I Had the Best Dentist Ever For 30 Years. Really?


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What prompted me to write today’s blog is actually a unique case of a walk-in patient who came into my practice wanting some pain relief on a Friday night. It’s a policy of Healthy Smiles Dental Group, one of its cornerstones in fact, that we never turn away anyone in pain. If you ring up the practice we’ll definitely see you, even if it means staying back after 5 pm on a Friday evening.

Let’s call this patient John Smith. Well, John walks into my practice on a Friday night in a bit of pain. Before he’s even filled out his New Patient form his first statement is, “Everything’s perfect in my mouth, I’ve been with my previous dentist for the past 30 years.” He then goes on to tell me about how his old dentist never charged him excessively like “all other dentists”, always patched him up, got him going and everything has just been perfect for the past 30 years. He claimed this was the first time he was feeling pain, and assured me it was because his old dentist, who was simply excellent, had retired. Then he explained he was trying out the different dentists in the area to find a perfect fit for his future oral healthcare, just like he’d found for the past 30 years.

Before starting I explained to him that just like any other emergency appointment, we’d do what we could to get him out of trouble but this was by no means a thorough examination. We’d carry out some x-rays to assess and make a diagnosis. Essentially, I would be explaining what was happening in his mouth and what the problem was. Based on this understanding of the problem and the consequences, he would be deciding on how he wanted to proceed, and we’d support him in that. That’s our philosophy with every patient, and John was fine with that.

Once he opened his mouth, what I discovered was actually quite shocking. Every tooth in his mouth, including his front teeth, had been filled and overfilled multiple times, to the extent that some of the fillings now made up about 90% of the tooth structure! As soon as I saw that I knew I’d have to ask him a few questions to find out what exactly happened over the past 30 years.

John described how whenever he wanted to see his old dentist, he’d always been extremely booked out and John would only get an appointment 2-3 weeks after ringing. During his visits he’d get as many fillings as possible – this would typically be six to seven fillings within a period of 30-45 minutes. He’d then be on his way feeling perfectly content because he would have spent a minimal amount for perfect-looking fillings, to the tune of $200 per tooth. He’d seen a few other dentists at the time, all of whom suggested getting crowns, ceramics or some other advanced treatment for his teeth. He figured they were simply trying to rip him off and stuck to his old dentist.

Coming back to his teeth – on the upper right side he had massive swelling in his gums, and was actually leaking some pus through a little hole called a sinus tract into his mouth. He complained of some foul smell and bad taste in his mouth as well, so we did an OPG, or a full mouth x-ray, took some photographs, then I sat him up to explain what had actually happened over the past 30 years. I started by assuring him that I had no intention of trying to sell him anything, I didn’t want him to do any crowns, root canals, implants, or anything whatsoever. All I wanted him to do was understand what was happening in his mouth so as a basic starting point he could be free of infections and have a healthy mouth.

What had actually happened to John in his 30 years with the lovely dentist he had been seeing regularly was that his trustworthy dentist had been treating John with what we call supervised neglect. Now supervised neglect is a complex term used in medical/legal circles, I’ll give you a typical scenario where supervised neglect has taken place. If you’ve entrusted your oral or medical health, or anything similar, to a health practitioner, and they assure you that everything’s fine so they can continue doing what they think is right while your condition actually worsens – that’s supervised neglect. In dentistry, supervised neglect is if the dentist fails to inform the patient of the condition or explain the consequences sufficiently, recommends and provides treatment he/she thinks is right just to keep the patient returning for more services over an extended period of time. Keep in mind that the treatments provided may not actually have been appropriate for the patient. In John’s case, supervised neglect had led  to his teeth being filled and overfilled to a point where the nerves in most of them had become necrotic (died), leading to abscesses in his mouth. These abscesses were now draining into large areas in his jawbone and had caused the development of multiple infections in the bone.

The thing about chronic infections, such as this local infection in the jaw, is that they can slowly and painlessly keep getting worse without any symptoms. This is why a lot of people, like John, think there’s nothing to worry about. As far as he understood the situation as a patient, he had not previously been in any pain and no pain means no problem. However, that’s not always the case when it comes to healthcare – no pain doesn’t always mean no problem. The only reason John decided to come in to see me was that his chronic infection had flared up into an acute abscess, and even then all he thought he needed were antibiotics to tide him over. Unfortunately, that’s all he’d been doing on multiple occasions with his old trusted dentist for the past 30 years. Each time such a situation arose, he’d simply take four to five courses of antibiotics, and the pain and swelling subsided. His dentist had never recommended any other complex treatment.

Once I explained everything to John, and once he saw the x-ray for himself, he saw the light and realised just how serious his situation was. I referred him to a specialist orthodontist for a thorough assessment, and let him know that fixing everything was probably going to cost him around 40 thousand dollars. He’d have to be prepared for that unless he was fine with losing all his teeth for life.

This was one of the more interesting incidents of supervised neglect I’ve come across at my practice, so I thought I’d share it on my blog. Hopefully this helps a lot of you understand that this is something you can’t take lightly. Always get regular assessments done, make sure you visit a dentist you can trust and who knows what he/she is doing, is proactive and not simply reactive to your dental problems! If you’re unsure how to go about finding a trustworthy dentist or have any questions feel free to give us a call on 03 9877 2035 or email us at info@healthysmiles.com.au. You can make an appointment for a free no-obligation assessment at our practice with one of our experienced dentists, and we’d be more than happy to answer any of your questions.

Source: http://www.healthysmiles.com.au/blog/dental-care/i-had-the-best-dentist-ever-for-30-years-really/

The History of Sedation Dentistry


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For many people, heading to the dentist causes feelings of anxiety and fear. However, sedation dentistry provides these patients with a way they can relax when dental treatments are required instead of dealing with panic, anxiety and fear. Sedation dentistry is not a new concept, although it has evolved significantly over time. A look at the history behind sedation and sleep dentistry finds that this type of dentistry has a long, rich history. Here is a closer look at the history behind sedation dentistry, as well as a look at how sedation has evolved today.

Understanding the Differences Between Sedation Dentistry and Sleep Dentistry

Before looking at the history behind sedation dentistry, it is important to understand the differences between sedation dentistry and sleep dentistry. Unfortunately, patients often confuse them or think they are the same thing, yet they have some significant differences to consider.

Sleep dentistry is an approach that makes use of general anaesthesia, rendering the patient fully unconscious, so they are asleep during the dental procedure. Certain extensive dental procedures may require sleep dentistry treatment, but there are some risks to using general anaesthesia. This type of approach is rarely used just to deal with phobias, anxiety or fear, but it is reserved for extensive, invasive dental procedures, such as certain types of oral surgery.

On the other hand, sedation dentistry is a more common that is very popular today. It is quite safe and is an excellent choice for individuals that fear the dentist’s office or those who deal with anxiety when they head into the office for dental treatment. Patients are still conscious when sedation dentistry is used, yet they are fully relaxed and in a dream-like state. In most cases, patients never remember the procedure, even though they are not asleep during the treatment.

The Origins and History of Sedation Dentistry

Although sedation dentistry is not a new concept, it has only recently become a popular option around the world. The history of sedating dental patients for dental procedures goes all the way back to William T. G. Morton, a dentist that used ether on a patient before performing a procedure. This occurred in 1846 and Morton administered the ether before a procedure in front of an entire amphitheatre of students and physicians. This took place at Harvard University.

Before this presentation by Morton, another dentist, Horace Wells, tried to demonstrate that nitrous oxide could work as an anaesthetic agent. This took place in 1845, and unfortunately, the trial was unsuccessful and the audience was unimpressed by his attempts to use nitrous oxide. However, since that time, nitrous oxide has quickly become a popular form of anaesthesia used by dentists and it is often used still today. However, it was not until 1864 that the American Dental Association finally recognized Wells for his discovery. Since the gas is easy to use, very safe and quite inexpensive, it is an excellent choice. It also helps to raise patients’ pain threshold, which is another benefit to using this gas on dental patients.

Sedation Dentistry Today

Although the idea of sedation dentistry goes back more than 150 years, technology has provided today’s dentists with many options to use when sedation patients for dental treatments. IV sedatives, nitrous oxide and many oral sedatives are available. Each type of sedation works to ensure that patients are completely relaxed and comfortable. Today’s sedation techniques are also very safe, especially when qualified sedation dentists administer them.

Sedation dentistry has an interesting history and it has been used successfully for many years now. If you fear going to the dentist, you deal with anxiety or you need to have significant work done in a single treatment, talk to your dentist about your sedation options. Sedation may be the best option for you, ensuring that you have a comfortable, relaxing experience while you get the dental care that you require.

What You Must Know About Your Cosmetic Dentist


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Cosmetic dentistry goes beyond traditional dentistry, focusing on the aesthetic side of a person’s mouth, teeth and smile. Instead of addressing necessary general treatments, a cosmetic dentist  offers elective services and treatments designed to improve the overall look of a patient’s smile. Restorative benefits are also offered by cosmetic dentistry, such as using dental fillings for decayed teeth that are designed to match tooth colour closely, ensuring that the natural appearance of the tooth and smile is kept intact. If you decide to visit a cosmetic dentist, here is some helpful information you should keep in mind as you decide if cosmetic dentistry is something you want to pursue.

Top Cosmetic Dentistry Trends to Discuss with Your Cosmetic Dentist

When you are looking for a quality cosmetic dentist, it is important to find a dentist that is keeping up with cutting edge dentistry trends. Take time to discuss current trends with your dentist before you begin having cosmetic dentistry procedures performed. New advancements in dental technology have resulted in cosmetic dental treatments that are more predictable and durable than ever before. Another top trend among the best cosmetic dentists is a conservative approach to cosmetic dentistry that works to preserve natural teeth whenever possible. Ask your cosmetic dentistry professional if he or she is committed to using techniques that will preserve your natural tooth structure whenever possible, based upon your specific situation.

You’ll also want to talk to your cosmetic dentist about cosmetic dentistry technologies that make treatments more convenient and more comfortable, such as using lasers, sedation dentistry and other new technologies. With cutting edge technology, your cosmetic dentistry professional can make smile makeovers and other cosmetic procedures easier, more comfortable and may reduce your recovery time, making it easier to finally get the beautiful, improved smile that you want.

Popular Cosmetic Dentistry Services


It’s also important to know what cosmetic dentistry services your cosmetic dentist provides. A top cosmetic dentist should provide a variety of different services and treatments so you can enjoy receiving all of your cosmetic treatments in one place. The following are some of the most cosmetic dentistry services that the best cosmetic dental clinics offer today.

Teeth Whitening

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Teeth whitening, one of the most popular cosmetic dentistry treatments, is offered by the best cosmetic dental clinics. This treatment helps to eliminate stains from teeth, giving patients a brighter, whiter smile. In-office teeth whitening offers fast, convenient, significant results.

Smile Redesign

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The best cosmetic dentists will also offer smile redesign, a process that involves assessing your smile and working on procedures that improve the overall appearance of your smile. Smile redesign usually involves using multiple cosmetic dentistry treatments.

Dental Veneers

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Dental veneers are bonded to teeth to help repair and correct cracks, chips or tooth discoloration. They can be used to deal with gaps in the teeth and are an excellent alternative for those who have not had success with in-office teeth whitening procedures.

Dental Implants

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For individuals that have lost teeth, dental implants are an excellent choice that helps to deal with tooth loss. Missing teeth can cause functional and aesthetic problems, but dental implants can improve the way you look and improve the overall function of your teeth.

Composite Bonding

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Composite bonding is used to repair decayed, discoloured, broken and chipped teeth. Composite material that looks like natural tooth material is applied, shaped, contoured and hardened, making use of the original tooth while creating a more beautiful smile.

Costs of Cosmetic Dentistry

When you head to a cosmetic dentist, it is important to talk to your dentist about the costs of cosmetic dentistry. The costs of cosmetic treatments vary greatly, depending on the specific treatment you require. Be sure to discuss costs with your dentist to find out what specific procedures will cost before you have them done. Many of the best cosmetic dentistry professionals offer payment plans, making cosmetic dentistry affordable for all of their dental patients.

Why Zoom Teeth Whitening?


Over time, most people experience tooth discolouration, which can result from aging, drinking or eating foods that stain or from smoking. The good news is zoom teeth whitening Melbourne clinic now offer a treatment that can help to whiten your teeth, giving you a whiter, more beautiful smile. While many teeth whitening options are available today, Zoom teeth whitening has become a popular choice for many reasons. If you’re considering zoom teeth whitening Melbourne, here are just a few of the reasons why this teeth whitening procedure makes an excellent choice.

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How Zoom Teeth Whitening Melbourne Clinics Can Help You

Before looking at the benefits of Zoom teeth whitening and the reasons to choose this treatment, it is important to understand how this procedure works. This treatment is an in-office teeth whitening treatment and it begins by ensuring that your gums and lips are protected before the whitening procedure begins. Then, the special Zoom whitening gel is applied to your teeth, which works with the special Zoom light to break up discoloration and stains by penetrating your teeth. After the gel is applied, it stays on your teeth while the Zoom light activates the gel. It is applied for a total of three 15-minute sessions under the Zoom light. After having Zoom teeth whitening done, dentists apply a special fluoride paste that helps to reduce problems with tooth sensitivity after having the teeth whitening procedure completed.

Tooth Whitening Before Other Cosmetic Dental Procedures

In some cases, your dentist may want you to have Zoom teeth whitening done before other cosmetic dental procedures are completed. If you plan to have composite bonding or veneers applied, then your dentist may have you go through the whitening treatment to make it easier to match the restoration and your teeth.

The Procedure is Quick and Easy

Zoom teeth whitening Melbourne clinics are a popular as zoom teeth whitening is such a quick and easy procedure. Since it requires three quick 15- minute phases, you can usually be done and out of the dentist’s office in an hour or less. The procedure is very simple and many individuals appreciate that they can easily fit this whitening treatment into their busy life. The best part is that this treatment is completed within a single visit, so you don’t have to go back to the office multiple times to complete your teeth whitening treatment.

No Discomfort to Worry About

With Zoom teeth whitening, there is no discomfort to worry about. There is no heat from the Zoom light, so you don’t have to worry about the light causing discomfort. While the mouth has to remain open during the procedure, most people feel little discomfort and find the teeth whitening treatment easy to deal with when it is completed.

Natural, Noticeable Results

Of course, the natural, noticeable results definitely make Zoom teeth whitening an excellent whitening choice. Some whitening options, especially over the counter choices, may not provide noticeable results. When your Zoom teeth whitening procedure is complete, you’ll notice excellent results and the treatment can offer whitening of up to eight shades. Not only are the results noticeable, but they look natural as well, which is definitely important. While you want a brighter, whiter smile, you want to make sure that your teeth still maintain their natural look.

Long Lasting Results

Zoom teeth whitening also provides long lasting results, so once you pay for this treatment, you can enjoy the results for years. In some cases, individuals may have to come back for a touch-up in a couple years, but most people find that the results look great for an extended period of time.

Touch-Up Kits for Home Maintenance

When you have the Zoom teeth whitening treatment, you’ll also be given some touch-up kits to take home for home maintenance of your whiter smile. The kit includes teeth trays and whitening gel that you can use at home. This way you can regularly maintain your whitening results, which makes your bright, white smile last much longer.

When Should You Visit Your Dentist for Wisdom Tooth Removal


Wisdom teeth usually grow in when individuals are in their late teens or early twenties, although some people never have wisdom teeth at all in some cases. Unfortunately, wisdom teeth can end up causing problems that result in wisdom teeth extraction. Since these teeth are well known for causing many problems, you may be wondering if you need to have yours removed or wondering when you should begin considering wisdom teeth removal. Here is a closer look at wisdom teeth, the common problems that occur and some information on when wisdom teeth removal may be right for you.

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Wisdom Teeth – What Are They?

First, you may be wondering what exactly your wisdom teeth are. These teeth are the lower and upper third molars that usually grow in at the very back of the mouth. Your wisdom teeth are the very last teeth to come in and they got their name because they don’t grow in until people are in their late teens or early twenties, a time when they should be old enough to have a bit of “wisdom.” Certain people may end up keeping these teeth forever, while wisdom teeth removal may occur for others at some point during their life.

Common Problems with Wisdom Teeth

Wisdom teeth can end up having many problems. Some problems may require wisdom teeth extraction, although not all problems will result in wisdom teeth removal. One of the main problems people have is a small jaw that doesn’t have enough room for these teeth. This can cause them to get impacted or stuck in the jaw, keeping them from fully breaking through the gums. When wisdom teeth are impacted, they can end up causing swollen, infected, painful flaps in the gums as well.

Another problem with wisdom teeth is that they are difficult to clean. This can lead to gum disease or cavities, which may become bad enough that you require wisdom teeth removal.

In most cases, people don’t have problems with their wisdom teeth until they are at least 15 years old, and people over the age of 30 rarely require wisdom tooth removal. However, because so many problems can occur, it is important for you to see your dentist regularly if you are near the age where your wisdom teeth should begin coming in.

When Do You Need Wisdom Tooth Removal?

Now that you’re aware of some of the common problems wisdom teeth often have, you may be wondering if you need wisdom tooth removal, and if so, when should you have the extraction done?

First, it is important to have your wisdom teeth monitored before and after they come in. Having your dentist check them regularly can help you avoid more serious problems. However, there are certain signs that you may need to see your dentist for wisdom tooth removal. If the wisdom teeth cause pain and the gums swell around them, you should see your dentist. If other teeth are getting crowded, then you should consult with your dentist as well. Impacted wisdom teeth may need to be removed as well.

If you experience any of these problems with your wisdom teeth, it’s time to visit your dentist to find out if wisdom tooth removal is the best option for your dental health.

What to Expect During the Sleep Dentistry Treatment


Sleep dentistry, or sedation dentistry as it is also called among professionals, refers to the practice of putting a patient – you, for example – under sedation before the dental procedure is performed. You are not actually put to sleep because you will still be able to answer questions, be aware of your surroundings, and be able to feel albeit in a limited capacity, thanks to the state of deep relaxation you have been placed under.

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Preparatory Measures

Before undergoing any sleep dentistry treatment, you and your dentist will discuss many relevant matters including but not limited to:

Your medical history. You may have an underlying medical condition that precludes the use of certain anti-anxiety medications, painkillers, and numbing agents, among other drugs used in sleep dentistry. Your medical condition may increase the risks for side effects and complications during and after the sleep dentistry treatment or may fall under one of the contraindications of sleep dentistry. You should provide for complete information about the medications you have been taking or have taken so that the appropriate sedatives, among other drugs, can be chosen for your treatment.

Your planned treatment. Each sleep dentistry treatment will have different requirements in terms of the level of sedation, the duration of the procedure, and the level of difficulty, among other factors. Your dentist, for example, may choose mild sedation for a front tooth extraction but moderate sedation for wisdom tooth removal.

Your level of anxiety. You may ask for moderate sedation instead of mild sedation because of your high level of anxiety, a reasonable request especially when you have a fear of needles.

Sleep dentistry is designed for patients who want to undergo dental procedures without being subjected to the physical and psychological pain of the treatments. But it is important to discuss these matters with the most reliable practitioners of sleep dentistry – the dentists at Healthy Smiles.

Treatment Procedure

The steps during a sleep dentistry treatment vary according to the level of sedation planned for each patient. Keep in mind that the drugs used will be administered in various ways – inhalation or intravenous are the two main methods – so the actual steps will also be different.

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Mild sedation, also known as anxiolytics, is primarily intended to relieve anxiety, a common issue among young and old patients alike. In it, you will be fitted with a small nose-hood placed over your nose, which will then be the site of inhalation for the analgesia. You will inhale the nitrous oxide (i.e., laughing gas) via the nose-hood before and during the entire sleep dentistry procedure.

Nitrous oxide induces a feeling of overall well-being, even a state of deep relaxation that significantly lessens your anxiety. You will also feel tingling and numbness but there should be no discomfort after its administration. Your dentist will now proceed with the planned treatment when you have already been mildly sedated – truly, the main reason for the popularity of sleep dentistry.

Moderate sedation is characterised by a depressed level of consciousness. You can breathe on your own (i.e., no oxygen tank), retain your reflexes, and respond to your dentist’s verbal and physical stimulation. You will be able to answer questions but you will probably not remember both the questions and your answers when the sedative wears off – a case of partial or complete amnesia, a standard effect of the sedatives used in sleep dentistry.

In moderate sedation, the sedatives and painkillers – the latter may or may not be mixed with the former depending on your dentist’s professional discretion – can be administered in two ways. First, intravenous sedation involves the injection of the drugs via a vein, which means faster onset of the effects. Second, intramuscular sedation involves the injection of the drugs into the muscles either of the upper arm or thigh. In both cases, a numbing agent may be applied to the injection area.

Because of the use of sedatives in sleep dentistry, you must have someone drive you home after the procedure but more than that, it has allowed people who were previously fearful to come forward and take care of their dental health.

Your Leading Emergency Dentist Melbourne Practitioner


Whenever you have a dental emergency, it is essential to see your emergency dentist Melbourne practitioner as quickly as possible. Injuries to your gums, the teeth and other emergencies can be very serious and you should never ignore a dental emergency. Failing to get treatment for an emergency can increase your risk of ending up with permanent damage, not to mention, it could end up requiring more expensive, extensive dental treatments in the future. At Healthy Smiles, we offer emergency dental treatment whenever you have a dental emergency. If you’re not sure if you should see your leading emergency dentist Melbourne clinic, here is a look at some of the dental problems that are considered an emergency.

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Knocked-Out Tooth

If you have a tooth knocked out, it is important to see your emergency dentist Melbourne as quickly as possible. If you can, try to get the tooth back in place carefully. If that doesn’t work, you can place it in a cup of milk, keeping it in milk until you see your dentist. Knocked out teeth can be placed back in their socket, but they are most likely to be saved if you see your emergency dentist Melbourne clinic within an hour or two after it is initially knocked out.

Toothaches

A toothache can be frustrating and very painful, and a toothache that causes severe pain is definitely considered a dental emergency Melbourne. Try applying a cold compress to the affected area to help with swelling and pain. However, pain is always considered to be an emergency.

Lost Filling

When you lose a filling, it can allow food to get in the cavity, which can make the cavity even worse. It is important that the filling is replaced as quickly as possible to ensure the problem does not get worse. When a filling falls out, call your leading emergency dentist Melbourne practitioner to schedule an appointment as quickly as you can.

Tooth Abscess

A tooth abscess is a severe infection that occurs around a tooth’s root or between the gums and the teeth. Abscesses are very serious problems because they have the ability to damage surrounding teeth and the tissue around the infection. If this dental emergency is not treated quickly, the infection can possibly spread. If you have any symptoms of a tooth abscess, make sure that you call your emergency dentist Melbourne clinic to get an appointment immediately.

Injuries to Oral Soft Tissue

Any injuries to oral soft tissue should be treated quickly by your emergency dentist .This includes damage to the lips, gums, cheeks and tongue. Try to control the bleeding and call your dentist to get an appointment quickly. If bleeding cannot be stopped, you may need to head to an emergency room.

Broken or Chipped Teeth

If an injury occurs that results in broken or chipped teeth, make sure you save the pieces if possible and call your emergency dentist Melbourne to schedule an emergency appointment. You can also apply cold compresses immediately to keep swelling down as well.

Health Smiles, your leading emergency dentist Melbourne practitioner can treat all of these dental emergencies, and many others. If you are unsure whether you hav   e an emergency, be sure to call and our staff can help you book an appointment.