Multiple dental extraction is defined as removal of more than one tooth in a single dental visit. This procedue usually will be done under general anaesthesia (GA) in the hospital setup. Dental extraction under GA also can be performed on children who is anxious, uncooperative or having medical condition such as cerebral palsy or hyperactive child. In some cases, dental extraction under GA is done on children with badly decay teeth which needed multiple dental visit for extraction. It is therefore, better to have it done under general anaesthesia.
The indications of dental extractions under general anesthesia are:
Young child with rampant decayed teeth
Children who is unsuitable for local anesthetic or conscious sedation due to lack of cooperation
Patient with medical condition such as cerebral palsy or severe seizure
Patient who required lot of tooth extraction
Dental extraction under GA di performed in the hospital setup as day-care (no hospitalization). The patient (or the child) is usually health (ASA I) and fasting since midnight. The anesthesiologist will assess the child and written consent is taken before the procedure started.
In the operating room, the anesthesiologist will put a tube in patient’s throat to administer ‘sleeping’ gas allowing patient to ‘sleep’ during the whole procedure. The oral surgeon will come in to perform the dental extraction. After the procedure, the tube with be removed from the patient’s throat, and he will placed in the recovery room. He will be allowed to discharge from the hospital when fully conscious and ambulated.
Upon the procedure, a minor bleeding in extraction site, swollen tongue/lip/chin/cheek, temporary mouth opening limitation are the sequelae or conditions to be expected.
Advantage of extraction under GA
Very useful to traet uncooperative patient
Patient has no experience of the awlful dental extraction
No need many dental visit for extraction
Other dental procedures such as fillings and dental cleaning can sometimes be done in the same visit
Disadvantage of extraction under GA
Patient has to be healthy for GA
The procedure has to be done in the hospital setup with OT facility
Treatment will cost more as the patient has to be admitted in the hospital as well as GA fees
It is recommended that every child has an introductory dental visit within 6 months of eruption of their first tooth. As parents, you might think this is too early- even more so when there is no “problem” with your child’s teeth yet. However, starting dental visits early has many advantages:
We can assess each child’s risk of developing tooth decay.
We can suggest preventive steps that is special to each child’s needs
We can have the opportunity to show your child that dental visits can be fun, hence reducing chances of dental anxiety in the future
Quite often, it is a child’s first visit to the dental clinic but he/she is having pain. We understand that it can be stressful and anxious for both parent and the child. For younger children, parents can be present in the treatment room. For older children, it is best that we can see the child by themselves, but if parents are not comfortable with that, parents can be passive observers- allowing us a chance to interact and explain in simple terms that your child can understand. Many studies have shown that when parents are anxious themselves, their child will also tend to be anxious as well.
Depending on the your child’s reaction to his/her dental visit and what treatment needs to be done, we will try our best to provide your child with the best care possible. It is however important for parents to understand that treatment should not be forced or rushed onto a child. We understand that parents are busy and prefer treatment to be done all in a single visit, but it takes a lot of patience and time for us to build a trusting relationship and bond with your child. This is how dental visits can become stress free and fun for your child.
Our services includes
Standard Cleanings and Check ups
The care we provide is the best we can for each child. This means that the cleaning frequency we recommend can vary from individual to individual. Your child might benefit from cleanings every 3 months, or every 6 months.
What happens during a standard cleaning and check up?
A standard dental examination
Scaling, polishing and flossing
Dental x-rays (if needed)
Fluoride varnish treatment
Fluoride Varnish Treatment
What is Fluoride? Fluoride helps to strengthen teeth and prevent decay. It is also able to remineralise teeth that have early decay (seen as white patches on teeth). Fluoride can be found in fluoridated toothpaste, and are available in various amounts and concentrations.
Fluoride varnish contains a higher than normal amount of fluoride and it comes in the form of a thick sticky paste that adheres to teeth to minimise swallowing. It is very well tolerated as well. Varnish is proven in many ways to slow, stop and even reverse the formation of cavities. Everyone is at risk of developing cavities, from the young infants to young kids to teenagers. Here are some risk factors:
Infants still bottle feeding past one year of age.
Infants sleeping with a bottle containing liquids other than water (eg. milk, juices, sweetened drinks like Milo)
Frequent breastfeeding without proper mouth cleaning afterwards, especially at night
Constant consumption of sugary or starchy foods and beverages
Dental history of cavities
Developmental disabilities
Application of Fluoride Varnish
Fluoride varnish may be unfamiliar to many patients, so here are some information for parents and children:
It will make your child’s teeth look dull and yellowish when leaving the dentist. Their teeth will return to normal as the varnish wears off, usually in 1 day.
In order for the varnish to have the most benefit, it needs to remain adhered to the teeth for as long as possible. For that, your child should not brush or floss until the next morning.
To prevent early removal of the varnish, avoid abrasive or hard foods for the rest of the day. Soft diet is ideal for the day.
Fluoride varnish should be done every 6 months for most children. For children who have a higher risk of cavities, we may recommend 3-monthly application of fluoride varnish.
Tooth coloured fillings
Tooth Colour Fillings
These are white fillings that look beautiful and blend in with the natural color of the tooth. Placement of fillings is fairly quick and easy. First the decayed part of the tooth is cleaned and removed, then the tooth is dried and filled.
Happy Gas
What is Happy Gas? Happy Gas is also known as nitrous oxide/ laughing gas. In our clinic, we use it as a mild analgesic. It works by filling the patient with a feeling of happiness, which helps them feel relaxed and less anxious about dental treatment.
How do we use Happy Gas? We apply the gas through a tube and nose piece that fits over your child’s nose. All he/she has to do is breathe through his/her nose
Why use Happy Gas? Happy Gas is fast acting and wears off quickly. Its effects can be felt within 5 minutes, and when the gas flow stops, those effects wear off within another 5 minutes of breathing oxygen. It is safe, easy to use and can be adjusted easily for your child’s comfort. The only thing that stops it is a stuffy nose. If your child can’t breathe through his/her nose, it won’t work.Children’s Primary Teeth
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[evp_embed_video url=”https://prestige-dental-care.com.my/wp-content/uploads/2014/10/eCligner.mp4″ width=”640″ height=”361″]
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This young girl had an accident at home, causing two-third of her crown fractured and worse of all, the pulp of the tooth exposed.
We did an emergency root treatment over the tooth to reduce her pain and later on, build back the tooth (below)…
So, now she can smile confidently and pain free.
Primary teeth or Deciduous teeth, otherwise known as reborner teeth, baby teeth, temporary teeth and primary teeth, are the first set of teeth in the growth development of humans and many other mammals. In some Asian countries they are referred to as fall teeth as they will eventually fall out, while in almost all European languages they are called milk teeth as they exist when the child is still mainly drinking milk. They develop during the embryonic stage of development and erupt—that is, they become visible in the mouth—during infancy. They are usually lost and replaced by permanent teeth, but in the absence of permanent replacements, they can remain functional for many years.
Deciduous teeth start to form during the embryo phase of pregnancy. The development of deciduous teeth starts at the sixth week of development as the dental lamina. This process starts at the midline and then spreads back into the posterior region. By the time the embryo is eight weeks old, there are ten areas on the upper and lower arches that will eventually become the deciduous dentition. These teeth will continue to form until they erupt in the mouth. In the deciduous dentition there are a total of twenty teeth: five per quadrant and ten per arch. The eruption of these teeth begins at the age of six months and continues until twenty-five to thirty-three months of age. Usually, the first teeth seen in the mouth are the mandibular centrals and the last are the maxillary second molars.
The deciduous dentition is made up of central incisors, lateral incisors, canines, first molars, and secondary molars; there is one in each quadrant, making a total of four of each tooth. All of these are gradually replaced with a permanent counterpart except for the first and second molars; they are replaced by premolars. The replacement of deciduous teeth begins around age six. At that time, the permanent teeth start to appear in the mouth, resulting in mixed dentition. The erupting permanent teeth causes root resorption, where the permanent teeth push down on the roots of the deciduous teeth causing the roots to be dissolved and become absorbed by the forming permanent teeth. The process of shedding deciduous teeth and the replacement by permanent teeth is called exfoliation. This may last from age six to age twelve. By age twelve there usually are only permanent teeth remaining.
Teething age of deciduous teeth:
Central incisors : 6–12 months
Lateral incisors : 9–16 months
Canine teeth : 16–23 months
First molars : 13–19 months
Second molars : 22–33 months
Primary teeth care
Proper care of deciduous teeth is very important and starts at early stages even prior to their eruption. At the earliest stage, a child’s mouth and gums are to be wiped with a clean damp cloth, gauze pad, or especially designed teeth wipes. Wiping the baby’s teeth and gums after each feeding, and particularly at bedtime, helps prevent baby bottle tooth decay. This practice also helps reduce premature decay caused by harmful plaque-like film and bacteria that builds when babies ingest juices or any food containing sugar. Moreover, to reduce the possibilities to develop baby bottle tooth decay is it better to give the baby only plain water at bedtime or during the night and avoid juices, sugar water, milk or any other liquid containing sugar.
Non-flouride toothpaste
Once the first primary teeth come in, brushing starts. Warm water is normally used in these cases or a non fluoride toothpaste. The market offers special toothbrushes or finger toothbrushes for babies that help protect tender gums and gently clean baby teeth and gums. Other toothbrushes are specially designed for toddlers to easily grip them. They also come in catchy designs that encourage toddlers to use them. Toothbrush designs vary according to age, therefore, it is better to check the age recommendation on the package to obtain the most convenient one. Toothbrushes should be replaced every two to three months. It is also important to brush children’s teeth after giving them medicine as their acids may affect the tooth enamel. Early brushing helps reduce harmful bacteria, remove plaque, sugar, or any other kind of food that may cause tooth decay.
Reduce intake of high sugar food
Parents are advised to take their children to the first dentist visit when they are 12 months old. During this visit, the dentist can define dental care plan. Two possible ways to prevent tooth decay are the use of fluoride and sealants.
It is important to bring your children for dental check-up regularlyFluoride makes teeth stronger over time which then prevents the initiation of dental caries and tooth decay. Also, it re-mineralizes those areas of the teeth which have been weakened by acid. Fluoride can be included in one’s diet. Other ways of obtaining fluoride are in toothpastes and mouth rinses that are normally used at homes. The dentist can provide it through gels and foams he applies during dental visits.
To add to the benefits of the fluoride, dentists also apply sealant in order to preserve the teeth even more. Sealant is applied in some locations of the teeth that smooth their surface. Therefore, food and plaque are less likely to get trapped in those areas.
Children can start flossing when they are about 3-4 years old. However, at this age they might still need help and will be able to floss by themselves when they are 8-10 years old.
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
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If you have any question, don’t hesitate to contact us, we are more than glad to provide you with the information you need!
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