The mainstay of any dental practice is the check-up appointment on a regular basis. Patients ideally should have these check-ups done before pain or problems arise - prevention is easier and less costly; and any procedure which can prevent pain or tooth loss is a winner.
- Hard-tissue (teeth and bone) and soft- tissue (gums, tongue, cheek, lips, and palate) diseases need to be identified, diagnosed, and then either treated or referred to the appropriate dental specialist.
- Xrays need to be taken on a regular basis to identify hidden carious lesions between teeth, under old restorations and crowns, as well as monitoring for bone loss associated with advancing gum disease. We use a Kodak digital xray system which is very convenient, fast and much safer for patients compared to the conventional chemical-processed xrays of old, as the xray radiation dosages are far lower. Digital storage on a pc is also extremely easy and convenient.
- We use a dedicated dental software programme, eXact, to chart all existing restorations, identify and chart indicated dental work, and to supply patients with a statement with all the necessary teeth numbers, medical aid tariff codes and ICD-10 codes as demanded by medical aids. The use of a pc and dental software expedites our work and lessens the need for cumbersome files jammed full of various forms which unavoidably accumulate over the years.
- After the initial consultation a printed quotation, with all the indicated treatments, codes and costs are supplied to the patient should they wish to verify costs and authorisations with their medical aid before embarking with any envisaged treatment plan.
- Youngsters need to be introduced to the dental team from at least the age of four. This is to firstly ensure the early identification of dental problems, and then if needed timely treatment or interception; but we also need to make our young patients comfortable and familiar with the dental surgery environment, which can be a bit overwhelming if their first dental visit is for an emergency procedure.
- With the advancing age of the general population and with an increased awareness for the need of correct dental hygiene we are seeing our older patients retaining their teeth for much longer and later in their advanced years. This presents new challenges for the dental team, with more emphasis being placed on oral hygiene, and being able to offer dental treatment options such as removable prostheses (dentures) versus fixed prosthesis (dental implants or bridges).
- The removal of caries and the placement of tooth-coloured composite (resin) restorations on not only the front teeth, but also the back teeth is now the norm. Composite restorations are aesthetically pleasing as well as being a very conservative minimal tooth preparation technique. The older silver amalgam restorations are no longer routinely used due to health concerns with mercury (quite a controversial topic!) and obviously having no cosmetic value.
- Composite veneers, using the direct bonding technique, on the front teeth is an extremely conservative approach when the appearance or shape of the front teeth needs to be improved. This is a quicker, much more economical method and far less aggressive technique as compared to the alternative options of ceramic crowns and ceramic veneers.
- Many patients brush too hard and literally brush away the hard enamel of the tooth exposing the sensitive, and much softer, underlying dentine layer at the neck of the tooth. These so-called tooth brush abrasion lesions are especially evident in our older patients - who have been at it for obviously more years than a younger person – can be very neatly and conservatively restored with a tooth-coloured composite restoration.
- Custom-made mouthguards for patients who engage in contact sports is an absolute must to prevent traumatic injuries to the teeth, as well as soft tissue lacerations and damage to the temporomandibular joint (TMJ).
- Bruxism or clenching is quite prevalent amongst a rather high percentage of patients. Problems associated with this habit include loss of tooth structure, either through a gradual wearing down of cusps, or a sudden traumatic tooth or restoration fracture; associated hypersensitivity due to loss of the protective enamel layer; head, neck and muscular pains; and, TMJ pain or dysfunction. Treatments include the fabrication of custom made night-guards, botox injections in the chewing muscles (the masseter and temporalis muscles), composite restorations or full-coverage porcelain crowns.