Archive for Dental Research Update
April 29, 2007 at 9:38 pm by Ian Kerr
Filed under Dental Research Update
I will be spending the coming weekend (May 4th/5th) at the British Society of Restorative Dentists annual conference in Brighton. This years meeting promises to be a very interesting one as it is tackling a far reaching topic and one that is very close to my heart. There are several keynote speakers from around the world all of whom will be looking at the long-term effects of conventional dentistry on our patients.
Conventional restorative dentistry has centred on placing large, primarily amalgam, fillings followed by full coverage crowns once the tooth has broken. This approach has worked well for many years but at a high biological cost to the patient. Large fillings produce fracture lines in teeth that eventually lead to the tooth breaking down. The crowns that are placed to restore these teeth require extensive drilling of sound tooth tissue to make the space for the porcelain and metal used to construct them. Now that people are living longer and expecting to keep their teeth for life we are finding that the drilling away of healthy tooth tissue is something that we want to avoid at all cost.
Modern restorative dentistry is much more interested in using adhesive “add on” approaches where drilling is kept to a minimum. This is certainly where my interest lies and is the basis of all of my treatment planning. I am very keen to see what the findings of this meeting are and what direction the profession as a whole is taking. It is my belief that there will be far greater push to minimal preparation designs where we support teeth using modern bonding techniques and much thinner porcelains to reduce the amount of drilling required. Along with this I am sure we will see much discussion about prevention centred treatment planning and minimal intervention techniques such as air abrasion and adhesive restorations. I will keep you posted with the findings and will make sure that StoneRock is keeping up with every new development.
March 30, 2007 at 9:15 pm by Ian Kerr
Filed under Dental Research Update
The statistics on oral cancer do not make very comfortable reading. The number of cases diagnosed annually is increasing whilst the survival rate (50%) has not improved for the last few decades. In Europe over 100,000 cases are diagnosed each year and in the UK alone over 1500 people each year die from this condition.
The increases in the disease that we have seen are not entirely attributable to the usual risk factors of smoking and alcohol use and so research in to the condition has now expanded to include areas such as diet, human papillomavirus and genetics. One piece of good news that has come out of this research is that regular daily portions of fruit and vegetables can half your risk of developing this disease. This evidence comes in the form of an exhaustive review of sixteen separate studies involving over 5,000 individuals and was reported in the American Journal of Clinical Nutrition. This research built on earlier work begun by the World Cancer Research Fund and showed that each portion of fruit or vegetable consumed per day reduced the risk of oral cancer by 50%
Although the overall survival rates for oral cancer are poor they can be significantly increased by early detection. Listed below are the signs to look out for, all of which should be checked for by your dentist at every review. At StoneRock Dental Care we provide cancer screening for every patient, which takes less than two minutes and is entirely painless. If you have concerns about this condition and would like to find out more then please do not hesitate to call the surgery and we will be happy to help you.
Signs and Symptoms of Oral and Pharyngeal Cancer
1.A sore or ulcer in the mouth that does not heal within three weeks
2. A lump or overgrowth of tissue anywhere in the mouth
3. A white or red patch on the gums, tongue, or lining of the mouth
4. Difficulty in swallowing
5. Difficulty in chewing or moving the jaw or tongue?
6. Numbness of the tongue or other area of the mouth
7. A feeling that something is caught in the throat
8. A chronic sore throat or hoarseness that persists more than six weeks, particularly smokers over 50 years old and heavy drinkers
9. Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
10. Neck swelling present for more than three weeks
11. Unexplained tooth mobility persisting for more than three weeks - see a dentist urgently
12. unilateral nasal mass / ulceration / obstruction, particularly associated with purulent or bloody discharge
March 26, 2007 at 9:53 pm by Ian Kerr
Filed under Dental Research Update
One of the re-occurring arguments against saving infected teeth is that the infection from the tooth may, in the long-term lead to problems else where in the body. This argument has been around since the 1930’s and is often called the “focal point infection” debate.
When a tooth has an infection it can be treated with a root canal filling (endodontics), which in over 90% of cases will lead to the complete resolution of the infection. Sadly, however, in a small number of cases the infection can remain, which is where the debate arises. It has been argued that the presence of this chronic infection can lead, to amongst other things, coronary heart disease at a later stage in life. Well we can all now breath a collective sigh of relief as a 32 year follow up study of 708 men showed no such link (J Dental research 2006). In reality this is no great surprise as the “focal point infection” argument has never really found support in any research but has always hung around in the background, occasionally making a come back.
The risk to patients of acute, untreated dental infection is very real and significant (I had to arrange for an emergency hospitalisation of a very sick patient last year who presented with a severe dental abscess) and should receive appropriate care as soon as possible. People should not be put off getting the correct dental treatment for any fear of possible long-term outcomes of that treatment.
If you would like to know more about root canal fillings and how they might help relieve your dental pain or infection then please do not hesitate to call the surgery and we will be happy to help.
March 22, 2007 at 9:39 pm by Ian Kerr
Filed under Dental Research Update
A recent article in the British Dental Journal (BDJ 2007) highlighted an alarming case of how poor dental care lead to a near fatal incident.
The case involved a 25-year-old woman living in London who experienced severe toothache over a period of several weeks, but was unable to get an adequate diagnosis or treatment for her condition. During the time of her extreme pain she visited 3 separate dentists, none of whom diagnosed her condition correctly (she had a large cavity under an old filling and a clearly inflamed nerve) or gave appropriate care. Left to her own devices the lady discovered that holding cold water against the tooth gave her some relief, albeit short lived. Unfortunately the lady swallowed the water after resting it against the tooth, which lead to a consumption of 10 litres or more per day. Such high levels of water consumption can, and in this case did, lead to dangerously low sodium levels in the body, which in turn resulted in a coma. The lady in question was admitted to hospital and stayed in a coma for 3 days, from which she made a full recovery. Her waking words from the coma were “I’ve got tooth ache” and this time, at last, they did not fall on deaf ears. She was transferred to the dental department of the hospital where her dental condition was treated quickly and painlessly.
This story, as well as painting a very poor picture of my profession, highlights an important diagnostic point that all patients should be aware of. The symptoms of this lady’s condition are very characteristic and should be well noted. Any one suffering from toothache with the following symptoms should seek urgent treatment, which will need to involve direct treatment of the affected tooth (usually removing the inflamed nerve under strong local anaesthetic). Antibiotics will not work in these cases.
- Spontaneous and severe pain often described as an agonising throb
- Pain worse on contact with heat (often cold in early stages, progressing to heat later on)
- Prolonged pain after the heat has been taken away
- Pain that wakes you in the night
- A previous history of milder sensitivity to hot and cold drinks
- Pain relieved by presence of cold liquid
If you would like to know more about this condition or the treatment of it then please do not hesitate to call the surgery and we will he happy to help you.
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