Dentistry on Lockdown - What is Emergency Dental Treatment?

We’re staying home and staying safe… meaning most dental work will have to be put to one side for now. But what if you need emergency treatment?

As part of Ocean Clinic’s specialist cosmetic team, patients come to us seeking elective treatment to improve and upgrade their smile, rather than just day-to-day basic dental care.

But while aesthetics are our speciality, health is, of course, the foundation of beauty. That’s why we always provide holistic dental care, making sure our cosmetic improvements are built around healthy gums and teeth, which are in harmony with the function of the muscles and jaw joints. 

We know problems can sometimes occur, especially as we deal with more complex cases, including patients who have had repeated treatments in the same area or have neglected their teeth for a long time (due to fear or financial reasons). 

So, what constitutes a dental emergency?

You need to seek urgent dental treatment if you have:

• Facial swelling extending to the eye or neck or floor of the mouth
• Bleeding due to trauma of the mouth
• A severely broken tooth or a tooth that has fallen out and is causing you pain
• Toothache that is preventing you from sleeping and eating, combined with swelling and fever that is not manageable by painkillers
• Difficulty swallowing due to swelling 

Bleeding gums, loose or lost crowns, rubbing dentures, broken fillings, chipped teeth with no pain and loose orthodontic wires are classified as non-urgent and may need to wait until regular services are reopened and able to help you again.

However, here are some solutions to less urgent, common causes of dental discomfort to help you cope at home during lockdown.

Coping with other conditions

For any other dental discomfort, over-the-counter painkillers can help. However, if you believe you may have covid-19, you should take paracetamol in preference to ibuprofen.

Sensitive teeth

If you have extreme sensitivity to hot or cold food or drink, sensitive toothpaste can help. Rub the affected area directly with a toothpaste such as Sensodyne Repair or even anaesthetic gel like Orajel and do not rinse away. Apply up to three times a day after meals and before bed.

Painful wisdom teeth

If you have wisdom tooth pain, most flare-ups can be managed with good home care. Do a thorough cleaning of the area with a soft brush (even if painful to touch) and use Corsodyl mouthwash. Try to keep to a soft diet and stop smoking. * Should you develop additional symptoms like a restricted mouth opening and swelling then you may need to be seen urgently.

Mouth ulcers

Most ulcers typically heal within 7-10 days. To ease the pain try hot, salty mouthwashes, Difflam Spray (benzydamine) and Orajel. Keep to a soft diet and use Corsodyl mouthwash to prevent infection.

If you are experiencing dental problems and are not sure whether you can get treatment, please call or email us and we’ll do our best to advise you. 

Cosmetic Injection or Brow Lift Surgery?

Are your eyebrows migrating downwards? Are your eyelids becoming hooded? When gravity starts to take its toll on our foreheads the effect can be ageing.

Restoring your brow to a more youthful position can be done both surgically and non-surgically using muscle relaxants. In this article, we’ll look at both options and help you understand which is best for you.

What is a Surgical Brow Lift?

A brow lift (also known as a forehead lift) is often combined with a facelift or upper eyelid surgery (blepharoplasty) but it can be performed on its own. In simple terms, a brow lift involves the lifting and tightening of the forehead and surgical removal of any excess skin.

There are two different methods we use to carry out a brow lift at Ocean Clinic Marbella. The first is the direct excision brow lift, which sees portions of skin removed from directly above the eyebrows, with incisions hidden in the hairline of the eyebrow. This raises the eyebrows and the upper eyelids, in order to “open up” the eyes.

The second technique, a temporal lift, involves incisions made in your hairline at your temples.  As the procedure is carried out endoscopically, it’s less invasive, however, it only lifts the outside tail of the brow. This helps to correct hooded eyelids and smooth crow’s feet but won’t be effective for a very heavy brow since it doesn’t alter the middle of the brow or forehead area.

Which method we use depends on your age, skin quality, the severity of sagging and whether you’re suffering from any asymmetry. We will assess your facial anatomy and bone structure to ensure your brows are placed in a natural position - you don’t want to be left looking permanently surprised! 

Both types of brow lifts can be performed under local anaesthetic with sedation and you can return home the same day. The operation is safe and recovery is rapid, although you may have some bruising and swelling. You’ll need to return to the clinic to have your stitches removed after 7-10 days and you can expect scarring to fade away within a few months.

The result of a brow lift is long-lasting, however, your skin will continue to lose elasticity as you age, meaning it won’t last forever.

What is a Non-Surgical Brow Lift?

A non-surgical brow lift is performed using cosmetic injectable muscle relaxants. The muscle relaxant is injected into the orbicularis oculi muscle that surrounds the eye. By relaxing this muscle, the downward force is released. This allows the forehead muscles to pull upwards and elevates the eyebrows. 

Meanwhile, placing injections at the ends of the eyebrows raises the tail of the eyebrow. This can help correct upper eyelids that are starting to sag and open up the eyes so you look more awake. 

This treatment can be carried out in a matter of minutes and requires no downtime. However, the results are more subtle than those achieved through surgery and they are also impermanent. The injection result typically lasts between three to six months, depending on the individual. After this time, the muscle action returns and the brow will resume its previous position. 

Cosmetic Injection or Brow Lift - Which is Right for You?

Whether you choose a surgical or non-surgical solution will depend on your age, the severity of sagging and your budget. Brow drooping normally becomes apparent in a person’s late thirties, although a low brow can be hereditary so it can also be seen in younger patients.

If you are only displaying early signs of skin laxity, injectables can be an effective treatment and can delay the need for surgery. In combination with the effect the injectable has on relieving forehead lines, crow’s feet and lines between the eyebrows, it can considerably freshen up a face. 

You might wish to experiment with the cosmetic injection and, if you like the results, opt for an endoscopic temporal lift in order to make the changes permanent. Injections need repeating several times a year and, while it’s considerably cheaper than a surgical brow lift, these costs clock up quickly. This can make surgery better value for money in the long run.

For older patients, with deep furrows in the forehead, pronounced eye hooding or a low-set brow, more extensive surgery is recommended since the results of cosmetic injection or an endoscopic temporal lift will be minimal. On the other hand, the result of an excision brow lift can be dramatic - you’ll no longer look tired or angry and it can take years off your face. 

For a full assessment of your forehead, brow and upper eyelids, make an appointment for a consultation with one of our plastic surgeons. 

Problem Teeth - Root Canal vs Extraction and Dental Implant

Many decades ago, patients were encouraged to consider extraction as a long-term solution to problem teeth, but this philosophy has been considered out-of-date for 50 years or more.

These days dentists would prefer to do anything to help their patients hang on to their own teeth for as long as possible! We have also become aware of what happens if we just leave a space instead of replacing the extracted tooth (something we discussed in a previous blog). 

Obviously, the consequences of an extraction depend on the tooth in question. When it comes to problem teeth, losing a lower back tooth will be a lot less traumatic for most patients than an upper front one, due to the major change in appearance.

However, losing a tooth in any position may significantly affect your occlusion or bite. Most patients will adapt and manage to retain a normal diet if they lose one or several of their molars, but if there are multiple spaces, overall function can become a problem.

In addition, biting forces may not be distributed evenly between the remaining teeth causing these teeth to have more wear and tear and suffer from sensitivity when biting. This can lead to chipping or fracture and increased mobility.

The loss of even a single opposing tooth may mean over time that the tooth directly below or above the space can grow into the space and become unstable. This may even – in worst-case scenarios – result in the eventual loss of this tooth as well. 

As teeth drift, spaces will open between them and these can trap food, making it difficult to maintain effective oral hygiene and lead to problems of dental decay and gum disease. 

Given all the potential consequences of tooth loss, it makes sense that the final decision to extract or try to keep the tooth should be considered carefully. If deciding to extract, then dental implants are a popular option to replace the tooth with a natural-looking alternative.

An implant not only improves aesthetics but also maintains the other teeth in their correct position with even distribution of force and harmony in function.

Of course, the final decision is down to the patient and there are many factors to consider. The three most common influential factors are cost, time of treatment and prognosis.

Cost

These days implants are a very popular and readily available treatment option. However, at first glance, they may still appear to be less economic than trying to save your own tooth. 

However, do be sure that you have a full estimate of what´s involved when trying to keep your problem tooth, which might otherwise be extracted.

Often these badly broken down/decayed teeth require a root canal treatment as the decay has now spread to the centre of the tooth where the pulp (nerves and blood vessels of the tooth) are found.

Once this has been done, the tooth structure remains very weak and may need to be built up with a large filling or more commonly a crown. 

There is often minimal difference between this series of restorative procedures and the extraction and straightforward placement of an implant and crown. 

Treatment Time

As with all things clinical, this varies from case to case. Generally though, both the restorative treatment (root canal, crown) and the implant procedure will require multiple visits over a period of time.

However, you might be surprised to know that the surgical stage of placing an implant often takes far less time than performing a root canal treatment on a back tooth. But implants must be allowed to heal and integrate with the surrounding tissues and this can often take several months to occur. 

Despite many advances in treatment protocols, this healing period is still essential although during this time you may have a temporary in place.

In contrast, the time from start to finish of completing the restorative treatment to save your own tooth doesn’t usually require any set healing time in between and hence can be completed much faster.

Prognosis

Again, this depends on what state the problem tooth is in. Front teeth are easier to access and treat and have single root canal systems so there is a higher success rate than when we are working on back teeth with complicated, multiple root canal systems. 

Modern techniques have resulted in a far better chance of retaining the tooth for many years, however, it does depend on who performs the treatment. An endodontist (root canal specialist) typically enjoys a success rate of around 95-98%, whereas studies indicate that for a general practitioner it is around 80-85%.

Unfortunately, in nature, nothing carries a total guarantee and if you are unlucky enough to be in the small percentage that does not succeed then extraction and implant placement may be needed.

It’s important to realise, though, that even if all goes to plan, you probably will not keep that tooth for your lifetime. The weakened nature of the tooth plus the possibility of reinfection may mean you have anywhere between a couple of years to around 10 years in good scenarios. So some might say you may just be prolonging that final extraction.

Implants, on the other hand, are more predictable in their success rate and, provided all factors are favourable once they have successfully integrated and they are well maintained, should last a lifetime.

The overlying crown may need to be replaced (just like any other dental work in your mouth subject to biting forces over time) but the root of the implant should remain healthy.

Keen to know what the best option is for your problem tooth? Why not make an appointment for a free consultation? 

Contact Ocean Dental Marbella on (+34) 951 77 55 18 or email dentalclinic.oceanclinic@gmail.com