As well as providing expert services to enhance your smile to the one you’ve been dreaming about, we also provide comprehensive general and family dental care. We especially focus on prevention of problems as we know this saves our patients time, hassle and cost
One of the most important things you can do to maintain the health of your teeth is having them regularly examined by a dentist. By catching any problems in their early stages you may be able to have a very simple fix such as having a fluoride treatment or perhaps adding in a different mouthwash or maybe just changing the way you brush your teeth. Why would you wait until something breaks or gets a hole in it or even worse, begins to get sore? By this time the problem is going to be pretty significant in size and therefore complicated to fix and expensive.
Dr Tiang’s approach, as with all the dentistry he provides, is to diagnose or figure out what the problem is exactly, discuss with his patients the options available, their relative pros and cons including costs, make a recommendation and then let the patient decide which treatment suits them best. There is no pressure to have any particular treatment although you may get a warning as to what might happen if you choose a compromise treatment option.
Dental hygienist services
A dental hygienist is a registered dental professional who is qualified to “remove hard and soft deposits on teeth” meaning they clean teeth very thoroughly as only a dental professional can. We know you clean your teeth everyday but no matter how well you brush and floss, everyone ends of with some plaque and tartar build-up after a time. This build-up can only be removed by a dental professional with special instruments and training. Dr Tiang’s patients are lucky enough to have access to some of the best dental hygienists in the country at both Downtown Dental and Northcare Dental.
If plaque and tartar build-up is left too long it can cause gingivitis or periodontitis (the technical terms for gum disease). Gums are very important as they are what hold your teeth in place and although dentistry has made fantastic technological advances in fixing problems like holes in your teeth, we aren’t so good at growing your gums back so if they get infected and your teeth get loose or the gums shrink, we probably wont be able to grow them back for you. Preventing gum problems by visits to a hygienist are an essential part of preventing dental problems.
As well as removing the plaque and tartar from your teeth, our hygienists are trained to make recommendations regarding the way you clean your teeth so that you can perfect your technique and do the best job you can of cleaning your own teeth. This will slow the build-up of plaque and tartar on the teeth so you don’t have to come so often to see the hygienist. This is your rewards for listening to our advice and taking good care of your own teeth. Our hygienists make their recommendations as to how many times per year based on how well you are cleaning your teeth rather than using an arbitrary timing such as 6 months. This keeps costs as low as possible for patients which still ensuring they are properly looked after.
Dentists are also qualified to clean peoples’ teeth but a dental hygienist does this all day every day whereas a dentist provides all the other services which dentists can do. As you can imagine hygienists do as good a job and often a better job than a dentist so we have full confidence is recommending our patients see our hygienists. As an added benefit, the charge for the services of a hygienist are generally less than if a dentist were to do the same thing. Hygienists help patients keep their dental costs as low as possible while still providing a very high level of service and skill.
The CariFree System
At Downtown Dental we have implemented the CariFree System which represents the cutting edge of preventative tooth decay. Using a simple, yet accurate system of microbiological testing, we are now able to determine how “at risk” a person is to dental decay or dental caries. Some people, no matter how well they clean their teeth, are simply more prone to getting holes in their teeth than other people. Dental researchers recently confirmed that a major factor in why this happens is the type of bacteria which a person has in their mouth. Some people have more aggressive bacteria and the CariFree system is able to detect if your bacteria are of this type. We can then prescribe a special mouthwash treatment to eliminate those bacteria plus have an accurate testing method to make sure the treatment is working. This is a major advance in helping people who just always seem to get cavities no matter how well they brush & floss.
For more detailed infomation check out the CariFree website
Composite is now the material of choice for filling cavities in many situations. If a cavity does not significantly weaken the structural integrity of a tooth then composite is an excellent material for restoring that cavity as it is tooth coloured and durable making it look great and last well. Compared to the traditionally used metal filling material amalgam, it actually looks like a tooth as opposed to black or silver and there is no issue with possible mercury toxicity. The only thing with composite as a filling material is that it is much more technique sensitive than amalgam is for dentists to use so dentists need to take more care in the way they put the filling into a tooth to ensure the filling lasts as long as it should.
Inlays/Onlays & Ceramic fillings
These are various ways to repair a damaged tooth similar to a filling but manufactured in a different way. With a filling, a hole in a tooth is filled with a filling material which is soft but then hardens into a proper filling. This is done on the spot in a single appointment. Inlays and onlays are made by taking a mould of the tooth and the hole in it and then sending the mould off to a laboratory where they can make a custom restoration to repair the damage to the tooth. This restoration is then cemented into place at a second appointment. The inlay or onlay can be made out of different materials such as gold or ceramic (hence being sometimes referred to as ceramic fillings) which are all harder and stronger than any “direct” filling and will physically protect the tooth much better than a direct filling can. Ceramic inlays and onlay have a advantage being tooth coloured so they can potentially restore a tooth to look like it never had a hole in it in the first place and also make it nearly as strong.
Crowns are a particular type of “indirect” way to fix a tooth. They completely envelop a tooth to the gum level like a sleeve over the whole tooth. These are reserved for particularly broken down teeth and are the ultimate way to strengthen a badly broken tooth as best as possible bearing in mind, any dental work is only as good as the tooth in which it is placed. They are custom made in a dental laboratory and can be made of a variety of different materials such as the traditional gold as well as more modern porcelain tooth coloured crowns. They can be used for cosmetic enhancement of the teeth and can often last very well especially if well looked after. However, their one drawback is that if any further damage occurs to the tooth underneath it is, more often than not impossible to repair that tooth again. Also they are more costly than a regular filling but will actualy serve to protect a structurally compromised tooth (such as back one with a large amalgam filling in it) whereas a filling cannot. Opting for a filling as a compromise option when a crown is the best option could result in a catastrophic failure of the tooth meaning it isn’t able to be fixed at all, even with a crown. Fillings in these situations tend not too last very long especially compared to a crown making a crown actually a more cost effective and better option in the long run. Having a crown put on your tooth will ensure your tooth continue to serve you as long as it possibly can.
Bridges are a prosthetic or ‘fake’ tooth replacing one which is missing (either having been pulled out or perhaps never having formed in the first place). They are constructed indirectly (similar to crowns and inlays/onlays) in a dental laboratory and are designed so the fake tooth is actually supported by the tooth or teeth adjacent to the gap. The next door tooth or teeth need to be prepared for a crown or inlay or onlay also to support the prosthetic tooth. The bridge is bonded to that adjacent tooth or teeth with the prosthetic tooth suspended over the gum so it looks like there is actually a tooth in that gap.
Implants are another option for replacing a missing tooth with a prosthetic one. They are made by surgically implanting a small rod of titanium in the jaw bone and then attaching a crown to the tip of the rod making it look like a tooth is coming out of the gum just like a real one. Implants have the advantage of being free standing as opposed to being attached to other teeth like bridges. They are anchored in very strongly as the jaw bone actually knits around the implant to hold it firmly. The surgery required is very minor often being done with local anaesthetic to numb the gum only and the success rate for the surgery is in excess of 95% which is extremely high for a medical procedure. It is usually the best option for putting a tooth in a gap.
Dentures are false teeth or plates. They can be a full denture, replacing all the teeth in a particular jaw (ie upper or lower or both) or can be a partial denture, meaning some teeth in that jaw are still left behind and the partial denture replaces the one(s) which are missing. They can also be acrylic (plastic) or have a metal framework for extra strength. Having a denture is better than having a gap or gaps but has been superseded by other treatments developed.
Full mouth rehabilitation
This is basically where an approach is taken to plan and provide dental treatment taking into account the big picture rather than focusing on one tooth at a time. By planning to treat the entire mouth, we can ensure that treatment for one tooth does not compromise another and wholesale changes such as altering the way the teeth bite together can be planned and designed into the dental work. In some cases where the majority of teeth are broken down, this is a far better way to approach fixing things up. Not all the dental work in a full mouth rehabilitation needs to be done in one big go but it certainly is best if the whole treatment is planned from the beginning then broken into stages.
Being able to plan such complex treatment, taking into account every single factor ranging from speech, to aesthetics and from jaw muscle comfort to chewing efficiency requires a dentist with extensive training and attention to detail. Dr Tiang has travelled to Seattle to train with Dr John Kois, a specialist in full mouth rehabilitation to study and learn about planning these complex treatments to ensure that the results he obtains look great and last a long time and are comfortable. Especially important is the ability to plan to stage treatment in more manageable chunks (both timewise and financially) so the end result is obtained without compromise but in a manner which the patient is able to manage more easily.
The temporo-mandinbular joint or TMJ is the joint connecting the bottom jaw to the skull. There are two (one on each side) and they are one of the most complex joint systems in the human body. They both have complex movements including rotating, sliding and moving and are also joined to each other via the lower jaw bone so are not independent. They allow us to chew in all directions for maximum eating efficiency. However, they can also be prone to problems due to their complicated structure. Jaw joint problems can show themselves in many ways such as a clicking or popping noise when opening or closing, pain on opening big, or even complete locking of the jaw. Something as subtle and not being able to open our jaw in a straight up/down line or the jaw not opening quite smoothly can be symptoms of a problem.
One potential source of problems of the TMJ is the arrangement of the teeth. As you close your jaw, eventually the teeth touch and then the movements of the TMJs is completely guided by the arrangement of the teeth. If you teeth are off to one side then the jaw closes to that side, shunting the TMJ sideways. Do this thousands of times a day and the joint can start to get worn out. Through his training, Dr Tiang is able to help patients for whom this is the particular problem. By analysing the way the teeth bite together he can recommend a treatment which can correct the misaligned bite and therefore misaligned jaws and TMJs.
Snoring has a number of causes such as flabby tissue at the back of the throat and a narrowed airway. Sometimes when a person lies flat, the tongue or soft palate can flop backwards in the throat obstructing the smooth flow of air and causing snoring. In certain cases, dental anti-snoring devices can virtually cure the problem.