Prosthodontics Archives - Prosthodontist in Johannesburg
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Prosthodontics

We are proud of the work shown on this page. It is of world standard. It really is a long-term investment that will continue to pay dividends for years. If you would like to read more about the long term benefits of sound dental care, please click here.

Do it right the first time.

Choose a quality restoration that will last for years and years. Choose gold or porcelain.

The most common white filling material used today is composite resin. It has replaced amalgam mainly because of its tooth colour. The research shows that it is a very poor restorative material. It is difficult to place in the tooth. It requires great operator skill, but in spite of that, it does not restore the tooth to its original shape and form. It is a poor filling material and does not produce good restoration.

The material is prone to promote secondary decay because of leakage and shrinkage. Is a causative factor in promoting gum disease and bone loss.

Although the initial cost of composite is low, it is a compromise solution with no long-term benefit. The biologic price is too high to pay. Why set your teeth on a path to loss which could have been avoided.

How many times do you want a tooth to be worked on in your lifetime?

Cheap is expensive – go for a cost-effective long-term solution. You will not regret it. This is sound professional advice that all good dentists will agree on.

I never knew about all the specialities in dentistry. I know about Oral surgeons who take out wisdom teeth. I know about Orthodontists who straighten teeth and make one look pretty.

But I never knew about Periodontists or Prosthodontists! I have been going to the dentist regularly for treatment and had never been made aware of the higher level of care that is available by specialists.

I really care about my teeth and want them to last a lifetime.

Consider these scenarios…

  • A filling has broken on a tooth which has been worked on so many times. Each time it is an inconvenience and more money, yet the problem persists. I am now told that the tooth needs an implant. Should this really have happened if I have been so conscientious with my dental visits?
  • I am told that I need a root treatment.
  • I have persistent pain in a tooth and nobody can find out why.
  • My gums are bleeding all the time.
  • A tooth has loosened.
  • Food catches between my teeth and I cannot floss without the floss tearing.
  • The crown on my front tooth is always falling out

Do your front teeth look like this?

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Do your back teeth look like this?

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The care you will get from a Prosthodontist looks like this…

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Is this the care you deserve?

A prosthodontist has acquired advanced skills to help you look after your teeth and achieve long-term dental health.

Take the first step towards good dental help, by giving us a call.

 

Everybody wants a beautiful smile. Everybody wants a comfortable mouth.

Everybody wants to enjoy eating their food. Everybody wants to enjoy self-esteem.

Sound healthy teeth provide all of this and more.

So what really is cosmetic dentistry? It is a buzzword.

There are so many ways to achieve all your dental wants and desires. Smile makeovers and a mouth restored in a day is what one sees on television but the reality is different.

Yes, there are modern techniques and sophisticated technology to offer fine restorative dentistry and there are many competent dentists who can offer this service. CAD-CAM dentistry offers restorative dentistry done in one visit. It is very technique sensitive and requires operator skill.

Are the results better than the time-tested techniques of conventional dentistry? Ask the question.

Have you considered adult orthodontics to achieve a beautiful smile?

Have you considered the biologic price of cutting sound healthy teeth to place veneers or porcelain crowns which certainly do not last a lifetime. The results are immediate and amazing, but for how long?

Natural teeth if properly maintained will last a lifetime.

Do your homework carefully before deciding on irreversible treatment.

 

This scene happens on an almost daily…

A patient arrives with a problem which needs prompt attention. Listening to the past dental history is so upsetting for me. Patients have visited their dentist regularly for years on end only to discover now that a major problem exists. Why? Is it because of poor dental service or poor patient compliance ( or both)? Clearly there has been a steady deterioration in their overall general dental health. Who has been neglectful? The mouth has been compromised.

Let me tell you Carol’s story – She is about 50 years old and she has had much dentistry over the years. She now complains that her bite does not feel natural. She can’t chew comfortably. Compared to her marriage photographs, her teeth look very different.

She had the misfortune of a front tooth falling out whilst on holiday overseas. What a hassle and inconvenience to find somebody to deal with her emergency.

How did she get to us? She was informed that her current dentist is giving up practice because of ill-health. She has ongoing work in her mouth which still needs to be completed but she feels uncomfortable in going back to him. A section of the mouth has had implants placed by a maxillofacial surgeon and temporary crowns have been fitted. It was he who suggested that she see a prosthodontist to finalize the case but he did not say who she should see.

Thanks to Dr Google she discovered what a prosthodontist is and she consulted with us.

I asked her what she would like to achieve through treatment. She replied by saying that she wants her mouth to feel natural. She wants to be able to enjoy eating a meal with comfort and she wants her teeth to look better. Is this not what everybody wants from their mouths?

Well she certainly has come to the right place. With proper treatment this is all achievable.

Her parting remarks after the first appointment were “ I wish I had known before about a prosthodontist. Why was I never guided by my general dentist to seek specialist dentistry?”

She now has hope to enjoy long-term dental health.

So many different questions are presented at the initial telephone call to the practice.questions

  • How much does an implant cost?
  • How much do you charge for a consultation
  • Do you charge medical aid rates?
  • Can I have a quote for a [particular procedure]?

I would venture to say that the caller is using one of these or similar questions to open the conversation in looking for a good, honest dentist. They have a problem and they are seeking a solution.

A recent caller wanted a quote for implant procedures. She had seen another practitioner who had given her a quote and she wanted to know if we could do it cheaper.

She presented the pertinent treatment codes as well as a note in which she wrote “I currently have a bridge, but the back ‘pillar’ is busy crumbling away and has no filling left. I was scheduled for the above procedure on Friday, 14 October, but simply not in a position to pay a shortfall of almost R9000 . Your urgent help with this will be greatly appreciated.

Can you identify with her dilemma? I certainly can. She has a problem and she needs help.

Let’s analyse the situation together.

I replied to the email with a phone call because the work was scheduled for the very next day and she was looking for an immediate answer.

I asked the following questions:-

  • Who is responsible for doing the final bridge?
  • Has there been liason between the restorative dentist and the surgical colleague?
  • What type implant system is to be used?
  • Have she been presented with a total cost from start to finish?
  • Has she been presented with treatment alternatives?

She was unable to answer these questions satisfactorily.

We are dealing with a problem in her mouth. Does she fully understand the proposed treatment and outcome?

Consider this. You are setting about building a new house. Does the electrician or plumber start doing his work without the direction of the architect?

All dental treatment begins with proper planning to achieve a sound long-term result.

Who is the architect for any dentistry especially implant dentistry.

It is the prosthodontist. Spend your money wisely.

IF TEETH COULD SPEAK!

If your teeth could speak to you is this not what they might be saying?

  • Please spend the time twice each day to brush me and floss me well. I want my gums to also be healthy. I want to have a pleasant breath.
  • I would love my teeth in your mouth to remain healthy and sound to last you a lifetime. I want to be able to help you chew your food well and be part of your beautiful smile.
  • Please look after for me by taking me to the dentist regularly to have me checked and cleaned.
  • Please be careful not to give me too many sweets, chocolates and cold drinks. If you do indulge, please rinse me thoroughly afterwards so that the sugar doesn’t linger.
  • I don’t want to get cavities! But if I do unfortunately have to have a tooth treated, please let the dentist that you take me to explain the options of treatment. I don’t want my filling to be done quickly, sloppily and cheaply. I am too precious to you to be taken for granted and so casually.
  • I don’t want the same tooth to be worked on over and over again so that the cavity becomes bigger and bigger and then I land up having to have a root treatment.
  • I am told that root treatments can sometimes fail and then I may have to be extracted with the unfavourable consequences. This could have been avoided in the first place.
  • I don’t want you to suffer from a chronic abscess.
  • I also know that implants are a wonderful option but not a panacea for the real thing. They really can be costly.
  • I’m also told that our medical aid is not an ATM just to get money out of.
  • Please familiarise yourself with the medical aid scheme rules that we belong to. Don’t allow the health professional that you have taken me to, to be limited by what the medical aid will pay. I want the best for myself and for you. I don’t want you to be dictated to by a third party about what can or can’t be done. They are our teeth – not theirs.
  • I don’t want to crack or break and cause you inconvenience and pain because I was not treated properly the first time round.
  • Please don’t book an appointment for me if you are not going to keep it for us. I don’t want to feel the embarrassment.
  • I don’t want to cause you unnecessary expense if prevention is so effective.
  • Don’t you think that if you take me to a prosthodontist initially, you will be looking after me so much better? He is so much more knowledgeable and better trained than a regular dentist.

I really love being so closely connected and attached to you. I want to be with you for a lifetime!

Advice from a Prosthodontist For Your Long-Term Dental Health

You have just seen the dentist for a specific problem and now after asking for an assessment of the rest of your mouth, you are told of the need for much dentistry to provide you with long-term dental health. That is a shock in itself especially when everything else feels fine. And then, on top of it all, comes the cost.

We all want sound, beautiful teeth that will last a lifetime without having to be faced with unexpected dental crises.

Let’s be realistic. Restorative dentistry and implant dentistry are elective procedures which can be planned and done over time. There is no need to approach the treatment without careful thought and understanding. It is not a matter of ‘drill, fill, bill’.

We are not talking about an immediate problem like a broken tooth or an abscess. These have to be taken care of immediately but how does one prevent such problems from happening in the future and preserve one’s long-term dental health? That is what good prosthodontic dentistry is all about.

A broken tooth or an abscessed tooth needs to be treated with a long-term solution in mind. There are treatment choices to consider as part of a solution for long-term dental health. Many times the decision does not have to be made immediately but you, the patient can be given the opportunity of reviewing the options without any pressure of time. It is possible to provide relief of pain and comfort promptly and then set about establishing a long-term dental plan. Know and understand that good dentistry is a wonderful long-term investment.

Go ahead and establish your long-term dental health needs now. Understand the commitment to time, effort and expense but also understand that a holding situation is oftentimes practical and feasible. Good dental care is important but usually not urgent.

The most important factor in long-term dental health is to keep your teeth free of plaque with effective daily brushing and flossing.

Regular professional cleaning and effective home care are essential to prevent any further deterioration whilst preparing to undertake extensive treatment. A holding situation in anticipation of extensive treatment is a very practical approach in achieving a long-term goal and is cost effective.

Don’t neglect your teeth and allow problems to become worse. Seek a specialist opinion from a prosthodontist now and plan accordingly. Be a partner with us in helping to look after you.

We would love to help you keep your teeth a lifetime. Let us plan together. Give us a call.

I was asked recently to present a talk to nursery school parents about how to look after their children’s teeth. You may wonder why a specialist prosthodontist who is trained to treat advanced restorative problems in patients that have very broken down mouths was so excited to talk to a group of young parents?

The reason is very simple.

Teeth are designed to last a lifetime. The care of teeth begins from early childhood and parent awareness is the key factor in helping young children develop the appreciation and skill of looking after their teeth.

I may be doing myself out of future business but there are enough problems that abound in adults and even teenagers as a result of both ignorance and inadequate dentistry.

In a presentation, diagrams charts and cartoons are entertaining but real-life pictures make the point. And so, I set out to find a suitable example

I wanted a photograph of a young child to include in my presentation. In searching for such a picture I walked past a young lady of five years old sitting with her mother on the pavement of a restaurant and I thought that she would be the appropriate candidate. As she smiled I noticed that she was missing a back baby tooth. That really upset me greatly. Why should such a young person lose a baby tooth ? The loss of such a tooth has major consequences in terms of long-term dental health. It changes the bite and sets the patient up for future orthodontic treatment during her early to late teens.

I suggested to the mother that she bring the young child in for a quick look see. She agreed and the clinical examination revealed the presence of seven teeth in need of restorative dentistry. That begs the question – Why was the decay not diagnosed earlier and why did she have to lose a tooth unnecessarily. Dental decay in a baby tooth should be treated promptly. It spreads fast because the tooth enamel is thin.

Now the young lady needed a general anaesthetic to do the fillings and also have of a space maintainer placed to prevent further loss of space while the jaw continues to grow. The permanent tooth will erupt at the appropriate age and they need space to fit into a healthy dental arch.

If that shock was not enough, I then had the pleasure of meeting her eight-year-old brother. I was aghast. This young man already has a mixed dentition, that is, both baby teeth and primary teeth present in the mouth which are in the process of growth and development.

Not only not only were his teeth laden with plaque and widespread decay on the baby teeth. This was revealed with disclosing solution . Plaque is invisible and effective toothbrushing needs to be checked. ( Has your dentist made you aware of disclosing?)  A permanent molar tooth was ravaged with decay as well.

The first permanent molar tooth erupts into the mouth at the age of between six and seven years of age and they should last a lifetime if properly cared for. These teeth are the most vulnerable teeth in the mouth for a young person and the teeth most frequently lost as the years go by. The problem is preventable with effective dental care both by the dentist and by responsible parents.

Now both of these gorgeous children have compromised mouths. They are fearful of sitting in the dental chair. They can only be treated under general anaesthetic with all the risk and anxiety that it entails. And what about the expense that could have been avoided with effective toothbrushing; regular fluoride treatment; and a proper diet.

The young boy’s mouth will now be the bain of his life. A downward cascade . Whose fault? – The parent or the dentist or both. I wonder. Poor child.

No dentistry is the best dentistry!

Dental problems are preventable with the knowledge of how to look after teeth and exercise effective plaque control. This skill needs to be taught and constantly supervised. Regular dental visits are essential.

There is a prevalent misconception that because one belongs to medical aid, all the costs of dental treatment are covered. This is not true! The fees set by medical aids and the limits imposed are so restrictive. They are unrealistic. Like all things in life, price is what you pay-value is what you get. (Kurt Vonnenberg).

Everything is on the Internet today. Yellow page directories and telephone books continue to shrink.

Want to search for anything? Just Google it.

And so it is with dentistry… Type in keywords like: / implant dentistry/, cosmetic dentistry/, prosthodontist/ and see what comes up . Perhaps that is how you found my website which I trust has been informative.

I also did some Googling and typed in the following: “ You get what you pay for”. Believe it or not, Google even had answers for that.

Amongst the articles that came up is one that caught my eye was one written by Bob Borson quoting from the 19th century English poet, fervent art critic and socialist, John Ruskin.

“There is hardly anything in the world that someone cannot make a little worse or sell a little cheaper, and the people who consider price alone are that person’s lawful prey. It’s unwise to pay too much, but it’s worse to pay too little. When you pay too much, you lose a little money – that is all. When you pay too little you sometimes lose everything because the things you bought were incapable of doing the thing it was bought to do .The common law of business prohibits paying a little and getting a lot – it can’t be done.”

And so it is with good dentistry. Good dentistry may be costly in the beginning but its benefits last and last.

Give us a call on 011 483 2281 . We would love to meet you and offer you real value .

Your teeth should last a lifetime. You deserve it.

Choosing a good dentist

Choosing anything be it a service or commodity can oftentimes be a daunting task.

A commodity is easier to choose.

You know what you want and you know what your price range is. You can actually feel and see the article that you are buying in making your choice. Finding the shop to go to is challenging. The lead may be an advert in a newspaper, magazine, radio advert or word-of-mouth. How far does one have to travel to reach the shop and what guarantee is there that the article is in stock? A telephone call can help.

Services are very different.                                                                                    

I know the story of somebody who entered into a business association based on an agreement that was drafted by an “experienced” lawyer. On presentation the agreement ostensibly covered all eventualities and was signed. The financial manager was duly appointed. Several years went past with the relationship based on the agreement working well until there was a takeover of the business. Now the new owner was faced with making staff changes. To his great surprise the financial manager found himself retrenched. The agreement was flawed. It had a loophole.

What is experience?

Is it perhaps doing the wrong thing year in year out? Sometimes it works, sometimes it doesn’t and when it doesn’t, the disappointment is real. Experience means knowledge and expertise. It doesn’t necessarily mean years on the job.

And what about fees for professional services? A patient once told me that his father said “whatever the professional asks for, just pay!”

How’s that for an undertaking. But there was a proviso. You have the right to choose the professional and once that choice has been made, relax with confidence.

So how do you go about choosing a good dentist?

  • Is it based on the appearance of the office?
  • The friendliness of the staff?
  • The way the telephone was answered?
  • The modernness of the equipment?
  • Whether an x-ray apron is used?
  • The location and adequate parking?
  • Good sterilisation of instruments?
  • The lightness of touch?
  • A painless injection?
  • Effective anaesthesia?
  • Good people skills?

All these are things that one can feel and see but dentistry is different. You cannot see what the dentist is doing. It is totally blind!

And so the question remains, how do you choose a good dentist?                      

Let me tell you another story which I’m sure you will enjoy.

The owl and the peacock were having an argument as to who was the most beautiful bird in the world. The owl said “I am” and the peacock said “I am “. They agreed to resolve the argument by consulting the first animal that they met in the forest and whoever won would bite off the other bird’s tail. Off they went and came upon the wild boar. They asked him to judge the case and eagerly awaited his opinion.

In my opinion said the pig, having thought for a while, “It is the owl”.  The owl rightfully bit off the peacock’s tail and the peacock ran out of the forest crying bitterly and uncontrollably.

The peacock then came across the wise old fox and she told him the story. Said the fox sagely and compassionately, “Look whose opinion you asked”. On what basis is word-of-mouth established?

I asked a periodontist colleague his valued opinion in choosing a good dentist and this is what his patients have told him: –

From the perspective of a layperson I think the primary motivation to select a dentist is the testimonials from other patients of the dentist. Another factor patients look at is the qualifications of the dentist and the institutions from which they were obtained. Affiliations to groups or bodies are also looked at. Patients also look at number of years in practice. If one has a website, patients like to look at photos of work done by the dentist.

Word-of-mouth is very powerful, but consider this…

In the South African Dental Journal March 2016,Vol71 Dr S Naidoo, senior professor and principal specialist, faculty of dentistry, University of Western Cape writes the following:-

The profession of dentistry has both benevolent and protective aspects with regards to duty of care to patients, to always try to do the best for patients and shall for the principles of non-maleficent’s – to do no harm. This principle expresses the concept that professionals have a duty to protect the patient from no harm.

General dentists are usually the first professional patients visit, seeking an evaluation of the oral and dental needs. The general dentist may then treat the patient or may refer the patient for speciality care depending on the conditions which have been assessed and diagnosed. This is because amongst general dentist there are differing levels of expertise, exposure to postgraduate training, and confidence in undertaking treatment of more advanced dental conditions. Whenever necessary, timely and appropriate referral is an ethical imperative which fulfils a professional duty to a patient.

The general dentist is expected to recognise when specialist care is more appropriate to the patient’s needs and completion of the treatment plan and should then refer appropriately.

Interestingly, general dental practitioners are entitled to carry out all dental procedures including those falling within the scope of specialists (provided they have the training).

Now, having made the choice of dentist by whatever criteria, are you satisfied that time has been spent on listening carefully to your past dental history?  Has the initial consultation included gathering of all the diagnostic records needed to formulate a comprehensive diagnosis and treatment plan?

Has a subsequent planning appointment taken place to empower you as the patient to make an informed decision and evaluate the possible treatment options?

The choice is yours… Choose wisely.

 

It is quite amazing how many people take their teeth for granted!

Everybody wants a beautiful smile with sound healthy teeth. That does not happen just by itself.

As I have written many times, the dental care starts from childhood with parental responsibility and guidance to the young child on how to look after their teeth. Effective brushing and plaque control together with a controlled sugar-free diet is a key to long-term dental health.

Unfortunately teeth sometimes do decay and a restoration is indicated.

What is the appropriate restoration to use?

There are choices of materials to use and each has their pros and cons. This decision needs to be made together with the dentist so that you as the patient can choose appropriately. No filling can last a lifetime but some materials are certainly better than others. The short-term expense should not be a consideration for long-term benefit. Cheap is expensive.

Dentistry is blind. The patient has no idea what the dentist is actually doing nor has the patient any control on the procedure being performed. Has there been a planning appointment designed to discuss and empower the patient prior to the commencement of treatment.

Once treatment has been completed:-

  • Has the appropriate material been chosen?
  • Has the tooth been adequately prepared?
  • Has the tooth been restored to its original anatomy or just filled?
  • Has the filling been properly placed?
  • Is there an open contact?
  • Is there post-operative sensitivity?
  • Is there an ill- fitting margin that will set the tooth up for recurrent decay
  • Is the technical work of the highest standard possible?
  • How many times will the filling need to be replaced in a lifetime?
  • Are the gums now in a healthy state ?
  • Can the restored teeth be adequately kept plaque free?

These are real questions that have an impact on long-term dental health.

So what can you do about it? Is it possible to check. The answer is yes.

It is suggested that you visit a prosthodontist for his assessment and evaluation. This is the way to possibly avoid unnecessary long-term problems the treatment of which may involve a commitment to time, effort and expense.

Have the work done right the first time. Please us a call. You will certainly be coming to the right place.

 

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