JK the dentist is a dental surgeon providing an exceptional service to his clients in a tranquil setting.

Dr. Jan H van Schalkwyk is experienced in both comprehensive and cosmetic dentistry, and this is what he offers:

 

Teeth Whitening

The Biolase Professional Teeth Whitening system is used here. The procedure is performed in the chair with the help of the latest generation Biolase Laserwhite Chairside laser.

  • The procedure has the following advantages:
  • White teeth in just an hour
  • Minimal sensitivity with longlasting effects
  • Whiteness can easily be maintained with the home bleaching kit, which can last up to one year
  • White teeth will give you more confidence and boost your self esteem
  • The system has been tried and tested and teeth whiten 6-8 shades lighter compared to the 4 shades of other professional products

 

Having a mouth free of biological and functional problems is no longer sufficient for modern day patients. People desire beautiful smiles which are integrated not only with their physical characteristics, but also in harmony with their character and emotional aspects.

DSD is a dental treatment planning tool used in aesthetic dentistry to digitally design a new smile and to marry this to the patients expectations and involve them in the process. 

Photos and impressions are taken and used to assess discrepancies in the smile and to provide a visual proposal which can be evaluated by both the patient and dentist and which can be discussed and changed, until the best treatment outcome is agreed upon.

The new smile is simulated both digitally and then transferred to the mouth, before the actual restorative work is started. 

Once all necessary changes have been made and both the patient and the dentist’s expectations have been met, the teeth are prepared and veneers/crowns are placed.

 
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This discipline involves smile analysis and enhancing the smile by means of Teeth Whitening and Veneers or Crowns. Elements of a beautiful smile includes white teeth, which are neatly arranged with no spaces, tilting or rotations. The width, length and shape also play a vital role. Some of these characteristics can be manipulated, but not to the extent of interfering with normal function i.e. biting and chewing.

Before one can embark on a cosmetic makeover, it's of utmost importance to first of all make sure that all the teeth are free of decay and that no periodontal disease is present.

 

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How does it work?

  1. After anaesthetising the area to be restored, the tooth is scanned
  2. Then a tooth is designed using the latest CAD/CAM technology. (CAD/CAM = Computer Assisted Design/Computer Assisted Milling)
  3. The design is sent wirelessly to the milling centre in the next room, which mills your new tooth (veneer/crown/inlay) in minutes within micrometer accuracy.
  4. After polishing and finishing of the crown, it is then cemented, adjusted and polished
 
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First of all the bone needs to be assessed to determine if there is enough space and availability of good quality bone.

Usually implants get placed within 3-6 months if not immediately after tooth extraction. After tooth extraction, the bone starts to recede. The longer one waits, the less bone there is to place the implant in and the less the chance of success becomes.

After placement, the bone needs to be given time to grow onto the implant. This is called "osseo-integration".


Once osseo-integration has taken place, impressions are taken to manufacture a crown, which then gets placed onto the implant permanently.


Implants have a 90% success rate, if not higher. It functions as an individual root which supports the crown and requires very little maintenance.

 

First of all, a consultation is necessary to decide whether this treatment is suitable for you. The Aligners can ideally be used in individuals with mild discrepancies and in the absence of major functional problems and jaw malalignment.

Impressions and photographs are taken and evaluated in order to set up a treatment plan.

It can take anything from 3-12 months to re-align the teeth with this method and is an alternative to doing veneers if the teeth are otherwise healthy. 

Clear aligners are worn full time (at least 22 hours a day) and are taken out when eating. 

Other than unsightly metal braces, these aligners are very discreet and are ideal for anyone, especially people in the public eye or those who work with people all day. 

Once treatment has been concluded, the teeth are re-evaluated and in most cases teeth whitening is performed and malformed or worn down teeth are aesthetically restored, to create a harmonious and appealing smile.

 

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What can it be used for?

  1.   Teeth Whitening
  2.   Dentine sensitivity
  3.   Pain Therapy
  4.   Treating of gum disease
  5.   Limiting infection in the mouth
  6.   Root Canal Disinfection
  7.   Frenectomies
  8.   Gingivectomy
  9.   Crown Lengthening
  10.   Post Surgical Healing

 

Benefits of Laser Dentistry include the following:

  • Minimally invasive
  • Little or no pain involved both during and after procedures
  • Procedures are of short duration
  • Shortened healing time compared to conventional cutting with a surgical blade
  • Bacteria are incinerated and there is thus a lower chance of post-operative infection
  • Immediate results which enables the dentist to continue and finish restorative work in one visit
 
 

For the very apprehensive or anxious person, there lies great relief in the use of Nitrous Oxide Gas, also known as Happy Gas or Laughing Gas. 

Nitrous Oxide is safe and easy to use. It is mixed with Oxygen and the strength is tailored to each patient’s needs. The regulator used is specifically engineered and calibrated for Dental needs and also ensures the safety of the patient.

 

Who are ideal candidates?

  •   The anxious person terrified of dentists (in short-every living being)
  • Children are put at ease and relax during routine dental procedures, which may    otherwise be overwhelming or uncomfortable.

 

When can it be used?

  • Most Dental procedures
  • Pediatric Dentistry
  • Teeth Cleaning (Scaling/Polishing)
  • Surgical procedures and more

 

For most Dental Procedures it is highly effective especially if someone is pre-stressed or apprehensive about the nature of a certain procedure. It is not only effective during surgical procedures, but also for the basic prophylactic visit such as scaling of teeth, especially for those who suffer from sensitive dentine and tooth sensitivity in general.

 

It can’t be used

  • during pregnancy
  • and also not for people who suffer from Malignant Hyperthermia (a side effect of Anaesthetics)
  • during the use of laser procedures

 

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Why visit my practice for Aesthetic Treatment?

Nine years of clinical experience in administering Botox and Fillers only the best products on the market are used for treatment. Botox and Juvederm Fillers are of the most researched and clinically trusted products available. 

(Botox is a brand name. Not all Botox is Botox as such. The generic name for botox is wrinkle reduction therapy. It’s like calling all animals dogs: all dogs are animals, but not all animals are dogs. In the same way, all Botox is wrinkle reduction therapy, but not all practitioners use Botox for wrinkle reduction therapy. Some use cheaper generic alternatives.)

Dentists are known to have exceptional knowledge of the facial muscles and their anatomy and function. As a Dentist, you inject for a living and you are therefore more conscientious of not inflicting pain and administering a very accurate injection

 

What is Botox?

Botox is a muscle relaxant which is injected into the skin or muscles and prevents excessive contractions of the muscles. It works by partially blocking the nerve impulses to muscles which have been injected. 

Botox can be used to treat the following:

  • Frown lines between the eyes
  • Frown lines in the forehead
  • Crow’s feet around the eyes
  • Bunny lines of the nose
  • Brow lift
  • Fine lines around the lips (typical smoker’s lines)
  • Overactive chin muscles
  • Pulling down of thecorners of the mouth (when Botox is used here, it slows down the formation of Marionette lines and jowls, it will also give you a happier and friendlier appearance, seeing as your mouth won’t be pulled down into a sad face all the time)
  • Grinding of teeth and muscles spasms of the jaw muscles

 

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The ideal age to start using Botox is 30yrs on an annual basis to slow down ageing. It is effective up to the age of 65.

Botox should NOT be used in the following cases:

  • Infection in the area to be treated
  • Known allergy to Botox
  • Pregnancy
  • Breastfeeding women
  • Certain Antibiotics and Muscle relaxants can increase the effect of Botox
  • 24-48 hours before flying
  • 24-48 hours before any strenuous exercise
  • Patients who suffer from Myasthenia Gravis or Lambert Eaton Syndrome

Possible side effects and complications:

In the time I’ve been administering Botox, the most common side-effect I’ve encountered is a transient headache and even this seldomly occurs.

  • 1% of the population form antibodies against Botox and this makes subsequent treatment ineffective
  • Bruising and swelling at the injection site
  • allergic reactions
  • rash
  • itching
  • headache
  • redness
  • infection
  • Drooping eyelid
  • Facial Asymmetry

Botox lasts for 3 months on average. The anti-ageing effects last for longer and therefore only needs to be repeated every 6-12 months.

 

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Fillers

Facial fillers are facial injections consisting of hyaluronic acid and is used to eliminate wrinkles, enhance lips and replace soft tissue volume loss, associated with ageing. Hyaluronic acid is the natural filler substance in the body which contributes to volume and hydration and is therefore safe to use.

With age, fine lines and wrinkles form and sagging of the skin occurs due to sun exposure and years of muscle movement such a smiling, chewing and frowning. All of this contributes to breakdown of the skin.

The face starts to lack volume and appears aged with deeper nasolabial folds, unaesthetic marionette lines, deep mentalis fold, lips start to thin, turning down the corners of the mouth and fine lines appear around the lips.

A filler such as Juvederm (the same company which manufactures the original Botox) can then be injected to replace the lost volume and to soften or even eradicate fine lines. Different types of filler is used to treat different deficiencies:

  • Fine lines
  • Volume loss
  • Lip Augmentation
  • Rehydration

Possible side effects include allergic reaction, bruising at injection site, temporary redness, swelling, pain or tenderness and discolouration. Lumps or nodules can also form.

There is no down time with Botox and Fillers, which allow patients to return to work and resume their normal activities. Excessive sun or heat exposure as well as strenuous activities should be refrained from for the first 24 hours.

Fillers draw in water and discreetly plumps and hydrates the injected area for the first 6-12 weeks after injection. Fillers last for 12-18 months depending on the rate at which your body breaks down the filler and depending on the product used.

 

Besides using Botox and Fillers, there are various ways you can age gracefully

  • Exercise
  • Balanced diet 
  • Use Sunscreen everyday
  • Don’t smoke
  • Drinking a lot of water
  • Apply moisturisers daily, both day and night creams and eye creams. Also don’t neglect other exposed areas such as the hands and neck. 

In order to perform good restorative work, proper anaesthesia is of utmost importance. Computerised aneasthetic known as "the Wand" is used instead of the conventional syringe. This effects a fraction of the sensation one would usually feel with conventional methods.

Modern restorative materials require very specific placement in order to prevent shrinkage with subsequent leakage and pain.

Therefore isolation in the form of rubberdam is used to assure a clean, uncontaminated work surface. Restorations are placed layer by layer, shaped and finished to an aesthetic and anatomically functional standard.

 

 

Only the latest White restorative materials are used. In the case of large fillings, especially when old metal (Amalgam fillings) are replaced, porcelain inlays are used due their durability, restoration of function and excellent interdental contour. This also helps to prevent food traps in between teeth.

Post-operative sensitivity: In many cases, after having a restoration (filling) placed, sensitivity is experienced, especially to cold stimuli or on biting. This is due to the heat, cold and vibration which gets translated to the nerve during the preparation of the cavity (drilling). This elicits an inflammatory response in the nerve chamber, which can take up to 12 weeks to resolve completely. In cases where decay is in close proximity to the nerve chamber, inflammation is already present, whether symptomatic or not. In such cases a protective base layer is placed in order to provide maximum isolation and protection of the nerve, before the restoration is placed.

 
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Scaling and polishing: No matter how well you brush, floss etc., there is always a build-up of calculus on teeth.

Calculus is hard mineralised plaque which can only be removed professionally. It forms especially in those hard to reach places and cannot be removed by brushing. Ultrasonic scaling, assisted by hand scaling is used to remove these hard deposits, without causing any damage to the teeth or gums. Scaling is followed by polishing, which smoothens tooth surfaces and aids in preventing future build-up.

Flossing between all of the teeth helps to remove debris where the scaler can't reach. This further clears the space between the teeth Fluoride application: No oral hygiene session would be complete without comprehensive oral hygiene instructions and diet analysis.

Products Recommended

  •   Philips Sonicare Electric Toothbrushes
  •   Champion Floss/Colgate Total Floss
  •   Colgate Plax Mouthwash
  •   Biorepair Toothpaste/Olgani Toothpaste
  •   Colgate Total Toothpaste

 

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The golden rule is never to do anything the child doesn't freely allow you to do.
(This applies to children of all ages i.e. 1-99!)


Each child has a unique and finely tuned emotional make-up. With adults you may have more than one chance, but if you overstep the boundary with a child once, the trust is broken.

  • The show-tell-do approach is followed.
  • First of all we make friends by talking and joking
  • We make sure our little patient knows why they are here (sometimes a prompt from Mom/Dad helps)
  • At the first appointments it is usually a good idea just to check the teeth and identify problem areas
  • At subsequent appointments necessary preventative and restorative work is performed, but first we

 

SHOW the youngster the equipment and materials to be used

TELL him/her exactly what we are going to do (this gets done throughout the session)

DO a little demonstration on their fingernail. When they feel/see/hear for themselves that it doesn't hurt, their minds are put at ease and work can commence.

 

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Brushing twice daily

Despite advice on selecting the correct toothbrush and toothpaste, brushing techniques are established to maintain a million dollar smile.

In brushing, the golden rule is to clean with maximum efficiency without hurting your gums or damaging your teeth.

  

Flossing once daily
Brushing alone is not enough. To prevent infection, swelling, bleeding and receding gums as well as tooth decay, trapped food and other debris needs to be removed between ALL the teeth at least once a day. The best time to floss is in the evening before you brush your teeth.

  

Rinsing twice daily

  • Rinsing with a reputable mouthwash, removes all debris loosened by flossing and brushing.
  • It prevents plaque formation
  • Teeth are strengthened
  • Gum disease and tooth decay is prevented
  • Freshens your breath (Major confidence booster!)
  • Don't rinse with water after rinsing with a mouthwash for 30 minutes. This will ensure the effectivity of your mouthwash


TRIPLE your kissability factor: BRUSH, FLOSS, RINSE!

  

Healthy diet

As in any other discipline, be it Medical or lifestyle related, a balanced healthy diet is essential. In terms of dentistry the same applies, but special attention needs to be given to exclude or limit the intake of the following substances:

Cola drinks: this includes Coke, Coke light, Pepsi and Tab. The phosphoric acid content of these drinks is what causes erosion, demineralization and decay of teeth. Should one occasionally drink Coke, use a straw. This stops it from flushing the teeth.

Energy drinks such as Energade, Lucozade, Powerade and Game are very acidic and cause the same damage as the Cola drinks. Should these drinks be utilized for sport purposes, the mouth should be rinsed frequently with water to neutralize the acidity and remineralize the teeth.

Citrus products are known to be rich in Vitamin C and other nutrients. They can however be the cause of serious erosion of the teeth. To counteract this effect, water can also be used to rinse the mouth after ingesting lemons, oranges and their related juice products.

Sweets and toffees: These stick to teeth and fuel the decay process. Hard suckers and toffees are also known to dislodge fillings and crowns and can even cause tooth fractures

  

Bi-annual visits to the dentist

The oral cavity should be examined and teeth should be cleaned (oral prophylaxis) every six months.

Bi-annual examinations are far removed from only detecting cavities. Except for identifying new decay on teeth, screening for other pathology such as malignancies and gum disease is also performed.

Whether you are the Queen or Superman, no one is born tartar proof! Scaling and polishing of teeth ensures that the calculus (tartar) accumulated is removed in all of those hard to reach places. This helps to ensure the longevity of your teeth and the health of your gums.

 
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Age Related Prevention

When food or fluid is ingested, the level of acidity rises. This is buffered by your saliva, which is your body's own defense against plaque formation and decay. Should one ingest highly refined sugars, sticky sweets and toffees and other like substances, the acidity levels remain raised, providing a favourable environment for tooth decay.


For each age group there are specific habits which should be managed carefully to prevent damage to teeth. Parents, remember that you carry responsibility for your child's teeth until they turn 18!

 

Infants

From the time the first teeth erupt, brushing needs to commence. This is usually as early as six months when the first lower incisors make their appearance. A first stage toothbrush with a bit of kids' toothpaste, the size of a match head, can be used to cleanse the teeth.

The infant's diet is key to preventing tooth decay. Your baby should never sleep with a bottle containing anything other than water. If you don't teach your children to ingest sugar, they won't crave it. Should your baby sleep with a bottle of milk, tea or juice, the acid levels in the mouth stay raised and decay sets in. This is referred to as baby bottle caries.


This type of decay is often mistaken for tooth decay caused by antibiotics. Doctors often tell the parents this, in order to passify them. This is however a fallacy. Pedodontists will tell you that there is not a single antibiotic on the market which can cause tooth decay. Antibiotics are ingested three to four times daily. This is not enough to cause a consistently raised level of acidity in the mouth. Tetracyclines, if ingested during pregnancy, can cause grayish staing of the child's permanent teeth.

It is paramount for you to closely consider your child's diet in collaboration with your pediatrician.

 

Toddlers

Hard suckers, toffees, excessive intake of energy drinks and cola drinks are the big culprits in this age group. We have long since given up trying to ban sweets and coke from the diet. Follow the following guidelines to maintain healthy teeth:

Brush twice daily, using a stage specific toothbrush and kids' toothpaste, no larger than pea size. Brush AFTER breakfast and BEFORE going to bed. Under NO circumstances should your child be allowed to go to bed without brushing.

At this age group you should visit the dentist at least once a year.

Intake of sweets should be limited to no more than twice a week. Once midweek and once on weekends.

Soft gelatine sweets, soft chocolates and marshmallows don't stick to teeth as much as toffees and hard suckers do. Hard suckers and sticky toffees can cause fracture of teeth and dislodge existing fillings.

  • The intake of the acidic drinks mentioned in the diet section, should be limited to once a week.
  • Should the abovementioned drinks be ingested (once a week max.), a straw should be used.
  • Let your child eat all their sweets at once, don't let them save some for later. This will elicit a once of rise in acidity.
  • After eating sweets or ingesting acidic drinks, let your child rinse with water. Water will buffer the acidity in the mouth and will remineralize the teeth.
  • REMEMBER: Coke light, Tab and other diet cola drinks are also acidic and are not suitable alternatives
  • Water, diluted juice and unsweetened non-acidic drinks are good alternatives.
  • Don't stock any sweets, toffees or any of the other harmful products at home. If it's not accessible or available, they will not be used.


Waver of liability: The abovementioned are just guidelines. Children's sugar intake at school, parties etc. can not always be controlled. To prevent decay, intake of all refined sugars, such as sweets and toffees as well as sweetened drinks must be avoided.

 

Pre-adolescence

Most of the permanent teeth erupt during this stage. Permanent teeth need to last you a lifetime, therefore a strict preventative programme and diet need to be in place.

  • Brush twice daily, using a stage specific toothbrush and adult toothpaste, no larger than pea size. Brush AFTER breakfast and BEFORE going to bed. Under NO circumstances should your child be allowed to go to bed without brushing.
  • At this age group you should visit the dentist at least once a year.
  • Intake of sweets should be limited to no more than twice a week. Once midweek and once on weekends.
  • Hard suckers and sticky toffees can cause fracture of teeth and dislodge existing fillings.
  • The intake of the acidic drinks mentioned in the diet section, should be limited to once a week.
  • Should the abovementioned drinks be ingested (once a week max.), a straw should be used.
  • Let your child eat all their sweets at once, don’t let them save some for later. This will elicit a once of rise in acidity.
  • After eating sweets or ingesting acidic drinks, let your child rinse with water. Water will buffer the acidity in the mouth and will remineralize the teeth.
  • REMEMBER: Coke light, Tab and other diet cola drinks are also acidic and are not suitable alternatives.
  • Water, diluted juice and unsweetened non-acidic drinks are good alternatives.
  • Don’t stock any sweets, toffees or any of the other harmful products at home. If it’s not accessible or available, they will not be used.

 

Adolescents

Puberty sets in and the last permanent teeth make their appearance in the oral cavity. Increased responsibility is accompanied by more freedom. A hormonal explosion sets the scene against a backdrop of rebellion and confusion. However, the parent stays responsible for looking after the child's teeth until adulthood.

Eating disorders such as Bulimia can cause rampant decay of the teeth. Since this often starts in teenage years, it's important to bring this to the attention of your dentist so as to discreetly restore and prevent damage to the teeth.

  • Brush twice daily, using a stage specific toothbrush and kids’ toothpaste, no larger than pea size. Brush AFTER breakfast and BEFORE going to bed. Under NO circumstances should your child be allowed to go to bed without brushing.
  • At this age group you should visit the dentist at least once a year.
  • Intake of sweets should be limited to no more than twice a week. Once midweek and once on weekends.
  • Soft gelatine sweets, soft chocolates and marshmallows don’t stick to teeth as much as toffees and hard suckers do. Hard suckers and sticky toffees can cause fracture of teeth and dislodge existing fillings.
  • The intake of the acidic drinks mentioned in the diet section, should be limited to once a week.
  • Should the abovementioned drinks be ingested (once a week max.), a straw should be used.
  • Let your child eat all their sweets at once, don’t let them save some for later. This will elicit a once of rise in acidity.
  • After eating sweets or ingesting acidic drinks, let your child rinse with water. Water will buffer the acidity in the mouth and will remineralize the teeth.
  • REMEMBER: Coke light, Tab and other diet cola drinks are also acidic and are not suitable alternatives
  • Water, diluted juice and unsweetened non-acidic drinks are good alternatives.
  • Don’t stock any sweets, toffees or any of the other harmful products at home. If it’s not accessible or available, they will not be used.

By following these guidelines, not only will the teeth be preserved, your child will be less prone to other conditions such as ADD, hyperactivity, irritability, acquired Diabetes etc.

Waver of liability: The abovementioned are just guidelines. Children's sugar intake at school, parties etc. can not always be controlled. To prevent decay, intake of all refined sugars, such as sweets and toffees as well as sweetened drinks must be avoided.

 

Adult

When embarking on a career or exploring life, it's easy to neglect the principles laid down by your parents. Irreparable damage is usually the result of prolonged negligence and ignorance. Excuses such as deadlines or the lack of time and money are by far outweighed by the regret when your negligence leaves you in a wake of pain and toothlesness.

Unless you have a mother, spouse or PA co-ordinating your healthcare, one has to be consistent in going for those bi-annual check-ups and prophylaxis (scaling and polishing).

Flossing DAILY will prevent not only tooth decay but also gum

disease. Not flossing however, will lead to gum disease and subsequently bone loss, tooth mobility and subsequently tooth loss. Brushing alone is not enough.

Flossing will also prevent bad breath. Only your spouse or your dentist will tell you if you have bad breath (if you're lucky). There are many causes for bad breath, but last week's chicken sandwich stuck between your molars is a pretty obvious one.

"I floss every day. I can't understand why my gums bleed and my breath still smells." Try flossing all your teeth, including the molars. Most of the food gets stuck here.

 

Pregnant mother

Raised estrogen and progesterone levels give rise to increased blood flow to the gingiva. There is an exaggerated response to any stimulus such as plaque, which elicits inflammation and swelling. Bleeding is caused more readily during brushing and flossing, unless a thorough oral hygiene regime is in place.

Morning sickness causes raised acidity in the oral cavity which then causes demineralization, erosion and decay. Rinsing out with water regularly and sticking to the five elements of a good oral hygiene regime will prevent damage.

Taking of x-rays (Rontgen Photo's) should be avoided during pregnancy.


Pregnancy does not cause a deterioration of teeth, neglect however does. This is not without good reason; pregnancy isn't for ninnys. Fatigue, aches, pains, nausea and emotional turmoil puts taking care of teeth on the back burner. As with adult specific prevention, consistency is of utmost importance.

If your teeth were healthy before pregnancy (according to your dentist), they'll be healthy after pregnancy should you follow a tight preventative programme.

AVOID taking Tetracycline during pregnancy. This is a type of anti-biotic which can cause staining of your child's permanent teeth.

 

Late adulthood

The five elements of good oral health stay the same, but times change and with that our bodies also change. During late adulthood you face the consequences of decisions made in years gone by. Does this mean you need to have all your teeth out? By no means! Once again consistently managing your oral health will ensure you of the longevity of your teeth.

Physiological changes during late adulthood include a decrease in salivary flow and in turn a decrease in the body's ability to fight decay. However, sticking to a strict hygiene programme and diet will counteract decay.

After many years of brushing too hard, gums recede and roots become exposed or decayed. Food traps appear and periodontal disease sets in. Mobility of teeth follows and subsequent loss is inevitable. Having your teeth regularly scaled and polished will prevent this from happening.

 

This is not without reason. Most people put off going to the dentist until excruciating pain or severe swelling persuades them otherwise. Often Dentists act on it too hastily. Rather than containing the infection first, they impatiently expose the nerve and elicit severe pain, not to mention lifelong mental scars.

There is a simple explanation for this phenomena: Infection creates an acidic medium which renders anaesthetic almost useless. Another explanation could be that more time needs to be given for anaesthetic to work before the procedure commences.

 

Why is root canal treatment necessary?

In short:

  • to relieve pain,
  • prevent further infection
  • prolong the lifespan and function of the tooth
  • preservation of the supporting bone and gums
  • to obtain extra anchorage for crowns and restorations


Once tooth decay penetrates the enamel (outer layer of the tooth), it spreads quickly through the dentine, heading straight to the nerve which is the main supply of sustaining nutrients, fluids etc. Bacteria produce waste products which are small enough to travel throught the tiny tubes in the dentine, straight to the nerve. This causes inflammation in the nerve chamber of the tooth. As decay progresses so does the inflammation. If the inflammation gets to a point where it can no longer be reversed by the body's own defences, the nerve dies of.

Once Bateria penetrates the nerve chamber, it can communicate freely with the bone causing inflammation and infection of the bone. This is the start of an abscess. Should the infection not be contained in time the abscess can become so large that tooth loss is inevitable.

Root canal treatment helps to relieve pain, but this is not the only reason it's performed. Once the nerve starts dying off, root canal treatment becomes necessary, to stop bacteria from multiplying in the nerve chamber and canals, which will in turn cause infection in the bone. A nerve in the process of dying off is extremely irritable and very often oversensitive to stimuli. The tooth is initially more cold sensitive and then later becomes more heat sensitive. By removing the nerve, this pain gets eliminated.

 

What does Root Canal Treatment entail?

At the first appointment, all decay gets excavated and the nerve chamber is opened up. The nerve is then removed after which the canals are disinfected and medicated with an anti-septic medicament. A small cotton wool pellet gets placed in the nerve chamber to cover the canals and the tooth is temporarily restored until the next visit. This gives the infection time to clear up and for inflammation to subside. There is usually very mild pain for the first two days after the procedure, after which the tooth settles down.

During the second appointment, the canals are shaped and disinfected. Should the shaping or preparation be very complex, a third visit may be necessary to to fill the canals. The canals are sealed off using small filler tips and cement which seals off the root right down to the tip.

 
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Crowns

Same day crowns are manufactured in the surgery while you wait. Crowns are used to protect teeth from fracture, leakage and decay. The crown covers the entire tooth surface and is manufactured in the surgery.

When is a crown necessary?
 

•After root canal treatment, teeth become brittle and usually discolour. The crown prevents fracture and maintains or restores the natural appearance.

•When a tooth is heavily restored, cusps have been undermined and are less resistant to bite forces. To prevent fracture and possible tooth loss, a crown is the indicated treatment option.

•Restorations (fillings) don't last as long as crowns and there is a constant attack on the integrity of the area where the tooth and the filling meets. This leads to micro-leakage with time and the tooth becomes decayed underneath the filling. By crowning the tooth, this is prevented, as long as good oral hygiene is maintained.

•Other reasons such as congenital staining, developmental defects and Orthodontics among other things also justify crowning of teeth.

What does the procedure entail?

•First of all the tooth needs to be strong enough and free of any decay or infection. This may necessitate a core build-up or even root canal treatment and the placing of pins so as to get anchorage from the roots.

•At a subsequent appointment, the outer tooth structure and filling gets stripped away, the tooth is scanned, the crown is designd digitally and then gets milled and cemented in the same visit. No temporary crown or second visit is needed.

 

Bridges


Bridges are meant to bridge the gap between two teeth. The bridge consists of two or more crowns and one or more pontics (dummy teeth). In certain cases, a bridge can be utilised to replace up to 4 teeth. The crowns hold onto the anchor teeth on both sides of the gap and the pontic/dummy is attached to these two crowns ensuring a solid unit.

A bridge can only be used to bridge a gap if there are healthy teeth on both sides of the gap. If this is not the case, implants or partial dentures can be considered.

The procedure is the same as for crowns. When a tooth is replaced by means of a bridge, directly after extraction, the extraction site should be given at least two months to heal before the permanent bridge is placed. Should this not be done, the gums will recede and there will be an unsightly, unhygienic space between the gums and the bridge.

Between the ages 16 and 20, the third permanent molars, better known as wisdom teeth, make their appearance in the mouth. If there is enough space to accommodate these teeth, you probably wouldn't know you had them. In most cases there is insufficient space for these teeth to erupt and they beome impacted or trapped in the bone. Sometimes they are trapped once they've started erupting, rendering them half erupted, half unerupted.

The mode of treatment most subscribed to is removal of all four wisdom teeth simultaneously under general anaesthesia. This is usually performed by a Maxillo-Facial surgeon.

Depending on the severity of impaction, a dentist can also remove wisdom teeth, especially if only one or two teeth need to be removed.

Why remove wisdom teeth? Why not just leave them as they are?

  • Food gets trapped between the wisdom tooth and the second molar. This can lead to tooth decay on the second molar which is needed for function in the mouth. Thus you lose a functional tooth for the sake of keeping a non-functional tooth.
  • Very often continuous infection comes about in the gum surrounding the tooth, causing a lot of pain and discomfort, especially when eating. It is very difficult to cleanse in between a partially erupted tooth and another. Also it's hard to reach that far back with floss and a toothbrush.
  • As mentioned already, it's very hard to keep clean as far back as the wisdom teeth. Often the wisdom teeth become decayed, which is often impossible to restore and extraction becomes necessary.
  • Wisdom teeth don't serve much of a function and are therefore not essential to maintain stability of the bite. They take up space which could rather be used to relieve/prevent crowding of other functionally essential teeth.
  • Wisdom teeth are often associated with cysts which, should they become malignant, can be devastatingly destructive.
 
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Depending on the severity and complexity of the specific case, either a Dentist or a Prosthodontist can perform treatment, the latter being the specialist of choice to treat severe cases.

Different types of treatment are used, depending on the client's budget i.t.o. time and financial. Biological considerations such as the quantity and quality of bone also play a role.

One also needs to take many other functional factors into consideration, such as how will it affect the person's speech, chewing, lip support (aesthetics) and the joints where the lower jaw articulates on the skull.

The use of full upper and lower dentures have become almost redundant, without the use of implants. Especially full lower dentures need to be supported by at least four implants, to ensure functionality. Four to six implants are usually placed in the upper jaw to sustain denture retention.

Full upper and lower bridges can be attached permanently to the implants to fully restore function, without having to remove and cleanse them. The implants need to be kept clean though, but bi-annual visits to the dentist will compliment daily home-care.

Where many healthy teeth are available, a combination of implants, crowns, bridges and dentures can be used to reconstruct the bite and the smile.

To perform a full oral rehabilitation, meticulous care must be given to the treatment planning and this is usually a team effort between the dentist and a group of specialists.

Extraction: Please read carefully!

  • NO Smoking or use of Alcohol for at least 48 hours following extraction! This can lead to severe complications.
  • Do not play with your tongue in the extraction site. This may dislodge the blood clot. The blood clot is centre to the healing process and the closing of the wound. Should it become dislodged, infection and severe pain may follow.
  • Be careful not to bite your lips, cheek or tongue until the anaesthetic has worn off. This may take a few hours.
  • Do not drink any hot beverages for the first two hours after the extraction.
  • For the first two days, eat soft foods on the unaffected side. Take special care for food not to go into the extraction site.
  • Brush the teeth very carefully after every meal, taking special care not to disrupt the blood clot.
  • Should the bleeding not stop, take a piece of gauze, place it over the tooth socket and bite firmly on it for at least 30 minutes. Should bleeding not stop, contact your Dentist, or your Doctor or the nearest Casualty unit. A damp teabag may be used instead of a piece of gauze.
  • Wait 24 Hours before rinsing out the mouth. Also don't rinse with any mouthwash for the first three days, unless prompted to do so by your dentist.
  • After the first 24 Hours following extraction, start rinsing the mouth with lukewarm saltwater, 3 times a day, for 3 days. The saltwater mixture can be prepared by dissolving one teaspoon of salt in a cup of warm (not Hot) water.
  • Mild pain and discomfort is to be expected after an extraction. However, should a throbbing pain prevail or keep you awake, or should there be severe swelling, please contact your dentist to advise you on what to do. Very often the cause is a septic tooth socket which needs to be cleaned out under local anaesthetic and medicated with an Anti-Biotic and Pain medication.
  • Pain killers other than aspirin may be taken to relieve mild pain. Aspirin can thin the blood and cause extensive bleeding. Should you be using aspirin as a blood thinner, your GP or Physician will advise you on what to do.

 

Do not use aspirin directly on the gum!!! Not ever!
This can cause severe chemical burns to the gums.
It will provide more relief if ingested as prescribed.