Month: March 2014

Acid Erosion

Many people know that drinking fruit juice and eating candy can cause tooth cavity.  However, forming tooth cavity is not the only way to damage a tooth.  Acid erosion can cause damage to the tooth enamel.  Today, we will talk about what acid erosion is.

Tooth Acidic Erosion, Demineralization of Tooth Enamel, Soda, Fruit Juice, Tempe, Chandler, Mesa, Phoenix, Gilbert, ArizonaAcid erosion occurs when we ingest food or beverage containing acidic ingredient.  For example, grape fruit juice, lemon juice, orange juice and soda are some beverages containing acidic contents.  If the tooth encounters repeated exposure to the acid in the fruit juices, those acid can erode the enamel of the tooth, thereby weakens the tooth structure making it susceptible to bacteria attack.  Weakened enamel may progress into tooth cavity.

Teenagers often develop these type of tooth cavity from acid erosion.  Drinking soda and acidic fruit juice affect their teeth.  Initially, the teeth will become sensitive to changes in temperature.  Slowly, the small pits will develop into tooth cavity.

My advice is to refrain from ingesting excessive acidic beverages and soda.  Optimal dental hygiene helps to cleanse out the acid and food debris.  Mouth rinse containing fluoride can help strengthen the teeth and minimize the negative effect of acid on tooth enamel.

However, if tooth cavity is formed, please come to see a dentist.  As an experienced cosmetic dentist, I would check and treat the cavity, and deliver a pleasing result.
Written by Daniel Tee, DDS, MS
Practicing Cosmetic Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

Dental Floss

Many people know what dental floss is but often they ignore its importance in oral hygiene.

Dental floss might be the most important tool for dental hygiene.  It can be used to remove the food debris in between the teeth.  When we eat and chew food with our teeth, the food debris would accumulate around the teeth and the gum area.  A piece of meat might get stuck in between two teeth, and sometimes it might be stuck in the gum pocket.  Toothbrush can brush the surface of the teeth but often toothbrush cannot clean the area in between the two teeth and also it cannot clean out the food debris in the gum pocket.  That’s why we need to use the dental floss.  Dental floss can be inserted in between the gap between the two teeth and clean out the food debris in there.

If the food debris is not removed in time, it will get pushed into the gum pocket and make the gum pocket becoming enlarged.  The enlarged gum pocket will in turn make the food debris more easily accumulate in it.  This becomes a vicious cycle.  Over time, the bacteria in the food debris will cause infection and tooth cavity.

Dental floss can be easy to use.  However, at the beginning, a person needs to learn to use it properly and it might take some time to floss all teeth.  With some repetitions and practice, it might take only 2-3 minutes to floss every teeth.

Remember, when flossing, it is necessary to insert the dental floss into the gum pocket and gently insert it into the deepest location of the gum pocket in the between the teeth.  Sometimes, there is some ginigval bleeding when flossing, and this might indicate the presence of inflammation in the gum.  With routine flossing and proper oral hygiene techniques, the gum will become stronger and the gum bleeding will become less and less or no more bleeding.

Dentist recommends flossing every day.

 

Written by Daniel Tee, DDS, MS
Practicing Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

Extraction of Wisdom Tooth Prevents Long Term Problems

Today, I have completed extraction of two impacted wisdom teeth.  I would need to perform surgery to take those two teeth out.  At the end of the procedure, I was exhausted but I believe it is worth it.  Generally, impacted wisdom teeth would often have developed problems in the long term.  By removing it in time, this will prevent any potential big problems in the future.

In some occasion, the wisdom tooth was grown  in the bad position in relation to the other tooth.  It could be growing side way or horizontally impacted  Then the wisdom tooth would often push against the the toot anterior to it and causes the rest of the teeth in the jaw to shift.  Crowding would result and this in turn would cause the food impaction in between the teeth.

Bacteria grows off the food debris jammed in between the wisdom tooth and the adjacent tooth, and causes infection and inflammation to the gum tissue around the wisdom tooth.  This infection is called pericoronitis and will cause severe pain and discomfort if left untreated.

Due to the most posterior location of wisdom tooth, it is not easy to gain access for the toothbrush to clean the area adequately.  In addition, if the wisdom tooth is impacted, food impaction is the most severely in between the wisdom tooth and the tooth adjacent to it.  This promotes increased likelihood of tooth cavity.  If the wisdom tooth is impacted, the tooth cavity develops at the root area of the tooth.  This is the area very difficult to get access to and to do the filling.

If the tooth cavity is deep, then the tooth would develop painful response and may become infected.  Then root canal therapy would be needed to treat the infection.

More frequentlly, the impacted wisdom tooth would cause tooth cavity to the tooth adjacent to it.  Some people think wisdom tooth is not functional and can be disposable, thus they tend to ignore the wisdom tooth.  However, wisdom tooth can cause severe problem to the other tooth.  For this reason, I generally recommend removal of wisdom tooth if the wisdom tooth is not growing in the good position.

 

Written by Daniel Tee, DDS, MS
Practicing General Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

Dental Care at Another Country — Hidden Costs Might Make You Pay More!

As the licensed dentist in the United States, I often hear patients talking about how expensive the dental care is in the United States and that they would go to their own countries for dental care.

Hidden Cost #1: Cost to redo inadequate dental work

I believe in the United States, we have the highest standard of dental care in the world.  Each of the licensed dentist has to go through extensive education and training and have to pass numerous tests and licensing exam and has to have great credentials in order to be granted the licence to lawfully become a dentist to treat people.  I myself have high expectation when it comes to my personal medical/dental care.  I personally wouldn’t want less qualified person to work on my teeth.

I know in some foreign countries, the qualification of becoming a dentist is less stringent than in the United States.  Also, their standard of care is not clearly spelled out as in the United States.  In addition, there is no dedicated governmental agency to oversee the dentists in some of those foreign countries.  So the quality of the dental care is not uniform and hardly a guarantee.

Of course, I know there are some great dentists in those foreign countries and I can see their work can be great.   But more frequently I see patients with inadequate dental care received from the dentist in their home countries and the dental work needs to be repaired or completely redone.  Teeth are valuable and cost is not only the cost of repairing the existing dental work but also the cost of sacrificing your tooth to additional dental problems and the risk of losing your teeth.

Hidden Cost #2: The Cost of Going to the Foreign countries

Many times people think the dental work at foreign country is cheaper.  They forgot that this is due to the exchange rate between the US dollars and the foreign currency.

In order to get to the dentist at the foreign country, one has to spend a large sum to either buy a round trip of air ticket or driving for more than 6 hours round trip with many tanks of gas.  Round trip ticket to Asia can be at least two thousand dollars.  Driving for 6 hours can cost at least 100 dollars of gas, plus stopping in the mid-trip for food, plus missing one work day of pay.

Even if you just go back to your foreign country for leisure and you go to see dentist as part of the trip, it would still cost you.  For example, if your trip is 10 days and you spend two days going to see your dentist for some major work, then the cost of going to the dentist there would be at least 20% of the total cost of your trip.  The total cost of your trip might include the air fare, the hotel costs, the food, and the local transportation, etc, and the dental visit costs at least 20% of the total cost of your trip.

Hidden Cost #3: You will have to take additional days off from your work.  This could mean missed paid wages.

Hiddne Cost #4: You get less than what you paid for.  In the United States, dentist would usually warrant their work for a reasonable amount of time and for reasonable cause. However, any work done in the foreign country is nearly impossible to be warranted.  A patient can not go back to their dentist in foreign country for any followup adjustments.

Hidden Cost #5: You don’t know what materials were being used in the foreign country.  Foreign country might not have FDA (like in the United States) to oversee the safety and efficacy of the dental materials.  The safety and efficacy of the materials used by the dentist in foreign country is largely unknown.  And many times, dental materials sold in the United States cannot be sold in the foreign countries.

Hidden Cost #6: Health Hazard Cost.  Hepatitis B is common in Asian countries.  If the instruments were not sterilized appropriately, there is a chance of getting transmittable diseases.

Hepatitis B, Tempe, Chandler, Mesa, Phoenix, Gilbert, Arizona

Countries where Hepatitis B is common

 

 

Written by Daniel Tee, DDS, MS
Practicing Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

Dental Hygiene — Some Useful Tips

I would offer the following useful tips for improving dental hygiene.  These small changes can bring big results if applied correctly:

Dental Hygiene, Dental Cleaning, Teeth Cleaning, Periodontal cleaning, Tempe, Chandler, Mesa, Phoenix, Gilbert, Arizona, Mouth rinseTip 1: When you are brushing your teeth, make sure you also brush the gum too.  Brushing the gum is like massaging the gum, providing blood circulation to the area.  This will make the gum more healthy and the immediate result is to see the gum bleeding stop.  Also, the food debris tends to accumulate around the neck area of the tooth and by brushing the gum, this helps remove the food debris from that area.

Tip 2: Do not open your mouth too wide when you are brushing.  This may seem like counter-intuitive.  So let me explain.  If you open your mouth too wide, the cheek will be stretched to its maximum and no further stretching is possible.  So if you try to brush the cheeky side of your back teeth, you will have to insert your toothbrush in between your cheek and the teeth.  However, if you open too wide, you won’t be able to insert the toothbrush into that area because the cheek cannot be stretched further.  Thus, I suggest patient to open the mouth half way when trying the brush the back teeth.  This allow the tootbrush to stretch the cheek and get to the tooth.

Tip 3: Do not rinse with water after rinsing with listerine or prescribed medicated mouth rinse.  Always use the mouth rinse full strength as prescribed.  After rinsing with the mouth rinse, do not follow by rinsing with water.  You will want the active ingredient in the mouth rinse to continue to remain on the tooth and the gum so its effect can be expressed.  However, water rinsing will dilute the active ingredient and tremendously decrease the potency of the medicated mouth rinse.

Tip 4: If your dentist tells you to improve your oral hygiene, sometimes it is a good idea to time your brushing with a watch.  Diligently brush for full three minutes can bring wondrous results.

Tip 5: Drink water after you eat.  Even if you cannot brush your teeth or rinse with water at a restaurant, it is beneficial to drink a glass of water after the meal because water can help wash away food debris on the teeth.

 

Written by Daniel Tee, DDS, MS

Practicing General Dentist Serving Tempe, Chandler, Mesa, Phoenix, Gilbert, Arizona

Dental Avulsion — Immediate Treatment

Dental Avuslion, Hanks Solution, Root canal therapy, Ankylosis, resorption, Tempe, Chandler, Mesa, Phoenix, Gilbert, ArizonaDental avulsion means that the tooth has been completely knocked out of bone socket.  This usually happens to the front tooth when the young child endures physical contact in a sport.  Generally avulsed tooth can be replanted back with good prognosis.  Here is what to do in a dental emergency involving tooth avulsion:

Upon immediate avulsion, try to pick up the tooth by the crown area.  Avoid touching the root area where the vital cells are on the surface of the root.  We need the vital cells to help the tooth to reattach to the periodonteum after replantation.

Next is to clean the tooth with cold running water for 10 second.  Wash off any visible debris but do not scrub the tooth.  You can either replant the tooth into the original socket or put the tooth into a bottle of milk.  The longer the tooth is dried, the poorer the chance of survival.

Take the child to the dentist for evaluation.

I would take a couple of Xray image to verify the condition of the tooth and the bone socket.  I would take xray to verify for proper placement position.  I would splint the tooth together with the adjacent tooth and tell the patient to wear the splint for two weeks.  I would also put patient on an antibiotic regimen.  If tooth is contaminated with soil, I would recommend patient to have medical checkup and evaluate for the risk of titanus.

Sometimes, the tooth would need root canal therapy in the next 7-10 days, followed by periodic checkup and Xray radiograph.

If the tooth has been dried for more than 60 minutes, the prognosis of the replantation goes down.  Root ankylosis or root resorption may occur and the tooth may eventually be lost.

 

Written by Daniel Tee, DDS, MS
Practicing Emergency Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

Sleep Apnea

Sleep Apnea, Tempe, Chandler, Mesa, Phoenix, Gilbert, ArizonaSleep apnea is the sleeping disorder in which a person is monmentarily not breathing properly during sleep.  This can happen to a numerous reason.  One common reason is that when a person sleep, the mouth is closed and the tongue is sitting more posteriorly and as a result, the air passage become narrow because the tongue sits closer to the opening of the airway.

Often, when the air tries to push through the obstruction, the vibrating sound results and this is what we called snoring.

To resolve this problem, dentist can fabricate a mouth piece that can fit in between upper and lower teeth so that the mouth becomes slightly open and the air passageway widens.

 

Written by Daniel Tee, DDS, MS
Practicing Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

Atraumtic Extraction of Teeth — Oral Surgery

Atraumtic extraction of teeth is a surgical extraction technique in which the teeth are extracted with minimal amount of damage to the surrounding bone and tissue structure.

As a dentist, I always focus to deliver optimal dental care to patient.  With all extraction, I take special care to minimize discomfort to patient and to efficiently perform the surgery.  With the new development of surgery instruments and increased popularity of implants, I am able to perform the surgery of extraction in the most atraumatic ways than it has always been in the past.

In the past, usually the two most common types of instruments are elevators and forceps.  The elevators is used to loosen the tooth in the socket by applying torquing pressure on the tooth against the bone socket or the surrounding tissue.  After the tooth has become loosen, a forcep is used to further grab the tooth out of the bone socket.

Most of the time, this traditional extraction technique requires a lot of blunt forces in the process of loosening the tooth.  Sometimes, the surround bone, especially the buccal bone,might become fractured inevitably in the process.

However, with the increased popularity of dental implants, dentists have become more aware of the importance of preserving the bone.  A good natural bone is desirable for optimal implant placement and osseointegration.  Thus, a newer generation of surgery instruments are developed.

The newer generation of surgery instruments are periotomes and luxators.  Even though they were first used by dentist more than a decade ago, these instruments have recently been reintroduced to the dental offices by popular demand due to their ability to allow dentists to perform atraumatic extraction and surgery.

Atraumatic Dental Extraction, Periotome, Periodontal Ligaments, Tempe Dentist, Tempe, Chandler, Mesa, Phoenix, Gilbert, Arizona

During extraction, periotome is iinserted into the gum pocket to sever the periodontal ligaments in order to loosening the tooth.

The periotome instrument is a small surgical knife-like instrument that is inserted into the pocket between the tooth and the alveolar bone.  In there, there are ligaments and fibers extending from root surface of the tooth to the surrounding alveolar bone.   The periotome instrument is inserted and is able to cut through these fibers/ligaments.  In essence, the periotome is performing microsurgery to sever the periodontal ligaments.  Once the fibers are cut, the tooth will be loosened.

Next, luxator is a small instrument with a thin blade at its tip.  The thin blade is further inserted into the space created by the periotome.  With a couple of small twist, the tooth will become completely loose and a forcep can be used to grab the tooth out of the bone socket.

Disclaimer: this surgery technique is not applicable to all situation.  And even though it was inteneded to perform surgery atraumatically, some unexpected situation may arise and dentist would need to perform additional steps to complete the surgery.  Not all tissue or bone can be preserved atraumatically as intended.

 

 

Written by Daniel Tee, DDS, MS
Practicing Emergency Dentist Serving Tempe, Chandler, Phoenix, Mesa, and Gilbert Arizona

 

Tooth Cavities — Grandparents spoiling your kids?

So you might be asking me how Grandparents and tooth cavities related?  Actually this is an actual story happened to my patient’s child in my office.  I remembered when the dad brings his 4 years old son to my office for evaluation.  I immediately see almost all of the child’s teeth were blackened.  I asked how this happen. The dad told me that their parents or (the child’s grandparents) have spoiled the kid and let them eat all these candies.  Also, grandparents did not monitor the brushing habit of their kids.

Pedodontics, Early Childhood Caries, Tooth Cavity, Oral Hygiene, Brushing, Tempe DentistThis family is new immigrant from China.  The mother and father works in Phoenix and occasionally they would fly back to China for vacation.  Last summer, when they go back to China for summer, they let their youngest child (who has not begun schooling) to stay with the grandparents for 6 months.  When the mother sees her child after six months, to her surprise, her child’s teeth have developed multiple cavities.

A lot of times, the older generations in China do not have adequate dental care at their old times and also they don’t understand proper dental hygiene instructions.  And also, the grandparents probably spoil the grandchild that probably allows them to eat the candies and not brush properly at night.

The importance of this story is that the parents should teach the child proper dental hygiene at an early age, and also have a routine schedule of taking them to dentists for checkup and cleaning, at least once every six months.  Also, when the child is away to stay with grandparents, proper instructions should be given and also routinely check up on them on nutritional habits, hygiene, and health.  Even the child is staying with relatives, it is pertinent to stay informed on your child.

 

Written by Daniel Tee, DDS, MS

Practicing General Dentist in Tempe Arizona

Infant Dental Care

A Baby’s dental health should start with the mother.  A woman in pregnancy should have a balanced diet so that the child can have normal skeletal development and healthy teeth growth.

Infant Dental, Pedodontics, Child Dentist, Tempe Dentist, Pediatric DentistAn infant should begin teething about age of 6 month.  This is when the baby teeth are starting to come in.  It is important that the mother does not allow the baby to sleep with milk or juice bottle in their mouth.  Otherwise, the accumulation of milk/juices in the mouth will promote tooth decay.  This is called the baby-bottle-syndrome.

At the infant ages, mother can try to clean the baby teeth with a clean wet cloth, preferably after each meal.  As the baby gets older, a small manual toothbrush can be used to brush the teeth.  Only a small amount of toothpast, about the size of a pea, is needed for each brushing.

Also, the parents can take the child as early as one years old to the dentist for a simple checkup.  This would allow the child to get accustomed seeing the dentist.  Also this develops a healthy dental hygiene habit that teaches the child the importance of dental health.

 

Written by Daniel Tee, DDS, MS

Practicing General Dentist in Tempe Arizona