dental-brisbane

REBUILDING A SMILE FOR A BUSY LIFESTYLE

In his late 50’s,  and 60 looming, Paul (real name withheld for privacy) decided it was time to fix his teeth.  Paul worked a high stress, long hour’s job and to cope with this he enjoyed marathon running.  Paul would often consume sport drinks and high sugar gels during events.

The combination of bruxing (grinding his teeth) due to the pressures of the job and the acid erosion due to the sport drinks, resulted in softened teeth that were ground down by at least half their original length.  Multiple fillings had failed, some teeth had broken and Paul no longer smiled to hide the appearance of his teeth.

Paul did not have the time for the hours it takes to crown the teeth so after much discussion he decided upon a composite rehabilitation – rebuilding teeth with composite resin or white filling material to reconstruct the teeth.

Composite rehabilitation and rebuilding teeth involves removing old fillings, and roughening the teeth, minimal tooth structure is removed making it a very conservative form of reconstruction.  Composite resin is then bonded to the teeth directly.

The Treatment Plan:

Day 1 (4 hours): Open the bite – Paul had become what we call “over closed”, to build the teeth back to their original height the bite had to be opened.

The top front 6 teeth were rebuilt first to the aesthetic smile guidelines – following these ensures the smile will look fantastic.

Day 2 (5 hours): The top back teeth (7 teeth) either side were rebuilt to their original height and an even bite plan established.

The very back top tooth was missing, but this did not require replacement. This tooth is subject to enormous pressures and is a high failure rate tooth, explaining why Paul already had this tooth removed.

Paul allowed 1 week to adapt to the new height of the bite. It is very easy for most people to adapt within a few days to changes to the bite.

Day 3 (4 hours): Paul returned the following week to rebuild the lower 6 front teeth to the original height.

Day 4 (5 hours): Finally the remaining lower back teeth were re-built to achieve an even bite plan and a restored smile.

 

With Pauls bite now restored,  he chose to replace the two lower missing back teeth with implants.

 

What can Paul expect in the future?

•Paul  now has the option in the future to replace any of the composite resin rebuilds with porcelain crowns.

•The normal life expectancy of composite resin reconstructions is excellent

•We can expect to rebuild at least one of the teeth every couple of years depending on the pressures the teeth are under.  This is often the perfect time to individually convert teeth over to stronger porcelain crowns if desired.

Paul has now stopped his sport drinks, increased his water intake and wears a night guard to protect the teeth from grinding.

“The process was well organised for me and very prompt – they were very professional and checked on me after every appointment” – Paul

(Real name and images withheld for privacy) Every surgical or invasive procedure caries risk and may not be suitable for everyone.

Brisbane Dentist

CREATING A SMILE FOR HER BIG 50TH

Today we have finished applying the final touches to our wonderful patients smile.  Its the best day of the week, and not because it’s Friday, but because we are a day closer to her big 50th bash on Saturday night.

Our gorgeous patient has lived with dark brown and opaque white spots on her front teeth from the minute they erupted as a 6 year old.  She also suffered a hockey injury when she was thirteen, killing another front tooth which was later root treated and took on a grey/black appearance.  Over the years she has thought about Veneers and even Crowns for the teeth, but was worried about cutting her teeth which were otherwise healthy.

With the help of GC Tooth Mousse we were able to develop a very conservative and tailored treatment plan:

 

• The plan was to internally bleach the dark tooth,  and externally bleach the remaining teeth.  This had to be carefully planned as we wanted all the teeth to end up the same colour, not one whiter than another.

• Inside the single black tooth, the root canal filling material (which is black in colour) was previously left high inside the tooth, making it instantly blacker.  This was removed and sealed with a white seal prior to internal bleaching.

In-chair teeth whitening (including laser whitening and light assisted whitening) can be unpredictable and sometimes even in-effective on brown enamel blemishes.  So we combined the in-office whitening with some custom made trays and take home whitening, as well as enamel micro-abrasion with GC Tooth Mousse applications.

Enamel micro-abrasion and Tooth mousse has been shown to “repair” areas of white and dark mottled enamel and help them to blend and disappear without cutting away good tooth structure.

Today we added one further appointment where we smoothed out a few minor chips and evened out the lengths of the teeth – a process known as enameloplasty.  The programme took about 4-6 weeks to complete.  She showed a wonderful commitment to following the instructions and did not suffer any pain or sensitivity.  Sensitivity is often less of a concern these days due to newer whitening gel formulations.  She will keep her custom trays to do a top up whitening in about 2 years.

Here’s to a wonderful party,  full of smiles!

(Photo’s and name have been withheld for privacy).   This treatment plan may not be suitable for everyone, each case is assessed individually.

 

Dental Smile Landmarks of Teeth

LANDMARKS OF A GREAT SMILE

There is far more to creating a smile then just the colour of the teeth.  The following will help you become an expert at analysing before and after images of teeth. When creating a smile the shape and position of teeth is based on symmetry, parallelism and mirror imaging.  These contemporary concepts of aesthetics are individualised for each persons smile.  Below is a brief outline adapted from an article by Dr Geoff Knight written almost 10 years ago but still relevant today,   of the initial landmarks we use to decide how to design your smile and shape your crowns, veneers and white fillings.

Mid-line –  The mid-line between the top front two teeth is in the middle of the smile and vertical. Shifts of more than a couple of millimetres can detract from the symmetry of the smile. (Red Line)

Lateral Emergence Profile –  The sides of the teeth are parallel and mirror images of each other with a slight inclination towards the midline. (Pink Lines)

Teeth Length, Width Proportions –  We call this the golden proportions where the lengths and widths of the teeth are in a certain proportion (the same proportions were used to build the columns of the Parthenon in Greece)

Smile Line –  The tips of the upper teeth, known as the smile line runs parallel with the lower lip. (Blue Line)

Gingival Line –  The gingival line, where the gum meets the teeth, runs parallel with the smile line but with slightly less curvature. This is critical if your gums are very visible when you smile. (Green Line)

Anterior Emergence Profile –  The side profile of the teeth is parallel with the side facial profile.  So when you look from the side of  the face, they follow the natural curve of the face.

Incisor Embrasures –  The size of the incisal embrasures (Grey Triangles)  and the angles of the incisal embrasures (Yellow Lines) increase from the midline outwards, they should be parallel and mirror each other.

So next time you see a smile that looks amazing like Megans, or indeed your own smile, it will most likely follow these rules.

 

whitening-870x350

HOW DOES TEETH WHITENING WORK?

Many of us know what teeth whitening is, but how does it actually work?  Knowing this will help you understand if it is right for you.

Teeth are discoloured due to large natural pigmented molecules that are trapped within the enamel and the dentine of the teeth.  The bigger these molecules and the more staining molecules that become trapped within them,  the darker the teeth appear.

All reputable whitening gels utilise hydrogen peroxide as the active end product.  Hydrogen peroxide breaks down into water, hydrogen and oxygen ions, and free radicals.  These are the ingredients that whiten your teeth.

Initially there is oxygenation of the stain molecules which removes them from the tooth structure.  This then starts to whiten the teeth and allows the free radicals to then penetrate further into the tooth structure.  The further these can penetrate with each treatment, the whiter the teeth become.  These radicals break down the large pigmented molecules into smaller components that become colourless or white.

It takes treatment over a period of time for the effective removal of the debris within the tooth structure.  If the treatment time is too short, the free radicals will not penetrate into the tooth structure enough and will not whiten effectively.

Whitening today is safe and effective but requires a degree of commitment and some well fitting custom trays to prevent saliva contamination which stops the gels working.

Keen for more….Discover the 5 Secrets of Teeth Whitening ..

We look forward to helping you smile with confidence.  Call us for  a chat on (07) 3839 7279

 

 

whats-in-a-good-smile

HOW TO FIX MY SMILE

What if we never smile because we don’t like the look of our teeth?

It is often said that putting on a great smile at the start of every day will make for a better day.  Smiling is believed to make us happier inside and make those around us feel happier and more positive.

Dr Barbara Szylkarski

“In many of the smile reconstructions we have completed, people often realise after the new smile is created, how little they did smile and how much this was affecting their day to day lives without even knowing it.” – Dr Barbara Szylkarski

What makes Teeth look Good?

What is it that makes one set of teeth look better than another?   It is usually the case that the dentist has paid close attention to the shape of the teeth and has avoided just fitting a crown, veener or filling of a “one size fits all” standard.

The criteria for fashion and beauty is constantly changing, influencing the way in which we want to look every day. The way we see teeth as beautiful is also constantly changing. Today a smile that is wide and bright is on demand.

Just like the beauty of the Parthenon in Greece, the guidelines for creating teeth are much the same: based on symmetry and parallelism. Many structures and designs in life that we see as beautiful follow this principle.

We aim for:

-A straight and centred midline

-The tips of the upper teeth run with the smile line of the lower lip

-The side profile of the teeth is parallel with the side facial profile

-The lengths and widths of the teeth are in proportion

-Rejuvenating a smile can be done by adding some curvature back to the edges of the teeth (reversing the worn look).

When these aesthetic and cosmetic dentistry principles are followed, we can create aesthetic smiles that look better than “off the shelf smiles”.

How do we make the changes?

We achieve the changes with a full mouth reconstruction or sometimes only with crowns, veneers, implants,  or white composite fillings.

It is also important to remember that some teeth may already follow most of these principles – it may be only one or two teeth that create disharmony.   So with some minor smoothing and re-contouring or some  teeth whitening, we can create aesthetic smiles very conservatively with minimal cost.

If you would like to read more about how to fix my smile , see our case studies: Rebuilding a smile for a busy lifestyle, or Creating a smile for her big 50th.

teeth-whiting

TEETH WHITENING FACTS – DON’T BE FOOLED

Teeth whitening is now the most googled dental search term. So with all the sales pitches you see on television, online and in the supermarket, does whitening actually work? And how should I whiten my teeth?

Facts about Teeth Whitening:

•Light and laser assisted teeth whitening will not give better teeth whitening than affordable take home dentist kits – As a professor at a recent seminar said – “the whitening is in the gels not the light”. But in-chair whitening is great if you want white teeth fast!

•At home teeth whitening with excellent fitting dentist custom made bleaching tray ‘s is the best form of whitening for longer lasting whiter teeth.

Carbamide Peroxide will only work if used in custom trays for more than 6 hours as it has to convert to Hydrogen Peroxide to whiten. This is why Hydrogen Peroxide can be worn for shorter times.

•Supermarket teeth whitening products are not in contact with your teeth for long enough to work,  and ultimately will not whiten your teeth.

•Higher concentrations can, but will not necessarily give you whiter teeth.

•Teeth that are difficult to whiten may even take 6-12 months of constant whitening, something that is very difficult to maintain and achieve. But for most teeth whitening is quick, easy and affordable.

There are many different systems and brands on the market which contain the exact same teeth whitening ingredients.  What differ’s is the other products combined with the whitening ingredient.  We use the Pola Day system as it is less acidic, causes next to no sensitivity and is fast and effective.  So now you are an expert in teeth whitening you will be better able to make an informed decision on what you choose to whiten your teeth.

You can Learn More about how teeth whitening works or call today (07) 3839 7279 for a chat about your options to Whiten your teeth.

onlay

ONLAYS – EXPANDING YOUR OPTIONS

When a tooth has suffered wear or tooth decay the options to restore the tooth are many, which makes for complex decision making.

The first and most affordable option is direct white composite fillings. As technology has improved since their invention, they are now a hard wearing and aesthetic choice. We have trained with Dr Didier Dietchi from Geneva. His method of placement results in a long lasting hand sculpted aesthetic restoration that can now out last the old amalgams. When a restoration is small this is the most conservative recommended option. However, direct resin can also be used in larger restorations with great success due to the now superior properties of the material.
The second choice is indirect resin restorations. The tooth is prepared, and an impression taken of the preparation, a resin filling is hand sculpted on a model and then cemented back into the tooth. This method is ideal if you have trouble keeping your mouth open and there is not suitable access to ensure an excellent fit.
The third choice is indirect porcelain or gold onlays or inlays. If the restoration extends into a flossing area between the teeth and includes some or complete coverage of a cusp, this is an excellent choice. The tooth is prepared, an impression taken and the inlay/onlay is made outside of the mouth by a laboratory technician and then re-cemented back into the tooth. Whilst the cost is more, the benefit is a harder wearing and longer lasting restoration. A favourable indication for onlays/inlays is where moving to a crown would be far too destructive to the tooth, but the size of the restoration is too large for a direct composite resin restoration.
Sometimes tooth structure needs to be sacrificed to protect a cracked tooth and sometimes teeth break or decay in a manner that makes them perfect for porcelain inlays and onlays. So every tooth needs to be evaluated individually and there is no one size fits all.

Click Here to Book an appointment online today or call us on (07) 3839 7279