Dos and dont’s

• Do wear a mouth guard at all times when playing sports.
• Do inform yourself about the most common oral injuries.
• Do wear a mouth guard custom-fitted by your dentist, especially if you wear fixed dental appliances such as braces or bridgework.

• Do not wear removable appliances (retainers, bridge, or complete or partial dentures) when playing sports.

What are your choices

There are three types of mouth guards: custom-made, mouth-formed and ready-made.

• Custom-made mouth guards are professionally designed by your dentist from a cast model of your teeth. Because they are designed to cover all back teeth and cushion the entire jaw, they can prevent concussions caused by blows to the chin. Custom guards may be slightly more expensive than commercially produced mouthpieces, but they offer the best possible fit and protection. They are more secure in the mouth and do not interfere with speech or breathing. Calling plays or formations, for instance, will not be impeded by custom guards.
• Mouth-formed guards, also called “boil and bite,” should also be fitted by your dentist. This is generally done by shaping a soft pre-formed guard to the contours of the teeth and allowing it to harden. However, these devices are difficult to design for athletes who wear braces and can become brittle after prolonged use.
• Ready-made, commercial mouth guards can be purchased at most sporting goods stores and are made of rubber or polyvinyl. They are the least expensive but also the least effective. Keep your mouth guard in top shape by rinsing it in water. Do not use denture cleaners. Keep it in a strong rigid box for protection.

Remember, your mouthguard will protect one of your vital assets.

Post Op information for restorative procedures

Following a procedure to restore your tooth - whether it be a filling, crown or bridge - you should realize that there is a certain amount of trauma/irritation that your nerve may encounter. This is usually a factor of the amount of decay and the size of the previous filling material. If you started with a cold sensitive tooth, post operative sensitivity may be more common. Following restoration of your tooth/teeth, you may experience some of the following:

• Thermal sensitivity either cold and/or hot. This is not of much concern if the sensitivity only last for a few seconds.
• Biting sensitivity. The most common cause of this is when the bite is a bit high. Sometimes it can be hard to duplicate the correct bite when you are still frozen.
• Jaw pain and headaches. This is usually a sign that the bite is high and you are grinding/clenching on the new restoration(s)
• Prolonged thermal sensitivity and/or throbbing pain. This may be a sign that the insult to the nerve was more than it could endure.

After a procedure, if you feel that the bite is not correct, we ask that you let us know within a week. If you ignore this sign, then you risk further trauma to your tooth as well as possible fracture of the new restoration.

Post Op information for root canal procedures

Following your root canal procedure, you should expect all thermal sensitivity for that tooth to disappear. For 95% of all root canal treated teeth, all symptoms should begin to disappear and subside within three days. 5% of root canal treated teeth will show postoperative sensitivity resulting in pain on biting as well as possible swelling. This may occur even in the event that the root canal procedure was entirely successful. We recommend you take a basic anti-inflammatory agent (we recommend advil/ibuprofin; 400mg every six hours) for up to two days, in order to greatly reduce postoperative discomfort. In the event that you are experiencing rapidly progressing pain and swelling after a root canal procedure, we recommend that you call your dentist as soon as possible. It is very likely that antibiotic therapy will be required at this point. Please have the phone number of your local pharmacy handy as the dentist will need this in order to phone in your prescription. Also, in the event that your call is after hours and your dentist is away from the office, please remind the dentist if you have any antibiotic allergies. Usually, the pharmacist will have this information on hand anyways.

It is important to note, that root canal treatment has a 98% success rate on the first treatment. Approximately 0.5% of root canal treated teeth will require extraction at some point. This is an inescapable statistic as with all other medical treatments.

Post OP information for extractions

After teeth have been extracted, you will be directed to place pressure over the extraction socket(s) with rolled gauzes provided to you. You must keep this pressure applied until bleeding stops. In the event, it continues, please place pressure on the socket using more gauze. If necessary, you may use tissue or a tea bag. During the healing process please note the following:

• Avoid and sucking or spitting actions as the negative pressure can dislodge the newly formed clot. This is usually critical for the first three days.
• Avoid carbonated drinks. Again, this is most useful for the first three to four days.
• Listen to your body. Avoid the site as long as it is uncomfortable.
• Clean the area by brushing the extraction site. As soon as you can, please remove all plaque and debris from the extraction site.

In the event that you experience discomfort, prolonged bleeding or swelling, it is important that you call our office (604.431.0431) as soon as possible.

1. Fixed braces - the teeth have small attachments glued to them. Fixed braces fitted to upper and lower teeth look a bit like railway lines, so some people call them “train-track braces”. Fixed braces are very good for correcting complex problems. These are commonly made of stainless steel, when used for children as they are easier to keep clean. Tooth coloured ceramic or acrylic appliances are also available, and are most often used for adults. They are much more aesthetic. We are investigating the use of lingual fixed appliances. this is where the attachments are glued to the back of the teeth, very helpful for straightening teeth for people in prominent positions.
2. Removable braces - can obviously be removed, but they must be worn full-time, apart from when they have to be cleaned. Removable braces are good for correcting simple problems, such as moving a single tooth.
3. Functional braces - These are also removable but have to be worn full-time, except for cleaning. They are used to correct the growth pattern of the jaws. They can be used when one jaw is bigger than the other, to correct asymmetry. They can be used in conjunction with headgear to help jaws to grow correctly.

What happens on the first appointment?

An initial short examination appointment is to discuss the possibilities of orthodontic treatment. This is followed by a full examination. A full examination is made which will include X-ray pictures and moulds of the teeth. You will not have a brace fitted, or any other treatment, on this visit. You will get a full report on the treatment to be undertaken, as well as a full schedule of the fees payable. Particular attention is paid to how well you brush your teeth! It is important to know that you are capable of keeping your teeth clean before a brace is fitted since it is very much more difficult to clean them with a brace on. We insist that all patients are seen regularly by a hygienist to ensure that their teeth are kept in the best condition possible. If you are ready for treatment, your next appointment will be to fit the appliances.

What is it like having a brace fitted?

A removable brace is fitted very easily by clipping it onto several teeth. There is no discomfort involved. Fixed braces are simply “glued” onto the teeth. There is no need for an anaesthetic injection.   Teeth can become a bit sore a few hours after a brace is fitted or adjusted and this can last for two or three days. Simple painkillers will help a lot. We also recommend a soft diet for the first few days.

What happens after the brace is fitted?

Your brace has to be adjusted regularly. Removable braces are adjusted every 4-8 weeks and fixed braces every 4 weeks.

How long will the treatment take?

This depends on how much work there is to do. Fixed brace treatment can take between 12 and 24 months, but longer if the problem is particularly severe. If braces are broken frequently this can add a lot of time to the total. Combination treatment for difficult cases can take as long as 48 months.

Retainer braces

It is important to realise that once a brace is removed the teeth can drift back towards their original positions. They must, therefore, be held in their new positions for a long time with retainer braces until they have settled. Retainers are either removable appliances or thin wires stuck onto the tongue side of the teeth.

Do braces mark the teeth?

The brace will not mark the teeth. If dental plaque is allowed to become thick around the brace the plaque itself may damage the teeth. Instruction will be given on the use of special brushes. A daily fluoride mouthrinse can be used to harden areas that are very difficult to clean. Care must be taken to choose an alcohol-free, pH-balanced rinse. Certain foods and drinks may also lead to damage. You should avoid drinking lots of fizzy drinks and keep in-between-meal snacks to a minimum.

Foods to avoid during treatment

Very crunchy and sticky foods can break your brace. Toffee and chewing gum must be avoided. Really enjoyable hard foods can be chopped up and chewed gently!

Your dental hygienist is specifically trained and responsible for the delivery of these important services. Their roles will include:

• Removing all debris (plaque, calculus and stain) from your teeth.
• Providing you with the tools and skills necessary to keep the debris to a minimum.
• Constantly evaluate both your gum health as well as home care efficiency.
• Evaluate your specific susceptibility to dental disease.
• Suggest hygiene appointment frequency and intervals (maintenance program).

Consider that not all people are equally susceptible to dental disease. While some have absolutely no dental disease, others will display susceptibility to either dental (tooth), periodontal (gum) or both disease processes.

Our first order of business is to advise you on any health recommendations such as smoking cessation.

Second order of treatment will be to mechanically remove as much calculus and plaque as possible. This will be limited by the extent of the gum disease as well as any areas which are difficult to access. Examples of this would be retained wisdom teeth or severely crowded teeth where access in between the teeth is difficult or impossible. Once we have removed as much of the bacteria from your mouth as possible, there will be an immediate healing process that takes place. This will continue for as long as the bacteria are kept away from the gums.

Our third order of treatment, and probably the single most important aspect of your oral health will be home care instruction. Simply put, much of your oral health and the ability to reduce your future dental treatments lies directly in your hands. Your hygienist will be carefully monitoring your home care techniques and will be encouraging you to do them on a daily basis. This is not as easy as you may think. First, we try to make this a daily habit. Even when this occurs, it may still not be dequate. Not to worry, once you have the habit, it simply becomes a matter of perfecting your technique. Home care techniques require a fair bit of manual skill and you cannot expect them to be perfect right off the mark. In many instances, with both hygiene treatments and home care, we will see continued healing and improvement for up to two years!

Consider that your dental health is not just about your situation today but about your ongoing dental health, especially as it relates to time and the ageing process. Certainly, not a very sexy subject, however, all of us are trying to limit the effects of ageing through various means. The mouth is no different and we continually see the effects of ageing. When we evaluate your dental health and create a treatment plan for you, we are looking at both your current situation as well as the future. Although you may be in good dental health today, we may notice factors such as progressing gum recessions which we will expect to continue and become a potential problem in the future. For this reason, we will be drawing your attention to these factors so that you/we can reduce the progression as much as possible and, if necessary, apply corrective treatments.

Our goal, currently, is to provide you with good dental health into your mid 90’s. This sounds rather astounding, but we have already found that an active lifestyle into the late 80’s is really nothing of note anymore. It is expected that within two generations, the majority of people will be surviving into their second century. What does this mean for those patients? It means that more time will be spent visiting all manor of health specialists (eyes, hearing, feet, spine, etc) including dentists. This means that we, in dentistry, have to become more proactive in the earlier years of our patient’s lives. If we consider that it is now unacceptable to lose one’s teeth at any time of life, we need to start the process during childhood.
It is now becoming clear to us that we need to prevent more disease in order to provide you with less treatment during your lifetime in order to avoid excessive treatments as you get older.

Its an obvious fact that the more disease that your teeth experience, the more treatments they receive and the more they become compromised. Also, the earlier in life that your teeth become diseased, the harder it will be to maintain them. The sooner we all realize this concept, the better your dental health will remain. For this reason, your dentist and hygienist will be constantly monitoring your gum health through pocket probing as well as recession values.

Whether we have completed your treatment plan or not, this maintenance process will be vital to your dental health. Needless to say that when patients fail to carry our their home care or to continue their professional visits with us, we will expect more dental breakdown than when the program had been followed

Remember, your hygienist is specially trained to provide you with the expertise to maintain your teeth and gums. Please contact us or let us know if you have any questions.

Clean teeth and gums

Having a clean mouth is important. In addition to being healthier, it gives you fresh breath and a nicer smile. When you eat, bits of food, some too small for you to see, remain in your mouth. They feed bacteria that grow in a sticky film on your teeth. This film, called plaque, is the main cause of tooth decay and gum disease.

Having a clean mouth is important. In addition to being healthier, it gives you fresh breath and a nicer smile. When you eat, bits of food, some too small for you to see, remain in your mouth. They feed bacteria that grow in a sticky film on your teeth. This film, called plaque, is the main cause of tooth decay and gum disease.

Why brush?

Brushing your teeth after meals and between-meal snacks not only gets rid of the food particles that you can see, it removes plaque from your teeth. Using a fluoride toothpaste is important because the fluoride can help kill bacteria, as well as make your teeth stronger. Ask us to recommend the best toothbrush for you. Generally, a brush with soft, end-rounded or polished bristles is less likely to injure gum tissue. The size and shape of the brush should allow you to reach every tooth. Children may need smaller brushes than those designed for adults. Remember: worn-out toothbrushes can not properly clean your teeth and may injure your gums. Toothbrushes should be replaced every three or four months.

Why floss?

Flossing removes plaque and food particles from between teeth and under the gumline, areas your toothbrush can not reach. Because tooth decay and periodontal disease often start in these areas, it is important to clean them thoroughly on a daily basis. Flossing is a skill that needs to be learned. Do not be discouraged if you find it difficult at first. With practice, you will find that flossing takes only a few minutes of your time each day.

What about mouthrinses and mouthwashes?

If used as directed, in addition to brushing and flossing, mouthrinses and mouthwashes can help to prevent tooth decay.

Traditionally, hygiene treatment has taken the form of a cleaning visit approximately every 6 months. However, in the light of new research, we now know that we need to devote more time to improved hygiene procedures.

Gum disease is the most common cause of adult tooth loss around the world today. It often starts without symptoms or awareness, and is caused by infectious bacteria which multiply when your resistance is lowered for whatever reason. New research allows us to control these bacteria.

When we examine your mouth we shall be classifying the state of your gums according to the world-wide codes for categorising gum disease:

• Code 0  Clinical health - No gum disease
• Code 1  Bleeding gums - on brushing or probing
• Code 2  Calculus (or tartar) - which cause gum inflammation
• Code 3  Pocket development - progressive destruction
• Code 4  Pockets over 5,5mm - severe advanced disease

It is highly recommended to monitor your dental condition on every visit by charting certain parameters:

• Plaque scores
• Bleeding points
• Pocket dimensions
• Mobilities

This will enable us to see, at each visit, whether your gum condition is improving, deteriorating, or remaining the same.

For healthy gums, we must keep a plaque score below 10%

Number of appointments - we will need to see you for as many appointments as are necessary for you to achieve and maintain a plaque score below 10%. For most patients’ this will mean probably two appointments in the first instance; if the gum condition is more destructive then up to five or more appointments may be necessary. The first step in treating your mouth will be to teach you to understand your bacteria, so you can begin to realize why you are like you are, in spite of whatever efforts you have been making. We shall also teach you how to control your disease once a day through disruption of these bacteria. Together with our team member you will co-discover why you have some areas of bacterial infection and how to deal with these so that your mouth remains healthy.  The hygienist will carefully clean and polish every surface of every tooth so that the bacteria can be kept under control. Some bacteria always live normally in your mouth, and it is a matter of keeping these bacteria under control.

Once you are able to keep these bacteria under control we shall place you on our recare wellness maintenance program. To determine your risk for gum diseases we will obtain special unique test for it. To maintain healthy gums we need to maintain the following criteria:

1. No gum pockets over 3mm
2. No bleeding when brushing or probing
3. No mouth odour
4. No calculus either above or below the gums
5. No discharge or matter in the pockets
6. No redness or discolouration of the gums
7. No plaque scores over 10%
8. No heavy stains

Our team member will also be carrying out a regular polishing of the teeth and irrigation of the gum pockets to stop bacteria from re-colonising. It only takes bacteria 6 weeks to organize themselves and stick to the surfaces of the teeth. It takes another 6 weeks for the toxins and waste products of the bacteria to cause disease of the gum tissues - leading to gingivitis and periodontitis. We must prevent this from happening, so the hygienist will instruct you in how frequently you need to be seen on the recare wellness maintenance program

Whether you do so is entirely up to you.

There are several occasions where tooth extraction is necessary, and these are decay, infection, fracture and severe crowding.

Dental decay is caused by the destruction of the outer enamel surface of the tooth structure, allowing bacteria to penetrate into the less dense dentine tooth body. As the process of decay progresses, the advancing wave of bacterial products begin to irritate, then kill the nerve tissue. Once the nerve tissue dies, depending on the bulk of the tooth remaining, it may be possible to save it by root canal treatment, or if the destruction is too great, accompanied with infection in the supporting bone tissue, removal or extraction becomes the reluctant treatment of choice. There have been many theories why dental decay begins and progresses, but it is generally accepted that the following processes occur. Decay occurs at sites where bacteria accumulate and convert sugars to acid by-products of living and reproduction. These acids dissolve the mineral components in enamel, and leave rough areas, which may be stained. These ‘early lesions’ can remineralize and ‘heal’ if recognized and you, the patient, become more motivated and efficient in your cleaning routines. As further minerals are dissolved out of the decaying area, more bacteria collect in the rough area and the lesion penetrates through into the dentine. Dentine is a living tissue. If you can imagine a tooth as follows, then you will understand of the process of decay better. The centre of the tooth is soft tissue, comprising nerve and blood supply tissue. The outer surface of the nerve tissue is similar, to you scholars, to a Medusa’s head, with millions of fine ‘hairs’ that are minute nerve ends. Each ‘hair’ runs up inside a single small tube with in the dentine. So if you can imagine the dentine as an enormous bundle of straws centred around a ball ( the nerve tissue), these hairs would run up inside each straw. Covering the outer ends of the straw tubes is the enamel which is a very hard crystalline material. This outer surface is the surface that takes all the abuse of the food we eat, fluids we drink, and trauma when we bite and chew, or get hit in the mouth during sports, brawls and accidents. The reason that our teeth do not fracture all fall apart after each knock is their unique design. The dentine is 50% water, and the tubular construction when wet with nerve fluids keeps this material flexible, and able to absorb energy. So, you may well have many fracture lines that you can see in your own teeth, but the properties of the dentine bind the whole tooth together and keep it intact and functional. The analogy that I use to my Patients is a grass leaf. When wet, it can be folded, knotted and woven. These processes can be reversed, and the leaf returned to a single leaf, usually without breakage. But once the grass leaf dries to become hay, it is fragile and brittle. If you attempted to fold, knot or weave it is this dried state, it would probably break or fracture. Nature has many other examples of this. Now once the acids and bacterial by-products gain entry into the dentine, the rate of penetration and destruction is increased by its unique ’straw-like’ construction. Depending on where the decay area started in the tooth, and the shape of the advancing decay, structural failure of portions of the tooth, or the whole crown, can occur. Unless this stage is quickly stabilized, the nerve tissue will die, leading ultimately to infection within the supporting bone tissue.

Infection in the bone tissue is not a reason per se to remove the tooth, as many patients that we see have teeth where the nerve tissue has been removed and the tooth restored once the infection has been eliminated. This process is called root canal treatment. However, re-infection can occur if the technique in cleaning, sterilization and filling of the root system is poor, or some of the cheap, outdated techniques are used. Bacterial toxins that are left in the dentine structure of the root system can cause an area of infection to develop at the tip of the root, and this occasionally can be controlled by specialized surgical procedures to remove the root tip and the area of infection. But even this extreme measure will ultimately fail if the canal system still harbors bacterial toxins. For a more predictable result, the canal system should be opened, re-cleaned and sterilised, and then filled whilst being able to access both ends of the root system. If this fails at some time after, then I personally feel the tooth should be removed with care to preserve as much of the bone structure as possible.

Other reasons for the removal of teeth are infection, fracture and severe crowding.

Infection may not be due to decay. Impacted 8’s or the teeth more commonly know as the ‘wisdom teeth’ often try to erupt into the mouth at an abnormal angle, and so are termed as impacted. The areas at the back of your mouth are difficult to get at , at the best of times, but now, with the added complication of the partially through tooth, it becomes a real hassle. If a food fragment zips into the space between the tooth and gum tissue, this can led to a low-grade infection of the gum. When this happens, the normal tight ‘collar’ of tissue around the tooth slackens off, and more food packs into the space. This food then becomes colonised by your normal bacteria within 30 to 40 seconds. You cannot usually clean this stagnating food and bacterial heaving mass out, and the material putrefies. So quite apart from the smell, the pain and a face out by your ears forces your attendance at a Dental Clinic. The treatment, after careful assessment is usually

1. reduce the infection, and so the swelling and pain
2. remove the tooth

Other sources of infection may result from advanced periodontal disease. The profound loss of soft and hard supporting bone tissue will allow food stagnation deep in gum tissue pocket areas, with resultant infection and pain. On occasion, if a particular tooth has no balancing tooth surface, it will continue to erupt out of the gum tissue. If this process is allowed to continue over a long time period, the tooth can fully extrude, and its loss is due to the complete absence of supporting bone tissue.

Fracture due to trauma or due to structural weaknesses brought about by the placement of fillings or presence of decay, can necessitate removal. Trauma, from accidents or blows to the face from, for example fights and sports, can remove the tooth completely from the socket. In other situations, a fracture that is below the gum tissue surface may result in insufficient root left to act as a retainer for any form of restoration.

In some Dental Teaching Institutions, extractions are still taught as the only successful way to reduce crowding and as a preliminary to orthodontic treatment. I was taught that this was the only way to treat crowding, and I was guilty of treating my patients in this way. But this has to be set against a background of the state of the knowledge in the early 80’s when I qualified, and the age of my teachers and their training. Now, of course, we know that there are many ways to avoid the trauma of extractions on young patients, and the results obtained by facial orthopaedics are brilliant. What is still sad is that in the UK, the National Health Service advisors and so called experts still perpetuate this myth. Young people in the UK are still subjected to unnecessary and traumatic tooth removal all because of cost and lack of knowledge.

Well, so far I have chatted about why teeth have to be removed. But how do we get them out ? Teeth are held into the bone sockets by fibrous strands called the periodontal ligaments. These are attached at one end to the root surface, at the other to the bone wall. It is easy to sever these fibres by applying pressure or by the use of very fine cutting instruments.

First, the surrounding tissue needs to be made numb, and this is done by injection of local anaesthetic agents. In some areas of the jaws, the bone is thin enough to allow these anaesthetics to permeate through the bone structure, and block the nerve tissue’s ability to conduct pain messages along the fibres to your brain. In other areas, such as the lower jaw, the bone is thick, and the diffusion of the anaesthetic cannot take place. In these places, the anaesthetic has to be placed by the nerve tissue in an alternative location. The main nerve tissue path way runs down from the base of brain, down the inner aspect of the jaw bone, and then loops into a canal inside the lower jaw. The anaesthetic is placed just as the nerve loops into the canal orifice. All nerve signals are then blocked from this point down. Hence the whole of the lower side of your face goes numb with this type of injection.

Alternative forms of getting the anaesthetic into the area required are to push a very fine needle between the root and the socket wall, and place the anaesthetic around the tooth we need to treat. A relatively new method of anaesthetic administration is to place a small amount of the anaesthetic in he gum tissue close to the tooth which needs treatment. A small hole is then drilled through the dense outer bone surface, into the softer bone that forms the core of the jaw bone. The local anaesthetic solution is then injected through this access.

Once the tooth and surrounding tissue has been made numb, the periodontal fibres are cut, and the tooth removed. It should be done with great care, as it is important to preserve as much of the bone as possible. Again, traditional dentistry involved squeezing the empty socket so that the walls closed and the blood clot that is essential to healing was small and easily retained. Now, we try to keep this site open but clean, so that we maximise the body’s ability to grow new bone into the socket.

There are times when the shape of a molar tooth means that extensive bone and gum tissue would result by trying to remove it intact. In this case, the tooth may be cut into small units, and each unit removed more easily.

If the root remains are buried, then the gum tissue may need to be folded out of the way, and a small amount of bone tissue removed to allow easy visualisation of the root fragment. The remains can then be more easily removed with very fine instruments.

Wisdom teeth seem to have numerous horror stories attached with their removal. The vast majority are simple and symptomless. As with many other things in life, you only hear about the problems, the pain, and the **** dentist who did it to you. But spare a thought of the dentist faced with a decayed and fractured wisdom tooth, which caused a painful episode about 12 months earlier, and the patient attached to it decided not to seek dental help. Now the dentist is presented with an area of infection, painful to touch and difficult to get at. Not surprising then this patient probably will have a horror story to tell at a later stage, and the dentist will get the blame.

If gum tissue needs to cut and folded to one side to gain access to root fragments, stitches need to be put in to hold the tissue together to allow healing to take place in a controlled way. These need to be removed, usually 3 to 7 days later, although in certain surgical procedures, they may be left up to 15 days.

Evulsed teeth

When a tooth is knocked out you should:

1. Immediately call your dentist for an emergency appointment.  Attempt to find the tooth.  Gently rinse, but do not scrub the tooth to remove dirt or debris.
2. Place the clean tooth in your mouth between the cheek and gum.
3. Do not attempt to replace the tooth into the socket. This could cause further damage.
4. Get to the dentist as soon as possible. If it is within a half hour of the injury, it may be possible to re-implant the tooth.
5. If it is not possible to store the tooth in the mouth of the injured person, (e.g., young child) wrap the tooth in a clean cloth or gauze and immerse in milk.

Extruded teeth

If the tooth is pushed out of place (inward or outward), it should be repositioned to its normal alignment with very light finger pressure. Do not force the tooth into the socket. Hold the tooth in place with a moist tissue or gauze. Again, it is vital that the injured individual be seen by a dentist within 30 minutes.

Fractured teeth

How a fractured tooth is treated will depend on how badly it is broken. Regardless of the damage, treatment should always be determined by a dentist.

Minor fracture

Minor fractures can be smoothed by your dentist with a sandpaper disc or simply left alone. Another option is to restore the tooth with a composite restoration. In either case, you should treat the tooth with care for several days.

Moderate fracture

Moderate fractures include damage to the enamel, dentin and/or pulp. If the pulp is not  permanently damaged, the tooth may be restored with a full permanent crown. If pulpal damage does occur further dental treatment will be required.

Severe fracture

Severe fractures often mean a traumatized tooth with a slim chance of recovery.

Injuries to the soft tissues of the mouth

Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away and the injured person taken to the emergency room for the necessary suturing and wound repair. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound area.

Outside the Clinic’s normal working hours, we have a messaging service to contact our Clinical Staff. Patients who require emergency dental treatment due to severe pain, persistent bleeding following an extraction, or for suturing of lip or oral lacerations following an accident should telephone Crystal Dental Centre.