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Prosthodontics

What is prosthodontics?

Prosthodontics is a dental specialty recognized by the American Dental Association. It pertains to the diagnosis, treatment planning, rehabilitation, and maintenance of the oral function, comfort, appearance, and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues.

What is a prosthodontist?

A prosthodontist is a dentist who has completed dental school plus three additional years of advanced training and education in an ADA-accredited prosthodontic graduate program. They specialize in treating and handling dental and facial problems that involve restoring missing tooth and jaw structures. A prosthodontist is highly trained in cosmetics, dental implants, crowns, bridges, dentures, temporomandibular disorders (TMJ/TMD), and sleep apnoea.

How is a prosthodontist different from other dentists and dental specialists?

The term “prostho” means replacement and “dontist” means dealing with teeth. Essentially, prosthodontists are the recognized experts when anything needs to be replaced in your mouth. This can range from a single tooth, multiple teeth, or all teeth and gums in the mouth. While many other dentists can do some of these treatments, prosthodontists are the specialists dedicated to this type of care.

Prosthodontists have advanced training in restoring and replacing teeth. Prosthodontists are considered the leaders of the dental treatment plan. They regularly lead teams of general dentists, specialists, and other health professionals to develop solutions for your dental needs.

Why choose a prosthodontist?

Choose a prosthodontist because of their advanced education and training, efficiency, and expertise with advanced technology. Prosthodontists are extensively trained in state-of-the-art techniques and procedures for treating complex dental conditions and restoring optimum function and aesthetics.

Rigorous training and experience give prosthodontists a special understanding of the dynamics of a smile and the preservation of a healthy mouth.

How can I find a prosthodontist near me?

Use the ACP's Find a Prosthodontist search to locate a prosthodontist in your area. Shane Mullane is a qualified specialist Prosthodontist.

What is board certification?

A board certified prosthodontist has successfully passed a rigorous examination conducted by the American Board of Prosthodontics. He or she is subjected to re-certification every eight years to insure that he or she is current in practices that affect the specialty.

How do I know whether my prosthodontist is board certified?

The American Board of Prosthodontics maintains a Locate a Board Certified Prosthodontist search.

Is the dental amalgam used in fillings safe?

Please see our advice section on the safety of dental amalgam for more info.

Toothbrushing tips for your child

Brush your child's teeth for about two minutes twice a day: once just before bedtime and at least one other time during the day.

Encourage them to spit out excess toothpaste, but not to rinse with lots of water. Rinsing with water after tooth brushing will wash away the fluoride and make it less effective.

Supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it. From the age of seven or eight, they should be able to brush their own teeth, but it's still a good idea to watch them now and again to make sure they brush properly and for about two minutes.

What's the best toothpaste for my child?
Start brushing your baby's teeth with fluoride toothpaste as soon as the first milk tooth breaks through.

Start brushing your baby's teeth with fluoride toothpaste as soon as the first milk tooth breaks through (usually at around six months, but it can be earlier or later). It's important to use a fluoride paste, as this helps to prevent and control tooth decay. 

There's no need to buy special "children's toothpaste" brands. In fact, some of them don’t have enough fluoride in them to help prevent tooth decay. 

Children from the age of seven can use family toothpaste, as long as it contains 1,350-1,500 parts per million (ppm) fluoride. Check the toothpaste packet if you're not sure, or ask your dentist.

Children up to the age of six who don't have tooth decay can use a lower-strength toothpaste, but make sure it contains at least 1,000ppm fluoride. 

Tips:
  • ‍Make sure children don't eat or lick toothpaste from the tube.  
  • Below the age of three years, children should use just a smear of toothpaste.
  • Children aged three to six should use a pea-sized blob of toothpaste.
Chipped / fractured baby tooth

Contact your dentist.

Chipped / fractured permanent tooth

Time is a critical factor. Contact your dentist immediately so as to reduce the chance for infection or the need for extensive dental treatment in the future. Rinse the mouth with water and apply a cold compress to reduce swelling. If you can find the broken tooth piece, bring it with you to the dentist.

Knocked out baby tooth

Contact your dentist. Unlike with a permanent tooth, the baby tooth should not be replanted due to possible damage to the developing permanent tooth. In most cases, no treatment is necessary.

Knocked out permanent tooth

If possible, find the tooth. Handle the tooth by the crown only. DO NOT TOUCH THE ROOT. DO NOT clean with soap, scrub, or handle the tooth unnecessarily. If necessary, give the tooth a quick, gentle rinse with cold milk. Try to reinsert the tooth in the socket as soon as possible. Have the patient hold the tooth in place by biting on gauze or a clean cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva, cold milk, or “save-a-tooth” solution, NOT WATER. The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving a tooth.

Cut or bitten tongue, lip or cheek

Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

Toothache

Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.

I think I have broken a piece of a filling in my tooth - what should I do?

Unfortunately sometimes fillings for whatever reason may fall out or become chipped or broken. 

There are many reasons for this including biting down suddenly on something hard such as a hard boiled sweet. Symptoms can vary from none at all to sensitivity to hot and cold or tenderness on chewing. A lost filling will always feel much bigger to the tongue. 

It is important to make an appointment with your dentist as soon as possible. However if you cannot immediately access a dentist here are some  helpful tips .

  • If you are having sensitivity try avoiding eating or drinking in that area, similarly if it is painful on biting. 
  • The use of toothpaste can help with the sensitivity by rubbing some fluoride toothpaste on the tooth in question.
  • As a temporary measure until you visit your dentist you may try and get some oil of cloves or a temporary filling kit from your pharmacy. However it is important that you attend your dentist as soon as possible to get the tooth restored to normal function. 

Finally the use of over-the-counter painkillers from a chemist if is constantly painful are also helpful until you contact the dentist. 

Don’t place any pain-killing tablets on the site of the tooth or its gum as this can cause burns to the gum.

Is tooth whitening a safe procedure?

Tooth whitening is a procedure that should be carried out by a dentist only. There are many reasons for this. Hydrogen peroxide is a substance that should be handled with care and this should only be done by a qualified dentist. Any staining on your teeth may be due to an underlying condition and your dentist may diagnose this. Further information is available here

Flossing, is it really any good?

Absolutely! Normal brushing doesn't clean in between the teeth fully. The most common and effective way of doing this is by flossing. The dental floss removes the plaque between teeth. It is important flossing is carried out correctly, and regularly, at least once a day. You should get your dentist to demonstrate for you. Some patients may need to use other methods, like small brushes that fit between the teeth, particularly if the spaces between the teeth are bigger than normal. Your dentist will advise you on the method most suitable for you.

What exactly is plaque and where is it found?

Normally it is white (in thick section), almost the colour of the teeth, and thus much harder to see.  Plaque is a soft sticky substance, and can be removed with regular, thorough brushing and flossing. Your dentist should be able to show you if there's plaque on your teeth. They will also show you how to brush and floss properly in order to stop plaque accumulating.

Why do my gums bleed every time I brush my teeth?

The most common reason why gums bleed is due to the teeth and gums not being cleaned thoroughly enough. If you leave bacteria-containing dental plaque sitting on the teeth beside the gums, the bacteria infect the gums themselves.  

ginigivitis

The picture to the right here shows gums that have been infected. Notice the red colour all along the edge of the gum beside the teeth. Compare this picture with the picture below, and you can see the gums are swollen as well as being red. This gum infection is called gingivitis.  

gingiva

The picture here on the right shows nice healthy gums. The teeth have been kept clean, and the gum has now healed up. It's no longer swollen, and is a healthy pink colour. Healthy gums like this will not bleed when brushed.

I think I may be pregnant. Does my dentist need to know this?

If you think there is a chance you might be pregnant, it is always wise to inform your dentist before you begin treatment. Being pregnant will not prevent you from having dental treatment carried out, but most dentists prefer to defer any elective procedures (procedures that are not absolutely necessary) until after the pregnancy is over. This is particularly the case during the first and third trimesters. The taking of dental x-rays is also best avoided, if possible, during pregnancy, but experts agree that x-rays may be taken, where necessary, in the case of an emergency.

What dental treatment are children entitled to?

The HSE operates the Schools Screening Services which aims to screen children in Second, Fourth and Sixth Class. Unfortunately due to restrictions in the public service, these target classes are not always reached. Children under the age of 16 should be entitled to receive emergency treatment from the HSE public dental service. 

I have a medical card. What treatment am I entitled to?

Generally, you are entitled to:

  • One oral examination in a calendar year
  • Two fillings in a calendar year
  • Extractions

Most other treatment has been limited to high risk patients i.e. patients who are suffer from a medical condition or emergency circumstances. Your dentist will apply to the HSE for approval for your treatment. 

What treatment is available under the PRSI Scheme?

PRSI payers are entitled to an annual oral examination free of charge.

How often should I visit my dentist?

You should visit your dentist at least once a year, more often if you have difficulties. 

Remember under the PRSI and Medical Card dental schemes you are entitled to a free oral examination once a year!