20/Feb/2011

Orthodontics is the art of repositioning the teeth in the mouth, and is traditionally thought of as something only buck-toothed children go through. In fact, orthodontics helps a host of positional problems in the mouth, in both children and adults. Take for example, some one with a large gap between his front teeth. There are several ways to close that gap, depending on what caused it, where it is, and the state of health of the surrounding teeth. You could restore the teeth through the use of a crown, or you could remove the affected teeth and replace them with a bridge or implants, which is clearly the least desirable option. Alternatively, you could reposition the teeth using orthodontics: the ideal treatment when your teeth are healthy and look attractive, because you don’t lose some of the healthy parts of your teeth as you would during crowding. You simply move the teeth in the gums and put them in a more attractive position. Orthodontics is mostly used for cosmetic reasons such as straightening teeth or closing gaps. You might have buck teeth, or you might have very skew teeth. Perhaps you have a gap that has bothered you all your life. If your teeth are healthy, but your simle needs improvement, orthodontics may be the way to go. Orthodontic treatment does take a long time, there’s no getting away from it. You’re looking at six months to three years, depending, of course on what your particular problem is, and you will require regular checkups and adjustments to ensure the desired result is achieved. However, modern braces are far less visible (as compared to the traditional full-sized braces), and treatment may be as simple as a retainer plate for a couple of months.

Traditional Braces

Traditional-full-sized-brac — Traditional full-sized braces

Mini Braces

Lingual Braces

These days, some problems may be corrected with lingual braces. These are mounted on the back surface of the teeth, and are virtually invisible. If those are not an option for your problem, you can also have clear plastic/crystal brackets fitted to your teeth instead of traditional metal ones, which also reduces their visibility to others.

Crystal Braces

Unlike ceramic brackets that are opaque and colored to mimic a particular tooth shade, clear brackets are crystal clear and virtually disappear regardless of tooth shade. For more info, click here

Of course, there are possible complications, of which you should be aware. In some cases, the teeth move back to their original positions. This is the reason you are required to wear a retainer plate that ensures the teeth stay put after the actual treatment. In additional, loose bands on the teeth can create decalcified areas where decay can begin. However, this is not common, and modern bonding methods ensure the brackets are fixed to the teeth in such a way that the risk of decay is greatly reduced.

Invisalign Aligner

Invisalign is a well known clear aligner used to correct misaligned teeth with ease and comfort from the US.

Mbrace Aligner

MBrace is a clear aligner used to correct misaligned teeth with ease and comfort. It is clear and removable which makes it almost unnoticeable by others and convenient to use. The aligners are custom-made digitally and fabricated individually to ensure a perfect and accurate fit for your teeth. Treatment can be performed by a general dental practitioner who has sufficient training in orthodontic field or by an orthodontist who specializes in this field. Generally, your dentist refers you to an orthodontist, with whom you make an initial appointment, so that he can assess the state of your teeth and propose a treatment plan. It is good idea, at this stage, to discuss cost implications, as orthodontic treatment can be very costly, and you need to know what you are letting yourself in for.

Your treatment plan may consist purely of braces and retainers, just retainers, or may even require that two or more teeth are removed to make space in your mouth. For example, you may have buck teeth in your mouth because there simply wasn’t enough space for all your adult teeth in your gums when they erupted. To correct this, the orthodontist may have to extract the back molar on each side of the top set of teeth to make extra room in your mouth. This then allows him to move the remaining teeth into a more favorable position. Also don’t forget to ask the orthodontist how long the treatment is likely to take. It’s a lot easier to put up with braces if you know when they’re likely to come out. All in all, however, orthodontics is a painless procedure; there is some initial discomfort from braces or even from a retainer, but this generally disappears after a few weeks. It’s more a case of getting used to the foreign objects in your mouth than them causing discomfort.

More info

…

Dr. Ng SN

20/Feb/2011

Prestige Dental Care

Tooth Crystal

Beutiful Skyce crystals from Ivoclar Vivadent applied to the tooth in minutes without drilling or pain that will not harm the tooth and can last for up to one year. Skyce crystals will definitely enhance your smile.

It is a professional solution for stylish tooth jewellery

The tooth jewels Skyce can simply be bonded to the tooth surface without preparation using tried-and-tested materials. Skyce is putting an extra sparkle into every smile. The crystal glass stones are available in two different sizes: Ø 1.9 mm and Ø 2.4 mm.

Indications

To be bonded to the labial (front) surfaces of upper anterior teeth

Advantages

Bonding without preparation
Tried-and-tested materials are used
Oral health is maintained

Cases done in our clinic

Skyce crystal was attached to the front surface of right lateral incisor

Another case where two Skyce crystals were attached to the incisor and canine

Topics

What is a veneer?
Case study
Other Clinical Cases with porcelain veneer
Dental veneers vs dental crowns
How to care for your cosmetic veneers
Benefits of Cosmetic Veneers
Porcelain veneers vs Resin veneers
Traditional porcelain veneers vs Lumineers

What is a veneer?

Nowadays there is a wide variety of treatments and methods that dentists can use to enhance a person’s smile. Cosmetic veneers have really gained in popularity over the last few years, and recently came to evolve into a veritable art form. Cosmetic veneers are usually sought by patients who have discolored, stained, chipped or uneven teeth. Placement of dental veneers requires the artistry, precision and skill of a talented cosmetic dentist.

Veneers are thin, semi-transparent facings usually made out of porcelain that are bonded onto the front of teeth to create a smile makeover. They create a beautiful result. Porcelain mimics tooth structure better than any other restorative material and it is a very durable and extraordinarily strong material that has similar texture, translucence and color to the enamel of your natural teeth. Dental artists can manipulate the color and translucency to re-create the look of any tooth. And it resists stain better than tooth enamel. Very rarely will it discolor, unless the surface has been damaged. These thin shells of porcelain are bonded to your frontal surface of teeth to conceal any discoloration, damage or altered alignment.

The procedure normally requires two or three appointments to be completed. The cosmetic dentist will begin the procedure by roughening the surface of your teeth to make sure the veneers will perfectly bond to the teeth. He will next trim down the outer surface of the teeth enamel to accommodate the veneers. Impression of the trimmed teeth will be taken. Your teeth will be covered with temporary veneers while the actual veneers are created in a dental laboratory. The lab technician will develop the permanent veneers after which your cosmetic dentist will have them placed in your mouth.

Case study

This young lady presented with a ‘space’ between her front central incisor which looked rather unnatural and unattractive especially when she smiled (below).

She decided to have all her upper front incisors to be veneered to close the gap. Before her teeth were prepared, the natural colour of teeth were recorded so that the porcelain veneer will match with the ‘neighbour’ teeth later.

Under local anesthesia, a thin layer (0.7mm) of tooth structure was removed at the front surface of each teeth (below). Then, an impression was taken to get a negative copy of her dentition and later, a dental model was produced.

The teeth were minimally prepared for porcelain veneers

The dental model was sent to lab where the laboratory technician would fabricate veneers over the dental model (below)

Finally, the veneers would be cemented onto patient’s mouth with strong resin cement.

Before and after result!!!

Other Clinical Cases with porcelain veneer

Another case of closing mid-line spacing with veneer

Crooked front teeth were corrected with veneer

Discolour front teeth

Discolour and malalignment 6 front teeth

6 porcelain veneers fabricated on the model

The veneers were cemented with resin cement to the front teeth

More cases of aesthethic makeover with full porcelain crowns and veneers, click here

Dental veneers vs dental crowns

Dental veneers and dental crowns are two different types of dental restorations that have similar cosmetic end results. Cosmetic dentists use these two dental procedures to correct similar dental issues. Each of these two dental techniques carries its advantages and disadvantages.

The main difference between crowns and veneers regards the amount of the tooth’ structure each restoration typically covers over. Dental veneers require significantly less reduction of the tooth structure than dental crowns. Porcelain veneers will cover over only the side of the tooth that shows when the patient smiles while dental crowns cover the tooth entirely.

While dental veneers are recommended to patients whose gums and teeth are generally healthy dental crowns are more appropriate for patients who wish to rebuild teeth that are decayed or badly broken. Dental crowns are ideal for teeth that are misshaped, worn down, cracked, broken or extremely weak. Individuals who have a tendency to clench or grind their teeth may want to treat their dental issues with dental crowns because bruxism can chip or crack dental veneers.

Make sure you find a knowledgeable cosmetic dentist who can determine which of the two techniques is right for your situation.

How to care for your cosmetic veneers

You should avoid extreme temperatures in food and beverages for at least two weeks following the veneers placement.
You should also stay away as much as possible from hard foods that may twist or stress the veneers.
Oral habits such as opening bobby pins or nail biting, could damage your veneers.
Frequent flossing will keep your veneers free of plaque so make sure you floss your veneers just like they were natural teeth.
Use a soft toothbrush to brush your dental veneers after every meal.
Don’t forget to keep up with your regular maintenance.
Make sure you have your teeth cleaned and checked every six months or so.
Your cosmetic veneers are designed to last up to fifteen years but it is up to you to make that happen.

Benefits of Cosmetic Veneers

Dental veneers can completely conceal the imperfections of your front teeth, providing a total smile makeover. The change in your smile will help you project an image of confidence and high self-esteem.
Cosmetic veneers can cover a wide variety of dental flaws including misalignment, discoloration, stains caused by excessive smoking or antibiotics, trauma-damaged and fractured teeth, diastemas, crooked, chipped or broken teeth, etc.
Dental veneers are compatible with most other cosmetic dental procedures. For example, you can place veneers in combination with TMJ treatment, teeth whitening, neuromuscular dentistry, or a full-mouth reconstruction to completely reshape your smile.
Many patients consider dental veneers a great alternative to traditional braces. Unlike other alternatives, cosmetic veeners wont’t compromise the strength and integrity of your teeth.
Porcelain veneers act as a barrier between your teeth and staining agents such as tobacco products, chocolate, sugary foods, wine, tea or coffee. Veneers can strengthen old filings and teeth that have been weakened by root canal treatments.
Cosmetic veneers can last up to 15 years if you maintain a proper oral hygiene through daily brushing and flossing.
Veneers can change the appearance of your smile within as little as three visits.
Anesthesia is usually not required as the procedure normally causes no pain or discomfort.
Cosmetic veneers are designed to look and feel just like natural teeth. Veneers however will not discolor over time as natural teeth do.

Porcelain veneers vs Resin Composite veneers

If you are considering dental veneers to restore your teeth, you may have to choose between the two types of cosmetic veneers that are currently available today, ceramic or porcelain veneers and composite resin veneers. Other dental restorative materials such as gold and amalgam cannot offer the same natural teeth color. The question is, which of the two is a better choice? Composite veneers are inexpensive, insoluble, insensitive to dehydration and aesthetically pleasing. In terms of durability however, porcelain veneers have a life span of about 15 years while composite resin veneers can break or chip more easily and may require touch-ups. While porcelain veneers are more durable, composite resin veneers are easier to repair.

Porcelain veneers possess a much more natural color compared to resin veneers which don’t look exactly as normal teeth. That’s what makes porcelain veneers an ideal option for front teeth while resin veneers are more suited for back teeth. Both composite veneers and porcelain veneers can be indirectly fabricated but only resin veneers can also be directly fabricated inside the patient’s mouth. Even though ceramic veneers can be up to 10 times more expensive than composite veneers, resin veneers will require much more aftercare that will add up to the initial, affordable cost. Make sure you find a qualified cosmetic dentist that can help you determine the best solution for your individual needs!

Topics

Vital Bleaching

Non-professional home bleaching
Professional home bleaching
In-office
Risk/Complication
Limitation

Teeth Whitening

Bleaching or teeth whitening provides a conservative treatment for mild to moderately discoloured vital teeth or root filled teeth. It is a common procedure in general dentistry but most especially in the field of cosmetic dentistry. A child’s deciduous teeth are generally whiter than the adult teeth that follow. As a person ages the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous. Teeth can also become stained by bacterial pigments, foodstuffs and tobacco. Certain antibiotic medications (like tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel.

Vital bleaching

Bleaching treatment which is done on healthy teeth. There are few methods done for vital bleaching:

Non-professional home whitening
Professional home bleaching
‘In-office’ bleaching

1. Non-professional home whitening

There are many teeth whitening product sell over the counter in dental store/pharmacy or even online and is much more cost-effective than the in-office procedure: bleaching strips, bleaching pen (eg: BriteSmile To Go whitening pen), bleaching gel, or even whitening toothpaste. Traditionally, at-home whitening involves applying bleaching gel to the teeth using a standard guard trays. At-home whitening can also be done by applying small strips that go over the front teeth. Oxidizing agents such as hydrogen peroxide or carbamide peroxide are used in these products to lighten the shade of the tooth. The oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and oxidizes interprismatic stain deposits; over a period of time, the dentin layer, lying underneath the enamel, is also bleached.

In some whitening toothpastes contain small particles of silica, aluminum oxide, calcium carbonate, or calcium phosphate that used to grind off stains formed by colored molecules that have adsorbed onto the teeth from food. Unlike bleaches, these whitening toothpaste does not bleach or alter the intrinsic (internal) color of teeth.

We have BriteSmile To Go whitening pen

2. Professional home bleaching

opalescence_takehome_new-11 — Professional home bleaching system

For professional home bleaching (eg. Opalescence, Discuss), clinician/dentist have more control over the usage of the bleaching agent on patient. Usually patient’s teeth will be assess and the expected result should be agree before treatment started. Patient will be prescribed bleaching gel (in syringes) and a customized bleaching tray and he will be taught to used the product properly at home.

bleaching tray2 — Bleaching gel is dispensed onto the tray and loaded into your mouth

Basically, patient has to clean his teeth before bleaching. Then, the bleaching agent has to be dispensed into the tray and wore it onto his teeth for 8 hours each day for several week (usually 2 weeks). After treatment, he has to brush his teeth again. He has to reduce or stop smoking and the ingestion of dark colored liquids like coffee, tea and red wine as these factors that decrease whitening.
Home bleaching gel contains 10-15% carbamide peroxide. This agent cause less irritation to the gum because it can be contained just on the teeth surface with custom-made tray. Bleaching result is usually better than the ‘over the counter’ product.

Home bleaching technique

Take an alginate impression
Ask the laboratory to make a bleaching splint
Fit the splint, dispense the carbamide peroxide (10%), and give instructions
Advice 6-8 hours treatment per day
Review weekly

3. ‘In-office’ bleaching

In-office bleaching (Eg. ZOOM!! Whitening system) in a treatment done in the dental clinic; usually required patient to be seated on the dental chair for 1-3 hours. Immediately after treatment, patient can see the final result!!. Because In-surgery or in-office bleaching is in total control by the clinician/dentist, the bleaching gels used are highly-concentration (25-38% of carbamide or hydrogen peroxide). The gel is caustic, hence, protective eyewear and isolation of gum with a resin-based, light-curable barrier required before treatment starts.

Dental light curing lights are commonly needed to activate the bleaching agent. This ‘Light cure’ unit usually use halogen, LED, or plasma to produce light energy to accelerate the process of bleaching. Most in-office teeth whitening treatments can be done in approximately 30 minutes to one hour, in a single visit to a dental physician. Treatment times and recommendations are dependent on the condition of a person’s teeth at time of treatment.

‘In-office’ bleaching technique

Polish teeth with pumice
Isolation of gum/soft tissue with a resin-based, light-curable barrier
Etch enamel, wash and dry, although the need to etch has been questioned
Apply the bleaching agent according to the manufacturer’s instructions
Bleaching gel is activated with light energy from ‘light cure’ or laser unit
Wash teeth with copious amounts of water
Remove gum/soft tissue barrier and polish teeth
Advice patient to avoid tea, coffee, red wine, cigarettes etc, for a week and that some sensitivity may occur
Can repeat as required

Case of in-office bleaching using ZOOM whitening system…Click here

Risk/Complication

Side effects of teeth bleaching include:

Chemical burns from gel bleaching (if a high-concentration oxidizing agent contacts unprotected tissues, which may bleach or discolor mucous membranes), sensitive teeth
Overbleaching – noticeable chalk white spot on the bleached teeth which usually lessen in a period of time
Pain if you have “sensitive teeth” caused by open dentinal tubules.

The side effects that occur most often are a temporary increase in tooth sensitivity and mild irritation of the soft tissues of the mouth, particularly the gums. Tooth sensitivity often occurs during early stages of the bleaching treatment. Tissue irritation most commonly results from an ill-fitting mouthpiece tray rather than the tooth-bleaching agent. Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment.
Individuals with sensitive teeth and gums, receding gums and/or defective restorations should consult with their dentist prior to using a tooth whitening system. People who are sensitive to hydrogen peroxide (the whitening agent) should not try a bleaching product without first consulting a dentist. Also, prolonged exposure to bleaching agents may damage tooth enamel. This is especially the case with home remedy whitening products that contain fruit acids.
Bleaching is not recommended in children under the age of 16. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age. Tooth whitening under this condition could irritate the pulp or cause it to become sensitive. Tooth whitening is also not recommended in pregnant or lactating women.

Limitation

In certain cases where the teeth are severely discolour, bleaching treatment might not be the best solution as it not achieve what patient desire. In this kind of situation, Porcelain veneer or full porcelain crown might be a better options. Therefore, you have to discuss with you dentist and tell him what you really and the pros & cons for each option.

Have your teeth checked regularly..

A standard dental checkup should take place every six months, and any additional procedures such as fillings or root canals, for example, require you to make additional appointments at later stage. This is because many of these procedures take longer than the time allotted to a checkup. They may even required preparation time on the part of the dentist, or time between appointments for the dental laboratory to manufacture crowns and dentures, among other fittings. Consequently, if your dentist finds any problems during the checkup, be prepared to visit him again in the near future.
At the routine checkup, the procedure is fairly simple. Generally, when reporting to the dentist’s receptionist, you are required to update your personal details and then wait to be called into the consulting or surgery room.
Once in the dentist’s chair, you are hoisted up and backward into a reclining position, and a light is positioned above you to afford the dentist the best view of your entire mouth. This is when you will be ask to relax – and open your moth wide!
The dentist will take a careful look at different parts of your mouth. He usually starts with your teeth, looking for any visible signs of disease. Then, taking a probe, he examines the surfaces of your teeth, keeping an eye out for any discolouration, soft spots and cavities.

Next he looks at the gum area to see if there are any signs of infection or recession, or bad deposits of plaque or tartar. He also looks for any lesions that might indicate more serious disease such as cancer, although these are rare. Overall, the dentist is assessing the quality of the gum tissue. Then, finally, he checks your tongue and palate to ensure they are healthy.
All of these procedures are completely painless; good news for those who avoid the dentist for most of their lives out of fear!

intraoral1 — Patient position while taking X-ray

The next step is X-rays that are really quite quick and easy, although they may cause a little discomfort. This is because the X-ray plates are placed inside your mouth, and you have to bite down on them to hold them in place while the X-ray is taken. From time to time they may feel uncomfortable, or may press on your gums or teeth. However, they take only a couple of seconds each, and are important for your dentist to be able to see cavities in your teeth, as well as the state of each tooth in its entirety, and the bone.

Once your dentist has checked the X-rays, his assessment of your oral health is complete. Should you have no problems requiring treatment, he simply cleans and polishes your teeth and says goodbye until six months later. If you do have any disorders such as caries or gum disease, you will still go through the cleaning and polishing. However, your dentist will also spend some time with you outlining the treatment plan and discussing your options.

More info on General Dental Treatment

…

Dr. Ng SN

01/Feb/2011

We close from 2^nd February (Wednesday) to 9^th February 2011 (Wednesday) due to Chinese New Year festival. We will resume business as usual on 10^th February 2011 (Thursday).

我们将在二月二日（星期三）至二月九日（星期三）休息。我们将在二月十日（星期四）照常营业。

Dr. Ng SN

22/Jan/2011

Prestige Dental Care

Topics

To read on dental bridge click here
Crown – What is it?
How do we do it?
Picture on cases done in our clinic
Maintenance

Crown – What is it?

A crown is a replacement of the outside casing of your teeth that is permanently fixed to the tooth below. In other words, the decayed or damaged area of your tooth is removed and replaced by synthetic material, such as porcelain, to create a new ‘tooth’ with permanent results.

crowns2 — A crown is a replacement of the outside casing of your tooth

Crowns are often used after a root canal treatment, because the removal of a nerve causes a tooth to discolour. However, there are other reasons your dentist might crown one or more of your teeth: to restore a damaged or fracture tooth, to protect a weakened tooth so that it does not fracture under stress or to reinforce a large filling where there is not enough tooth structure left below.
Crowns are also made out of various material: gold or non-precious alloy, porcelain or ceramics, acrylic or composite resin, or even a combination of porcelain on metal. Obviously the material chosen will be in line with what will work best for your particular problem.

Currently, most dentist use porcelain fused to metal crown or full porcelain crown as both crowns produce good aesthetic result

How do we do it?

When crowning a tooth, your dentist starts by filing away away between 1mm and 2mm on every surface of your teeth, and then the entire surface is smoothed. Next, an impression is taken of the prepared tooth by syringing an impression material into the space around the tooth and holding an impression tray in position until the material has set. This gives the laboratory a perfect negative copy of your tooth, which allows them to make up the permanent crown. The dentist also ensures he sends the laboratory details of what the colour porcelain to use, to ensure the crown looks natural.

tooth prep — 1) Tooth are prepared and smoothen

impression1 — 2) Impression material is syringed into the space around the tooth to get the copy of the tooth

impression2 — 3) Negative copy of the teeth produced by impression material which is hardened on the impression tray

4) The crowns are fabricated on the model by laboratory technician

4.1.1 — 5) Finally, the crown is cemented onto the prepared tooth

Your are then fitted with a temporary crown, which is really just a rough space-filler, while you wait for the laboratory manufacture the permanent fixture.
At the following appointment, the dentist will have taken delivery of the permanent crown. The temporary crown is then removed, and the prepared tooth below thoroughly cleaned and dried. Then the new, permanent crown is cemented onto the tooth below. Any excess cement is removed, and the treatment completed.

Picture on cases done in our clinic

Here is a example of a discolour tooth that is replaced with a full porcelain crown (E-Max)

The young gentleman dislike his front discolour right central incisor

His tooth discolouration was due to old filling and the tooth is non-vital

After the tooth is prepared, colour of the porcelain crown is chosen to match his neighbour teeth

The full porcelain crown is cemented onto the tooth

Final Result – natural looking crown!! (Treatment done by Dr. H.W.NG)

Maintenance

You do need to take care of your crown and not overstress it by biting or chewing very hard food. You can also floss normally around a crown. If at a later stage, your crown should break, you need to see your dentist as soon as possible, especially if the tooth inside becomes sensitive. Save the fractured piece if you can, as this can be glued back on temporarily until a new crown is made.

More info on General Dental Treatment

…

Dr. Ng SN

22/Jan/2011

Pregnancy-gingivitis — Pregnancy Gingivitis

Topics

What is Gingivitis?
What is Pregnancy Gingivitis?
Causes of Gum Disease in Pregnancy
Symptoms of Pregnancy Gingivitis
Complications of Pregnancy Gingivitis
Treating Gingivitis in Pregnancy
Prevention

Some ladies may feel that their gums are uncomfortable than usual during pregnancy. Their gums are sore or tender, or if they bleed when brushing or flossing, they may have a condition called pregnancy gingivitis. Pregnancy gingivitis is a very common occurrence during pregnancy however; if it is not treated it can lead to complications with their pregnancy. If you are pregnant and notice any of the symptoms of pregnancy gingivitis it is important that you visit with your dentist in order to get appropriate treatment.
Pregnancy gingivitis is an hyperplastic reaction to microbial plaque. Elevated estrogen or progesterone levels resulting from hormonal shifts enhance tissue vascularity, which permits an exaggerated inflammatory reaction to plaque.

What is Gingivitis?

Gingivitis is more commonly referred to as gum disease, and it will affect over 90% of Americans at some point in their lives. Caused by the sticky plaque that accumulates on our teeth and gums, it can leave your gums swollen and tender, and even cause them to bleed. Gingivitis can also make brushing and flossing extremely painful. Gingivitis is one of the earliest stages of a more severe type of gum disease, called periodontal disease. Untreated gum diseases will progress into periodontal disease, which can cause irreversible damage to your gums and teeth. (More info on gingivitis)

What is Pregnancy Gingivitis?

Pregnancy gingivitis is simply gingivitis that occurs during pregnancy. More than 50% of all pregnant women experience some form of pregnancy gingivitis. Though gingivitis disease is annoying, it is usually harmless, unless it is left untreated. Pregnancy gingivitis is an hyperplastic reaction to microbial plaque. Elevated estrogen or progesterone levels resulting from hormonal shifts enhance tissue vascularity, which permits an exaggerated inflammatory reaction to plaque. Pregnancy gingivitis produces fiery red, swollen and tender marginal gingiva and compressible and swollen interdental papilla. If pregnancy gingivitis progresses to periodontal disease, it can increase your risk of going into preterm labor.

Causes of Gum Disease in Pregnancy

There are a number of causes of gum disease in pregnancy. One such reason is increased blood flow. During pregnancy, your blood flow actually increases by between 30% and 50%. This is to ensure that your baby is provided with the appropriate nutrients to grow and develop. Unfortunately, this increased blood flow can also cause you gums to swell and become very tender. It may even cause your gums to bleed, leaving them at increased risk for gingivitis.
The rise in your hormones can also play a role in you developing pregnancy gingivitis. These higher levels of hormones leave your gums and teeth more sensitive to the bacteria that hide in plaque. This is one reason why gingivitis is so common in pregnancy.
Morning sickness may also play a small role in contributing to pregnancy gingivitis. Many women find that they can no longer stand the smell or taste of toothpaste, making it difficult to maintain good oral hygiene. Increased vomiting during pregnancy can also take its toll on your gums. Vomit contains stomach acid which can eat away at your gums and teeth, making your mouth very sensitive.

Symptoms of Pregnancy Gingivitis

There are a few symptoms of gum disease to keep an eye out for. If you notice any of these symptoms, it is important to seek treatment as soon as possible.

tender, swollen gums
red or purple-red gums
gums that look shiny
bleeding gums after brushing or flossing
persistent bad breath
a bad taste in the mouth that won’t go away
mouth sores

Complications of Pregnancy Gingivitis

Generally speaking, pregnancy gingivitis is nothing to worry about. However, if your gingivitis is left untreated it could cause potential health problems for both you and your baby.
Sometimes, gum disease can cause sores to form on your gums. These sores are often called pregnancy tumors. These tumors can grow up to three-quarters of an inch in size and may cause discomfort or even pain. If ruptured, pregnancy tumors can become infected. Most tumors can be easily removed though, before they cause any complications.
It is important to take pregnancy gingivitis seriously because, if untreated, it will lead to periodontal disease. Periodontal gum disease is an advanced form of gingivitis that attacks the bones and tissues supporting the teeth. This disease can cause permanent damage to your mouth, and can cause you to lose both your gums and teeth. Periodontal disease has also been linked to a higher risk of premature birth – in fact, women with periodontal disease are seven times more likely to give birth prematurely.

Treating Gingivitis in Pregnancy

There are no cures for gum disease although its damage can sometimes be reversed or halted. All pregnant women should receive at least two thorough dental cleanings during pregnancy. This should help to reduce your chances of developing pregnancy gingivitis or periodontal disease.
If you already have gingivitis, the best gum disease treatment is to have a complete cleaning at your dentist’s office. Your dentist will scale your teeth using a variety of instruments. This will remove excess plaque from your teeth and around your gum line. Serious gingivitis may also require root planning, a process during which the roots of your teeth are cleaned of plaque completely.

Prevention

As always, the best treatment for gingivitis is prevention. Maintaining a good oral hygiene routine will ensure that you have healthy gums and teeth for a long time to come. Try following these tips:

brush twice a day for at least five minutes
use a soft bristle brush – this will prevent you from irritating your gums
floss once a day or use an anti-bacterial mouthwash to get rid of plaque from between your teeth
avoid eating large amounts of refined sugar – this will cut down on plaque and tartar buildup
visit your dentist regularly

More info

Treatments of gum disease:

Scaling and polishing
Air Polishing – A way to eliminate staining due to smoking, coffee or tea
Root Planning
Gum Surgery
Fear of Dental Treatment? How to overcome it..?

Dr. Ng SN

30/Dec/2010

Sterilization

Dental instrument that are used or contaminated have to be cleaned and bacteria-free before reuse. Therefore, they need to be sterilized before use. Sterilization is a term referring to any process that eliminates (removes) or kills all forms of life, including transmissible agents (such as fungi, bacteria, viruses, spore forms, etc.) present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media. Sterilization can be achieved by applying the proper combination of heat, chemicals, irradiation, high pressure, and filtration. (Source from wikipedia)

Autoclave

In dentistry, we use autoclave to sterilize our dental instruments. Autoclave is a device to sterilize equipment and supplies by subjecting them to high pressure saturated steam at 121 °C or more, typically for 15–20 minutes depending on the size of the load and the contents. It was invented by Charles Chamberland in 1879, although a precursor known as the steam digester was created by Denis Papin in 1679. The name comes from Greek auto, ultimately meaning self, and Latin clavis meaning key — a self-locking device. (Source from wikipedia)

Most dental clinic use autoclave unit to sterilize their instruments. According to the European Standard EN 13060, autoclave are divided into:

Type B- It has 3-times per-vacuum preceding vacuum drying. It can be used on wrapped and hollow instruments, which means a piece of equipment can be sterilized now for use later. This is the most effective autoclave as the steam able to penetrates deep into the pouches/wrappers or even double pouched instruments.

Type S – Comes with a one times pre-vacuum and vacuum drying function and efficient quick spraying steam generator. It can’t be used to sterilize instruments which are double pouch or the instruments which are wrapped in the thick wrapper/pouch.

Type N – This autoclave comes without vacuum function, it can be used for hollow instruments and solid instruments.This autoclaves are only suitable for a specific type of

load–for solid, unwrapped instruments.

Type B European Standard Autoclave – It has the highest standard among the type S and type N. It allows deep penetration into pouched/wrapped instrument. Type B Autoclave used widely in operating theater and it is used by our clinic too.

Dr. Ng SN

12/Nov/2010

Orthodontic treatment involves correcting of malocclusions (improper bites), which may be a result of tooth irregularity, disproportionate jaw relationships, or both. It usually involves the wearing of braces (removable or fixed) and very occasionally jaw surgery (orthognathic surgery).

Why might I need orthodontic treatment?

There are 3 main reasons for having orthodontic treatment:
• To improve the appearance of the teeth and face.
• To make your gum healthier by allowing you your teeth better.
• To improve function i.e. to make it easier to eat.

Who will going to treat you?

Orthodontic can be treated by a general dental surgeon (who has undergone adequate of training in orthodontic field) or a specialist (consultant orthodontic). General dental surgeon usually pick the simpler cases whereas the orthodontic consultant sees moderate to difficult cases especially cases the require jaw surgery later. Therefore, a dental examination is required first!!

What types of braces are there?

There are those which can be removed for cleaning, known as removable braces (Usually cater for very mild teeth misalignment or for young children). The second type of brace is fixed to the teeth and cannot be removed for cleaning. This type of brace is commonly used in our practice and it can be further divides into:

Conventional (metal brackets)
Transparent (crystal brackets)
Lingual brace (brackets that places at the back of your teeth)

lingual brace — Lingual brace – brace that put at the back of your teeth

removable appliance — Removable brace (appliance)

When will the brace be fitted?

This depends very much on the teeth being present in the mouth and the stage of growth of the face and jaws.

How long will treatment take?

Treatment with braces usually takes between 6 – 36 months to complete depends on the difficulty.

If teeth need to be extracted, who will do this?

General dental surgeon usually does this.

Is it painful?

Having the brace fitted is not painful. However, it is common to have slightly tender teeth for 3 – 5 days after each fitting and adjustment appointment.

How often will I need an appointment?

Once your brace has been fitted you will need monthly appointments for it to be adjusted.

Will the brace affect what I can eat?

In order to prevent damage to both your teeth and brace, you will need to:
• Avoid eating toffees, boiled sweets, sugared chewing gum, chocolate bars, etc.
• Avoid drinking fizzy drinks (including diet drinks) and excessive amounts of fruit juice.
• Take care eating hard foods which might damage the brace such as crunchy apples, crusty bread, etc.
Cut them up first.

Will orthodontic treatment damage my teeth?

It is important you brush your teeth well, three times per day and use interdental brush to clean your brace. A fluoride mouthrinse should also be used last thing at night, after tooth brushing, to further protect the teeth. Failure to keep your teeth and brace clean will lead to permanent scarring of your teeth. Having orthodontic treatment to improve the appearance of the teeth will be pointless if such scarring is allowed to occur.

clean brace2 — Cleaning your brace with interdental brush

Will I still need to see my regular dentist?

Yes. It will be important you still have check-ups with your regular dentist throughout orthodontic treatment so that your teeth can be checked for decay. Anyway, your teeth and brace will be checked and cleaned grossly every time you see the dentist who treat you!!

Will I still be able to play contact sports?

Yes, but it is recommended you wear a gumshield when doing so. This will also be the case if you enjoy riding a bicycle, roller-skating, or skateboarding. You will
be advised about this.

What if I play a musical instrument?

If you play a wind instrument, particularly the flute or a brass instrument, then a fixed brace may make it more difficult. You will need to discuss this with your
music teacher.

What if my brace breaks during treatment?

You will need to contact the us for an emergency appointment for the brace to be repaired as soon as possible. Repeated breakages will slow down the treatment and increase the overall treatment time.

What happens at the end of treatment?

Your teeth will try to return to their original positions. In order to prevent this you will be fitted with retaining appliances. These may be worn full time at first and
eventually worn part-time.

How successful is orthodontic treatment?

Smiling Lips — A smile that last forever!!

This very much depends on your commitment to the treatment. As a general rule, patients who co-operate well with treatment get good results, whilst
those who do not co-operate well, get poor results. Unless retainers are worn in the longer term some settling and growth changes may occur after treatment.

More info

…

Traditional Braces

Mini Braces

Lingual Braces

Crystal Braces

Invisalign Aligner

Mbrace Aligner

More info

Tooth Crystal

It is a professional solution for stylish tooth jewellery

Cases done in our clinic

Read more

Topics

What is a veneer?

Case study

Other Clinical Cases with porcelain veneer

Dental veneers vs dental crowns

How to care for your cosmetic veneers

Benefits of Cosmetic Veneers

Porcelain veneers vs Resin Composite veneers

Read More

Topics

Teeth Whitening

Vital bleaching

1. Non-professional home whitening

2. Professional home bleaching

Home bleaching technique

3. ‘In-office’ bleaching

‘In-office’ bleaching technique

Risk/Complication

Limitation

Read more

Have your teeth checked regularly..

Read More

More info on General Dental Treatment

We close from 2nd February (Wednesday) to 9th February 2011 (Wednesday) due to Chinese New Year festival. We will resume business as usual on 10th February 2011 (Thursday).

我们将在二月二日（星期三）至二月九日（星期三）休息。我们将在二月十日（星期四）照常营业。

Topics

Crown – What is it?

How do we do it?

Picture on cases done in our clinic

Maintenance

Read more

More info on General Dental Treatment

Topics

What is Gingivitis?

What is Pregnancy Gingivitis?

Causes of Gum Disease in Pregnancy

Symptoms of Pregnancy Gingivitis

Complications of Pregnancy Gingivitis

Treating Gingivitis in Pregnancy

Prevention

More info

Sterilization

Autoclave

Why might I need orthodontic treatment?

Who will going to treat you?

What types of braces are there?

When will the brace be fitted?

How long will treatment take?

If teeth need to be extracted, who will do this?

Is it painful?

How often will I need an appointment?

Will the brace affect what I can eat?

Will orthodontic treatment damage my teeth?

Will I still need to see my regular dentist?

Will I still be able to play contact sports?

What if I play a musical instrument?

What if my brace breaks during treatment?

What happens at the end of treatment?

How successful is orthodontic treatment?

More info

We close from 2^nd February (Wednesday) to 9^th February 2011 (Wednesday) due to Chinese New Year festival. We will resume business as usual on 10^th February 2011 (Thursday).