This month The Tooth Whisperer is tackling the topic of what the public are entitled to at the dentist. We often get phone calls from new and existing patients enquiring what treatments they are can have free of charge. Below we have tried to cover the treatments available for free at a general dentist, the services provided by the public dental services and the treatments that are tax deductible.

So tomorrow morning you wake up with a toothache , what are your options? For most adults the only viable option is to go to a private dentist. The public dental service deals almost exclusively with children and special needs patients. In the past there have been some adult clinics but unfortunately these have been suspended in most areas. If you are willing, it is possible to go to the Dublin Dental Hospital A&E. This involves taking a number and waiting to be seen. The A&E will treat the cause of the pain and will assess your suitability for treatment by a dental student. If you are deemed suitable you may be placed on the undergraduate waiting list if there is space available. There is no guarantee that you would recieve any treatment other than relief of pain. There is a charge for all treatment but it is less if you are being treated by a student.

If you choose to make an appointment with a private dentist what happens next? They will usually ask a few basic questions to work out what you may be entitled to. I will deal firstly with patients with a medical card.

When you apply for a medical card there is a wait time while the application is processed. Once approved you will receive a letter with your number advising you that your card will be issued shortly. Occasionally we have patients who arrive for treatment before the actual card is issued. Unfortunately until the number is registered on the HSE computer system the number is not valid. Over the past 4 years this time period has varied from two to eight weeks. Once the number is registered and the card is issued you are able to attend a private dentist.

A patient is entitled to one exam and two fillings in a calender year. All extractions are covered. Root canal treatments on the front teeth (incisors and canines) and dentures are allowed subject to approval by the principle dental surgeon in each HSE area. This approval can take up to 3 weeks but mostly is 7/10 days. Cleaning is no longer allowed unless the patient is pregnant or medically compromised and in these cases it also must be approved by the principle dental surgeon. A patient is only entitled to have new dentures once every 5 years and a tooth can only be filled for free once in 5 years. All of this information can be found on the link below

http://www.hse.ie/

If a patient doesn’t have a medical card, they may be covered for an exam because of their P.R.S.I. contributions. There are specific requirements to qualify. A person must be employed, self employed people are not covered as they pay a lower rate of PRSI. If employed your eligibility is determined by age.  As a rough guide we advise that under 25′s must have approximately 3 years of contributions and over 25′s need about 5 years. It is possible to for the patient to check online with the link below but when a patient makes an appointment we ring dental benefits and check eligibility on the patients behalf. A patient is entitled to one exam in a 12 month period.

http://www.welfare.ie/EN/Schemes/DentalOpticalAndHearingBenefits/Pages/Dental.aspx

There are also some treatments which qualify for tax relief.  These treatments are

  • Orthodontics
  • Bridges
  • Crowns
  • Veneers
  • Root Canal Treatment
  • Periodontal Treatment
  • Surgical Extraction of a Wisdom Tooth

To claim tax relief a patient needs to send the receipts for the treatment received with a med 2 form to the relevant tax office. There is a 20% tax rebate on these specific dental treatments. All of this information is available on the link below.

http://www.revenue.ie/

The above information mostly applies to adults. In a private dental surgery children are not covered by a medical card or their parents P.R.S.I. A child will be seen in the public dental system through their school in 2nd, 4th and 6th class or if they are in pain. They will usually have their 1st molars fissure sealed and will have any decayed permanent teeth filled. Baby teeth which are decayed will not be treated unless the child is in pain and then will only be extracted. Braces are available from the public system but only in the worst cases. The child is assessed by the health board dentist in 2nd and 4th class and if they are suitable they will be placed on the waiting list for treatment. There are very long wait times for treatment and I have included 2 links to recent newspaper articles on this topic.

  http://www.irishtimes.com/newspaper/ireland/2012/0305/1224312795392.html

http://www.irishtimes.com/newspaper/ireland/2012/0305/1224312795402.html

I hope you have found this helpful. If you have any questions not covered here today, give the practice a ring on 045 865 045 and we will try answer any questions you have.

Healthy Smoothies not so innocent!

On February 7, 2012, in General, Kids, by admin

After a break for a month The Tooth Whisperer is back and this month we are blogging about hidden sugars in every day items. Below is an informative article about the sugar content of smoothies and following that we thought we’d highlight other high sugar items. Sometimes people get confused about healthy food and food high in sugar. There is lots of healthy food like fruit and smoothies which are high in sugar and can cause decay.

It is important to realise that decay is caused by the amount of times a day that sugar is consumed and dentists advise patients to reduce snacks and drinks between meals. There are some foods which have a high sugar content, tomato ketchup is a good example, but are unlikely to be consumed outside of mealtimes and so are not a big cause of decay.

When sugar is consumed it reacts with the bacteria in the mouth and forms an acid. The acid stays in the mouth for 20 minutes and it is the acid which causes decay. Your teeth can withstand three meals and two snacks a day but any more sugar attacks and the teeth are at risk of decay.

http://www.telegraph.co.uk/health/healthnews/9013144/Healthy-smoothies-not-so-innocent-for-teeth-says-dentist.html

One of the biggest causes of tooth decay is soft drinks . Aside from the obvious fizzy drinks, squash drinks can be a problem item for children especially. They are marketed as ‘NO ADDED SUGAR’ which many mistake for sugarfree. They are made from fruit which contains lots of sugar the labelling just means the manufacturers haven’t added extra sugar. The drinks made from high sugar fruit like blackcurrant and pineapple would be the worst.

Another drink to watch are isotonic sports drinks. This is a particular cause of decay in teenage boys who play a lot of sport. As the article highlights smoothies are high in sugar as are fruit juices (apple, orange, cranberry etc). Patients often say ‘ but I water them down’. Unfortunatley they will still cause decay if consumed too often between meals.

Another area to watch are between meal snacks. Again healthy snacks can be very high in sugar. It is important to avoid grazing, where a person eats a small amount every 30/60 minutes rather than the three meals and two snacks recommended. Food marketed at children often is high in sugar. Actimels and petit filoux, which parents give their chidren as a way to increase calcium in the diet, are very high in sugar. If eaten between meals they can be a factor in causing tooth decay. Raisins, which have a high sugar content, can also be a problem item for children as parents give them as a between meal snack. Children then tend to nibble at them over a long period increasing the time period of the acid attack.

The important points of this blog are

  • check the sugar content of all food and drinks.
  • reduce the amount of times a day food/drink is consumed between meals
  • remember healthy food/drinks are not neccesarily sugarfree

We hope this has been helpful but if you have any further queries come in and discuss it with us.

 

Why do I need a crown?

On December 15, 2011, in Crowns, Veneers & Implants, General, by admin

This month The Tooth Whisperer is delighted to introduce Dr. Mark Condon as guest Blogger. Mark is a graduate of Trinity College Dublin where he attained his postgraduate Prosthodontic qualifications 2009. He is practicing as a Specialist Prosthodontist in Dublin. 

Why do I need a crown?

 

Has your dentist suggested a crown is required for a tooth? Do you actually know what a crown is? Or are you wondering what’s involved in the process? In this article I am hoping to give you an overview of what a crown is and most of the reasons why you may need one.

Crowns are usually made in a dental laboratory and then “cemented” onto the tooth that is present. Prior to the crown being made the dentist will need to shape the tooth so the new crown can be placed (cemented) on top of this. This involves drilling away some of the tooth structure to create space for the crown. So effectively a crown is a replacement for the visible part of the tooth in your mouth. Crowns are one of the most versatile dental restorations and can be used to improve your teeth in many ways including colour and shape. Dentists primarily place crowns to “protect” the remaining tooth structure to prevent future damage. As crowns completely surround the remaining tooth they structurally brace the tooth making the tooth crown combination stronger than the damaged tooth on its own.

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Blessington Dental can see parents and children alike throwing their eyes to heaven at this one. If we’re honest Blessington Dental Granny has been heard to say ‘sure one small chocolate in the morning couldn’t hurt anyone’. Though it has to be said it was under her breath as she walked out of the room!

Advent Calenders are great fun and all over every grocery shop at the moment. Dentists would probably prefer an advent calender without chocolate but one chocolate a morning just for December will not lead to the destruction of all their teeth. However if you would like to have chocolate free option we have a few ideas for you!

It is possible to buy an advent calender box which you can reuse every year. The one in the picture is from www.reddirect.co.uk. In the slots you can put little presents for the kids, mini bubbles and play doh, bobbins and slides, rubbers, pencil parers, bouncy balls or whoopee cushions. Any thing that you would normally find in a party bag.

An advantage that wasn’t anticipated in the Blessington Dental house is the speed with which a child can get dressed for school when it is their turn to open the box!

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Charting Nialls Mo for Movember!

On November 1, 2011, in General, Oral cancer, by admin

After the Mouth Cancer Awareness Day at Blessington Dental a patient asked me about the relevance of these activities in the treatment of cancer. My answer is my own opinion but I think one that is echoed by most health care professionals. One of the most important factors in successful cancer treatment is, I feel, early detection. The mouth cancer awareness day, Movember, Breast cancer day etc are partly about increasing public awareness of these diseases and encouraging people to visit the relevant health care professional for screening.  With this in mind our Blog this month is about Movember and raising awareness for mens cancer. Niall had decided earlier this year to join in this movement and all at Blessington Dental would like to thank Niall for allowing us to post his progress on the blog and facebook page.

During November each year, Movember is responsible for the sprouting of moustaches on thousands of men’s faces in Ireland and around the world. The aim of which is to raise vital funds and awareness for men’s health, specifically prostate cancer.

On Movember 1st, guys register at Movember.com with a clean-shaven face and then for the rest of the month, these selfless and generous men, known as Mo Bros, groom, trim and wax their way into the annals of fine moustachery. Mo Bros effectively become walking, talking billboards for the 30 days of November and through their actions and words raise awareness by prompting private and public conversation around the often ignored issue of men’s health.

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The Tooth Whisperer is delighted to introduce our October guest blogger,Dr Jason Owens. Jason is a native of Naas. He received his under graduate dental training in Trinity College Dublin, from where he graduated  in 1993. After working for five years in private general practice in England, Dr Owens then attended Indiana University where he graduated from in 2002 with a certificate in Periodontology and a Masters in Dental Science. He is practicing in the Millenium Park in Naas delivering quality specialist care in periodontics and implantology. Today he is blogging about the link between general health and and the chronic inflammation associated with gum disease.

Periodontal disease and inflammation

Most people know that maintaining healthy teeth and gums is a necessary step in achieving overall wellbeing. In fact now not only dentists encourage brushing and flossing but many doctors also promote oral hygiene as a way to keep the body healthy. Several research studies have suggested that gum disease may be associated with other health issues including heart disease, stroke and diabetes. With more and more research reinforcing the connection between periodontal and systemic health scientists are beginning to understand why these connections exist.

One theory points to chronic inflammation as the culprit. Inflammation, the body’s reaction to fight off infection, guard against injury or shield against irritation initially intends to have a protective effect. Untreated chronic inflammation on the other hand can lead to the destruction of affected tissues which can lead to more serious health conditions. For many years dentists believed that gum disease developed as a result of bacterial build-up of plaque between the teeth and under the gums. While plaque build-up is still a factor in the development and progression of gum disease researchers now suspect that the more severe symptoms, namely swollen bleeding gums; recession around the gum line and loss of the bone that holds the teeth in place may actually be caused by chronic inflammatory response to the bacterial infection rather than the bacteria itself. Scientists hypothesize that the chronic inflammatory response mechanism may be the reason behind the periodontal-systemic health link. Many of the diseases associated with periodontal disease are also considered to be systemic inflammatory disorders including cardiovascular disease, diabetes, rheumatoid arthritis, kidney disease and certain forms of cancer, suggesting that chronic inflammation itself may be the basis for the connection.

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Dentists have a key role to play in the early detection of mouth cancer and in the prevention of the disease by identifying those patients who are exposed to risk factors. Last year’s awareness day at the Cork and Dublin Dental Hospitals was a phenomenal success with so many people attending that some had to be rebooked on another day. When asked, a huge proportion of these people weren’t aware that this screening could be done by a general dentist.

At Blessington Dental this was a huge surprise and a wake up call. Every dentist does an Oral Cancer Screen as part of their routine examination and it is usually recorded on the patient chart as ‘OCS’. Blessington Dental along with a lot of other general dentists had never made a point of telling the patient that they were doing this screen unless there was something that needed investigation.

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Getting to the Root of the problem

On September 16, 2011, in General, Root Treatments, by admin

 

This month The Tooth Whisperer is delighted to introduce Dr. Frank Gallagher as guest Blogger. Frank is a graduate of Trinity College Dublin and he attained his postgraduate Endodontic qualifications from the Eastman Dental Institute in London in 1997. He is practicing as a Specialist Endodontist in Clane, Co. Kildare. 

When a patient presents to Blessington Dental with an abscess and we advise them a root treatment is needed, we are usually greeted with a grimace and a story of a friend or family members disasterous root treatment with stories of endless visits, continued pain and eventual extraction of the tooth. What we try to explain to the patient is that this has been a problem in the past but with the expertise of specialist endodontists using microscopes and advances in the equipment used the succes rate has vastly improved and the number of visits and discomfort is vastly reduced. Frank has submitted an article to explain what a root treatment is, how he goes about treating it and discusses the succes rate of modern root treatments.

Getting to the Root of the problem

 

‘Root Canal’….. It’ a word that can strike fear into the heart of a grown man. So what’s it all about? Underneath the gum every tooth is hiding one or more roots just like a tree. Inside each root is a fine network of canals and spaces….the aforementioned ‘root canal’. These canals contain what is usually referred to as the ‘nerve’ or ‘pulp’. This is essentially a small amount of tissue containing some blood vessels, cells and nerve tissue

Root canal treatment is one of the treatments advised when the nerve inside the tooth has become damaged or if there is a risk that the nerve may become damaged. This typically happens due to a deep cavity in a tooth, a deep filling, trauma, micro-cracks or sometimes due to very deep naturally occurring grooves within the tooth.

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One of the most common things asked by patients at the practice is for advice on whether to have composite(white) fillings or amalgam(silver)on back teeth. There are numerous factors to consider and either choice has advantages and disadvantages.

Below is a link to an article on the controversy surrounding amalgam fillings Within the dental community there are practitioners who only do composite fillings and those who only do amalgam on the back teeth. At Blessington Dental it is our policy to inform the patient of all the factors and let the patient make the choice. 

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What is a dry socket?

On August 15, 2011, in Oral Surgery, Wisdom Teeth, by admin

Following a short break from blogging while we were on holidays The Tooth Whisperer is delighted to introduce Dr. Gary Leonard who is our guest blogger this month. Gary is a graduate of Trinity College Dublin and he attained his postgraduate Oral Surgery qualifications from the Royal College of Surgeons in Ireland in 2007. He is practicing as a Specialist Oral Surgeon in Naas, Co. Kildare. Oral Surgery treatment can be provided under local anaesthetic or intravenous sedation in his rooms in Naas or under general anaesthetic where he has admitting rights in Clane General Hospital.

What is a dry socket?

A dry socket is an unpleasant and by and large short-lived condition that can follow a dental extraction. It is uncommon and can be managed promptly by your dentist once a correct diagnosis is made. The condition usually results in pain in the vicinity of the socket of an extracted tooth. The pain is normally intense in nature and well localized to the socket, although it can radiate from the area.

A dry socket normally presents 3-4 days after an extraction although occasionally it can take up to a week to develop.  It is characterized by a sudden increase in pain, normally in the absence of swelling in the area. The condition is caused by a loss of the clot that normally forms in a socket after a dental extraction. As a consequence of this, the whitish, bony wall of the socket may become visible. If untreated, the pain can last for a up to a week and occasionally longer.

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