04 November 2018

What will happened after a tooth is extracted?

What will happened after a tooth is extracted?

Bone lose/collapse/ridge resorption

Without socket preservation, the bone quickly resorbs resulting in 30–60% loss in bone volume in the six months after dental extraction. The jaw bone will never revert to its original shape once bone is lost and tissue contour has changed.

What type of treatment can minimise the effect ?
~socket preservation~

A socket or alveolar ridge preservation procedure involves placing a bone graft into the socket, where the tooth once was. This graft can be made of  synthetic materials, bone from other animals (such as cows) or human bone. After putting the graft in the socket, the dentist usually covers it up with a collagen membrane, then sutures the opening to keep it closed.

What is the purpose of socket preservation? 

The goal of socket preservation is to improve the appearance of the remaining teeth and gums and to make the process of getting a dental implant less complicated.
The severity of the healing pattern may pose a problem for the clinician in 2 ways: it creates an esthetic problem in the fabrication of an implant-supported restoration or a conventional prosthesis; and it may make the placement of an implant challenging if not unfeasible.
The placement of an implant at a site with a thin crestal ridge (e.g., postextraction ridge) could result in a significant buccal dehiscence. Thus, it seems prudent to prevent alveolar ridge destruction and make efforts to preserve it during extraction procedures.

However, it is possible to minimize such problems by simply carrying out ridge preservation procedures in extraction sockets using grafting materials with or without barrier membranes. Socket preservation procedures help reduce horizontal or vertical alterations in the alveolar ridge near the site of a tooth extraction.

Is Socket Preservation Necessary?

Bone graft dental work is not done just for fun, not at all. By having your socket preserved, you improve your appearance by protecting your jaw bone both vertical and horizontal alteration are reduced. Additionally, you protect your gums and make it easier to get dental implants in the future should you need them. 

07 September 2018

Does your child have tooth decay?

Tooth decay or cavities are the most damaging, painful and troublesome issue that can happen to anyone especially kids. Some parents think there’s no reason to worry about these baby teeth getting decay. The baby teeth are going to fall out anyway. Unfortunately, many parents do not know that a proper set of baby teeth can help the child to be able to eat and nourishes proper nutrition as well as develop proper speech.

Why does tooth decay occur?

“My child brushes everyday but why does his/her teeth still decay?” claimed some parents. Our mouth contains hundred different types of bacteria found in our gums, teeth, cheeks or even our tongue. These bacteria consume the sugar and starches in our food and produces acid which destroy the protective layer of our teeth over time. When the child goes to sleep with bottle feeding throughout the night, these bacteria joyfully takes up the sugar causing the teeth to decay. This process can cause rampant caries or decay.

How can we spot tooth decay in children?

“Hi Doc, how can I know when my child’s teeth are starting to decay? How can I spot the decay?” asked one of the parent. At the age of 2-3 years old, normally a child has their full set of baby teeth. Tooth decay can be difficult to notice sometimes but there are some signs to help parents identify the issue.
  • White spots lesion near the gum line
  • Yellowish, brown or black bands near the gum line
  • Chipped or ragged edges of the teeth with discoloration- indicates advanced decay
  •  Discomfort or pain when the child eats cold or hot food

What can we do to prevent tooth decay?

“I want to protect my child from all the sufferings caused by tooth decay. How can I do that?” asked an eager parent. Though at such a young age, children are susceptible to tooth decay and other oral problems, there are also measures of prevention.
  • Avoid bottle feeding throughout the night
  • Avoid snacks between meals
  • Reduce sugary intakes especially candies and chocolates
  • Drink plain water instead of sugary drinks
  • Proper brushing at least twice a day. Use fluoridated toothpaste
  • Obtain sufficient fluoride (from water or supplements)

Regular visits to the dentist is crucial to prevent and treat tooth decay. During the visits, examination and cleaning are done by the dentist:
  • Check and identify early tooth decay
  • Thorough cleaning to remove plaque
  • Apply Fluoride varnish if necessary
  • Dental sealants to prevent tooth decay or cavities- normally done on the developing molars (back teeth)
  • Teach the child proper brushing technique
  • Schedule the next visit for follow up and review

Lastly, parents should supervise their kids during brushing, encourage them to eat healthily and make time to bring their kids to visit the dentists. Parents can be a good role model to exercise proper oral habits so that the kids can be motivated to do so to prevent tooth decay.

03 July 2018



Topik ini agak berat untuk dibaca, tetapi sangat bagus untuk pengetahuan am kita mengenai pengambilan ubat antibiotik. 


Pernahkah anda mengalami sakit gigi yang terlalu kuat sehingga tidak boleh tidur atau melakukan kerja harian? Bagi sesetengah kes yang serius, akan terdapat bengkak pada pipi, muka ataupun gusi, sehingga kadang kala terdapat nanah keluar daripada tisu sekeliling gigi.

Apakah punca anda mendapat masalah ini?

Dalam kebanyakan kes, masalah seperti ini adalah disebabkan oleh jangkitan kuman di dalam mulut. Lebih spesifik,  jangkitan kuman pada gigi yang berpunca daripada bakteria. 

Di dalam mulut kita, terdapat berbilion bakteria yang tidak merbahaya sebenarnya. Tetapi, jika kita tidak menjaga mulut dan gigi dengan bersih, penjagaan yang tidak betul; maka bakteria akan membiak dan menyebabkan masalah seperti gigi berlubang, gusi bengkak dan merah, mulut berbau busuk dan lain-lain. 

Jika terdapat jangkitan bakteria, doktor akan memberi ubat antibiotik untuk membunuh kuman dan menghilangkan kesan jangkitan. Tetapi, terdapat sesetengah pesakit agak memandang ringan akan kepentingan antibiotik dalam merawat masalah yang mereka hadapi. Sesetengah pesakit tidak mahu memakan antibiotik langsung, atau ada yang ambil tetapi makan tidak mengikut jadual aturan yang betul. Paling teruk adalah ubat diambil atau dibayar, tetapi tidak dimakan, hanya disimpan di dalam peti atau diletak atas meja sahaja. 

Terdapat pesakit tidak mahu mengambil atau memakan antibiotik kerana mereka berfikir antibiotik boleh memudaratkan badan (kerana bahan kimia yang terdapat di dalam ubat). Pendapat ini adalah tidak tepat kerana tiada keburukan mengenai antibiotik, tetapi (keburukan) hanya datang jika seseorang itu tidak habis memakannya.  Jika dos tidak cukup, ia bukan hanya memberi kesan kepada satu orang, tetapi kepada satu komuniti kerana kuman tidak mati, malah semakin kebal, kuat dan tahan lama. Jadi seharusnya ubat antibiotik yang telah dipreskripsi oleh doktor perlu dihabiskan mengikut arahan. 

Yang penting, pesakit jangan memandai-mandai mengambil antibiotik tanpa saranan atau preskripsi doktor. Pesakit perlu tahu yang antibiotik tidak boleh dimakan dan dihabiskan dalam tempoh tiga hari kerana jika ia sekurang-kurangnya memerlukan lima hari untuk dimakan berterusan mengikut waktu dan dos yang ditetapkan ahli farmasi. Apa yang penting, orang ramai perlu fahami dan patuhi konsep 5B dalam pengambilan dan penggunaan ubat yang digariskan persatuan iaitu 'pengguna yang betul, ubat yang betul, dos yang betul, cara pengambilan ubat yang betul dan masa pengambilan ubat yang betul'.


  1. Baca arahan pada label ubat.
  2. Pastikan dos yang diambil adalah betul.
  3. Ketahui tempoh pengambilan ubat.
  4. Gunakan bekas bersukat atau picagari yang dibekalkan untuk minum ubat. 
  5. Gandaan dos tanpa nasihat doktor atau ahli farmasi akan membahayakan kesihatan manakala pengurangan dos akan mengurangkan kesan ubat.

Penggunaan antibiotik untuk rawatan gigi.

Bagi rawatan pergigian, kadang kala ubat antibiotik akan diberikan kepada pesakit. Hal ini bertujuan untuk mengelakkan jangkitan kuman bertambah semakin teruk, terutama sekali apabila selesai rawatan pembedahan. Contohnya pembedahan implant (tanam skru pada rahang) atau surgeri untuk membuang gigi geraham bongsu. 

Ubat antibiotik yang kerap diberi kepada pesakit adalah Amoxicillin (daripada group Penicllin) ataupun Metronidazole. Jika pesakit allergi terhadap amoxicillin, ubat Erythromycin/clindamycin/tetracycline akan diberikan (bergantung kepada sama ada jangkitan kuman serius ataupun tidak).

Jika ubat yang diberikan diambil ikut waktu yang ditetapkan dan seperti yang telah dinasihatkan oleh doktor, maka kuman dapat dibunuh dan jangkitan kuman pada badan akan hilang cepat. 

06 June 2018

Dental Implant

For many years, the only treatment options available for people with missing teeth were bridges and dentures. But, today, dental implants are available.

Public has wrong perception towards dental implant (People who has no teeth  or wearing full denture is not suitable to put implants.)

Without a doubt, implant dentistry has allowed for more treatment options to replace single and multiple missing teeth with long-term stability and contributes to improved oral health.

However, not everyone is a candidate for implant dentistry. Patients with a history of uncontrolled diabetes,heart disease and bisphosphonate use, or certain blood disease may not be suitable candidates for implant therapies Heavy smokers or patients who have radiation therapy to the head/neck area need to be evaluated on an individual basis. 

Dental implants require the same care as real teeth, including brushing, flossing, rinsing with an antibacterial mouthwash, and regular dental check-ups. Implant survival rate decrease if without proper oral hygiene daily care.

Treatment Options Available:
1. Single implant
2. Implant supported bridge
3. Full arch  -Implant fixed bridge
-Implant supported denture ( removable )

Implant Supported Bridge ( full arch )

Single Implant

3-units Implant Bridge

Implant supportted denture ( LOCATOR)

Another important issue is the amount of bone available for implant placement and stability. A result of edentulism is the deterioration of the alveolar bone. There must be sufficient bone structure to consider implants . Augmentation of the bone and ridge may be accomplished with a variety of methods and grafting mediums.


How do I care for my dental implants?
Well-placed and cared for dental implants have the potential to last a lifetime. Caring for teeth restored with dental implants is just like caring for your natural teeth: brush, floss and get regular dental cleanings and check-ups. 

The destructive process affecting the soft and hard tissues surrounding dental implants.The periodontal pathogens found around failing implants (those affected by peri-implantitis) are very similar to those found in association with various forms of periodontal disease.
Post implant placement care and follow up with dentist are equally important to prolong implant lifespan.

23 April 2018

X-rays in Dentistry

Let’s talk about radiography(x-rays) in dentistry. Why do we need x-rays in dentistry? These tools help the dentist with the diagnosis and treatment planning of the patient’s dental issues.

Uses of dental X-rays:
-to diagnose cavities

-identify the broken or crooked roots of teeth

-view the bone health or periodontal disease around the teeth

-identify the status of developing tooth

-monitoring the oral dentition health

There are several types of x-rays routinely used and categorized into the intraoral and extraoral radiograph. Intraoral x-rays include: Periapical radiograph(PA), bite-wing, occlusal x-rays. The extraoral x-rays are: Panaromic x-rays (Orthopantomagram(OPG), lateral cephalogram) and computed tomography (cone beam CT(CBCT)).

Intraoral Radiography:
  • 1.  Periapical x-rays

 Image result for xrays in dentistry
  • 2.       Bite-wings x-rays
  • Image result for xrays in dentistry

  • 3.       Occlusal x-rays

Image result for x rays in dentistry

Extraoral Radiography:
  • 1.       Panaromic X-rays
  • a)       Orthopantomogram (OPG)

 Image result for xrays in dentistry
  • b)      Lateral cephologram

 Image result for x rays in dentistry
  • 2.       Computed tomography (CBCT)

-produce three-dimensional images of the teeth and jaw bones.

Image result for cbct dental

Concerns of dental x-rays:
Dental x-rays emit a small dose of radiation (0.0005-0.2mSv) and represents a minor contribution to the total exposure of natural and man-made sources. These are used with caution and used only when necessary. 

 Steps taken to reduce the radiation exposure includes:
-wearing of lead shields or apron before getting x-rays

-using better film (F-speed film which is the fastest film can limit the amount of radiation)

-digital radiography (reduces the amount of radiation as much as 80%)

- having regular inspection and licensing (to ensure the X-ray machines are safe and accurate)

-using film holders (prevents exposure to fingers holding the film in the mouth)

Image result for x ray in dental lead apron, film holder Image result for x ray in dental lead apron, film holder

X-rays during pregnancy
Most of the pregnant patients concern about the safety of taking x-rays during pregnancy. American Dental Association (ADA) recommends the use of aprons with thyroid shields for pregnant patients. Studies of pregnant patients receiving dental care have affirmed the safety of dental treatment.

Image result for x ray in pregnant woman dental

X-rays in children
Besides that, many patients are worried if x-rays are safe for their children. The American Academy of Pediatric Dentistry reassures parents that the amount of radiation received during a dental X-ray is extremely small. Nowadays, X-ray equipment lets dentists focus the X-ray beam on the area of interest to reduce radiation exposure. 

Image result for x ray in children dental Image result for x ray in children dental

 In conclusion, dental x-rays have many important uses. The ADA encourages dentists and patients to discuss dental treatment recommendations, including the need for X-rays, to make informed decisions together. If you are concerned about dental x-rays do consult your dentist to seek for further advice.