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Orthodontics

1.- Is orthodontic treatment contraindicated in adults with periodontal disease?

It is not contraindicated, but before any orthodontic treatment the periodontal problem must have been perfectly controlled by going to the periodontist who will indicate the proper treatment, with scrapes and possible grafts.

2.- If I have a malocclusion and I do nothing about it, may it have consequences?

The consequences of a malocclusion are aesthetic and functional issues. Having crowded teeth, for instance, may cause gum disease or cavities, as it is tough to keep a good hygiene. By not having a good occlusion, muscle forces are not balanced and that may cause temporomandibular joint dysfunctions.

 

Prevention

1.- Is there any way to prevent a malocclusion?

A malocclusion could be caused by genetics and there is little margin for prevention in such cases. Instead, it could also be caused by other circumstances, such as carrying pacifier or dummies for a long time, by thumb-sucking, by breathing with mouth open given allergies, due to vegetation, due to tonsillitis, sinusitis or for other multiple reasons. In these cases it is important to detect and treat the habit.

 2.- How can I prevent tooth decay?

Teeth, like any other tissue in the body, are subject to oxidation processes. However, the more you take care of your teeth, the more such processes are slowed down. Brushing after every meal is essential; and so it is using quality products, toothpaste and non-abrasive mouthwash with fluoride; having a very balanced diet; avoiding when possible sugars, chocolates and pastries; practicing sports; or going to the dentist once a year so that your dentist can advise at any unexpected event.

 

Paediatric Dentistry

1.- At what age range it is advised to start visiting the dentist?

At the age of 4, if no problem has arisen before that. At this stage, dentists advise on diet habits, hygiene habits and functional habits for best prevention. Dentist may also treat at this early age any possible dental cavity and any possible orthopaedic problem that may exist.

2.- Does a temporary tooth get devitalized?

If the dental cavity has reached the tooth pulp we can opt for a pulpectomy depending on the degree of the alteration. That is, we “take out” the nerve of the tooth in a different way to that of an adult tooth, so that it can be replaced when appropriate.

 

Temporomandibular Joint Disorders (TMJ)

 1.- What is bruxism?

It is an anomaly of the masticatory habits characterized by an excessive creak and clench of teeth, causing erosion on teeth and orofacial pain.

2.- Can bruxism be solved?

Given it is caused by muscle hyperactivity, dentists should mitigate bruxism effects by advising on hygiene and other habits: trying to rest one hour before bedtime; avoiding alcohol, coffee, tobacco and other exciting substances; doing physiotherapy techniques of muscle relaxation; or using night splints to prevent tooth decay and to allow proper blood flow through the muscle to supply the necessary oxygen and avoid the pain that can be caused by such muscle hyperactivity.

 

Conservative Dentistry

1.- Is there a vaccine against cavities?

A cavity is the most prevalent infectious disease in humanity. Even though the organism that causes it is known and studied, no vaccine has yet been found since the origin and causes of cavities is multifactorial.

2.- Why are cavities painful in some cases and not in others?

Pain varies from person to person. The “sensitivity threshold” is different in each of us. Pain depends on the extent of cavities, the deeper, the more pain; but if the cavity reaches the nerve, pain may not be felt given necrosis, causing then abscess and infection.

 

Prosthesis

1.- Do prostheses give greater resistance to teeth?

Prostheses are suggested to be used to protect teeth in the following cases: when missing more than a third of tooth tissue; when there is teeth destruction; or to prevent a rupture in cases of non-vitalization of a dental piece. Prostheses thus provide protection rather than resistance.

2.- How should prosthesis be cared?

As a natural tooth; in a very hygienic way and thinking no one is like “Robocop”: teeth should be used for eating purposes, but not for crushing hard things, open bottles, cut wire or nail biting.

 

Implantology

1.- Do implants fail?

Risk factors for an implant failure are numerous. One of the most relevant is the periodontal disease. This is usually the cause of tooth loss. It is important to have it controlled to prevent a second failure. Hence the emphasis on hygiene controls and good health habits. Another risk factor related to periodontal disease is tobacco. Tobacco is the responsible for the alteration of the periodontal bone which supports teeth and implants. Cancer therapies such as chemotherapy and radiotherapy could also be the cause of failure, as well as certain chronic diseases requiring specific drug treatments.

2.- How does age matter when placing implants?

Answer 2: We advisable not to use implants before the age of 17. Regarding the elderly, each case needs to be properly studied, particularly the bone characteristics.

 

Aesthetics

1.- Is teeth whitening recommended for any patient?

As any other treatment, we need to address it on a case by case basis. For instance, when taking staining antibiotics teeth whitening works very little because normally in these situations there is a colour gradient in the tooth; the whitening treatment acts in every one of the colours of such scale and so we could still see the gradient. In the case colour degradation was a result of tobacco or chromatic substances such as tea, coffee, cola, red berries, red wine, etc. tooth whitening would work if the intake of these substances was suspended. If the loss of tooth colour is because of oxidation, we suggest to opt for porcelain veneers as not only the colour is improved, but also its texture and shape.

2.- Do porcelain veneers last “forever”?

There is nothing “forever” in the mouth as all structures are subjected to oxidation processes, physical and mechanical damage, or infections. However, the more caution we have, the more these structures will last. Porcelain veneers are placed above organic matter, meaning they can undergo transformation given mechanical or physical degeneration. The more we “pamper” them, the more we will lengthen their lives.