Gold Standard

"An overview of the tools and techniques we employ to provide the best for our patients"

Tags: gold standard,dentist, quality dentist, good dentist, london dentist.

Mr Anish Patel Jan 10, 2013
stick
We have come a long long way!

Background

The aim of high quality dental treatment should be to relieve pain and infection, restore the shape and colour, and restore lost function (maintain chewing capability). Having the best equipment for the job is an integral part of success.

Dentistry in the UK is performed at different standards. A filling or crown is not the same wherever you go. Ever had a filling or a crown that stands out? Ask yourself does it even look like a tooth? Do you ever have long-term jaw/muscle ache after treatment. Then you may have had treatment not fit for purpose.

Restoring teeth to its proper shape and height is very important for the long-term stability of the filling and for the surrounding teeth and tissues. If it is made too low (which is of course no use to anyone) or high , where it does not contact the opposing tooth respectfully it can lead to a few problems including:

  • The opposite tooth is forced to grow downward/upwards- often tilting and not contacting as it should
  • Unstable bite-problems with eating, jaw and muscle ache,can make gum disease worse
  • A decrease in support for your cheeks and lips
  • A lower overall height of back teeth- eventually causing wear of your front teeth (know as a lack of mutual protection to us)

How do you prevent problems from poorly shaped fillings and crowns?

Gold Standard 1- Use the most accurate equipment
Your mouth moves in many different ways and the interaction between your jaw joints, muscles and teeth is hard to map once it is lost. With the proper techniques and considerations we can get pretty close and provide a restoration that sits harmoniously with the surrounding teeth in the mouth.

If you require a simple filling, all we need to do is build the tooth up to what was there before we started.Therefore we are not making any changes to the way you bite, as a result you should have no discomfort afterwards. Sounds simple, however often not done routinely leading to a slowly progresing un-even bite.

If you require a laboratory custom made restoration, we need to record how you bite down and chew from side to side.

blog_justify_header
Fig. 1: A simple hinge articulator (left), and a semi-adjustable denar articulator(right).

The laboratory has to place a model of your teeth into a device known as an articulator. It can be a simple open shut device (left) or an adjustable device (right) that can be programed to you, to mimic opening/closing, side to side and forward and backward movements. A crown made that replicates opening and closing does not fuction well in the other planes of movement. . I have had no patient yet that chews straight up and down only! Simply put, the better we record and reconstruct how you bite, the more natural the filling or crown we can make.

Worried about root canal treatment?

Gold Standard 2- We use the most efficient equipment available
Root canal treatment has moved a long way from its origins. The equipement has kept pace, and we are now able to treat cases that before we would have never attempted.A major break through was the introduction of rotary endodontics. It involves using a single motor drill over hand files, with the major advantage being reduced treatment time and fewer files used.

If you require root canal treatment, you have two options with regards to equipment used depending on the individual case.

blog_justify_header
Fig. 2: Manual stainless-steel hand files (left), and a rotary root canal treatment motor(right).

The rotary-files are made from Nickel-Titanium and are therefore better at treating curved roots, due to increased flexibility This is especially important on back molars. A well condensed, fully extended root filling is the key to the success of fillings, crowns, and bridges placed ontop.

blog_justify_header

We also routinely use microscope at our practice to better visualise problems early, aim to work more conservatively as well aas giving our patients an invaluable tool to better understand their treatment and oral health.

Keep out the bad, seal in the good

Gold Standard 3- Rubber Dam Isolation.
Rubber dam isolation is placed over your teeth to prevent saliva from getting into the area where we are working, or to protect you from some of the materials and instruments we use. When placing a white filling having a seal is a must as the strength of the filling depends on keeping the area away from saliva. It can be done without if you like but the adhesive strength may be compromised and the result cannot be guaranteed.

A seal again is a must during root canal treatment so we can prevent bacterial and salivary contamination, inhalation of instruments or toxic chemicals used to clean the tooth. It is simple to understand that when trying to disinfect a tooth and prepare it for a root filling, the last thing you would want is bacteria from saliva washing around potentially infecting the root canal(s). This is outlined clearly in the European standards, and is a requirement if you are going to practice to the highest standards.

blog_justify_header
Fig. 3: A typical rubber dam with frame.

“Aim at perfection in everything, though in most things it is unattainable. However, those who aim at it, and persevere, will come much nearer to it than those whose laziness and despondency make them give it up as unattainable” Lord Chesterfield