Dr. Brian Saby's Dental Blog

As we suffer through this cold snap, my mind sometimes drifts back to days past where the weather was a bit nicer.  Last spring, I was fortunate enough to attend a performance windsurfing clinic in Florida.  One of the best sailors in our class was a fellow from New York who invented toys for a living.  He was unfortunate to have lost one of his legs just below the knee.

One day at lunch I mentioned to him that I found it amazing that he could sail so well with a prosthetic limb.  He told me that he actually designed and constructed his own attachments for his leg to allow him to utilize the foot straps on the board.

He then mentioned that the most critical part of a prosthetic limb is the interface between the prosthetic and the limb.  He had many different prosthetic legs made and was not able to participate in sports.  Apparently the fit is so crucial that any errors or distortions create extreme discomfort when extra stress is placed on the prosthesis.  Eventually he was able to find someone who could make an interface that worked for him.  He had to travel over 300 miles to see this man and the cost of the prosthesis was 5 times that of his previous legs.  Before he had experienced the better artificial leg, he was okay with the leg that he had and was adapting; he thought that he would just have to learn to live with the limitations imposed by his disability.  Now that he has the new limb, he could never go back to the other.

Now you are saying, “Brian has the cold weather frozen your brain, what has this to do with dentistry?”

I found that in some respects, the situation described above is very similar to the full and partial dentures.  There are millions of people who are using dentures as a replacement for their natural teeth.  Most of these dental prosthesis, while functional, are not optimal.

Those wearing these appliances may not even know that there could be a substantial improvement in comfort, esthetics and the ability to speak. 

The common perception about dentures is that they are equal replacements to natural teeth.  This is far from the truth.  Teeth are anchored in the gums and jawbones, dentures sit on top of the gums.  Dentures are held in place by suction.  Of course the upper dentures with six times the surface area suck in better. 

For dentures to function at the maximum efficiency, they must be made in a very precise manner.  The interface between the denture and the gums must be very carefully constructed.  The extensions of the edges of the denture have to be exact to prevent sores yet allow maximum suction with minimal movement.  The way the teeth hit in function (occlusion) has to be made in a way that maximizes the chewing ability yet minimizes the dislodgment of the dentures.  Of course, the teeth must look good and be set up to allow for proper speech.

Since the bone that supported the teeth is no longer required for teeth, it slowly disappears.  This means that the fit of a denture is constantly degrading.  It is important that dentures be relined every two years.

The best way to minimize the problems associated with dentures is to have dental implants placed.  This moves the load bearing responsibility from the gums back to the bone where it belongs.  Implant supported dentures are the ultimate in dental prosthetics.

If you have dentures and feel that you are not ready to have implant-supported teeth, you should get the best dentures that you can.  A high quality set of dentures may cost you 2-3 times as much as a bargain denture, but you will appreciate the difference.

If you have any questions about dentures and the options available to you ask Dr. Saby.

Despite the publics increasing attention to improving their oral health, the thought of going to the dentist still evokes overwhelming fear in many patients.  In some people, the fear of going to the dentist is so great that they will put up with discomfort and even severe pain, rather than seek dental care.  Some will only seek dental help when the pain becomes intolerable.  They then choose to have their teeth amputated rather than fixed.

Why is it that dental fear is so prevalent?  Nearly everyone knows a person who has an exaggerated negative dental experience.  Of course the entertainment industry has not helped quell the fears of dental patients and even Blue Cross the dental insurance company uses a subtle reference to dental fear to help keep you from using your dental benefits.

Almost every dentist has heard the story of the “old horse doctor who put his knee on my chest to get the tooth out!”  Yet no dentist I know of has ever had to put a knee on a chest to extract a tooth, nor would this ever help get a tooth out. 

To some dental fear may arise from the belief that the procedure will be uncomfortable, while others fear the feeling that they have no control over the situation.  Some people associate the sterile smell of a dental office with medical facilities that may trigger associative fears. 

In the early years of dentistry, good pain management was unavailable and there was pain associated with dental procedures.  As science progressed, the effectiveness of dental procedures and local anesthetics became better and better resulting in more comfortable dental appointments.  Today, it is possible to perform dental procedures in a totally comfortable manner.  Excellent topical anesthetics and computer controlled local anesthetic systems allow for comfortable delivery of local anesthetics with profound effects.

In the modern caring dental office, the dentist must make every effort to make the patient feel relaxed.  It is important to establish a relationship with your dentist prior to having your work done.  You should feel comfortable with your treatment plan and be confident that this is the right treatment for you.  You should also have a signal worked out with your dentist to ensure that he or she will stop the procedure should you feel any discomfort or simply need a break.

Should you need a little more that TLC to help you with your dental appointment, there are other avenues that could be explored.  Today, many dental practices are marketing “Sleep Dentistry” to aid nervous patients.  Sleep dentistry is simply the utilization of medications to help a patient through the appointment.  A medication such as Atavan, or Halcion produce a sleeplike state but still allows enough alertness for response to verbal or physical commands.  In some patients, there is also an amnesic effect that results in little or no memory of the appointment.  The utilization of these medications has allowed for even very nervous dental patients to have great dental appointments.

If you have a fear of dentists and would like to find more information about techniques to help you get the dental care you desire, contact Dr. Saby.

If you are missing one or more teeth and wish to replace them, dental implants are the first treatment choice.  This innovative technique replaces the root of missing teeth with a titanium appliance that actually fuses to your bone and becomes part of your body.  The single tooth or tooth replacement appliance is then screwed to the implant and acts in a manner similar to natural teeth.

Traditionally, missing teeth were replaced by fixed bridgework, where crowns on teeth adjacent to a space support an artificial tooth.  This works very well for short spans such as one missing tooth.  If more than one tooth is missing or if the missing teeth do not have sound teeth on either side, fixed bridgework becomes more complex.  If the spans are too long or all the teeth are missing, removable appliances such as partial or full dentures were constructed to replace the teeth. 

Anyone who has experienced partial dentures or complete dentures knows that there are all sorts of problems associated with these devices. 

Over 30 years ago, an accidental discovery by Dr. Branemark in Sweden led to the modern dental implants.  Dr. Branemark , an orthopedic surgeon, discovered that titanium screws used to hold bone plates in place were extremely difficult to remove.  Study of this phenomenon revealed that the titanium had fused to the bone and become part of the bone.  This process was called osteointegration.  He postulated that osteointegration of titanium could be used to replace missing teeth. (more…)

Most people are familiar with a dental check up, either having had one themselves or knowing someone who has had one.  While almost everyone is aware that the dentist is looking for cavities in the teeth, there is more to a dental examination than merely looking for holes.

 Today, I would like to walk you through a typical complete dental examination.  Hopefully, this will help you to understand what is going on at your next dental check up.

The first part of the examination involves an interview with the patient, either by the doctor or one of the staff members.  In this interview, we hope to discover what your long term plans are regarding your teeth.  What do you want your teeth to be like in the future, are there any changes you want to make regarding the appearance or function?  Are you currently having any dental problems, and if not, what brought you to the dental office today?  What are your concerns regarding dental treatment?  These are the types of questions that help your dentist establish a treatment plan that custom fits your desires. (more…)

We are very fortunate to live in Canada where our standard of living is amongst the highest in the world.  Our consumer driven economy allows us to have choices in almost every aspect of our life.  We get to decide on what level of service and quality of consumer products we would like to obtain.

Let’s say that you decided you wanted a larger television for the family room.  Not many of us would be happy if the salesperson were to inform us that they had looked at our old television and decided that it was still pretty good and they would not sell us a new television until it quit working completely. 

If you decided to get a new car, you would be shocked if the sales representative told you that you didn’t need a new car right now.  “Your old car is fine, you can probably get another 100,000 km out of it, come back and see me in a few years.” Is something you will not likely hear at your auto dealer.

In dentistry, you also have choices.  (more…)

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