulcerative gingivitis
• Alveolar osteitis
• Ameloblastoma
• Amelogenesis imperfecta
• Angular cheilitis
• Anodontia
• Aphthous ulcer
• Attrition see loss of Vertical Dimension
• Bisphosphonate-associated osteonecrosis of the jaw
• Black hairy tongue
• Bruxism
• Calcifying Odontogenic Tumor
• Calcifying odontogenic cyst
• Cementoblastoma
• Central giant cell granuloma
• Central odontogenic fibroma
• Central ossifying fibroma
• Chapped lips
• Cheilitis
• Condensing osteitis
• Congenital epulis
• Crossbite see Orthodontics
• Dental fluorosis
• Dentigerous cyst
• Dentin hypersensitivity
• Dentinogenesis imperfecta
• Desquamative gingivitis
• Enamel hypoplasia
• Epulis
• Eruption cyst
• Erythroplakia
• External resorption
• Facial trauma
• Geographic tongue
• Giant cell fibroma
• Gingival hyperplasia
• Gingivitis see Gum Disease
• Gingivostomatitis
• Glossitis
• Glossodynia
• Hairy leukoplakia
• Herpangina
• Herpes labialis
• Hyperdontia
• Hypodontia
• Internal resorption
• Keratocystic Odontogenic tumors
• Lateral periodontal cyst
• Leukoedema
• Leukoplakia
• Lichen planus
• Ludwig's angina
• Macrodontia (tooth)
• Malocclusion see Orthodontics
• Maxillary hypoplasia
• Metastatic tumor of jaws
• Microdontia
• Micrognathism
• Mouth ulcer
• Mucoepidermoid carcinoma
• Mucous retention cyst
• Mumps
• Nasolabial cyst
• Nasopalatine cyst
• Nevi and melanomas
• Nevus
• Odontogenic myxoma
• Odontogenic Tumor
• Oropharyngeal lesion
• Ossifying fibroma
• Osteoporotic bone marrow defect
• Overbite see Orthodontics
• Parotitis
• Pemphigus
• Pericoronitis see Wisdom Teeth
• Peripheral giant cell granuloma
• Peripheral odontogenic fibroma
• Plasma cell cheilitis
• Pleomorphic adenoma
• Polymorphous low-grade adenocarcinoma
• Primordial cyst
• Prognathism see Orthodontics
• Pulp polyp
• Pyogenic granuloma
• Radicular cyst
• Ranula
• Retrognathism
• Root resorption
• Sialolithiasis
• Smoker's melanosis
• Squamous odontogenic tumor
• Stomatitis
• Stomatitis nicotina
• Strawberry tongue
• Temporomandibular joint disorder(TMD)
• Tongue thrust see Orthodontics
• Tongue disease
• Tooth impaction
• Traumatic bone cyst
• Traumatic neuroma
• Treponema Denticola
• Trismus or Lockjaw
• Xerostomia
• Some of these conditions may be obvious, painful or result in gum bleeding or halitosis and alert us to a problem
• Other conditions, however, may give no symptoms until late in their course, or may be a manifestation of an underlying systemic disease. Thus, it is very important to have regular dental examinations to check on the health of both the teeth and soft tissues of the mouth, as early diagnosis of problems often results in better treatment. For example cancer can occur anywhere in the mouth and is often painless in the early stages.

ORTHODONTICS/BRACES

• Orthodontics refers to the diagnosis, prevention and correction of dental Malocclusion ie misaligned, crooked, crowded, spaced teeth, overjets (protruded) and deep overbites whether they only involve teeth or teeth and bone. They may be purely inherited (genetic), acquired (environment) or both.
• Most malocclusions involve crowding of teeth. The most accepted theory to explain this refers to the effect of modern diets on jaw bones. Modern soft processed foods do not give muscles and bones enough stimulus for adequate growth (environment influence). The size of teeth is genetically predetermined (not environment) and thus discrepancy often arises. This is also the theory of wisdom teeth impaction ( ie smaller jaws and not enough room).
• Another reason may be mouth breathing as a result of nasal blockage. This is most commonly due to dust mite allergy. Here, the tongue controls the shape of the jaw bone resulting in a “Gothic Arch” shape ie pointed and narrow as opposed to a broad and well developed “Roman Arch” (look at the two ends of an egg). In such cases or as general prevention use:
  • Dust mite protectors for pillows and mattresses
  • Remove carpets in bedrooms
  • Air purifiers/ionizers
  • Occasional oils sparingly eg eucalyptus, tea tree, lavender,Vicks
  • “Breath Right” nasal expanders available from chemists
• Tongue thrusting, pacifier and thumb sucking (if still done after five years of age) usually results in an open bite (note that pacifier sucking habits are also correlated with otitis media.[11][12])
• Yet another reason may be the early loss of baby teeth usually from gross decay. Here, only the loss of posterior teeth can cause loss of space and in such cases a space maintainer should be utilized
• Correction is achieved by one or a combination of three methods:
  • Jaw bone expansion (slow or rapid) to increase the room for teeth
  • Tooth removal
  • Interdental stripping with diamond polishing strips
• The correction may reduce the risk of tooth decay, trauma to teeth, speech impediments and gum disease or may be purely for aesthetic reasons (which may increase confidence and self-esteem). A cost/risk/benefit analysis is discussed as part of the process.
• The appliance(s) used may be fixed (eg braces, space maintainers or Rapid Maxillary Expanders) or removable (ie plates eg aligners, twin blocks, Slow Maxillary Expanders or Invisalign) or both.
• Major skeletal discrepancies may also require some surgery (orthognathic surgery)
• The best time for treatment is just after all baby teeth are lost, usually around twelve or thirteen but adults of any age can have treatment too. Sometimes, plates or other appliances are used when baby teeth are present. This is usually:
  • To correct a crossbite at the front of the mouth. If not corrected this will usually encourage the lower jaw to grow too far forward and also risk jaw joint problems
  • To possibly avoid the need for braces and
  • To improve the results from braces. This can cause “burnout” with regards to the childs compliance and many practitioners prefer to wait until all baby teeth are lost
• Before treatment commences:
  • Any decay must be attended to
  • Excellent oral hygiene must be established
  • Photos are taken
  • Models are constructed from impressions and
  • Panoramic (OPG) and Lateral Cephalometric X rays are taken and analysed. From this,
  • A case specific diagnosis and treatment plan is established
• Adjustments are usually done every 4 weeks
• Treatment times vary greatly between 2 and 24 months on average but much depends on patient cooperation. Chewing lollies, not cleaning properly, breaking appliances and missing appointments all will lengthen the time required and affect the result
• Braces can be stainless steel, porcelain or tooth coloured plastic. Generally stainless steel are cheaper, stronger and slightly quicker as there is minimal friction between wire and bracket (brace)
• At the completion of treatment retainers are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth. If they are not worn according to instructions, the teeth may move back towards their original position.
  At SAS Dental we strongly recommend fixed lower retainers and removable upper retainers
• Risks involved :
  • Oral health — Tooth decay, gum disease, and permanent markings (decalcification) on the teeth can occur if orthodontic patients eat foods containing excessive sugar
  • Inflammation of the gums and loss of supporting bone can occur if bacterial plaque is not removed regularly with good oral hygiene
  • Relapse — Teeth may have a tendency to change their position after treatment. The faithful wearing of retainers will reduce this tendency. Teeth can however, move at any time whether or not they have been orthodontically treated. This may be caused by growth and maturational changes, mouth breathing, playing a musical instrument and other oral habits such as unresolved tongue thrusting.
  • Root shortening — Some patients suffer problems in the jaw joints, including joint pain, clicking, headaches, or ear problems. Generally, the literature demonstrates that orthodontics play a neutral role in regard to jaw joint problems. Therefore, these problems may occur with or without orthodontic treatment. However, any of the above symptoms should be reported.