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We share informative articles and news.


Dr. Chong
03/Oct/2016

General-Dentistry
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Valplast® is a type of flexible, nylon resin that is developed for the use in flexible removable denture. Valplast®  Flexible Partials were invented in the early 1950’s as an alternative to traditional metal and acrylic removable partial dentures (RPD’s). By using a flexible nylon base, Valplast®  eliminates the need for metal frameworks or acrylic resins for the construction of removable partial dentures.
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Tooth Replacement Options

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When you’re ready to replace missing teeth, you have a number of potential solutions available, each with its own set of advantages and disadvantages. Replacing your missing teeth is a big decision and it is important to consider several factors.

Comfort

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When considering a removable partial denture, many people find the Valplast®  Flexible Partials to be the most comfortable option, and the final restoration can be made very quickly. While the cost is often higher than a partial made with visible clasps, the results of the flexible partial are beautiful, and patient satisfaction is very high. The Valplast®  Flexible Partials involves only non-invasive procedures, and gives you confidence in your restoration while talking, eating and most importantly: smiling.
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Aesthetic

If you can’t bear the thought of visible metal clasps or a series of temporaries that change with each appointment, Valplast®  Flexible Partials is an option that looks very natural and will stay beautiful and comfortable for years to come. Even fixed restorations that look good at first could deteriorate over time due to gum recession or changes in your mouth.

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Valplast Denture can be flexed

Longevity

Denture acrylics and metal alloys may be prone to breakage and fracture over the course of time. Valplast®  Flexible Partials come with a lifetime warranty against breakage and fracture for the denture base under normal use. Valplast®  Flexible Partials can also be rebase and have teeth added to it if modifications are necessary over time.

Expense

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If cost is your primary consideration, removable restorations are the more affortable solution, Valplast®  combines great value with excellent aesthetic that often rival the appearance of more expensive fixed restorations.

Information above is taken from Valplast®  International Crop.


Dr. Tham
02/Nov/2011

Why it is important?

  • Improper oral hygiene leads to plaque build-up
  • Plaque formation can lead to gingivitis, an early form of gum disease
  • If left untreated, gingivitis can progress to periodontitis, a more severe form of gum disease
  • Recent evidence indicates that periodontitis is associated with certain medical conditions

That is why it is important for your overall health to understand the importance of good oral hygiene.

Plaque

Plaque

What is plaque?

  • A colourless film of harmful bacteria that sticks to your teeth
  • It is constantly form on the tooth surface.
  • Combination of saliva, food and fluids produce these deposits that collected on teeth and where teeth and gums meet.

Why prevent it?

  • Plaque build-up can lead to gum irritation, gingivitis, periodontal disease, cavities, and even lead to tooth loss
  • Plaque build-up may also harden into tartar

Tartar

  • Tartar trapped between the teeth and gum

    Tartar or calculus is a crusty deposite that can trap stains on the teeth and cause discolouration.

  • It creates a strong bond to the tooth surface, making it difficult to be remove by using dental floss or brushing
  • Tartar formation may also make it more difficult to remove new plaque and bacteria
  • Tartar can only be removed with dental scaling by a dental professional

Tartar attach on the extracted teeth

Plaque and Tartar will lead to dental problem such as:


Gingivitis

Periodontitis and tooth loss

Dental Caries

Poor Oral Health Could Mean Poor Overall Health

Oral health is integral to general health – from the Surgeon General’s Report on Oral Health, 2000

What is the association?

  • The mouth is directly connected to the body by the bloodstream and the digestive system
  • Left untreated, plaque and inflammation can lead to gingivitis
  • Untreated gingivitis may progress to periodontitis
  • Recent evidence suggests that periodontitis is associated with systemic diseases such as heart disease (eg. heart attack, stroke) and diabeties.

Prevention is better than cure

Daily Oral Care: Cleaning In Between

1. Dental Floss

Step 1

Step One:
Take about 18 inches (50cm) of floss and loosely wrap most of it around each middle finger (wrapping more around one finger then the other) leaving 2 inches (5cm) of floss in between

Step 2

Step Two:
With your tumb and index fingers holding the floss taut, gently slide it down between your teeth, while being careful not to snap it down on your gums.

Step 3

Step Three:
Curve the floss around each tooth in a “C” shape and gently move it up and down the sides of each tooth, including under the gumline

How to floss your teeth – source Mouth Healthy (ADA)

2. Interdental Brushes and Threading Floss

Threading Floss

For people with widely spaced teeth, braces, bridges or implants, they may benefit from an interdental toothbrush.

Interdental Brush

Daily Oral Care: Brushing Teeth

Video: How to brush your teeth – source Health Education England (NHS)

Twice yearly: To visit a dentist for dental check-up & dental scaling

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More info

 

Treatments of gum disease:

 


Avatar
26/Mar/2011

Topics

  • Consultation
  • Examination
  • Other Investigation
  • Diagnosis
  • Treatment
  • Other Options
  • Warnings
  • Financial Arrangements

Consultation

A consultation for braces by dentist/orthodontist is a necessary to determine the need for braces, to size the braces and decide on various other factors concerning the impending braces. The consultation will last about a half an hour and cover various aspects of the braces as well as provide patients and their parents with all the necessary information.

During consultation, you will be asked questions such as:

  • What you don’t like about your teeth/face?
  • What do you want to achieve at the end of the treatment?
  • You expectation  form the treatment

Examination

Next, the orthodontist will examine your face profile (such as skeletal pattern, facial height and symmetry) , position of you nose, upper and lower lips and position of you chin.
Then, he will looks into your mouth to see the position of the upper front teeth; how much the teeth inclined, whether they are in front or behind the lower front teeth. He will examine each segment of your teeth; whether the teeth overlap each other (insufficient space) or spacing, any tooth tilted, submerge
Finally,  oral hygiene, any teeth need to be restored, decayed teeth or impacted wisdom teeth to be extracted.

Other Investigations

Photos of patient face for orthodontic assessment

To complete the assessment, photos of your face and teeth as well as X-rays of the mouth will be taken at the consultation, and a molding of the teeth may be taken.

Photos of patient’s teeth

Dental Panoramic Tomogram or OPG radiograph

Cephalometry Analysis done with  computer software

Two radiographs that required you to have are the dental panoramic tomography (OPG) and  lateral cephalometry radiograph. Dental panoramic tomography (OPG) allows orthodontist to examine the whole upper and lower jaw; to look of any missing teeth, impacted or embedded teeth. It is a good radiograph to look for any pathological lesion in the jaw bone.  Lateral cephalometry radiograph is used to determine the upper and lower jaw relationship. Computer software is used to analyze the severity of  jaws discrepancy and is it important for treatment planning.

Dental Model – Duplication of patient’s mouth

Diagnosis

The main focus at the braces consultation is determining the need for braces. This diagnosis is often obtained before the consultation appointment but will be discussed in reference to treatment plans for your orthodontic problems.

Treatment


Each specific treatment plan will be discussed and outlined at the braces consultation. Treatment plans may include wearing a retainer for a few weeks before having the braces placed. The amount of time the braces will need to remain in place will also be discussed at the consultation. It is during the discussion of treatment when the orthodontist will explain to you the necessary care for braces. At the consultation visit, you will be allowed to decide the types of braces (metal or crystal) and the colors of each brackets.
He will also discuss with you other dental treatments that you needed before orthodontic treatment such as scaling, restoration work and extraction. Sometime, you are required to undergo minor surgery to remove impacted or embedded tooth prior orthodontic treatment.

Other Options

Alternative treatments will also be discussed at the braces consultation. Alternative treatments may include only wearing a retainer or wearing a clear mouth guard apparatus.

Warnings

At the consultation appointment, the orthodontist will discuss the risks and complications associated with wearing braces. The orthodontist will then warn you about pain and discomfort associated with the braces and possible problems the braces can create, such as the removal of enamel from the teeth and gum soreness and bleeding. He will ask you to clean your teeth very well to prevent teeth decay during orthodontic treatment. You will have to wear a retainer at the end of the treatment to minimize relapse.

Financial Arrangements

Because braces are expensive, it is important that payment arrangements be discussed at the consultation appointment. At the consultation, the orthodontist may ask the patient and guardians if the patient has dental insurance. If the patient does not have dental insurance, the orthodontist may be able to set the patient up on a payment plant or may require the total cost of the braces be paid up front or by installment.

More info


Avatar
11/Mar/2011

Topics

  • Problems with missing teeth
  • What is a dental bridge?
  • Anatomy of a dental bridge
  • Composition of a bridge
  • Types of dental bridge
  • How bridge is fitted
  • Cases done in our clinic
  • Maintenance of dental bridge
  • How Long do Bridges Last?

Problems with missing teeth

Missing tooth

Most people want a gap in their mouth filled for cosmetic reasons, and understandably so: beautiful smile is a very important part of the impression you make to the outside world. However, there is a more important reason to close gaps in your mouth where teeth are missing; it is actually harmful to have a missing tooth, because teeth tend to drift out of place when there is a gap and move forward into the space that has been created. This leads to all kinds of serious problems, including bone loss, and, if left untreated, you can loose more teeth. Therefore, replacing a tooth is important!! Usually it can be done by fabricating a denture, bridge or implant.

What is a dental bridge?

Dental Bridge
Bridge stting on the implants

A bridge is a way of replacing one or more missing teeth in the mouth. It is also known as fixed partial denture, which used to replace a missing tooth by joining permanently to adjacent teeth or dental implants. Unlike traditional removable dentures, a dental bridge is permanent as it’s anchored to the teeth at one, or both, sides using metal bands held in place by resin or cement. If well cared for, a dental bridge should last for 10 to 15 years.

Anatomy of a dental bridge

A bridge consist of a ‘false teeth/tooth which is called pontic connected by connectors to retainers. Bothe retainers sit on the abutment teeth: Retainers. Part of the bridge will have metal castings, called retainers. They are made to fit onto what the dentist has cut away on the abutment teeth. Retainers also secure and support the bridge’s artificial tooth or teeth. Pontics. A pontic is an artificial tooth that is suspended from the retainer casting. A pontic occupies the space formerly filled by the crown of a natural tooth. Connectors. A pontic is attached to a retainer by a connector. Connectors can be rigid or nonrigid. Nonrigid connectors take the form of male- and female-locking arrangements. Rigid connectors are classified as either cast or soldered. Abutments. The teeth that support and hold the retainer are called abutments. It is almost mandatory that an bridge be supported by an abutment at both ends. This requirement is waived in special situations. When a pontic is suspended from only one retainer, it is cantilevered.

Composition of a dental bridge

The materials used for the bridges include gold, porcelain fused to metal, or in the correct situation porcelain alone (full porcelain). The amount and type of reduction done to the abutment teeth varies slightly with the different materials used. The recipient of such a bridge must be careful to clean well under this prosthesis.

Types of dental bridge

There are three types of dental bridge: fixed, resin bonded, and cantilever. The type of bridge used will depend on the quality of the teeth on either side of the gap, as well as the position of the gap. 1.) Fixed Bridges With a fixed bridge, the false tooth, or pontic, is anchored to new crowns attached to the teeth either side of the gap. These crowns are usually made from porcelain with the new tooth made from either ceramic or porcelain. This forms a very strong bridge that can be used anywhere in the mouth. 2) Resin Bonded Bridges Sometimes called Maryland Bonded, these dental bridges do not involve crowning the adjacent teeth, so are useful where these show little or no previous damage. The new tooth is generally made from plastic and is attached via metal bands bonded to the adjacent teeth using resin. This type of bridge is particularly suitable for front teeth where stress is minimal, and the bond can be made out of view behind the teeth. 3) Cantilever Bridges These dental bridges are used where there is a healthy tooth only on one side of the gap. The bridge is anchored to one or more teeth on just one side. As a result, this type of bridge is generally only suitable for low stress bridges such as front teeth.

How your bridge is fitted

Getting a bridge usually requires two or more visits.  While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown.  Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated.  In addition, a temporary bridge will be made and worn for several weeks until your next appointment. At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit.  Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge.  The new bridge will be permanently cemented at a later time.

Cases done in our clinic:

Case One: Multiple missing teeth This patient was a young female, wearing denture for more many years. She came to us, wanted something fix or permanent which looked more natural than her denture. She presented with multiple missing (below). After assessing her, we suggested a 9 unit bridge extending from upper left canine to her upper right molar with non-rigid connector between her upper right canine and first premolar. We also suggested her to have a implant-supported bridge for her upper left quadrant. Shade or colour selection was chosen and the remaining teeth were prepared for bridge construction under local anaesthesia. Impression of her teeth were taken and a dental model was fabricated. The laboratory technician construction the bridge on the model. The non-rigid connector just behind the right canine used to connect the rest of the bridge a the posterior right (above) The connector at the back of the upper right canine was covered properly with porcelain. The anterior part of the bridge was cemented onto patient’s mouth (above and below – the back view) Finally, the back portion of the bridge is cemented to the back molar Final result!! Case Two: Multiple missing teeth This gentleman complained that his old denture was getting shorten and he wanted something permanent His denture looked really old with discolouration over the ‘pink’ part of the denture On the palatal view showed multiple missing teeth involving the upper front and right side. A 9 unit bridge was constructed and cemented onto patient’s mouth. Due to bone resorption at the front part, ‘pink’ porcelain was added to supported his upper lip giving him a youthful look. Palatal view: the bridge extended from left canine to right molar Final result!!

Maintenance of dental bridge

Superfloss

Dental hygiene becomes a little more complicated if you have a bridge, making normal flossing impossible in that area, nevertheless you do have to take care that the teeth adjoining the artificial tooth are thoroughly cleaned. Even the best fitting bridge will still have gaps around and beneath it, and these can quickly accumulate damaging debris if you do not follow a strict hygiene regime.Your dentist can show you how to do this, using special floss (eg. superfloss) or flossing needles. These floss go ‘under’ the pontic area and area near to the abutment to remove the food usually stagnant there.

 

How Long do Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings. To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.

Read more

 


Avatar
05/Mar/2011

 
 

 

Resin Veneers or better know as composite veneers are thin shells of tooth-colored, translucent filling, custom made to fit over teeth and improve their color, shape and overall appearance. Placement of composite veneers can dramatically improve your smile and appearance.

Composite veneer technique

Courtesy of Dr Markus Lenhard, Heidelberg, Germany
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Types of problems that composite veneers can correct

Placement of dental veneers is sometimes referred to as “instant orthodontics” because they can be used to cover a variety of dental problems involving teeth in the “smile zone” including:

  • Spaces between the teeth.
  • Conical or ‘peg’ shape lateral incisor.
  • Poorly shaped or crooked teeth.
  • Broken or chipped teeth.
  • Permanently externally stained and/or internally stained teeth.
  • Unsightly or stained fillings.

Generalize spacing and ‘peg’ shape right lateral incisor

Chipped incisor

Unsightly or stained fillings

Dental veneers (either composite or porcelain veneer) can improve the appearance of the teeth but they cannot realign the jaw or correct overbites and underbites. Orthodontics are required to correct these more complicated problems.
 

The advantages of composite resin veneers vs. porcelain veneers

  • Composite veneers can be done on the spot. The time spent might be from 30 minutes to 2 hours or more depends on the number of tooth involved.  They do not required second visit.
  • Composite veneers produce the same aesthetic result as porcelain veneers. Therefore, no one can tell whether you have a composite or porcelain done except your dentist!
  • Composite veneers can be repair if there is any chipping or fracture.
  • Composite veneers are very cheap (From MYR150 toMYR250 per tooth; depends on how difficult and big the defect is).

The major disadvantages of porcelain veneers over composite resin include the following:

  • Porcelain veneers are not made at chairside. Porcelain veneers are fabricated in a dental laboratory and therefore require at least two visits. Composite resin veneers are accomplished in one visit. An adequate amount of tooth structure is removed to allow for placement of composite resin in the desired shape without added tooth bulk. Bonding agent is applied. Composite resin is then added, light cured, then finished and polished.
  • Porcelain veneers are more expensive than composite veneers. The placement of veneers requires more time, expertise and resources in order to fabricate and bond and therefore cost more.
  • Porcelain veneers cannot be repaired. If they break porcelain veneers must be replaced.

The advantages of porcelain veneers

Porcelain veneers have several advantages compared to composite resin including:

  • Porcelain veneers are very durable. Although porcelain veneers are very thin, usually between 0.5 – 0.7 millimeters and inherently brittle, once bonded to healthy tooth structure it becomes very strong. Porcelain veneers can last for many years, usually 10-15 years, if you take good care of them using good oral hygiene and avoiding using them to crack or chew hard objects like ice.
  • Porcelain veneers create a very life-like and natural tooth appearance. The translucent properties of the porcelain allows the veneers to mimic the light handling characteristics of enamel giving it a sense of depth which is not possible with other cosmetic bonding materials such as composite resin.
  • Porcelain veneers resist staining. Unlike other cosmetic dental bonding materials, porcelain is a smooth, impervious ceramic and therefore will not pick up permanent stain from cigarette smoking or from dark or richly colored liquids or spices.
  • Porcelain veneers are conservative. Only a small amount of tooth structure is removed, if any during the procedure.

Cases done in our practice using composite veneers…

Case 1


This young man complaint of generalized spacing and a peg-shaped right lateral incisor. Composite material was used to close all the gaps between his teeth (Below).
 
Csss

Case 2


This patient fell down and broke her front teeth while playing spot. The tooth was restore with composite veneer. ‘Stained’ or chalky white patches resin composite was place on the front surface of the veneer to mimic the neighbour  teeth (Below).

Case 3


Old filling at the center of his upper front teeth looked yellowish and rough. Those fillings were removed and replaces by new composite veneers (Below).

 

Case 4


Yellow stain due to uneven surface at the front teeth and old yellow filling were replace by composite veneers (Below).

Case 5

Multiple decays at the front teeth were treated with composite veneer  (Below).

Case 6


Defect of the lateral incisor was repaired with resin composite  (Below).

Case 7


Generalize unevenness of this young man front teeth gave a older look. With composite veneer correction, he looks youthful again!! (Below).

Case 8

Old composite veneers on all the six front teeth on this lady was stained at the margin. The composite were removed and were replaced with the new one  (Below).

Are you a good candidate for dental veneers?

Dental veneers are not appropriate for everyone or every tooth. Case selection is an extremely important factor in the success of this technique. Veneering teeth is not a reversible procedure if tooth structure must be removed to achieve your desired result Only an examination by your dentist can determine whether dental veneers are appropriate for making the changes you want. Some of the situations where certain teeth or people are not good candidates for dental veneers include:

  • Unhealthy teeth. Dental decay and active gum disease must be treated prior to fabricating and bonding dental veneers.
  • Weakened teeth. If a significant amount of tooth structure is missing or has been replaced by a large filling the teeth will not be strong enough to function with a dental veneer.
  • Teeth with an inadequate amount of enamel present. Dental veneers are more successfully bonded onto tooth enamel.
  • People who habitually clench or grind on their teeth. Habitual clenching and grinding of the teeth can easily chip or break dental veneers. Dental nightguards may be a solution for this in some cases.
  • Persons without a stable bite.
  • Severely malpositioned teeth or misaligned teeth. Orthodontic treatment may be required to achieve the desired result.

How to maintain Dental Veneers?

Dental veneers can chip or come off if not cared for properly. To improve their durability and longevity you need to maintain consistent good oral hygiene and have regular dental examinations and cleanings at least twice each year. In addition, you must avoid using them to bite or crack hard objects like nuts and ice.

What are the alternatives to composite veneers?

The closest cosmetic alternative to composite veneers is porcelain veneers which are more durable and more resistance to staining. However, they are more costly and require at least 2 visits. On top of that, there is another method to improve smile: Snap-on Smile, a  multi-purpose restorative appliance that requires no preparation or altering of tooth structure, no injections, and no adhesives. It is non-invasive, making it completely reversible.
Dental crowns may also be used to correct the same problems that dental veneers correct, however it is a much less conservative procedure.

More info..

 
 


Avatar
20/Feb/2011


 

Types of denture

 
Basically, denture (false teeth) is prosthesis device to replace missing teeth. The denture is supported by the surround soft and hard tissue. It is the most economical and easy-to-make prosthesis. Denture can be further divided into complete denture (denture to replace all missing teeth) or partial denture (denture to replace a few missing teeth)
Beside denture, there are other options to replace missing teeth:

 

Pro and cons of having a denture:

Pro:

  • Simple to make (no surgery/cutting your adjacent teeth)
  • Economical
  • Easy to clean
  • Produce good aesthetic and function

Cons:

  • Feels like a fake teeth (Can be taken out of the mouth)
  • Uncomfortable for the first time wearer
  • Cannot bite very hard or sticky food
  • Interfere with your speech initially
  • Need to be taken out at night
  • It can be loose (if the remaining alveolus bone is less)
  • Have to make a new one with it’s loose and uncomfortable

 

Basically we have 3 types of denture:

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Acrylic Denture

Conventional acrylic denture (Plastic denture)
  • The ‘pink’ part is purely made of plastic
  • Look natural
  • Simple
  • Thicker on the palate and tongue
  • Sometimes loose and needed stainless wire to grab hold to the remaining teeth

 

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Cobalt chrome denture

Cobalt chromium denture (Metal denture)
  • The ‘pink’ part is supported by a metal frame with clasps to attach to the remaining teeth
  • Thin especially on the palate area and more comfortable
  • Rigid and quite retentive
  • Not so aesthetic as you can see some clasp coming out

 
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Valplast®  Flexible denture (Flexible denture)
  • Comfortable
  • Flexible slight
  • Quite retentive
  • The clasps to hold the nature teeth are part of material from the ‘pink’ part thus, more aesthetic
  • For more information on Valplast, click here…

 






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