Treatment Risks and Considerations
Dentista Dental Centre is a general Dental Practice. As health practitioners we aim to serve your smile taking into consideration your optimal health outcomes. Should you chose to have any kind of intervention to improve your overall dental health, functioning, or aesthetics there are risks associated with those procedures. Please find a list of common procedures we offer and the associated known risks. This list and descriptions are not exhaustive. Please contact your dentist should you wish to discuss further.
Whitening Info & Risks
Whitening is a cosmetic dental procedure to lighten the colour of your teeth. Existing issues should be treated before undergoing a whitening procedure. Results will vary or regress due to a variety of circumstances. Whitening treatments are not intended to lighten artificial teeth, caps, crowns, veneers or porcelain, composite or other restorative materials, and that these types of restorations may need to be replaced at the patient's expense to match their newly whitened teeth. Darkly stained yellow or yellow-brown teeth frequently achieve better results than people with gray or bluish-gray teeth. Teeth with multiple colorations, bands, splotches or spots due to tetracycline use or fluorosis do not whiten as well, may whiten unevenly, may require additional whitening, or may not whiten at all. Previous orthodontic treatments may cause teeth to whiten unevenly if any resin from the treatment was not properly removed from the teeth, either due to residual resin remaining on the teeth or over polishing upon removal. Those with porcelain fused to metal crowns, amalgams, lingual bars or implants may feel excessive heat. Teeth with many fillings or cavities may not lighten and are usually best treated with other non-whitening alternatives. The Zoom Lamp emits visible LED light and all materials used in the isolation process, when properly used as directed, will block any exposures of soft tissues to this light. It is recommended that those currently treated for a serious illness or disorder (e.g. immune compromised, AIDS, etc) should consult a medical doctor before use. Zoom treatment / whitening is not recommended for pregnant or lactating women. The results of the whitening / Zoom treatment cannot be guaranteed. In-office whitening treatments are considered generally safe by most dental professionals. Although the dentist or therapist has been trained in the proper use of the Zoom whitening system, the treatment is not without risk. Some of the potential complications of this treatment include, but are not limited to: - Tooth Sensitivity/Pain - During the first 24 hours after Zoom treatment, some patients can experience some tooth sensitivity or pain. This is normal and is usually mild, but it can be worse in susceptible individuals. Normally, tooth sensitivity or pain following a Zoom treatment subsides within 24 hours, but in rare cases can persist for longer periods of time in susceptible individuals. - People with existing sensitivity, recession exposing root surfaces, exposed dentin, untreated caries, cracked teeth, abfractions, oral tissue injury, open cavities, leaking fillings, or other dental conditions that cause sensitivity or allow higher penetration of the gel into the tooth may find that those conditions increase or prolong tooth sensitivity or pain after Zoom treatment. - Gum/Lip/Cheek Inflammation/Burn - Improper isolation during the whitening procedure may cause or result in (i) inflammation of the gums, lips or cheek margins due to exposure of a small area of those tissues to the whitening gel or the LED light, or (ii) a chemical burn due to whitening gel coming in contact with soft tissue. The inflammation or burn is usually temporary and will subside in a few days, but may persist longer and may result in significant pain or discomfort, depending on the degree to which the soft tissues were exposed to the gel or LED light. - Dry/Chapped Lips - The Zoom treatment involves three, 15-minute sessions during which the mouth is kept open continuously for the entire treatment by a plastic retractor which covers the lips. This could result in dryness or chapping of the lips or cheek margins, which can be treated by application of lip balm, petroleum jelly or Vitamin E oil. - Cavities or Leaking Fillings - Most dental whitening is indicated for the outside of the teeth, except for patients who have already undergone a root canal procedure. If any open cavities or fillings that are leaking and allowing gel to penetrate the tooth are present, significant pain could result. If teeth have these conditions, they should be filled or fillings redone before undergoing the Zoom / whitening treatment. - Cervical Abrasion/Erosion – These are conditions which affect the roots of the teeth when the gums recede and they are characterized by grooves, notches and/or depressions, that appear darker than the rest of the teeth, where the teeth meet the gums. These areas appear darker because they lack the enamel that covers the rest of the teeth. Even if these areas are not currently sensitive, they can allow the whitening gel to penetrate the teeth, causing sensitivity. If cervical abrasion/ erosion exists on teeth, these areas will be covered with dental dam prior to Zoom treatment. These areas can not be covered with take home systems. -Relapse -After the take home / Zoom treatment, it is natural for the teeth that underwent the whitening treatment to regress somewhat in their shading after treatment. This is natural and should be very gradual, but it can be accelerated by exposing the teeth to various staining agents. Treatment usually involves wearing a take-home tray or repeating the Zoom treatment. The results of the Zoom / whitening treatment are not intended to be permanent and secondary, repeat or take-home treatments may be needed for me to maintain the tooth shade desired.
Cosmetic Veneers Info & Risks
Drilling teeth (to make space for the ceramic) may cause them to become sore and need root canal treatment or extraction. Changes in the bite caused by change in shape and position of the new restoration can cause pain in the teeth and or the jaw muscles and or joint. Maintenance Requirements: Maintenance is very important, and most probably replacement of the restorations will be required at some stage. To ensure the restorations last as long as possible we encourage you to have regular six-monthly check-ups. This ensures any problems are identified and managed earlier, which generally means less complex and less expensive management. The four main causes of damage to ‘Bonded’ restorations i.e. porcelain / composite / printed veneers are outlined below: 1.Breaking NOT RECOMMENDED TO BITE WITH FRONT TEETH: -Nails / pen biting -Sticky food such as toffees, minties, boiled lollies, crackling -Hard food such as chocolate, hard crusty bread, carrots (cut up and chew with back teeth) -Ripping plastic tags / anything that should be cut with scissors oFor example, eating hard sticky things like crackling, toffees, minties, or accidentally biting into something very hard like a fork or olive pip it is likely the restoration will break/fracture. We recommend cutting up food and chewing with the back teeth. This includes hard crusty bread and hard chocolate. Also, if nails are bitten, or pens etc they can also severely damage the front teeth restorations and even pop them off. Once a restoration pops off it can be re-bonded but never with the same strength. Use a knife or scissors to cut or open something, do not use the teeth! 2.Weakened Bond The restorations are bonded (glued) to the teeth, acid in food and drink will dissolve the bond. So, it’s best to minimise the contact acidic food and drink makes with the teeth. ACIDIC FOOD AND DRINK TO MINIMISE TIME AND FREQUENCY IN YOUR MOUTH: -Citrus drinks lemon, orange etc (including straight and diluted in water) -Any drink with bubbles (including SODA WATER, and of course soft drinks such as Coke and Pepsi) -Any sugar free drink (including Coke no sugar, Pepsi no sugar, GATORADE - as they are usually very acidic) -Energy drinks (Mother, Red Bull etc even if they are ‘sugar free’) -Tea and coffee - black or white -Wine, beer -Control gastric reflux where you can with medication/ diet / sleep posture -Lots of time exposure to chlorine / environmental acids 3.Decay The ‘seam’ where the restorations meet the teeth is vulnerable to new decay. Minimise treats (both sugary and acidic) and protect the teeth with x2 daily at home brushing and 1x per day cleaning between the teeth with floss and/or piksters. Choose fluoridated toothpaste and have 6 monthly checks and cleans with your dentist to pick up any problems early! 4.Receding Gums Some people are vulnerable to receding gums. When gums recede around a dental crown or veneer the part of the tooth that becomes exposed under the gum can be a different colour and shape to your restoration. Generally, this does not cause any weakening of the restoration, however it can be an aesthetic issue. If the way it looks is bothersome, the restoration can be replaced, or the gum can have grafting. Everything ages and experiences wear and tear. The changes experienced in the mouths(similarly to those in the rest of our body) are more pronounced the younger we are. It is important to note that the younger you have dental treatment, the sooner it will need replacing. For example, treatment for a 20 year old will need to be replaced sooner than the same treatment on a 60 year old.
Implants Info & Risks
There are several inherent and potential risks and side effects in any surgical procedure and in this specific instance, such risks include, but are not limited to, the following: a.Post-operative discomfort and swelling that may require several days of at-home recuperation b.Prolonged or heavy bleeding that may require additional treatment c.Injury or damage to adjacent teeth or roots of adjacent teeth if present d.Post-operative infection that may require additional treatment including removal of the implant e.Stretching the corners of the mouth that may cause cracking and bruising which may heal slowly f.Restricted mouth opening for several days – this may sometimes be related to swelling and muscle and sometimes related to stress to the jaw joints (TMJ). Pre-existing TMJ symptoms may be worsened g.Injury to the nerve branches of the upper &/or lower jaw resulting in numbness or tingling of the lower eye lid, side of the nose and upper lip/cheek area, lower lip, chin and tongue, along with the gums on the operated side. This may persist for several weeks, months, or in rare instances, permanently h.Infection of the treated area may occur, possibly necessitating the total removal of the implant / any graft material. The removal of grafted bone from any donor site has its own potential risks and complications. i.Smokers should not smoke one week prior to surgery, the day of surgery and one week following surgery Surgery involving the sinus: j.Some bleeding through the nostril on the side of the surgery may occur which usually will last one to two days. k.Swelling around the eye of the surgical side may even result in closing of the eye for a day or two . l.Opening of the sinus may occur after surgery and would require additional treatment. During the course of this procedure, a treatment plan may be amended due to unforeseen conditions that could surface which will necessitate the extension of the original procedure for the best possible outcome and for the benefit of the patient. In rare instances it may not be possible to continue with a procedure during which time any further options will be discussed with the patient. There are other forms of treatment and the choice to seek these treatments or to have no treatment at all is entirely the choice of the patient. Antibiotics may be prescribed as a precautionary measure before and/or after surgery. Refusal to take prescribed medication could lead to further complications such as implant failure and will incur additional costs due to further treatment required.
Full Mouth Rehabilitation Info & Risks
A Full Mouth Rehabilitation (FMR) involves various forms of treatment to help improve the overall health of the mouth. These treatments can include but not limited to changing the bite, crowns, veneers, implants, extractions, root canals, dentures and gum treatment. The three main risks to be aware of with respect to Full Mouth Rehabilitation (FMR), are: 1.Drilling teeth may cause them to become sore and need root canal treatment or extraction. 2.Opening the bite may cause joint and muscle pain – assessment of the joints and muscles at the beginning phase to identify any pre-existing joint or muscle issue can identify need for referral to the appropriate specialist before making changes to the bite. 3.Maintenance Requirements. If teeth require a full mouth rehabilitation it is likely they have lived a hard life. It is important to note that if the teeth did not last forever it is unlikely any man-made restoration will either. The teeth and restorations will require maintenance and most probably replacement at some stage. To ensure the restorations last as long as possible we encourage regular six-monthly check-ups. This ensures problems are identified and managed earlier which generally means less complex and less expensive. For the risks specific to veneers / cosmetic treatment see above.
Bone Grafting Info & Risks
Bone grafting procedure involves augmenting bone volume in areas of bone deficiency using a bone graft material. There are different type of graft material which will be discussed with you. Bone grafting risks include, but are not limited to the following: a. Bleeding, swelling, infection, scarring, pain, numbness, or altered sensation (possibly permanent) at the donor site (if used) which may require further treatment. b. Allergic or other adverse reaction to the drugs during or after the procedure. c. The need for additional or more extensive procedures in order to obtain sufficient bone. d. Rejection of bone particles from donor or recipient sites for some time after surgery. e. Rejection of the bone graft. f. Postoperative infection that may require additional treatment including removal of the graft. g. Injury or damage to adjacent teeth or roots of adjacent teeth if present. h. Numbness of pain in the area of the donor or recipient site, or more extensive areas, which may be temporary or permanent. i. Penetration of the sinus or nasal cavity which could result in infection or other complication requiring additional drug or surgical treatment. j. smokers should not smoke for at least one week prior to surgery, the day of surgery and at least one week following surgery. Smokers tend to have more post-operative complications and a higher risk of graft failure. The graft material may be in place for months before it can be exposed for the placement of implants. No guarantee can be given that the graft will consolidate and thus be adequate for implant placement. There are alternative treatment options.. Other treatment options or no treatment at all are choices the patient has. During the course of this procedure, unforeseen conditions may be revealed which will necessitate extension of the original procedure or a different procedure. In rare cases, it may not even be possible to continue with the procedure.
Crown Lengthening (Gum Shortening) Info & Risks
Crown lengthening is a procedure where the height of the gum is made shorter. This is generally done to cosmetically improve the appearance and proportion of the tooth / restoration, or to mechanically increase the tooth structure above the gum available to hold a restoration. Depending on the circumstance, it may be only gum tissue removed (gingivectomy), or it may also involve the bone (surgical crown lengthening). The risks of gum shortening include but are not limited to: - pain, discomfort, swelling, infection - uneven healing requiring further refinement / gum grafting - relapse - which is where the shortened gum grows back - exposure of the underling root tooth structure making it sensitive
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