Best dental health involves home care with twice daily toothbrushing for 2 minutes morning and night, flossing once a day, and 6 monthly preventive dental care appointments with professional scaling and cleaning, to reset your gum health.Read More
dentistry life at Brisbane Smile Boutique
The life and times of our dental practice, up to date news in dentistry and celebrations, happy moments in dentistry. Our blog outlines dentistry life at Brisbane Smile Boutique in Spring Hill in inner city Brisbane
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There are two type of tooth coloured restorations that are placed by dentists. One of these is COMPOSITE RESIN which is matched by the dentist to the remaining tooth structure. It is an advanced kind of plastic with glass filler particles, usually lasts about 5 to 7 years in a back tooth, but can chip, debond and stain with wear and tear. Resin is placed by the dentist straight on to the tooth, and set with a light and can be a good filling material when there is enough tooth structure to support it but if there is more tooth missing than present, it isn’t usually strong enough to hold up in the long term.
Porcelain is a natural looking option to restore teeth, that is not porous, and is much stronger than composite resin fillings. It is the most durable way to repair a damaged tooth with high aesthetic and functional demands. It is computer generated to match the defect in the tooth, without removing too much more tooth structure and is seamlessly bonded by your dentist. It is extremely durable, has excellent aesthetics and is very stable. It is made outside of the mouth with computer technology and hand finished and glazed by a master ceramist.. It takes two appointments to complete, where the first appointment is the preparation appointment, a temporary restoration is placed, and two weeks later the porcelain restoration is bonded into the cavity. They are bonded seamlessly to the remaining tooth by your dentist and look as good as the day they were placed many years later.
What is bruxism?
Excessive clenching or grinding of the teeth, is called bruxism, and is thought to be caused by physical or psychological stress, or a sleep disorder. If untreated, bruxism can cause excessive wear of the teeth leading to permanent damage of the teeth and sometimes of the jaw joints. Treatments involve repairing worn or damaged teeth with restorations, crowns or inlays, to replace the damaged tooth surface, and making an occlusal splint, or night guard, custom made from hard plastic that fits over the top teeth, and is worn at night to prevent further wear of the tooth surfaces, and to allow the jaw joint and muscles to relax.
TMJ disorders and muscle relaxant therapy
Disorders of the jaw joint, or TMJ (temporomandibular joint) are not uncommon and may lead to symptoms of pain and discomfort in the jaw called temporomandibular dysfunction (TMD) . Patients may complain of earaches, headaches and a limited ability to open their mouth. Other symptoms can include clicking, popping or grating sounds in the jaw joint, pain when opening and closing the mouth, a general tightness and pain in the muscles of the jaw, or broken teeth due to the excessive forces.
Muscle relaxant injection treatments are available for jaw pain caused by excessive tooth grinding. These can reduce the muscle activity of the jaw and provide relief from wear in the joint system, and can prevent the teeth grinding excessively.
Dentists will try to determine the cause of tooth grinding and associated symptoms, and offer a range of treatment options to reduce the discomfort and intervention before the excessive forces damage your teeth. There are several treatment options that can be used to immediately stop clenching or tooth grinding , and hopefully relieve the jaw pain.
People who clench or grind their teeth are able to relieve the pain in the jaw joints and muscles with physiotherapy treatments, pain relief, prescribed sedatives, occlusal splint therapy or therapeutic use of muscle relaxant injections into the jaw muscles.
Current management for bruxism
Current management by dentists for jaw muscle pain caused by grinding or clenching is with occlusal splint therapy or night guards made by the dentist, orthodontics, pain relief, full mouth rehabilitation, muscle relaxant injections, and very rarely, surgery.
Muscle relaxant injections with Botulinism Toxin A can decrease the destructive effects of tooth grinding. A diluted form of the muscle relaxant is injected in the jaw muscle to partially weaken muscles for a period of 4 to 6 months.
Bruxism is a disorder of repetitive and unconscious contraction of the masseter muscle, the large muscle that moves the jaw. Muscle relaxant injections weaken the jaw muscles enough to reduce the effects of teeth grinding and clenching, but not so much as to prevent proper use of the jaw muscle for eating and normal facial movements. A muscle relaxant treatment typically involves injections into the masseter muscles. It takes a few minutes per side, and you can start to expect feeling the effects after 5 days.
What is the muscle relaxant injection?
The muscle relaxant injection is Botulinism Toxin A, a prescription medicine which contains 100 units of muscle relaxant liquid and is a natural, purified protein that is used therapeutically in medicine to relax facial muscles, and is approved by the FDA (US) and TGA to treat medical conditions such as cerebral palsy. It is widely known for its uses in cosmetic work, as anti wrinkle injections.
How are muscle relaxant injections used in dentistry?
Dentists who have undergone appropriate training can use muscle relaxant injections to treat muscular pain and headaches due to muscle contractions in the head and face, focusing on the jaw area.
Severe and undiagnosed tooth grinding and clenching can lead to headaches, pain in the jaw joint, muscles of the jaw, enlarged masseter muscles, tooth wear and broken teeth, and is thought to be cause by fatigue, stress and emotional extremes.
How does the muscle relaxant injection work?
Approximately 90% of all headaches are thought to be caused by muscle contraction. Pain is minimised with muscle relaxant injections into the muscles of the jaws so that they cannot be contracted fully, therefore the pain is minimised.
What does the treatment involve?
Muscle relaxant injections are usually administered by a very fine needle into the muscles that are causing the pain (eg. masseters, temporalis, frontalis) with a selected appropriate dose. The rest of the muscles still can function normally therefore chewing is mostly unaffected. No anaesthetic is required since the procedure has minimal discomfort, with just a slight sting at the injection site. The treatment generally takes around 15 minutes for a full treatment. The muscle relaxant treatment takes around 5 days to begin taking effect and up to 7 days for the full effect to be felt.
How long does it last?
This varies from individual to individual but usually 3-6 months. Repeat injections may result in the effects being prolonged.
Contraindications to using muscle relaxant
- Pregnancy or breastfeeding
- Allergy to albumin
- an infection, skin condition or muscle weakness
- Have Eaton-Lambert syndrome, Lou Gehrig’s disease or myasthenia gravis.
Any surgical or invasive procedure carries risks. Before proceeding, we recommend that you ask any questions that you wish, advise of any associated issues and seek a second opinion from another qualified health practitioner.
What are the Side Effects?
The amounts are carefully measured appropriately for your case and the injection site is very localized therefore the side effects are minimised.
Possible side effects include but are not limited to discomfort, burning/stinging, swelling, redness or bruising around the injection site. Side effects are minimised by using a trained professional and usually minimal.
Although primary (or baby) teeth are only present during early childhood years, they play an important role in the development of your child’s smile and long term oral health.
This is because primary teeth:
- Help protect developing adult teeth
- Prevent jaw bone loss and gum deterioration
- Retain space within the mouth for the correct positioning of adult teeth
- Support the development of your child’s jaw and facial structure
It is highly important to invest in the health of your child’s baby teeth by maintaining a comprehensive at home dental care routine and visiting the dentist and dental hygienist every six months for a check-up, or yearly at least.
TOP TIPS TO CARE FOR BABIES AND TODDLERS' TEETH
1. Give your baby and toddler whole and unprocessed foods, as much as is possible.
2. There is no reason to ever give your baby or toddler anything with refined sugars, including cakes, biscuits, lollies, ice-cream and sugary drinks, including juices. Some fruit or cheese is a good little treat.
3. Breast feed your baby as long as is possible, and as long as your are comfortable.
4. Never add anything to formula or milk in a bottle or cup. Adding honey or something like that will not make your baby sleep better.
5. Start brushing your baby's teeth as soon as they come through, around 6 months of age, but don't worry if they come through later than this.
6. Do brush your toddler's teeth even if they get upset with you about this. The night time brushing is incredibly important to remove all of the food debris that gets stuck in the back teeth to prevent decay.
7. It sounds impossible, but if you can, floss your toddler's teeth from 2.5 years of age.
8. Take your toddler to the dentist around the age of 2.5 for a gentle introduction and ride in the chair, and to make regular dental preventive care a part of life for your child. Six monthly dental checks are best. Polishes with the dentist are normally done around the age of 5 to keep the teeth stain-free.
9. Use a baby toothbrush twice a day from when the teeth come through, and use the smallest dab of child's toothpaste. Keep the toothpaste away from your baby and treat it like a medicine. Change your baby's toothbrush regularly.
10. The baby teeth are critically important to keep the bite in the correct place, and toddlers are often seen with draining and painful abscesses which require General Anaesthetic work with Dental specialists. Although they do all fall out by the time your child is a teenager, the condition of the baby teeth is a marker of how the adult teeth will most likely be.
Good habits from a very early age create good habits for life.