1. In the news today…

    28th May 2010 by thecourtyardclinic

    Headlines today are reporting again the known link between gum health and heart disease..recent studies have again confirmed that patients with gum inflammation are more likely to go on to have heart disease.

    The recent research has accounted for factors such as lifestyle, exercise and diet and so confirms the advice we give… that regular check ups and visits to the hygienist (two or three times a year) to ensure good oral health, is of significant benefit to our patients.

    Posted by Dr. Yasmin George.


  2. Headache

    26th April 2010 by thecourtyardclinic
    Many people suffer from headache, but few realise that the teeth or the bite may be the reason behind it.

    Headache can be caused by:

    Grinding/clenching

    The headache caused by grinding or clenching the teeth is usually a ‘tension’ headache.

    Grinding often happens during sleep and may last for hours, putting a lot of pressure on the muscles around the jaw, forehead, scalp, neck and shoulders. As a result, these tense muscles may cause tension headache the following day.

    Whether the affected person is aware or unaware of grinding during sleep, he/she may not relate it to the tension headache. This condition may even go undetected for years.

    People usually visit their doctor regarding tension headache, but are then referred to their dentist once the grinding is established as the cause of the headache.

    In many cases, the connection between grinding and tension headache is pointed out by the dentist during a routine visit as there can be signs on the teeth that this is occurring.

    Once the grinding is treated by your dentist, the tension headache can disappear or improve vastly. 

    The bite (occlusion)

    Tension headache can also be caused by the bite (occlusion).

    If you lose your back teeth (molars), the stability of the bite might be compromised putting strain on the muscles around the temporomandibular joint (the jaw joint situated in front of the ear). This can later lead to joint ache and headache.

    Other malocclusions (abnormal bites) can cause similar problems.

    Consult your dentist for the best advice on how to restore your bite.

    Other causes for teeth-related headaches

    • A decayed tooth.
    • An infected tooth.
    • Wisdom teeth.
    • A high filling or a high crown

  3. Wisdom Teeth

    23rd April 2010 by thecourtyardclinic
    Wisdom teeth are the last teeth to erupt in the mouth. Often the rest of the teeth have already taken up the available space in the jaw and the wisdom tooth is left with little or no space at all.

    This means the wisdom tooth can erupt partially (part of the tooth outside the gum and the rest covered with the gum) or stay completely covered with bone and gums and is then called impacted wisdom tooth.

    People usually have four wisdom teeth, but some people have fewer or none. In rare cases some will have more than four.

    Do I need to remove my wisdom tooth?

    There are few reasons for a wisdom tooth to be removed. The most common ones are:

    • Pericoronitis: It is when the socket around the wisdom tooth gets infected and inflamed. It becomes swollen, painful and can cause a bad taste.
    • Decay.
    • Abnormal growth of the surrounding tissue like cysts, tumours or other rare conditions.
    • Pain associated with the eruption of the wisdom tooth.
    • Gum disease
    • Lack of space: The wisdom tooth can erupt in an unfavourable angle where teeth are crowded causing irritation to the adjacent oral tissue.

    Can my dentist remove wisdom teeth?

    Some wisdom teeth are easier to remove than others. The dentist decides whether the case should be treated as a normal extraction, or should be referred to a specialist in oral surgery.

    Questions

    Q: My teeth were straight but now they are getting crowded and uneven in the front. Are my wisdom teeth pushing the other teeth together?

    A: No. This happens even if a person does not have wisdom teeth present.

    Q: I had a problem with the lower wisdom tooth but my dentist took the upper wisdom tooth out. Why did he do that?

    A: In some cases the upper wisdom tooth bites on the gum around the lower tooth causing it to get swollen and painful. The patient experiences the pain in the lower jaw. If the upper wisdom tooth is removed, the cause of the trauma is removed and the pain and the swelling go down.


  4. Thumb Sucking

    16th April 2010 by thecourtyardclinic

    Sucking the thumb is considered normal behaviour for babies and may even start in the womb. However, if it continues after the age of two or three, it can have negative effects on developing teeth and bite.

    Thumb sucking has the following effects on the mouth and teeth:

    • An open bite in the front: The front teeth in the upper jaw and the lower jaw cannot meet.
    • The back teeth in the upper jaw are pushed inward towards the palate, affecting the bite.
    • High palate: The pressure from the thumb on the growing palate bone affects the shape of the palate.

    If the habit is interrupted very early, the bite recovers and the permanent teeth often grow into a correct position without the need of orthodontic treatment.

    How to stop thumb sucking?

    • Support and encourage your child to stop.
    • You could try coating your child’s thumb with a taste you know they find unappealing such as vinegar.
    • Use Mavala Stop. The bitter but harmless taste help your child (over 3 years) stop sucking the thumb.
    • Consult your dentist. A dentist can provide your child with a thumb sucking deterrant but also can advise if there is an effect on the developing teeth . If there is an adverse  effect ‘orthopaedic’ orthodontic treatment may be indicated.
    • Be patient, children do often grow out of the habit but if you are concerned seek professional advice.


  5. Gum Disease

    11th April 2010 by thecourtyardclinic

    Gum disease is also known as periodontitis. It is a very common disease that can affect you  without clear symptoms or pain. The condition may go undetected for years before a patient becomes aware of it.

    How it starts:

    We all have some plaque covering our teeth.

    If we do not clean our teeth thoroughly, the harmless bacteria population inside the plaque changes into a harmful one that irritates the gum margin around the teeth. The immune system fights the dangerous bacteria and its products, with its own potent defensive products. The constant battle between the body and the bacteria damages the surrounding tissue that supports the tooth. The tooth then slowly loses the attachment between its surface and the surrounding bone. The bone is destroyed and the tooth becomes loose to the point were it no longer can function and has to be taken out.

    The initial phase of the disease is called Gingivitis. Gingivitis is a reversible process. This means that if the plaque is removed the gum will go back to the original healthy status with no persistent damage. A big percentage of the population has gingivitis.

    If the plaque is not removed, it turns into calculus (tartar). Calculus is a hard layer that is attached to the surface of the tooth and is not easily cleaned with a conventional toothbrush.

    If calculus is left long enough, the minor infection or Gingivitis turns into a more severe infection: Periodontitis. Periodontitis is an irreversible process. This means that even when the infection is treated and the bacteria are removed, the damage caused by the disease cannot be fully repaired. The bone level around the affected tooth recedes and a pocket is created between the tooth and the gums.

    The longer you leave the disease untreated, the more difficult it is to cure.

    Regular visits to the dentist and simple oral hygiene instructions such as brushing and flossing can prevent gingivitis from turning into periodontitis.

    Symptoms:

    The affected gums bleed easily, swell and change colour from light pink into dark red. Gum infection often causes bad breath.

    In patients suffering from gum disease, the affected teeth can be tender to the touch.

    Treatment

    A big part of gum disease treatment relies on the patient’s cooperation with the dentist. The treatment plan may consist of:

    • Oral hygiene instructions in brushing, flossing and using interdental brushes.
    • Scaling: removing the plaque and the calculus.
    • Root planing: smoothing the surface of the root after scaling.

    The above treatments are often carrried out by a hygienist.

    • Gum surgery: is used to reach the infected area and change the gum structure to make it easier for the patient to clean between the teeth.
    • Using antibacterial mouthwashes and gels.
    • Treatment with antibiotics injected directly in the infected pockets.

    Why do some people get gum disease more than others?

    Some people get gum disease easier than others because of their genetic disposition.

    Such people are prone to attracting harmful bacteria and their immune system reacts differently towards the plaque causing more damage to its own gum structure.

    Smoking is another contributing factor to gum disease as nicotine impairs the body’s immune system’s ability to fight the gum disease.

    Pregnancy: during pregnancy the hormone balance in a woman’s body changes affecting even the gums. The gums become swollen and bleed easily when brushed amd are far more reactive to the effects of plaque. Careful cleaning and flossing is necessary to eliminate the plaque and help the gums during the pregnancy until the hormone balance is restored again when the baby is born and after breast feeding is finished.


  6. Grinding

    9th April 2010 by thecourtyardclinic

    Grinding or clenching the teeth is also known as bruxism.

    Bruxism can occur at any age, from young children with milk teeth to adults. People are usually unaware of the condition as it occurs mostly during sleep. But there are a number of visible signs of grinding:

    • Flat shiny areas on the chewing surface of the tooth.
    • The impression of the teeth on the side of the tongue.
    • Linea Alba: a white line on the inside of the cheek along the bite line caused by chewing the insides of the cheeks.

    Until today there is no clear explanation as to why we suffer from bruxism, but we know the condition is influenced by many factors, including stress.

    Bruxism is a common condition that may vary in intensity and frequency. It becomes more intense and frequent with stress.

    Many people can live with bruxism if it occurs in a mild form.

    When do I have to do something about it?

    You should seek professional help from a doctor or a dentist if:

    • The grinding is wearing down your teeth: when the enamel is worn down, it makes the teeth more sensitive.
    • Your teeth or the dental restorations in your teeth start to break.
    • You start to lose the enamel close to the gum line.
    • It causes the enamel to crack.
    • You suffer from tension headaches, a stiff neck and shoulders.
    • You experience tender jaw muscles in the morning.
    • You have tender teeth: during the grinding phase certain teeth are exposed to pressure more than others hence the tenderness.
    • The grinding is so loud during the night that your partner’s sleep is disturbed.
    • You damage the inside tissue of the cheeks while grinding.

    Treatment

    • A bite guard : Your dentist can provide you with a custom-made bite guard. It should be worn over the upper or lower teeth and mostly during sleeping hours, but may also be worn during the day.
    • Relaxation: by choosing a suitable way for you to de-stress such as: aromatherapy, massage, hypnotherapy etc.
    • Medication: see your doctor for muscle relaxants

  7. Tips to reduce enamel erosion….

    3rd April 2010 by thecourtyardclinic

    Enamel erosion or wear is surprisingly common and one of the causes of sensitive teeth, these tips can help reduce enamel erosion:

    • Reduce or eliminate carbonated beverages
    • Skip the additives in tea such as sugar, lemon, and milk
    • Drink acidic drinks quickly and through a straw
    • Acidic drinks should be consumed at meals only to limit the exposure to acid on the teeth
    • Chew sugar-free gum to increase saliva flow in your mouth
    • Rinse with water to neutralize the acids, and wait an hour before brushing
    • If you suffer from heartburn or indigestion, acid from the stomach can be a factor so consult your doctor.

  8. Dry Mouth

    29th March 2010 by thecourtyardclinic

    Dry mouth is also known as Xerostomia.

    Not until we suffer from a dry mouth, do we appreciate the role of saliva.

    People may suffer from low saliva production for many reasons.

    The most common ones are:

    • Taking medication such as antidepressants, antihistamines and medication for treating high blood pressure.
    • After receiving radiation therapy in the head-neck area. This can damage the salivary cells and limit the production of saliva.
    • Suffering from other systemic diseases like Sjogren’s syndrome and diabetes.
    • Surgery to the neck area where the salivary glands are affected.
    • Smoking
    • Alcohol

    As we age some of us will experience lower saliva production and hence a drier mouth.

    The role of saliva:

    • Lubricates the mouth.
    • Protects the teeth from decay and gum disease.
    • Enzymes in the saliva soften and break down the food to make it easier to swallow and taste.
    • Protects the tongue, lips and the inside of the cheeks from drying up and cracking.
    • Facilitates speech.

    What should I do if I have a dry mouth?

    • If dry mouth is caused by a specific medication, ask your doctor for alternative medicine if possible.
    • If the cause of your dry mouth is lower salivary gland function, try to stimulate it by chewing sugar free gums.
    • There are also medicines that could be prescribed by your dentist or doctor to stimulate the salivary glands.
    • If your saliva production is extremely low, you could use saliva replacing products.

    Other tips that may help:

    • Visit your dentist regularly to monitor your oral health…this can mean 4 or 5 monthly check ups.
    • Use mouth lubricators to protect lips and tongue from cracking and to facilitate speech.
    • Drink sugar free fluids with food to facilitate chewing and swallowing and even for better digestion.
    • Brush your teeth and gums gently and meticulously to prevent decay and gum disease.
    • Rinse with mouth washes rich in Fluoride. Fluoride neutralises early decay and strengthens the surface of the tooth.
    • Avoid alcohol as it dehydrates the mouth.

    Posted by Dr. Yasmin George.


  9. Invisible braces

    16th March 2010 by thecourtyardclinic

    What are invisible braces?

    One type of Invisible braces use a method of straightening teeth gradually with a series of clear plastic trays or ‘aligners’ instead of conventional metal braces.

    The distinctive feature of this treatment is that the plastic trays are virtually invisible, making them less noticeable to others.

    How does it work?

     The treatment starts with:

    • Your dentist taking impressions, x-rays and pictures of your teeth.A model of your teeth is cast and then scanned by a specialised scanner.
    • Computer software is used to design custom made trays for you to wear for each step of the treatment.
    • Each tray is designed to gradually move the teeth and therefore has to be worn in a specific order to achieve the desired effect. 
    • Trays are usually worn for two weeks before being replaced by the next ones in the series.
    • Trays are worn at all times including night time. The only time they are taken out is when eating or cleaning the teeth.
    • Treatment time may vary depending on the complexity of the individual case and can take between six and eighteen months.
    • This method is not suitable for every case. Ask your dentist whether you are a candidate.

    Why Invisible braces?

    Compared to conventional metal braces:

    Advantages:

    • Cosmetically more appealing.
    • Easier to clean the teeth during the treatment period. 
    • More comfortable to wear.

    Disadvantages:

    • The treatment is dependent on the patient’s consistency of wearing the trays. 
    • The trays have to be removed when eating. 
    • The treatment is not suitable if the patient suffers from bruxism.

    If your teeth are not suitable for the clear ‘aligners’then metal braces on the insides of the teeth are another ‘invisible’ option….this can be on all the teeth or just the front teeth.

    Check out our orthodontic page for more information.

    Companies providing invisible braces:

    • Invisalign®


  10. Gumshield

    5th March 2010 by thecourtyardclinic
    A gumshield is also known as a sportsguard or a mouthguard.

    It is an appliance you wear if you run a risk of getting hit on the mouth while engaging in sports such as boxing,  football, rugby, martial arts, hockey etc.

    It is designed to protect the teeth and the surrounding tissue from trauma. The rubbery plastic material absorbs the pressure and distributes it evenly over the whole jaw, minimising the risk of injury.

    There are different types and makes of gumshields, but there are three main categories:

    • Custom-made gumshields.
    • Off-the-shelf gumshields.
    • Boil-to-fit gumshields.

    Custom-made gumshields

    These are made with the help of your dentist. The dentist takes an impression of your teeth and sends it to a dental technician to be made. The technician laminates the sportstguard which make it more effective in protecting the teeth.

    The dentist then makes sure it fits the patient’s teeth properly and comfortably. The procedure takes two visits. Out of the three categories, these gumshields provide the best protection.

    Off-the-shelf gumshields

    Advantages:

    • Ready to use.
    • A temporary solution while waiting for a custom-made gumshield.
    • Affordable prices

    Disadvantages:

    • May not fit the teeth properly due to the standard sizes available.
    • Reduced protection compared with a custom made one.

    Boil-to-fit gumshields

    Made of thermoplastic material, these gumshields can be softened in boiling water and then put in the mouth to be shaped. These gumshields are  better than the standard off-the-shelf ones due to their better fit. Although custom-made gumshields are more expensive than the others, the benefit is invaluable when it comes to adequate protection during sports.

    Repairing damaged teeth after a sports injury can cost hundreds or even thousands of pounds, so the cost of the best sportsguard you can afford is well worth the investment.

    Ask your dentist for the best advice.


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