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Setia Clinic

by on May 30, 2018 | Posted in Gallery, slider

What Is Orthodontics?

Orthodontics is the branch of dentistry that corrects teeth and jaws that are positioned improperly. Crooked teeth and teeth that do not fit together correctly are harder to keep clean, are at risk of being lost early due to tooth decay and periodontal disease, and cause extra stress on the chewing muscles that can lead to headaches, TMJ syndrome and neck, shoulder and back pain. Teeth that are crooked or not in the right place can also detract from one’s appearance.
The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime.
How do I Know if I Need Orthodontics?
If you have any of the following, you may be a candidate for orthodontic treatment:
  1. Overbite, sometimes called “buck teeth” — where the upper front teeth lie too far forward (stick out) over the lower teeth
  2. Underbite — a “bulldog” appearance where the lower teeth are too far forward or the upper teeth too far back
  3. Crossbite — when the upper teeth do not come down slightly in front of the lower teeth when biting together normally
  4. Open bite — space between the biting surfaces of the front and/or side teeth when the back teeth bite together
  5. Misplaced midline— when the center of your upper front teeth does not line up with the center of your lower front teeth
  6. Spacing — gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not “fill up” the mouth
  7. Crowding — when there are too many teeth for the dental ridge to accommodate
  8. How Does Orthodontic Treatment Work
  9. Many different types of appliances, both fixed and removable, are used to help move teeth, retrain muscles and affect the growth of the jaws. 
  10. Braces — the most common fixed appliances, braces consist of bands, wires and/or brackets. Bands are fixed around the teeth or tooth and used as anchors for the appliance, while brackets are most often bonded to the front of the tooth.
  11. Removable appliances include: Aligners — an alternative to traditional braces for adults, serial aligners are being used by an increasing number of orthodontists to move teeth in the same way that fixed appliances work, only without metal wires and brackets.  Removable retainers — worn on the roof of the mouth, these devices prevent shifting of the teeth to their previous position.
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Should the “every six months” rule apply to everyone?

How often do you get your oil changed? Every 3,000 miles? Or is it every 6,000 miles? Thanks to computers, most cars today will make that determination for you based upon the type of driver and the temperature extremes the car has to endure.

So why is it that you have been told to see the dentist every 6 months (or every 3 months if you have gum disease)? How can it be so for every human, without the predictable variability of life styles and environmental triggers being a factor? Who says you have to see the dentist every 6 months?

So why is it that you have been told to see the dentist every 6 months (or every 3 months if you have gum disease)? How can it be so for every human, without the predictable variability of life styles and environmental triggers being a factor? Who says you have to see the dentist every 6 months?

Well, we do, us dentists. We, in our infinite wisdom have decided, as a group of health care professionals concerned for the health of our patients, that it is in your best interest to come see us every 6 months. Every person, whether you have good teeth or not, whether your gums are healthy or not, whether you build up a lot of plaque and tartar or not, whether you are the world’s best brusher and flosser, or not. That’s right, everyone needs to see the dentist every 6 months. And we certainly are not about to the reward the patients that brush and floss regularly because the rules are the rules…

 

Is this sounding ridiculous yet?

I hope so, because it is. Let’s first discuss the origin of this insanity, as risible as it may sound. Afterwards, we’ll arm you with the knowledge to make the right decision in your own case.

So are you a fast driver that drives in very cold weather or dusty conditions, or do you baby your car, warm it up every morning and drive like the owner of a Zamboni in an ice rink? How soon would your car’s onboard computer tell you to go in for service? And where (and when) did the profession of dentistry come up with that 6 month interval?

From Amos and Andy of course, a TV show from the 50s! I’m not joking. First a wildly popular radio show, a television adaptation ran on CBS-TV from 1951 until 1953, and continued in syndication though 1966. The show was sponsored by Pepsodent Tooth Powder. Toothpaste had not yet been invented (the procedure was to put some powder on the palm of your hand, wet your toothbrush, and touch the powder with your brush) and in those days going to see the dentist was not a routine activity. In fact, most people went to see a dentist when they needed an extraction or when they were in pain. The Pepsodent ad campaign was quite successful, and in an attempt to appease dentists and gain their recommendation, stated in the ad that in addition to brushing twice daily, that they see their dentist twice yearly (or every 6 months).

Yes, the ad men of Pepsodent (clearly “mad men”) are responsible for determining the frequency of your dental cleaning visits today!

Tartar and plaque form in the mouth at different rates. I can’t tell you how many times I’ve seen a patient for a recall cleaning visit only to see them two weeks later for a scheduled filling and already see tartar forming on the teeth. I also have some patients that need to come in for a cleaning only every 12 months. When dentists polish the teeth, the pellicle (skin of the tooth) is removed, but will reappear in 3 days. The sticky biofilm (plaque) will then stick to the pellicle.

Home care is vital in determining this rate of buildup of the product that is partially responsible for gum disease. Good brushers and flossers (determined by the frequency and quality of doing so) of course will fare better and last longer before needing another cleaning. It is extremely important to remember that gum disease is 100% preventable, but once seen in the mouth it is not 100% curable, and is less than 100% arrestable. So patients (and dentist) need to be armed with methods that properly address and pay for this degree of infection.

And the plot thickens: The insurance companies prefer the “Amos and Andy gig” by a wide margin. They like the steadiness of the 6 month recall concept. It means they have their providers, the dentists that have joined their plan, doing periodontal work for prophy fees! The insurance companies are then able to essentially reduce the utilization of the plan, which in turn increases profits. In the mean time the patient is being undertreated and the dentist is either committing malpractice or committing financial suicide.

The Amos and Andy rubber stamp of the 6 month recall has allowed the insurance carriers (their actuaries) to accurately predict their risk (the outlay of cash to provide for the utilization of the plan). By this quantifying of gum disease into absolute terms, they then know how much to add (to the bottom line) for profit.

The dentist is seeing something completely different. She is seeing a huge group of patients (80%) that need more than just 6 month recalls. Sure, the dentist can bill for SRP (scaling and root planing, otherwise known as “a deep cleaning”). However, it does not provide for the patient that is not yet inflicted with the disease but exhibits patterns that need more aggressive attention to prevent the disease.

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When Should You Consider Braces?

by on January 16, 2016 | Posted in dental, slider

If you have crooked teeth and/or a misaligned bite (an underbite or overbite), there are a variety of treatments that can help straighten teeth, including braces and retainers.

Many general dentists are doing basic alignment and orthodontics, but orthodontists specialize in correcting irregularities of the teeth.

The dentist or orthodontist you choose will ask questions about your health, conduct a clinical exam, take impressions of your teeth, take photos of your face and teeth, and order X-rays of the mouth and head. An appropriate treatment plan is made based on analysis of the gathered information.

In some cases, a removable retainer will be all that’s necessary. In other rare cases (especially when there is an extreme overbite or underbite), surgery may be necessary. In most cases, however, braces will be needed.

What Types of Braces Are Available?

If braces are indeed the solution for you, the dentist or orthodontist will prescribe an appliance specific for your needs. The braces may consist of bands, wires, and other fixed or removable corrective appliances. No one method works for everyone.

How Do Braces Work?

In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction. As the teeth move, the bone changes shape as pressure is applied.

Braces are made up of the following components:

  • Brackets are the small squares that are bonded directly to the front of each tooth with a special dental bonding agent or are attached to orthodontic bands. Brackets act like handles, holding the arch wires that move the teeth. There are several types of brackets, including stainless steel and tooth-colored ceramic or plastic, which are often selected because they’re less obvious. Occasionally, brackets are cemented to the back of teeth, in order to hide them from view.
  • Orthodontic bands are stainless steel, clear, or tooth-colored materials that are cemented to the teeth with dental bonding agents. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more cosmetically appealing options but are more expensive than stainless steel. They are not used in all patients. Some people have only brackets and no bands.
  • Spacers are separators that fit between teeth to create a small space prior to placement of orthodontic bands.
  • Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Arch wires can be made of metal or be clear or tooth-colored.
  • Ties are small rubber rings or fine wires that fasten the arch wire to the brackets. They can be clear, metal, or colored.
  • A buccal tube on the band of the last tooth holds the end of the arch wire securely in place.
  • Tiny elastic rubber bands, called ligatures, hold the arch wires to the brackets.
  • Springs may be placed on the arch wires between brackets to push, pull, open, or close the spaces between teeth.
  • Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (A headgear is another tool used by orthodontists to aid in correcting irregularities of the teeth; see below)
  • Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit of individual teeth.
  • Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct bite discrepancies and also to create room for crowded teeth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap.

Newer “mini-braces,” which are much smaller than traditional braces, may be an option for some. There is another method of straightening teeth that uses removable plastic retainers that may also work when crowding of the teeth is not too severe. Your orthodontist will discuss the various types of braces with you and determine which might be the best option for your situation.

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How To Choose A Great Dentist?

by on August 26, 2014 | Posted in slider

What To Look for in a Dentist
Take your time choosing a dentist; don’t wait for an emergency! There are several things to consider when looking for a dentist.

Location and office hours– Choose a dentist close to home or work. This will make it easier to schedule visits and to arrive on time. Also, make sure that the dental office is open on the days and at the times when you are able to schedule an appointment.

Cost–Does the dentist accept your insurance? Does the dentist offer multiple payment options (credit cards, personal checks, payment plans)? If your insurance plan requires referrals to specialists, can this dentist provide them?

Also, be aware that costs vary by practice. If you can, get estimates of what your dentist might charge for common procedures such as fillings, crowns or root canal therapy. Even if you have dental insurance, you may be paying part of the costs yourself.

Personal comfort–One of the most important things to consider when you choose a dentist is whether you feel comfortable with that person. Are you able to explain symptoms and ask questions? Do you feel like the dentist hears and understands your concerns? Would you feel comfortable asking for pain medicine, expressing your fear or anxiety, or asking questions about a procedure?

Professional qualifications–The dentist’s office should be able to tell you about the dentist’s training. The office also should have policies on infection control. If the staff seems uncomfortable answering your questions, or you are uncomfortable with their answers, consider finding another dentist. You can also obtain information about a dentist’s qualifications from the local dental society or your insurance carrier. Most organizations of specialty dentists also list their members and qualifications.

Emergency care–Find out what happens if you have an emergency, either during normal office hours, or at night or on a weekend. A dentist should not refer you to a hospital emergency room. You should be able to contact your dentist (or a suitable substitute) at any time by calling an answering service, cell phone or pager.

State licensing boards–Most state dental boards have a website where you can verify if your dentist is licensed. The website also should tell you whether there have been any disciplinary actions taken against him or her.

How To Find a Dentist
Here are some suggestions on finding dentists to evaluate.

People to ask:

  • Your friends and family — Friends and family members are a great resource. They can tell you about the personality of the dentist and office staff, and answer questions. Here are some good questions to ask:
    • How well does the dentist explain treatment options?
    • How long do you have to sit in the waiting room?
    • Do you feel comfortable asking questions?
    • How does the office handle emergencies?
    • How long do you have to wait for an appointment?
    • How are bills handled?
  • Your current dentist — If you are moving, ask your current dentist if he or she knows of someone to recommend near your new home.
  • Your physician — Your physician may be able to provide some names of dentists.
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Here are a few ways you can help keep your gums healthy.

1. Floss.

Floss at least once a day. This helps remove the plaque and food that is beyond your toothbrush’s reach, according to the ADA. It doesn’t matter when you floss: Do it at night, do it in the morning, or do it after lunch…just do it!

2. Get regular dental cleanings.

Your dentist can detect early gum disease symptoms if you see them on a regular basis. That way they can be treated before they become more serious. A professional cleaning is the only way to remove tartar, and it can also get rid of any plaque you missed when brushing or flossing. If you have gingivitis, brushing, flossing, and regular dental cleanings can help reverse it.

3. Quit smoking.

Yet another reason for smokers to quit: Smoking is strongly associated with the onset of gum disease. Since smoking weakens your immune system, it also makes it harder to fight off a gum infection, say the Centers for Disease Control and Prevention (CDC). Plus, smoking makes it more difficult for your gums to heal once they’ve been damaged.

4. Brush twice a day.

Brush your teeth after every meal. This helps remove the food and plaque trapped between your teeth and gums. Scrub your tongue too, since it can harbor bacteria. Your toothbrush should be soft-bristled and fit in your mouth comfortably, says the Mayo Clinic. Consider a battery-powered or electric one, which can help reduce gingivitis and plaque more than manual brushing. Swap toothbrushes or toothbrush heads every three to four months (or sooner if the bristles start to fray).

5. Use fluoride toothpaste.

As for toothpaste, store shelves are lined with brands that claim to reduce gingivitis, freshen breath, and whiten teeth. How do you know which one is best for healthy gums? Make sure to choose toothpaste that contains fluoride and has the ADA seal of acceptance. After that, the flavor and color is up to you!

6. Use a therapeutic mouthwash.

Usually available over the counter, therapeutic mouthwashes can help reduce plaque, prevent or reduce gingivitis, reduce the speed that tarter develops, or a combination of these benefits, according to the ADA. Plus: A rinse helps remove food particles and debris from your mouth, though it’s not a substitute for flossing or brushing. Look for the ADA seal, which means it has been deemed effective and safe.

It doesn’t matter whether your brush, floss, or rinse first. Just do a good job and use the right products.

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