This patient disliked the slight protruding of her upper canines. The patients’ options were discussed in detail, taking into account the patients time constraints, budget and lifestyle. It was decided that 6 months smiles was the best option for the patients needs.
Duration of treatment: 10 months (with regular adjustments)
Cost of full treatment: €3200 (includes at home whitening treatment)
Result: This patient was absolutely thrilled with the results achieved using 6 month smiles. She now has a stunning smile with all teeth moving in-line beautifully.
Dentist: Dr. Gina Kilfeather
For more information on orthodontic treatment and to see more before and after pictures see here
Dr. Kilfeather is currently on maternity leave, however if you would like to discuss ortho treatment further please contact us on T: 01 4542022 or E: email@example.com. You can use our online booking form here (book online via our website) to book a new patient exam.
There are many different causes of halitosis, but the good news is most of them can be easily managed.
Our brilliant hygienist Juliet spoke with the Independent newspaper this week to tackle the very common problem of bad breath… we’ve all experienced it at some point in our lives!
Julia Molony (Independent newspaper)
Articled appeared: April 10 2018
Do you suspect you suffer from halitosis (bad breath)? Then here are some helpful ways to check for the problem, and a range of treatment options which will hopefully eradicate this social scourge. If your best friend won’t tell you…
1 Keep gum disease in check
One of the most common causes of bad breath is periodontal disease, according to registered dental hygienist Juliet Gwasira from the Portobello Dental Clinic in Dublin. “The bacteria involved in causing periodontal disease can actually produce some compounds or gases which will then result in someone having bad breath,” she says, explaining that the two conditions often go hand-in-hand.
Gum disease needs to be treated by a professional, who may carry out a scale and polish of your teeth or prescribe a treatment regimen.
“Your dentist or hygienist can then go through oral hygiene instructions on how to control the bacterial growth in your mouth and maintain a healthy oral environment, using interdental brushes, flossing, and brushing twice a day,” Gwasira says. They can show you the best techniques using an electric or a manual toothbrush, and highlight areas you might be missing where you would be getting more plaque accumulation. If the problem is not going away when you’ve tried to target or treat it at home then you would definitely need to see a professional,” she says.
2 See your doctor
Although in 80 to 90pc of cases the source of halitosis is the mouth, “certain systemic diseases, namely diabetes mellitus, chronic renal failure and cirrhosis of the liver can give rise to particular bad odours in the breath,” according to Ireland’s Dental Health Foundation. When these illnesses cause changes to the breath, it can indicate a serious medical problem which requires prompt attention from a doctor.
Other more common and less sinister medical causes of halitosis include tonsillitis, sinusitis, post-nasal drip and gastroesophageal reflux disease. In each of these cases, appropriate treatment of the underlying infection or condition should resolve the problem.
3 Manage the microbes
“Halitosis is mainly caused by excessive amounts of volatile sulphur compounds (VSCs) being produced by bacteria in the mouth,” according to Ireland’s Dental Health Foundation. “The amount of VSCs in a person’s breath can vary greatly during the day and is influenced by factors such as eating, drinking, oral hygiene, sleeping and the effect these activities have on saliva flow.”
The latest research around halitosis has focused on how an individual’s oral ecology – or the particular balance of different types of bacterial colonies in the mouth – affects breath odour. We all have between 100 and 200 different types of bacteria living in our mouth. Some species of bacteria have been found to help reduce volatile sulphur compounds, while others produce them.
Probiotics have been proposed as a possible weapon in the fight against bad breath, particularly those containing a bacterial strain called Streptococcus salivarius K12, which has been proven to keep bad bacteria in check. One small study carried out at the University of Otago, New Zealand demonstrated that participants taking a week-long course of a probiotic streptococcus salivarius experienced a significant reduction in types of bacteria which are known to be associated with bad breath.
4 Ask a friend to check
It can be difficult for someone to determine whether they really have bad breath or not. Blowing into your hand is unreliable. Licking your forearm, letting it dry for about 10 seconds and then smelling the skin can provide a guide as to whether your breath is sweet or not, according to Dr Harold Katz, founder of the California Breath Clinics, but the most reliable indicator is to ask a trusted friend or family member, whom you can count on for their honesty, to check.
Transient bad breath, like morning breath or a temporary unpleasant odour caused by eating strong smelling food such as garlic or onion affects everyone from time to time. But for up to 25pc of the population, having foul breath is a chronic problem.
A significant number of people, however, believe they suffer from bad breath when they don’t. Dr Katz estimates that up to 25pc of people seeking help for halitosis do not actually have the condition but are instead suffering from a psychological condition called halitophobia, or delusional halitosis.
Delusional Halitosis is related to hypochondria and obsessive compulsive disorder. Sufferers become paranoid that they have unpleasant smelling breath, and become fixated with repetitive behaviours such as using mouthwash, brushing their teeth or chewing gum. The appropriate treatment for this is a psychological one, such as cognitive behavioural therapy.
5 Eat yoghurt
Parsley used to be the food of choice for those hoping that they could eat their way to fresh breath. But research into its effectiveness has found little evidence that guzzling the herb is of any benefit.
You’d be better off giving yogurt a go. In a small study conducted by microbiologists at Tsurumi University in Japan, the researchers found that volunteers who ate 6oz of unsweetened live yogurt daily for six weeks experienced a reduction in the levels of “bad breath” bacteria and their by-product, hydrogen sulphide, in most cases by more than half.
6 Use a tongue scrape
“The tongue has a lot of follicles, it’s a rough surface in your mouth and it does tend to trap food and bacteria,” says registered dental hygienist Juliet Gwasira. “It is a big source of halitosis for some people. Tongue scraping does help to get rid of the food debris and the bacteria from the tongue surface. You can get tongue scrapers from the pharmacy. Or otherwise you can just use your toothbrush.”
7 Get prompt treatment for cavities
Cavities provide the ideal environment for bad breath to fester. “If you’ve got a hole in your tooth that hole can pack food and bacteria, which can go bad if it’s not removed from the cavity, and then that can produce an odour,” explains Gwasira.
8 Keep your dentures sparkling
“We advise our patients who wear dentures to remove them every night before they go to sleep, and to clean them properly,” says hygienist Juliet Gwasira. “If they don’t carry out good hygiene and maintenance on the dentures then they can develop a foul odour,” she says.
“Pharmacists can be very good with advice on what cleaning products to use,” she adds. “You can get a toothbrush specifically for dentures as well to remove all food debris around the dentures and keep them clean.”
9 Quit smoking
Smoking, according to Gwasira, along with eating strong flavoured food, is a common cause of transient halitosis. Smoking is also known to be an important cause of gum disease.
Her first recommendation is to give up the cigs. Failing that, she recommends following a cigarette with a good brush of the teeth or chewing on sugar-free gum “to increase the saliva flow in your mouth”.
“That can help to get rid of the odour.”
10 Cut out the crash diet
Certain types of weight-loss regimes are known to cause halitosis, especially those that involve extreme limitation of carbohydrates. Those who embark on juice fasts or intermittent fasting are also at increased risk of bad breath. These regimes are based on triggering a metabolic state known as ketosis, when the body begins to burn its own fat stores. This prompts the release of ketones into the bloodstream which in turn can cause an acetone, or an unpleasant ammonia-type smell on the breath.
At Halloween dentists might see a rise in emergencies such as broken teeth or loosened crowns. This may be because people tend to eat harder or stickier foods than usual or do things they don’t normally do such as cracking nutshells with their teeth or playing boisterous games. What’s more, at this time of year, more subtle damage can occur with the onslaught of sugary goodies and sticky treats which can lead to cavities down the line. However, you can take a few simple steps to avoid your own Halloween nightmare and protect your family’s teeth.
PREPARE FOR COMBAT
Tooth decay is caused by acid eating away the protective enamel. Acid is produced when bacteria in the mouth feeds on sugar. We don’t suggest you spoil Halloween for the kids and stop them enjoying a few sweet treats on the day, but if you have them brush their teeth just before the Halloween party you get ahead in the battle by reducing much of the bacteria. Brushing immediately after eating just spreads the acid around the mouth.
NIGHTMARE ON ENAMEL STREET
From twenty minutes to an hour after you stop eating, saliva, which is alkaline, neutralises the acid. Avoiding snacks between meals helps limit the number of times tooth enamel is exposed to acid. If the kids dip into their spoils while out Trick or Treating the temptation is there to graze all afternoon and evening, prolonging the acid bath. How about awarding spooky stickers or toys for keeping the goodie bags intact until after a substantial dinner? Make a game of it by covering the bags in fake cobwebs and spiders until the plates are (magically) cleared.
SWAMP OF GOO
The worst treats for your teeth are the gooey ones like toffee and caramel as they stick to the surfaces and in between teeth. If possible, switch them out for fast dissolving sweets such as chocolate, which doesn’t linger as long in the mouth.
NUTS, TRICK OR TREAT?
If your household is free from nut allergies, though they are a hard food, there is no reason why reasonably healthy teeth cannot have this traditional Halloween fare. Dentally speaking, crunchy is better than sticky. Nuts are packed with nutrients including calcium, zinc and magnesium and are good for teeth. Some nuts, such as cashews and walnuts, are softer than others and easier for small teeth to handle.
Adults who have crowns or bridges etc should go very carefully with very hard foods and certainly avoid sticky toffee. Those who wear braces for straighter smiles are also reminded to avoid both types of foods.
If you are serving your vampire guests cranberry juice, or for adults, Bloody Marys, provide straws to help keep the acidic juice away from teeth. The celery served with a Bloody Mary is low in acid but also a good, crunchy and saliva-inducing tooth cleanser.
Teeth are meant for biting and chewing food. It can be too easy to forget when you are having fun, but they are not designed to be nut crackers or bottle openers. Though healthy teeth are strong, improper use can easily lead to chips, fractures or loss of a filling.
THE END IS NIGH…
Sugar free gum helps produce extra saliva which will neutralise acid faster and also wash out the mouth. Gum containing the sugar free sweetener, xylitol, has also been linked with remineralisation of tooth enamel. For adults and kids old enough for gum make sugarless chewing gum containing xylitol the last treat of the party.
If you have every had a tooth extracted you may have heard of a complication call dry socket.
In this article we will explore what exactly is dry socket, how you can avoid it and if it does develop how it can be resolved quickly with the appropriate treatment.
What is dry socket?
Dry socket is a painful complication that can sometimes occur after having a tooth extracted.
When a tooth is removed, a blood clot should form at the extraction site. This blood clot helps protect the bone and nerves as the site heals.
Dry socket occurs when this blood clot doesn’t form or is dislodged, therefore leaving the bone and nerves exposed.
What are the risk factors?
It is important to note here that not everyone that has a tooth extracted will develop dry socket. No one is sure why some people develop it and other don’t, but there are some risk factors that may increase the risk of developing it- such as;
smoking / chewing tobacco
not following the proper care instructions after the extraction
poor oral hygiene
having had dry socket in the past
What are the symptoms to look out for?
sever pain at the extraction site after approx 3 days
no evidence of a blood clot forming at the extraction site
bad taste in the mouth
pain radiating to the ear on the side of extraction
Treatment of dry socket.
While some pain and discomfort should be expected after a tooth extraction, severe pain that does not improve should be investigated.
If you suspect you may have dry socket, please book an appointment with us to help you manage the pain. We will flush out the site to remove any debris that may be there, put some dressing on the site and also prescribe some pain medication for you. With proper care and maintenance dry socket can be treated quickly and should only last a couple of days.
How to reduce your risk of developing dry socket.
Before getting a tooth extracted, we advice the following to help reduce the risk of developing dry socket.
try to stop smoking before the appointment
stop taking any medication that can inhibit the formation of a blood clot developing. (as directed by a doctor or dentist)
After the extraction doing the below will further prevent the development of dry socket
keeping the sterile gauze given by the dentist on the extraction site for at least 30 minutes
avoid sports and other activities that may disrupt the blood clot out of place
eating only soft foods the day after surgery
don’t rinse your mouth for 24 hours after extraction. After that, rinse gently with warm salty water – half a teaspoon of salt in a glass of water is enough.
If you have any questions or queries on dry socket, please don’t hesitate to contact us here on T: 01 4542022 or E: firstname.lastname@example.org
If you ask an adult to list what their biggest fear is, usually a “fear of the dentist” will feature highly within that list. Children quite often express a similar fear of the dentist, and bizarrely, this is often without having had any experience of dentists or dental treatment. Maybe it’s because of what they hear from us adults, and also the fact that dentists are usually associated with having a drill and sharp instruments!
This fear, and how we manage it, is what prompted us to introduce a treatment called Inhalation Sedation to the practice.
What is Inhalation Sedation?
Inhalation Sedation (or “happy air” as its also known) in dental treatment helps alleviate dental anxiety in children.
How it works…..
The process involves the child breathing in a special “happy air” (nitrous oxide and oxygen) through a small nose piece. This in turn leads to a pleasant, relaxed floating feeling- much like day dreaming. Most children become less aware of their surroundings making the dental treatment easy and comfortable for them.
If your child is having a filling or a tooth removed under local anaesthetic ( tooth numbing solution also known as the “injection” ), the breathing of the “happy air” will take most of the anxiety associated with this away for the child, thus making it more tolerable. It is important to note that we will still need to use local anesthetic in most situations.
Who would benefit from Inhalation Sedation?
Inhalation sedation works very well with children who have a mild to moderate dental anxiety. It also works well for children who have a gag reflex that interferes with dental care. Children with certain special needs have benefited greatly from the process. In all instances, your child must be willing to co-operate for inhalation sedation to be useful for them.
How will my child feel after the treatment?
Once the gas is turned off, the effects wear off quickly. By the time your child leaves the practice at the end of their treatment the “happy air” should be out of their system.
Is the treatment safe?
Inhalation sedation is very safe. It works quickly, is reversible, can be adjusted in various concentrations and is non allergenic. While sounds and noises will seem more distant, your child will not go asleep and will be aware of their surroundings throughout the dental treatment.
How will it help my child in the long term?
We strongly believe in the use of inhalation sedation treatment when appropriate to improve a child’s comfort during treatment and to allow treatment to be carried out as easily as possible in order to build a child’s confidence in the dental surgery until such a point that they can have treatment without it.
Dr Daisy McCarthy is our dentist with a special interest in children’s dentistry who is highly trained and experienced in treating children under inhalation sedation. You can read all about her here. If you would like further information on inhalation sedation for your child please contact us on T: 01 4542022 or alternatively if you would like to book an appointment with Dr. McCarthy you can book online here.
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New patient examination (what’s included) *From December 1st 2013 we will refund the cost of your consultation on all extensive treatment plans (all plans over €1000)
Six Month Smiles (Eligible for Med 2 Tax Relief) Note – fee includes all orthodontics, as well as additional treatment to the value of €625; including fixed and removable retainers, an extensive hygienist appointment, and free upper and lower teeth whitening.
€2200 one arch
€2995 both arches
Silver amalgam fillings
€75 – €99
White composite fillings
€88 – €165
€90 – €165
Root treatments (eligible for further 20% reduction from MED II tax relief)
Root canal treatment
€420 – €590
Airflow (Ideal for surface staining)
Slow release tooth bleaching
Crowns & Veneers (eligible for further 20% reduction from MED II tax relief)
All-porcelain cosmetic crown
(usually most suitable for front teeth)
Tooth coloured crown, metal inside (the best combination of strength and appearance)
Cerec one visit crowns and inlays
Bridge (dependent on design)
Da Vinci Porcelain Veneers
There are still circumstances in which a removable plate is the best option. Newer materials make them stronger and less obtrusive. Sometimes they can be held in tightly by using a press stud technique to hold them to suitable remaining roots.