Daniel Molyneux
Oxford Dentist
Daniel Molyneux Discusses Key Advancements in Modern Dentistry
The field of dentistry has come a long way in recent years, from improved materials and handling, better understanding oral environment, to the advent of digital dentistry.
Effective Communication with Patients
The old adage of 'prevention is better than cure' is particularly important in dentistry. Not only for the young, but also older generations. We want the service we provide to last, and that means it also needs to be maintained. Effective care of the mouth is key. Plaques in the mouth have now been linked to an increased risk of Cardio-vascular disease and Alzheimer’s. Enabling patients to better understand how to effectively care for their mouth will improve prognosis of not just their teeth, but will also help reduce other health risks.
Magnification
I first started working with 2.5x magnification and now use 5x magnification for almost everything. This includes the general examination of teeth. Being able to clearly see, for example, the junction between a filling or crown and the natural tooth as this is the most likely point of failure. The difference can be described like comparing an old VHS video with a 4K film.
Recently we have installed an operating microscope for even closer investigation. This comes in very handy, especially when it comes to root canal treatments (endodontics).
The image on the left is actual size, the image on the right is with about 5x magnification. It becomes apparent that there is early decay between the teeth.
Understanding the Oral Environment
The mouth is a constantly moist, has changing pH levels and high biting forces make it a very harsh environment. Plaque is a form of biofilm that forms on the surface of teeth. Whilst completely normal, it is now understood that its presence affects how well fillings and crowns bond to the teeth. It is therefore important to remove before restoring a tooth. This is done with a cross between a gentle sandblaster and water jet.
Pink areas show biofilm, this can affect the bond of a filling to the tooth and also cause staining around the filling.
Biofilm still present after hygiene visit, very sticky stuff!
Complete biofilm removal and ready for treatment.
Digital Dentistry
From clinical photographs and x-rays, to new scanning technology. Photographs and x-rays help with diagnosis and informing patients about their oral health. Digital x-ray sensors are more sensitive than conventional film and help reduce radiation exposure. New scanning technology for the provision of crowns and bridges produces a very precise fit that is key to the success of a restoration. This also virtually eliminates the need for conventional impressions. This all has the added benefit of being more environmentally friendly, reducing plastic, chemical and paper waste.
Materials
The warming of composite filling material before being placed improves it’s adaptation to the tooth, allows it to flow around the tooth more - thus improving bond, and reduces the number of voids present in the material for improved properties.
High strength milled Zirconia crowns are designed and produced in the lab with the aid of CAD-CAM and 5 axis milling machines. The aesthetics of these are improving, but for front teeth eMax pressed ceramic crowns provide a very life-like appearance.
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