that time of the year

yep, the oral health month organized by colgate is in the month of april every year. so all throughout this month dental check ups are done for free in participating clinics. in conjunction with that i would like to give some guide to you guys on what to ask/query/pester your dentist:

1. calculus and scaling
- ask your dentist whether you have calculus, how bad is it and whether you need scaling or not. also ask him to show you the areas where calculus first appear so that you can check yourself at home. that way you can straight away detect whether calculus has formed or not, so you can determine yourself your need for scaling. you can also focus your brushing and flossing on that area to minimize calculus formation.

2. caries and filling
- some small caries lesions may not be apparent to the naked eye. one of the sign of small caries is sensitivity on one particular tooth that was not sensitive before. these cavities may be hidden in between teeth and that is where your dentist can help you in detecting it. other than that you can also ask your dentist to determine the conditions of your old fillings and he can tell you whether you need new filling or not.

3. sensitivity
- your dentist can check on why your teeth become sensitive and how can you solve that problem. there are numerous reasons for hypersensitivity and equally numerous ways to lessen it, from take-home solutions to in-office treatment.

4. wisdom teeth
- ask your dentist on the condition of your wisdom teeth, whether it has erupted or not. next is to ask whether these particular teeth is erupting upwards or its face is facing somewhere else. this is because wisdom teeth almost always gives certain degree of problems especially those ages between 18-40. this is so that you can prepare mentally on problems that might arise from your wisdom tooth.

5. others
- just ask anything that's been bugging you about your overall mouth condition, or you brothers' or your parents' or your children's. this is the chance for you to get to know everything for free! and don't forget to ask for freebies from colgate as well!!

mind that gap!

beauty is in the eye of the beholder. some people think mocha-skinned people are exotic. some people think hairy-chested guys are macho. i think tall men are sexy. i also think i look sweet in purple (eceh! perasan!) although all my sisters think purple is a boring colour..

those gaping hole between your two front teeth has been bugging you lately? you actually have several choices in improving it, if it's that what you are after.

1. braces
spacing in between your teeth can easily be corrected with braces. the good thing is it doesn't involve extracting any of your teeth. but, though this is the easiest solution, you still have to wear it for quite a long time for the result(1-3 yrs). the good thing: it doesn't involve cutting any of your tooth structure or any foreign material. its your natural teeth minus the gap.

2. filling
if the gap is small, you can always have the space filled. we usually will take the colour of your teeth first to suit the colour of the material that we are going to use. the procedure will take about half hour and voila! no gap no more. but it does come with a hitch: you cannot eat hard stuff with your front teeth or those filling will break. you should also refrain yourself from taking too much coffee/tea/coloured food because that filling are easily stained. but then, its cost is much much lower than wearing braces, so if it breaks, or if the colour has changed, or if you want the tooth shape done differently... you can always repeat this treatment. no problem there.

3. crowning / veneering
because it is lab-constructed, doing crown or veneer will eliminate all the problems that you might have with a tooth filling. meaning; it doesn't break easily, it doesn't stain and it looks really good and natural. the downside of it: its cost. it may cost lower than braces, but it is about 10 times higher than if you do a simple filling. crowning also involves cutting some structure of the teeth- so you might have sensitivity problem later on. veneer doesn't have this problem, but its cost is double the cost of crowning.

4. or else












or else... leave it alone!!
beauty is in the eye of the beholder. some people may think that gap in your teeth make you look sexier..

in too deep

choices, choices, choices.

pumps: red? blue? purple?
football: man u? liverpool? chelsea?
cars: toyota? mazda? honda?

teeth: cabut? cabut? cabut? *huh?*

YES!
we do have choices when it comes to the health of our teeth. all the choices available is to eliminate whatever discomfort that we have. be it just a small hole, or major pain in the (ermm..) oral cavity... YES! we have!

a small to medium-sized hole on our tooth will present itself as a slight discomfort: during eating, drinking... especially hot or cold or sweet. its solution is simplest of all: filling! because the cavity is small, only involves the enamel and a little bit of dentin and very far away from the nerve, pain during this type of treatment is zilch!

a medium to large-sized cavity will cause a more apparent discomfort. added to that is the feeling that there's always some food stuck at that area whenever we eat, and it is becoming more and more difficult for us to take the food out. the other sign would be, whenever we floss, the floss gets stuck. the solution again, is filling. but apart from the normal filling material, we will also add a medication (a calcium hydroxide material) that will stop the caries from going deeper and nearer to the nerve by promoting the production of secondary dentin, which is a harder, stronger layer as compared to our primary dentin.

a large cavity may well has your pulp (the chamber housing our nerve) involved already. you will have: - hell of a pain, accompanied by swelling of gum, and the occasional facial asymmetry. Solution: root canal treatment. basically we will take out all the nerve and blood capillary that supplies that particular tooth; clean the canal area and fill it up with a type of rubber. it is almost the same process as mummification: we embalm the tooth so that the tooth is dead, no sense whatsoever, but still can remain in the mouth and still can be used to chew.

if all these fail, then you can consider extracting the tooth. but, you can also consider redoing the treatments.

choices, choices, choices. its all up to you. how much value do you put to your teeth? or should i say, how much value do you put in comfortably and without worry eating the satay kajang.. pizza... nasi dagang... soto ayam.. mee bandung muar... roti canai... lamb chop... strawberries and vanilla ice-cream... lobster thermidor... cupcakes....




choices, choices, choices.

euro: italia! italia! italia! :D

black or white

It is generally known that there are 2 types of tooth filling: the black silverish ones (or amalgam) and the white tooth-coloured ones (composite). But the thing that we always wonder would be, which one is better? Is it the black ones, because it has been used as tooth filling material for more than a century now; or is it the white ones, simply because it looks better?

Let the competition begin, and I will let you be the judge. ;-)

Round 1: strength

Amalgam is known for its high strength; it can stand up to 350MPa of pressure (even higher than natural teeth – 250MPA). It is also not affected by surrounding factors such as saliva and blood. Problem is, its strength can only be achieve in bulk; means the filling must be at least 1.5 mm thick (or the hole must be 1.5mm deep) or it will easily fell.

Composite, on the other hand, has similar strength with our natural teeth (260MPa). It can be used on a shallow cavity, but its strength can easily be altered by surrounding factors. For example, if it is mixed with our saliva or blood, its strength will become low. Also if composite is exposed to the dental overhead light for too long, its composition can also be altered.

Round 2: cost

Cost of amalgam is about 30% less as compared to composite. Also, a relatively greater amount of time and skill is needed for your dentist to place a white filling as compared to an amalgam filling. Your dentist has to make sure the cavity prepared is free of blood and moisture. Also, composite cannot bond itself to tooth surface. It needs extra help, a bonding agent; which equals to extra cost.

Round 3: bonding strength

Amalgam bond itself to our tooth surface via mechanical retention, means your dentist has to prepare a ‘lock’ or an ‘undercut’ before amalgam is placed. Think ‘lock and key’. Composite, on the other hand, depends on chemical retention. Your dentist has to place the bonding agent first before your tooth can be filled with composite.

Round 4: aesthetics

Hmm.. its pretty obvious, don’t you think? Composite is tooth coloured, it even has different colours so your dentist can match the shades with your exact tooth colour. We can even do it in layers you know, if the neck of your tooth has different shade than the tip of your tooth. Amalgam is… well..

Round 5: composition

This might be new for some of you. For your info, amalgam consists of mixture of metal alloy and mercury, on a 1:1 ratio. Mercury, as is generally known, is a highly unstable element. A little bit of mercury is released when tooth is being filled, or when amalgam filling is removed, and even during chewing. Side effect of mercury ingestion includes personality change, memory loss, psychological distress and a lot of others. However, rest assured, there are no scientific evidence that shows dental amalgam does affect our general heath. Our Health Ministry has produced a Position Statement on use of dental amalgam in 2002. Ask your dentist for a copy of you want to read it.

Composite on the other hand is pretty safe. Manufacturers of dental composite upon producing new composite product has to comply with American National Standard/American Dental Association Document No 41 for Recommended Standard Practices for Biological Evaluation of Dental Materials, 1982 before it can be distributed. This evaluation consists of Cytotoxicity, Mutagenicity, Sensitivity and Carcinogenicity test. So no worries.

Round 6: life span

Generally, amalgam has longer life span as compared to composite. Van Nieuwenhuysen in 2003 and Forss in 2001 conducted a comparison study between dental composite fillings and dental amalgam fillings. They found an average life span of 12 to 12.8 years for amalgam fillings and 5 to 7.8 years for composite fillings. However, composite is an evolving material. Every year dentists are introduced to composite that has better strength, durability, polishability, aesthetics.. so I am pretty sure its life span and strength will improve with time.

And the winner is…

its there, its not there

kRUUKKKkkk!!!!

hmmm why does this nasik feels like batu??
whhooppss.. its my tooth filling!!!
#@@***@@##!
i just did that filling about a week ago!!!!!!!

*sigh*

trust me, its a dentist's worst nightmare.. having to face your patient again after you've just filled his teeth just one week before. worse still, now he's complaining of pain that has not been there before..

and now i feel obliged to explain how can a filling become loose. it might because of one or multiple reasons. but first and foremost, please dont come banging on the clinic's counter... at least go inside and let your dentist have a look at the tooth and explain to you, okay.. we are also human, we really dont like to let our patient feels dissatisfied, really we dont,.. so satisfy yourself by hearing our explanation.

so my preaching today would be aptly titled-
why does and how can tooth filling become loose/fallen:

1. the filling has probably become too large for the tooth to handle. the tooth will be unable to withhold the filling, the tooth structure becomes weak, and after slight pressure onto the tooth while we are eating, the filling become loose. there are cases in which the remaining tooth structure is fractured. the solution: crowning. for this type of problem dentist will always suggest crowning for that tooth. just like our socks will cover our feet, the crown will cover the whole tooth structure so the tooth will become stronger and able to withheld great pressure (i.e chewing/biting).

2. there might be a secondary infection/caries underneath the old filling. tooth filling is bonded to a cleaned surface, but when the area become infected it will become soft, causing the filling to dislodge. this will usually accompanied by pain because the infection will further deepen the previously restored tooth. your dentist will have to remove the old filling, scoop out the infection until no more is left and refill the tooth. when needed some type of medication will be placed so that the floor of the filling is stronger and void of further infection.

3. our material is very sensitive to moisture. if ever our saliva is mixed with the material, the material itself will become weak. so please avoid putting your tongue whilst having your tooth filled, okay. that's the need of the suction, and some dentists resort to using rubber dams (rubber sheet placed over your mouth to prevent any water/saliva into entering the tooth preparation, but some people claim its really uncomfortable). but contrary to popular believe that expensive material will bond better, well, it wont. the price of material depends more on the polishability/cosmetic/colour/strength, not how they bond to tooth surface.

4. there is one condition called abrasion cavity, this is caused by usage of hard or medium-bristled toothbrush that is just too harsh for tooth surface. the cavity is triangular shaped, situated at the neck of your tooth near the gum, and it will cause sensitivity. your dentist can fill it easy, with one really important condition: change your toothbrush!! your naturally hard enamel tooth surface itself cannot withstand the harsh effect of hard/medium-bristled toothbrush, let alone tooth fillings. preferably change it into a supersoft/extrasoft-bristled toothbrush. you might have to change your toothbrush more frequently, but i supposed that is so much better than to have your teeth filled repeatedly!



5. erm... you might accidentally bite on a really hard thing i.e small stone or chicken bone that may have caused the filling to break. i encountered one patient with his whole, unfilled, healthy back tooth split straight into two after he indulged in his favourite snack during a man u game: kacang cap tangan. i assure you the pain is terrible, i really feel sorry for him. i had to extract his tooth, there was no other choice. :( . anyway, if a healthy tooth can break, so can filled tooth..

mmm.. i'm pretty sure your eyelid will become heavy if i continue droning on this subject. so that's it. the important ones, that is. there are more to these, of course, but they are less important and less frequently happen.

if ever your tooth filling become loose after only a few weeks having it filled, please visit your dentist a.s.a.p. its never good to leave your tooth unfilled, because it may lead to more problem. and as a normal practice, dentist will usually charge you nothing if you come back (to the same dentist) within 30 days to redo the less than a month old filling.
its free! so why delay??