September 2014 - Prosthodontist in Johannesburg
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September 2014

By: Dr Gerald Kaplan

Teeth are designed to last a lifetime with proper care both at home and professionally in the dental office. This home care really begins with the baby teeth. It requires diligence on the part of the parent to maintain effective plaque control with good and regular toothbrushing. Many times the child is reluctant to brush but the way around it is” monkey see, monkey do”. The parent needs to be a good role model. Baby teeth are very  important in the growth and development of the child into a young person. They maintain the space needed for the eruption of the permanent teeth into the dental arch.

Without effective plaque control and regular fluoride treatment, the baby teeth are susceptible to dental decay. When baby teeth are decayed they need to be restored but the handling of the young patient  often presents great difficulty and may require general anaesthesia. Why not avoid the problem in the first place?

Adult teeth are lost through two main causes a) dental decay and b) periodontal disease. Both conditions are preventable with effective plaque  control which involves regular tooth brushing, flossing  and professional care. Tooth loss is preventable and totally unnecessary unless of course there is injury due to an unfortunate accident.

So why are so many patients going for implant dentistry these days? It is to replace missing teeth or teeth that have become unrestorable for a host of reasons and need to be extracted.

A decayed tooth needs to be restored to its original shape and form with the appropriate restorative material. The operative word is “restore” and not ” fill“. A good restoration with the appropriately chosen restorative material should last many years. The problem is many times iatrogenic ( dentist caused) . That means that the tooth with a very small cavity has not been treated properly the first time and then begins a cascade spiraling downwards with the tooth having to be worked on many times.

Each time the tooth is worked on more and  more tooth structure loss is caused resulting in a larger and larger restoration to the point with a root canal system becomes compromised. Then follows the root treatment which only has a 75% success rate. But then an abscess develops or the tooth may fractured resulting in loss and then an implant replacement. Why go through all this trouble and expense when the problem is preventable in the first place.