Unfortunately children in particular can consume too much sugar in the form of drinks and candy which causes decayed teeth at a very young age, before most parents even have a chance to realize what is happening.

The modern family often splits child care between working parents and family members to share the time of looking after a pre school child.  Once at school it is not always possible for parents to monitor all the snacks and “treats” a child has during the course of the day, especially when they have older family looking after the children who we all know love to spoil them.

Our goal is to educate the whole family to maintain healthy teeth in our patients of all ages.  Beth Otto-Darko our Hygiene Therapist, qualified in the UK, helps to educate parents and young patients to be aware of hidden sugar items, develop good eating and brushing routines and form long term maintenance plans for a lifetime of strong, healthy teeth.

Call for an appointment with Beth 946 4321

Dr Eagan, specialist orthodontist, has brought his machine to the island to assist in his assessment of patients needing braces and Invisalign treatment.

Dr Jo is now able to utilize the machine to study complex wisdom teeth cases; to better plan root canals and extensive restoration crown and bridge work. He can also offer emergency diagnosis for jaw injuries.

Dr Jo provides restorations for implants placed by Dr Mellado, specialist periodontist and Director of the Board of Periodontology in the USA. Together they can review 3D images of individual teeth and bone areas to provide the best possible treatment for each individual patient.

Call our office at  (649) 946-4321 for more information on how our diagnostic tools can help you achieve your best possible smile.

Regardless of the reason for teeth bleaching a visit with the dentist for a thorough examination is essential to determine if bleaching is appropriate for each patient.  Tooth discoloration may be the result of decay, age, food and beverages, smoking, medications or other causes.  Sometimes the discoloration is on the inside of the tooth.

Unlike natural tooth material crowns, fillings and other dental materials are not affected by bleaching.  The dentist will determine the cause of the discoloration and discuss with each patient how to achieve their desired effect.  Stains from food and drinks are deposited on the outside of the tooth and can be removed by a visit with the hygienist.  Once stains are removed you may be a candidate for tooth whitening.

You can take several approaches to whiten your smile:

In Office Bleaching:

This is usually a single appointment.  We protect the gums with a barrier and hold the lips away from the teeth before applying a concentrated gel to the teeth.  This is left on the teeth for 15 to 30 minutes and several applications may be given during the session.  A special light is used to activate the gel.  At the end of the treatment the teeth are washed clean and a brighter smile is revealed.

At Home Bleaching:

An impression is taken of the patients teeth and custom trays are made.  The patient applies a less concentrated gel to the trays which are then worn for 1 hour – 4 hours.  The procedure is repeated until  the desired color change has been reached.  Repeating with regular applications is needed to maintain the results.

Power Bleaching:

If the teeth are especially difficult to bleach we combine both in office and home options.  Usually beginning with a regimen of at-home bleaching followed by an in office treatment.

The most commonly observed side effects of professionally applied hydrogen peroxide products are temporary tooth sensitivity and occasional irritation of oral tissues.  These usually resolved themselves in a day or two.  It is important to understand that all teeth react differently to bleaching.  Some teeth are denser than others and may be more difficult to whiten.  If you have very sensitive or thin teeth then bleaching is not for you.  It is also not recommended for children or young adults.

If you would like more information or to book a free consultation for teeth whitening drop by the office or call us on 946 4321 or click on Book An Appointment

Now nitrous oxide (laughing gas) is available for every procedure from cleaning to root canals and implants.  This form of sedation is a rapid on-set form of sedation – the gas takes 3 to 5 minutes to take effect and it takes just 5 minutes to completely reverse the procedure.  Patients are able to walk out of the surgery afterwards and drive a car.  We would be delighted to discuss the process in more detail and Dr Pretorius can demonstrate the how easy it is to use.

How does your diet affect your dental health?

If your diet is low in certain nutrients, it may be harder for the tissues of your mouth to resist infection. This may be a contributing factor to periodontal (gum) disease, the main cause of tooth loss in adults. Although poor nutrition does not actually cause periodontal disease, many researchers believe that the disease progresses faster and is more severe in patients whose diet does not supply the necessary nutrients.

To be sure that you are getting enough nutrients for good general and oral health, you should chose foods from the four basic food groups: bread and cereals, milk and dairy products, fruits and vegetables and meat, fish and eggs. When you do snack, avoid soft, sweet, sticky foods such as cakes, candy and dried fruits that cling to your teeth and promote tooth decay. Instead, choose dentally healthy foods such as nuts, raw vegetables, plain yogurt, cheese, popcorn and sugarless gum or candy. To have a diet that promotes dental health, you must develop sensible eating habits.

Certain foods are healthy for the body but unhealthy for the teeth. For example, raisins, prunes and other dried fruits provide healthy nutrients that the body needs. The sticky nature of these foods makes them cavity causing foods! Choose to eat these snacks at a time when you are able to brush and floss your teeth immediately after eating them. Cheddar cheese is a wise dental snack as it neutralizes the acidity in your mouth and reduces the chances of cavities.

How can I be sure that I am getting enough fluoride?

If you and your family have a balanced diet, you will get all the nutrients you need for good dental health, with one possible exception – fluoride. Fluoride is vital for decay resistant, strong teeth. Fluoride may occur naturally in well water and you would have to have this water tested to determine the fluoride content of it. Many people in the Turks and Caicos Islands drink “city” water, bottled water or rain water. With the exception of a very few of the bottled waters available, fluoride is not in the drinking water. If there is not enough fluoride in your community water supply, ask you dentist how you can get the fluoride you need. Fluoride supplements (taken in the form of vitamins, drops or fluoridated water) help to form strong enamel (the outer surfaces of the tooth) and are most beneficial while the crowns of the teeth are forming (ages 3 – 12).

Fluoride is also available in most toothpaste. Be sure that you supervise your children while brushing their teeth to ensure that they do not swallow toothpaste. Fluoride mouth rinses are also available and have been proven to be effective in helping prevent dental decay. They do not contribute to your dietary fluoride. Topical fluoride gel can be applied at your dental clinic. Not only does the fluoride reduce your chances of cavities, it also reverses and remineralizes early cavities as well as reducing root sensitivity. Check with your dental team to see if they recommend a fluoride supplement – either topical (applied to teeth) or systemic (internal).

Together, a balanced diet, daily use of fluoride, brushing and flossing and sensible eating habits will reduce the risk of or even prevent dental disease.

Evidence shows a link between chronic (long standing) gum disease and a lot of serious medical problems. Dental problems can affect medical problems. Some of these diseases include heart disease, stroke, diabetes and respiratory disease.

Some medical conditions can have an affect on one’s dental health. Many systemic conditions make a person at risk to periodontal disease. Some of these include diabetes, human immunodeficiency virus infection (HIV), osteoporosis, menopause, smoking, stress and side effects of medications.

As mentioned, more and more evidence shows a link between long standing infection of the gums and a lot of other diseases. One way to assess a person’s overall health is to check their dental health. It is usually a good indicator of overall health!

Researchers believe that the bacteria shed by long standing oral infections can spread through the blood stream and contribute to disease in the heart and other parts of the body. Other research shows that chronic gum infections may trigger a chain of chemical events that causes inflammation and swelling throughout the body. When plaque lining the arteries becomes inflamed blood clots can form, leading to heart attack or stroke.

People who have periodontal disease (advanced gum disease) are 2 times more likely to suffer from coronary artery disease when compared to those who don’t have it. Chronic gum disease can also worsen existing heart conditions.

This is not the only medical condition that can be affected by periodontal disease. Researchers have also found that periodontal disease may make it more difficult for people with diabetes to control their blood sugar. The reverse is also true. Uncontrolled diabetes also affects the body’s ability to resist periodontal disease! Gingival (gum) tissue tends to over react to plaque germs when diabetes is uncontrolled.

Patients who smoke are at a much greater risk for the development of periodontal disease than non smokers. Other dental health risks associated with smoking will be discussed in a future article.

Hormonal imbalances in females also play a significant role in the body’s response to plaque germs. There, if a woman is pregnant, breast-feeing, taking oral contraceptives, hormone replacement therapy, in menopause or on her monthly cycle, the gum tissue may once again over-react to the plaque and the body’s ability to resist infection may be compromised.

Certain medications may alter the gum tissue and increase a person’s risk for periodontitis. Some of these medications include anti-depressants, sedatives, tranquilizers, narcotics, antihistamines, bronchodilators and some analgesics. Some of these medications affect the saliva flow putting the patient at risk for cavities as well as increasing plaque accumulations.

Patients with HIV infection are considered to be at risk for periodontal disease. There is also growing evidence that shows a relationship between osteoporosis and periodontal disease. High levels of stress have been known to have a negative effect on overall health.

This is just a quick overview of how other parts of the body can affect one’s dental health. Your dental healthy can affect your overall health.

Periodontal disease is a risk factor for certain internal conditions such as cardiovascular disease and preterm low-birth-weight babies. Periodontitis has also been linked to respiratory infections.

So the next time your dental team reviews your medical history you will know why! Same goes for the medical team asking about your dental health. It is all part of one big package and total health from head to toes is our goal.

See you at your next wellness dental appointment. Our goal is not only to help you to become healthy but to help you stay healthy.

1. Do my gums bleed when I brush or floss?
2. Are my gums red, tender or swollen?
3. Do I have bad breath or a bad taste in my mouth that does not seem to go away?
4. Do I smoke or chew tobacco?
5. Do I have diabetes or osteoporosis?
6. Do I sometimes skip brushing and/or flossing?
7. Has it been more than 6 months since my last dental visit?
8. Do my teeth feel loose? Are there spaces between my teeth that weren’t there before?
9. Does anyone in my family have periodontal disease?
10. Are there changes in the way my teeth fit together when I bite?

A “yes” answer to any of these questions should make you consider scheduling a dental appointment with your dentist, dental hygienist or a periodontist (gum specialist). This will give them an opportunity to assess the status of your periodontal health.

At that time, a “treatment plan” will be discussed. The only way to confirm a diagnosis of periodontal disease is to have your mouth thoroughly examined including taking the necessary x-rays. A thorough prophylaxis (teeth cleaning) at least twice a year is also recommended. In some cases, depending on individual needs, 3 or 4 month intervals might be suggested.

Once you have been diagnosed by a dental professional with adult periodontitis or any for of progressive periodontal disease, you should receive appropriate treatment as soon as possible to control or prevent further destruction of the supporting structures.

Periodontitis has two components: bacterial infection followed by the body’s production of tissue-destroying enzymes as part of the body’s attempt to fight the infection.

The best way to control periodontal disease is through a two-step process that treats both components, including:
1. Reducing the amount of bacteria in the mouth.
2. Blocking or suppressing the action of the tissue-destroying enzymes released in the gum tissues.

The most common procedure used to eliminate bacteria is an intensive professional cleaning method called scaling and root planing (SRP), during which soft (plaque) and hard (calculus) deposits are removed from the tooth surface above and below the gum line; this includes shaving off a layer of the root surface, which encourages the gum to re-attach to the tooth.

Patient has booked an appointment to “get their teeth cleaned.” When booking the appointment there is sometimes a certain amount of skepticism when our receptionist informs them that they will likely be at our office for an hour.

Patient: “An hour? But it is just a cleaning.”

Receptionist: “Yes. Our Dental Hygienist will likely need that amount of time.”

Patient: “Are you sure? I don’t need to see the dentist this time. It is just a cleaning.”

Receptionist: “Yes. Your appointment is at 9 am. We will see you then.”

Day of Appointment

Patient shows up for the appointment. After registering with the receptionist, the patient is greeted by the enthusiastic Dental Hygienist and is seated in the dental hygiene room (“wellness room”). The Dental Hygienist will proceed to ask about a zillion medical questions.

Patient is thinking: “I am just here for a cleaning. Why does she need to know all of that information?”

Dental Hygienist: “There are many medical conditions that affect ones’ dental health and ones’ dental health can also affect other medical conditions. It is not just teeth and gums we are treating but a WHOLE person!”

Next she proceeds to query your daily dental routine.

Patient thinks: “I am beginning to see that she is more concerned about my dental health and wellness than I am. She means well but here comes that dreaded question…”

Dental Hygienist: “Do you floss?”

Patient thinks: “So…should I tell the truth or should I lie? And if I stretch the truth…she will likely say ‘Hmmmmmmm – it doesn’t look like you have been flossing’.”

Patient thinks: “Well, I have been thinking about it. Doesn’t that count?”

We all know that there is the mistaken thought that one can brush and floss off the last six months worth of “plaque” the night before one’s dental appointment! Right??

All joking aside now. A dental hygiene appointment is more than an esthetic procedure. Yes, the stain is polished off the crowns of the teeth but that is the last part of the appointment. Removing what the patient can see must be complimented by removing deposits below the gum line as well.

The dental team will do an assessment of your gums for gum disease. This involves measuring the space between the gums and the teeth. (You know the spot where popcorn shells get stuck). They will also check for bleeding spots. 7 out of 10 people have some stage of gum disease and are likely not aware of it as it does not hurt. Most people might have noticed that their gums bleed but often tell themselves “Oh, I just brushed a bit too hard – or – Well, I rinsed and it stopped. No big deal.”

Yes, it is a big deal – spontaneous bleeding from any part of our body is a warning sign that something needs attention. A thorough professional “cleaning” will help ensure that the supporting structures are healthy and that the teeth are not lost!

After the initial assessment a treatment plan will be discussed. Sometimes, it may take more than one visit to get ones’ teeth “just cleaned.”

Appointment Options

During a “cleaning” appointment, a screening examination of the gum tissue will take place. Depending on the findings, the following treatment plans may be indicated:

1 Visit – Dental Hygiene Appointment – Minimal professional cleaning required. Ultrasonic tools and/or hand held instruments are used. Polishing (as required) to removed plaque and stain. Topical fluoride may be applied to prevent cavities and to remineralize and desensitize the teeth.

This would be considered a “wellness” visit or a “maintenance” appointment. Gum tissues are healthy and there is a minimal amount of stain and tartar deposits above and below the gum line area. The gums are relatively healthy with minimal bleeding during the assessment. X-rays may or may not be required. Personalized oral hygiene instructions will be provided at this time.

2 Visit – Dental Hygiene Appointments: During the assessment and evaluation portion of the initial screening, slight to moderate amounts of tartar and stain are present. The dental team may suggest 2 separate dental hygiene appointments. Gum infection is present and there is bleeding during evaluation.

Sometimes local anesthetic (“freezing”) may be required depending on patient comfort level. X-rays will likely be required if current ones are not available. This will confirm diagnosis and extent of periodontal/gum disease. Ultrasonic tools and/or hand held instruments are used. Often the 2 sessions are set up with 7 – 10 days between appointments. This allows the soft tissue (gums) to respond to the treatment. 2nd appointments often are more comfortable and gum tissue is healthier. Personalized oral hygiene instruction will be provided. Polishing (as required) to remove plaque and stain may be performed. Topical fluoride may be applied to prevent cavities and to remineralize and desensitize the teeth.

3-4 Visit – Dental Hygiene Appointments: During assessment and evaluation portion of the initial screening, moderate to heavy deposits of tartar and/or stain are present; the dental team may suggest 3 – 4 separate dental hygiene appointments. Gum infection is present and there is bleeding during evaluation. Local anesthetic (“freezing”) is likely indicated as often the periodontal/gum disease is quite advanced and deposits are deep. X-rays are required to confirm diagnosis of periodontal disease. Ultrasonic tools and/or hand held instruments are used. Personalized oral hygiene instruction will be provided. Polishing (as required) to removed plaque and stain may be performed. Topical fluoride may be applied to prevent cavities and to remineralize and desensitize the teeth.

Maintenance Intervals – Soft Tissue Management – Wellness Appointments

After the initial series of dental hygiene appointments, your health care provider will recommend a “recall” interval. Based on your specific needs, that may be in 3 months, 4 months or every 6 months. Several factors are taken into consideration and it will be re-evaluated on an ongoing basis as per each patient’s individual needs.

Our goal is to work with our patients to attain and maintain optimal dental health. We are here to help.