Many people are not aware that decay is not the only way you can lose part or all of your tooth. Let’s deal with the hard tissue in this post – namely the enamel and dentine.

Like all parts of a system that are subjected to grinding action, the enamel and dentine in our teeth are subjected to wear and tear. With use and abuse, teeth will quite naturally wear out. Some wear out a lot faster than others. Why? Well, let’s take a look at the causes.

1. Improperly formed teeth.
Our permanent teeth are being formed in our jaws when we were children. Illness and other hereditary factors may cause the teeth not to form properly. Signs include discolouration, unusual shapes or brittle surfaces. Teeth which are innately weak will wear out a lot faster than normal teeth. Some unfortunate individuals may lose all their enamel before they are teens. The only solution here is crowning.

2. Attrition
This refers to the shortening of teeth due to use or overuse. People who are fond of chewing on bones, crab shells, sugar cane are prone to attrition. People who grind their teeth when they sleep at night are also very prone to attrition. When enamel is lost, teeth become sensitive to cold. Patients complain, ask for fillings, but are presented with a treatment plan costing tens of thousands of dollars. If the attrition is so bad that teeth are shortened by half or virtually down to gum level, the only solution is in fact a mouth full of crowns worth tens of thousands of dollars.

Prevention is the least expensive solution. People who grind their teeth when they sleep should get nightguards done as soon as possible. Unfortunately, by the time I see most of these patients, they already need $20,000 worth of crowns and not just nightguards that cost only a couple of hundred. Those who cannot afford end up extracting their teeth and fitting full dentures. People who love to chew on their crab shells and bones are advised to kick the habit.

3. Abrasion
The most common cause of abrasion comes from a hard toothbrush or overzealous brushing. Yes, even something as harmless as a toothbrush can cause abrasion cavities in your teeth. Sensitivity can also be a problem here when enough enamel or dentine are lost. Fortunately, most of the cases of abrasion I’ve encountered are not destructive enough to warrant extraction. Many can be filled or restored with crowns after root canal treatment.

4. Erosion
This is another pretty common sight. Teeth which are chemically dissolved away by corrosive food, drinks or stomach acids. This is big topic by itself. Suffice here to say that chewable vitamin C tablets, apple cider vinegar (for slimming), slimming teas, wines and other vinegar rich foods like salads can actually dissolve away the mineral content of your teeth over time.

Weight conscious individuals who suffer from bulimia, anorexia nervosa, are also prone to having eroded teeth. Fortunately, there is now a simple preventive measure for those who love acidic food. Acids take time to act on your teeth. Rinsing your mouth with water will not repair the damage, but the use of a tooth mousse that contains remineralising agents can reverse the decalcification process. Again, this is a preventive measure and not something that can make your teeth grow back when they have been eroded to gum level.

© New Age Cosmetic Dentists

Astralagus is commonly known as bei qi or huang qi in Singapore. There are many varieties of it and it’s readily available in Chinese medical shops and even supermarkets. Most housewives who put it into their soups have no idea what the herb does, even though astralagus has already taken the world by storm. Many Westerners are taking it and ironically, they often have much more knowledge about the herb than their Asian counterparts.

So what does bei qi actually do to you? For healthy individuals not requiring tonics, it will have absolutely no effect. In TCM terms, bei qi tonifies spleen qi and lung qi, boosts vitality, improves digestion and the immune system. The last benefit probably has more to do with Western medical than TCM concepts. Research in Western medicine also supports the claim that bei qi lowers blood pressure.

Bei qi does have a blood thinning action that may impair blood clotting. This could lead to bleeding problems. The American Cancer Society advises against taking astragalus if you are taking blood thinners or aspirin. If you’re having surgery, it may be best to stop taking astragalus and let your doctor know you have been taking it.

So far, we have yet to encounter any bleeding problems after surgery from patients who are on astralagus. It would be good to learn from your TCM practitioner the contents of the herbs you are taking. If self-medicating, there is even less excuse not to know what you are taking and what it can do for you.

© New Age Cosmetic Dentists

Angelica sinensis or dang gui is a pungent, bitter and very common Chinese herb that goes into many soup dishes. Some people refer to it as “female ginseng”. This is because the herb is often used in premenstrual syndrome formulas as well as menopausal formulas.

According to TCM theory, Dang gui is a “heaty” herb that tonifies the blood and clears the bowels. In TCM terms, the herb exerts its effects on the Liver, Heart and Spleen. With tonification being its main function, it is used with menstrual disorders involving deficiencies. It is also used to treat chronic pain, including joint pain due to blood deficiency. To dispel the misconception that it’s a women’s herb, dang gui can also be used to treat premature ejaculation.

As TCM gains popularity in Singapore, we see more and more of our female patients who are either self-medicating or consuming prescribed tonics containing dang gui. The result is that we see more and more cases of prolonged bleeding or delayed blood clotting after surgery. Dang gui is the most common culprit after red yeast rice.

Nevertheless, the kind of bleeding that we encounter in the clinic is not life-threatening. The wound will probably just ooze for a couple of days more than the average individual. Just be aware and prepared to bite a bit longer on the gauze.

© New Age Cosmetic Dentists

Red yeast is the product of rice fermented with Monascus purpureus yeast. Known as 红曲 in Chinese, it has been used in Chinese cooking for thousands of years, but it was only in recent years that its potent blood lipid-lowering properties were recognised by the scientific community. Readily available OTC, red yeast rice is classified as a dietary supplement. At one time, red yeast rice capsules were going at the same rate as ginseng capsules. The National Institutes of Health (NIH) gives red yeast rice an “A” grade for treating high cholesterol, meaning that there is strong scientific evidence to support the notion that it can lower cholesterol. Red yeast rice contains monacolins, which are thought to play a role in its cholesterol-lowering abilities.

With all the hype about lowering cholesterol levels and what not, hordes of excited people suffering from hyperlipidemia have flocked to the stores to stock up on red yeast rice capsules. However, potent as the product is, it comes with side effects associated with prescription statins – including possible liver damage.

When the FDA discovered that red yeast rice contained a substance found in prescription drugs, it banned red yeast rice products containing lovastatin. In August, 2007, the FDA issued a warning that several red yeast rice products still contained lovastatin. The manufacturers of these products have since recalled these products.

By this time, the popularity of red yeast rice has fallen tremendously. It is now “on offer”, going at much lower prices than when it was first launched. Here is a list of drugs that may interact with red yeast rice.

http://altmedicine.about.com/od/druginteractions/p/red_yeast_rice.htm

What about the traditional use of red yeast rice? TCM recognises red yeast rice as a herb that promotes circulation. And in TCM, anything that promotes circulation can also cause bleeding. Anecdotally, I have already observed a few cases of prolonged bleeding after extractions in patients who have been taking red yeast rice capsules for high cholesterol. However, many of these folks take more than one supplement and though red yeast rice is the common factor, it may be due to interactions rather than red yeast rice per se that is causing the prolonged bleeding after dental surgery.

© New Age Cosmetic Dentists

It’s quite natural for veterans like myself to doubt the new stuff. Sales people working for the dental suppliers often find us hard nuts to crack. A few even hint that we are dinosaurs. Of course, we aren’t. Or at least I’m not. It would be impossible to practise happening dentistry without offering at least some cutting edge technologies. I’m certainly receptive to new products and techniques.

For the manufacturers, they just want to sell the products to dentists. As dentists, we too “sell” the product (often much more expensive than the old stuff) to the patients. When something goes wrong, we are left to deal with unhappy patients. The manufacturers point to the fine print and disclaimers which we dentists never read. The buck often stops in the dental clinic.

I’ve had 3 fractured flexible dentures that broke within a year of use so far. That’s a small percentage compared to the number of Flexite dentures I’ve done in total, but these dentures are supposed to be virtually unbreakable. That’s what the manufacturers tell us. That’s what the labs tell us and that’s what we tell our patients.

So why do these dentures break within just one year? Could it be due to the technical sensitivity? The labs would be quick to deny it and there’s really no way dentists can find proof of less than meticulous work in the labs. Neither is there a lot of objective information on the internet. We get our information from peers and others who have more experience in these new materials. Such sources may be less biased than that from the manufacturers, but they are by no means foolproof.

The patients blame only one person – the one who “sold” them the denture, who, for all intents and purposes, is also a victim of media hype and artful persuasion on the part of the sales reps. In the end, it’s really down to dentist and patient. Some patients ask for good old acrylic in the end. At least when it breaks, it can be repaired on the spot and it’s not so costly to replace.

Of course, I will take care not to oversell or overpromise my patients when I indicate a flexible denture. It’s not even cool to boast that you’re wearing one, so if there is no reason to switch from a chrome or acrylic, you may be better off with the conventional stuff.

© New Age Cosmetic Dentists

Is lidocaine enough? For some patients, it’s not the pain, but the anxiety or pure fear of feeling the pull of the extraction forceps or elevators. To get rid of that feeling, we can provide sedation using Dormicum (Midazolam). Sedation dentistry is new age dentistry. Now you can pamper yourself with a trauma-free dental procedure. Check out our website for more information.

© New Age Cosmetic Dentists

Have you ever had a tooth broken before? If yes, you may be curious to know which type of tooth fracture you had experienced. Here is a small information for you to know more about broken teeth.

There are different types of tooth fractures. Below is a summary of the more common ones.

1) Cracked tooth
- Parts of the tooth is broken and can be noticed visibly. If the crack is not very serious, then the dentist will usually recommend dental filling to solve your problem. However, such tooth fracture may also affect the nerve, which means that you will need to undergo root canal treatment.

2) Serious fractures
- Bleeding occurs and you may experience tooth sensitivity. This is because the nerve of the affected tooth is exposed and it is important that the nerve is removed. This means that root canal treatment is required. After root canal treatment, crowning will be needed so that you will have no problems with your eating and chewing.

If you ever experience tooth fractures, please consult your dentist as soon as possible. Do not be afraid of the words ‘ root canal’ and ‘crowning’ as they are very much painless after anaesthesia. (:

Have you ever wondered when did your teeth begin to form and grow? Well, believe it or not, it begins as early as when you are still in your mother’s womb. Therefore, a pregnant mother’s diet plays a vital role in the growth of the baby’s teeth. If the mother is able to have a balanced diet, then she will be able to provide her future child with the nutrients required for a beautiful and a healthy set of teeth! (:

The growth of the baby’s teeth requires a considerable amount of calcium, minerals and vitamins. It is important for pregnant mothers to consume food rich in calcium as the baby absorbs calcium from the food his mother consumes and also from her bones. High calcium food products include dairy food such as low fat milk, yogurt, cheese and also sardines with bones. Medium calcium sources includes broccoli, almonds, and salmon/mackerel with bones. It is also equally important to take in vegetables and fruits which are rich in vitamins.

The key is to consume food from a variety of sources so as to achieve a balanced diet.

On the other hand, it is important and appropriate for mothers to first consult the doctor before the consumption of any calcium tablets. The doctor will assess the case and recommend the correct amount to consume if required at all. Please keep in mind that excessive or unnecessary ‘tonic’ will only do more harm than good.

If you would like your child to have a healthy set of teeth, then mothers, please eat smart. Providing your child with calcium supplements only after their teeth have grown fully would have been too late!
Thus, start early and you will not have any regrets. (:

Brushing of teeth is something that everyone has to do everyday as it helps to remove dental plaque. This will in turn help you prevent oral diseases such as periodontosis. However, not all brushing methods are capable of helping you remove the plaque on your teeth. It is only when you adopt the correct way of brushing will you be effective in maintaining a good oral health.

Since brushing of our teeth is of such paramount importance, we would like to recommend a brushing method for you. This brushing method will not do any damage to your teeth and it will help remove your dental plaque.

To brush the outsides of your teeth
- place your brush where your teeth and gum intersect, hold it at a 45 degree angle with respect to your teeth
- for the brushing of your top outsides, you should be brushing it downwards
- for the brushing of your bottom outsides, you should be brushing it upwards

To brush the insides of your back teeth
-it is the same as what is mentioned above

To brush the insides of your front teeth
- it is similar to the above
-the direction should be an outward motion

To brush the chewing surfaces

- position your brush such that the brush and the chewing surfaces are parallel to each other (as shown by the picture above)
- brush them back and forth

If you have been doing the above since young, it means that you have adopted the correct way of brushing. If your way of brushing is very different from what was mentioned above, then please consider adopting the one that we have recommended here (: