When using the home system, we generally recommend only using very small amounts (about a sesame seed to match head size for each tooth).
Only the front surfaces of the front 8 or ten teeth need to be done
- If sensitivity does occur it is only temporary (1-2 days) and usually occurs where there is exposed dentine such as in gum recession or wear from grinding (see Bruxism). Sensitivity can be minimized by:
- Treating the exposed dentine surfaces prior to beginning treatment either with fillings or Tooth Conditioner (GC “Tooth Mousse” is highly recommended).
- Decrease frequency of use, e.g. every second day especially if alternate with Tooth Mousse. May even take a break and condition.
- Decrease duration to two hours or less as opposed to overnight.
- Decrease duration to two hours or less as opposed to overnight.
- Make sure you use only very small amounts (sesame seed size for each tooth).
- Use Colgate Pro-Relief or Sensodyne tooth pastes.
- Maintain optimal Oral Hygiene.
- Bring the trays in for an adjustment.
If your oral care is less than ideal you may have gingivitis. Even though oxygen is healthy in the mouth any sore, reddish, swollen areas of gum that bleed on brushing may feel irritated with the use of peroxides
Another issue is seen in teeth where the enamel is not uniform in density. Here, the most porous enamel, usually seen as white opaque spots, whitens first before the more dense, less porous translucent enamel. Also, sometimes the edges of the teeth may whiten first. Again, with time, the enamel evens out but it is best to ring us if you are unsure.
Tooth whitening does not change the colour of dental fillings. After a whitening treatment, it may be necessary to have fillings resurfaced or replaced to match the new shade.
- Other benefits include:
- Remineralization and strengthening of Enamel and Dentine from the Fluoride in the whitening solution. This is further augmented if Tooth Mousse is used and
- Antibacterial effect from the oxygen released creating a healthier environment for Gums.
- The custom-made stints are ideal for later use to deliver other medicaments to the teeth such as:
- Tooth Mousse and Tooth Conditioners.
- Fluoride strengthening pastes.
- Desensitizing pastes.
- Whitening touch ups.
Tooth Brushing
The ideal tooth brush has well dispersed soft bristles on a small head. Ideally it should used two to three times a day with the whole aim being the removal of as much plaque as possible. The ideal way to brush is with very small circles and angled into the gum. The application of a moderate amount of pressure is good but care must be taken to keep circles very small.
The very best tooth brushes we have come across are:
- Colgate Sensitive (Switzerland)
- TePe Supreme (Sweden)
- Sensodyne 35
- Colgate Total Professional
- Colgate 360 soft
Is electric good?
Question
What technique should I use massaging gums with toothbrush bristles is generally recommended for good oral health?
- ?as cleaning behind the last tooth, the third molar, in each quarter.
Answer
When brushing your teeth it is best to place your toothbrush at a 45-degree angle to your teeth, aiming the bristles of your brush toward the gum line. The join between the teeth and the gum is a nice niche for bacteria and plaque to accumulate, so it is important to get to this area.
Once you have the brush at the correct angle, all you need to do is jiggle the brush gently back and forward, only brushing one or two teeth at a time. Don’t be excessively vigorous but also don’t be too mild.
Remember. You are trying to penetrate the bristles into the gaps between teeth to remove a very soft plaque.
You need to be systematic – brushing all teeth in order, inside and outside – and you really should do it in front of a mirror so you can see what you are doing.
History various excavations done all over the world, in which chew sticks , tree twigs, bird feathers, animal bones and porcupine quills were recovered. The first toothbrush recorded in history was made in 3000 BC, a twig with a frayed end called a chew stick. Indian medicine (Ayurveda) has used the twigs of the neem or banyan tree to make toothbrushes and other oral-hygiene-related products for millennia. The end of a neem twig is chewed until it is soft and splayed, and it is then used to brush the teeth. In the Muslim world, chewing miswak , or siwak, the roots or twigs of the Arak tree (Salvadora persica), which have antiseptic properties, is common practice. The usage of miswak dates back at least to the time of the Prophet Muhammad , who pioneered its use. Rubbing baking soda or chalk against the teeth has also been common practice in history.
Japanese Zen master DōgenKigen recorded on Shōbōgenzō that he saw monks clean their teeth with a brush in China in 1223 with brushes made of horse-tail hairs attached to an ox-bone handle.
A photo from 1899 showing the use of toothbrush.
The earliest identified use of the word toothbrush in English was in the autobiography of Anthony Wood, who wrote in 1690 that he had bought a toothbrush off J. Barret. [2]
William Addis of England is believed to have produced the first mass-produced toothbrush in 1780. [3] [4] In 1770 he had been jailed for causing a riot; while in prison he decided that the method used to clean teeth – at the time rubbing a rag with soot and salt on the teeth – could be improved, so he took a small animal bone , drilled small holes in it, obtained some bristles from a guard, tied them in tufts, passed the tufts through the holes on the bone, and glued them. He soon became very wealthy. He died in 1808, and left the business to his eldest son, also called William; the company continues to this day [5] . By 1840 toothbrushes were being mass-produced in England, France, Germany, and Japan [5] . Pig bristle was used for cheaper toothbrushes, and badger hair for the more expensive ones [5] .
The first patent for a toothbrush was by H. N. Wadsworth in 1857 (US Patent No. 18,653) in the United States , but mass production in the USA only started in 1885. The rather advanced design had a bone handle with holes bored into it for the Siberian boar hair bristles. Animal bristle was not an ideal material as it retains bacteria and does not dry well, and the bristles often fell out. In the USA brushing teeth did not become routine until after World War II , when American soldiers had to clean their teeth daily. [3]
Synthetic Fibres, usually nylon , by DuPont in 1938. The first nylon bristle toothbrush, made with nylon yarn, went on sale on February 24, 1938. The first electric toothbrush , the Broxodent, was invented in Switzerland in 1954.
In January 2003 the toothbrush was selected as the number one invention Americans could not live without according to the Lemelson- MIT Invention Index. [6]
Toughness
Toughness:
The ability of a structural material to resist shock or impact; its ability to absorb energy before fracture.
Strength:
Strength measures the resistance of a material to failure, given by the applied stress (or load per unit area).
Toughness and Strength are related. A material may be strong and tough if it ruptures at high strains exhibiting high forces. The quality known as toughness describes the way a material reacts under sudden impacts Brittle materials may be strong but not tough. Strength indicates how much force the material can support, while toughness indicates how much energy a material can absorb before rupture. In short, the opposite if tough is "brittle." A good example of a tough material that has low strength is rubber. A good example for a strong material that is brittle is porcelain.
Fibre-reinforced composites are so strong that dental bridges made with them can be attached with less invasive techniques to adjacent teeth.
Credit: UC San Diego
Vistasp Karbhari, a professor of structural engineering at UC San Diego, has developed Fibre-reinforced polymer composites as strong, lightweight materials for aerospace, automotive, civil and marine applications, so he thought, "If they work so well in highway bridges, why not dental bridges?"
In a paper scheduled for publication in Dental Materials, Karbhari and Howard Strassler, a professor and director of Operative Dentistry at the University of Maryland Dental School, report the results of detailed engineering tests on dental composites containing glass Fibres as well as the type of polyethylene Fibres used in bullet-proof vests.
Karbhari and Strassler found that the toughness of Fibre-reinforced dental materials depends on the type and orientation of the Fibre used. Their report, available at the Dental Materials website, shows that braided polyethylene Fibres performed the best, boosting toughness by up to 433 percent compared to the composite alone.
Many of the strength and durability tests reported in the paper are not currently required by the U.S. Food and Drug Administration (FDA), which regulates dental composites as class II prescription devices. The agency requires eight minimum tests plus biocompatibility tests to ensure that dental composites are safe and nontoxic.
“Fibre-reinforced composites are now widely used in the aerospace and automotive industries and the experience we’ve gained in these applications can be applied in a more rigorous way in dentistry and medicine to tailor performance to exacting requirements,” said Karbhari. Dentists began using particle filled composites 10 years ago as an alternative to ceramics and mercury-containing metal amalgams. Strassler selected three commercially available Fibre-reinforced composites for analysis.
Dental composites made with glass or polyethylene Fibres are sold as pliable ribbons that dentists mold into the required shape and then harden with curing lights. “Many reinforcing Fibres can add strength and toughness to dental composites,” Karbhari said, “but if they are improperly aligned they could actually accelerate damage to existing teeth.”
“What’s been missing until now is a rigorous, reproducible way to test the durability and resistance to breakage for these materials,” Strassler said. “Makers of Fibre-reinforced dental composites need a much better understanding of how their products actually perform as part of a restoration, crown, or bridge, and this study provides an analytical standard with which all composites should be evaluated in the future.”
The three products tested were a 3-millimeter-wide ribbon of unidirectional glass Fibres, a 3-millimeter-wide ribbon of polyethylene Fibres woven in a figure-8 stop-stitch leno-weave, and a 4-millimeter wide ribbon of polyethylene Fibres woven in a biaxial braid. The resistance to breakage and various measures of toughness of the three preparations were compared to the dental composite alone.
“All three Fibre fabrics dramatically increased the durability and strength of the dental composite, but the polyethylene Fibres braided in a biaxial ribbon performed best,” said Karbhari. “The tests required by the FDA indicate that Fibre-reinforced composites are safe, but those tests are only partially informative. Our analyses show that we can optimize these materials to match and improve performance of teeth, for greater durability, toughness, and resistance to breakage.”
Strength Vs Toughness
Trauma
What if I get my teeth knocked out?
The upper front permanent teeth are the most common teeth to be completely knocked out. Knocked out baby or primary teeth are usually not reimplanted in the mouth, since they will be naturally replaced by permanent teeth later. However, knocked out permanent teeth should be retrieved, kept moist, and placed back into their sockets (reimplanted) as soon as possible. The most important variable affecting the success of reimplantation is the amount of time that the tooth is out of its socket. Teeth reimplanted within one hour of the accident frequently reattach to their teeth sockets.
The knocked out tooth is rinsed in clean water or milk and placed back (reimplanted) into the socket from which it came. This can be done by the patient or parent and then checked by the dentist. Care should be taken to handle the tooth only by its crown and not by its root. If the parent or patient is unsure about reimplanting the tooth, then the tooth should be stored in milk (if available) or in water and brought to the dentist as soon as possible. Alternatively, in older children and adults who are calm, the tooth may be held within the cheeks inside of the mouth while traveling to the dental office.
After reimplanting the tooth into its original socket, the dentist can then splint this tooth to adjacent teeth for two to eight weeks. Splinting helps to stabilize it while the bone around it heals. During the splinting period, the patient eats soft foods, avoids biting on the splinted teeth, and brushes all the other teeth diligently to keep the mouth as clean as possible.
In adults, the reimplanted tooth should have a root canal procedure within seven to 10 days. On the other hand, reimplanted permanent teeth in children (where the tooth root has not yet completely formed) may not need a root canal procedure. These teeth are observed for at least five years for symptoms of dying pulp, such as pain, discoloration, gum abscesses, or abscesses seen on an X-ray.
In most patients who have had tooth reimplantation, over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) are sufficient for pain relief. Chlorhexidine (Peridex) mouth rinse may be prescribed to prevent and control gum inflammation ( gingivitis ), since the splinted teeth cannot be brushed normally and the splint usually collects extra dental plaque and food debris. Oral antibiotics and tetanus toxoid injections are considered for patients with accompanying significant soft tissue cuts (lacerations).
What is a displaced tooth?
Instead of being completely knocked out of the mouth, a tooth can be displaced. A displaced tooth may be pulled out and appear elongated, or be pushed in and appear shorter. A displaced tooth can also be pushed forward, backward, sideways, or rotated. While not an emergency, the sooner the dentist can splint or realign the tooth with orthodontic brackets and wires, the easier it can be brought back into proper alignment. Trauma significant enough to cause tooth displacement can also lead to pulp injury. Therefore, a displaced tooth should be evaluated periodically for several months to determine if a root canal procedure or tooth extraction is needed.
- If an area is bleeding, apply a piece of gauze to the area for about 10 minutes or until the bleeding stops.
- Apply a cold compress to the cheek or lips over the broken tooth. This will help reduce swelling and relieve pain.
Most Fractures happen when you least expect them
However, you can reduce the risk of breaking teeth by
- aiming to eliminate clenching habits during waking hours
- avoiding chewing hard objects (eg bones, pencils, ice)
- avoiding chewing hard foods such as pork crackling and dried peas etc
- wearing a Mouthgaurd while playing sport
- being careful with fruit seeds and pips eg olives, peaches
If you grind your teeth at night a night guard or Splint may be recommended see Bruxism
It is very important to preserve the strength of your teeth so they are not as susceptible to fracture. Therefore have decay detected and treated early as heavily decayed and therefore heavily filled teeth are weaker than teeth that have never been filled
Individuals who have problems with tooth wear or "Cracked Tooth Syndrome" should consider wearing a night guard while sleeping. This will absorb most of the grinding forces
It depends on the direction and severity of the crack.
If the crack is small enough, it may be removed by replacing the filling.
Bonded white fillings hold the tooth together making it less likely to crack.
Sometimes the cracked part of the tooth fractures off during the removal of the filling and this can be replaced with a new filling.
The dentist may first place an orthodontic band around the tooth to keep it together. If the pain settles, the band is replaced with a filling that covers the fractured portion of tooth (or the whole biting surface). Other options include the placement of gold or porcelain fillings or even a crown.
If the crack goes too far vertically, there is a possibility the tooth may need to be removed and replaced with an artificial one. (See bridgework, denture, and implant)
The nerve may sometimes be affected so badly that it dies.
Root canal treatment will be required if the tooth is to be saved.
Front teeth usually break due to a knock, an accident or during biting.
Back teeth can also be fractured from a knock. They are much more likely than front teeth, to crack from forces applied by the jaws slamming together rapidly. This is why sportspeople wear mouthguards to cushion the blow.
Other forces occur unconsciously during sleep because people grind their teeth with a much greater force than they would ever do while awake. The first sign of problems may be what we call "cracked tooth syndrome" – a sore or sensitive tooth somewhere in the mouth that is often hard for even the dentist to find. In some individuals the grinding, called bruxism, causes tooth wear rather than fracture.
The tooth may be displaced and loose, and the gums may bleed. To prevent the loose tooth from falling out completely, the dentist can splint the loose tooth by bonding it to the adjacent teeth to help stabilize it while the underlying bone and gums heal.