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Advances make pulling teeth a last resort

From the Victorian era until as late as the 1940s, it wasn’t uncommon for brides in the United Kingdom and Ireland to have their teeth removed and replaced with dentures –as a wedding gift.Not only did the practice ensure a perfect smile, it was thought doing so would eliminate potential dental problems and expensive dental bills later in life. Dr Sami Moid, a dentist at Bakery Hill Dental in Ballarat, shares this history to illustrate just how far dentistry has come. The emphasis today is on evidence-based,minimum intervention dentistry; in essence,preserving as many of a patient’s teeth as possible, as well as the natural tooth structure.Although we’ve moved on from the days when extracting all teeth seemed like a good idea, Dr Moid still has patients coming to see him who have had teeth removed unnecessarily.

I’ve never found any age group that was unaffected by unnecessary  tooth extractions,” 

                                                                                                                                                                                                                                        he adds. “Even a young person at age 20 may have had a tooth pulled out. Some cases are genuine, where they’ve split the tooth in half or it’s a severely infected tooth that was left untreated. But I often see patients who have had teeth taken out and they don’t really know why except that it was painful and that’s the only option they were given.” However, patients should consider long-term implications, as removing teeth changes the facial profile. Dr Moid’s advice is to do everything possible to save a tooth. Modern dentistry provides several options.“There are procedures we do that buy time temporarily so you can make the right decision, hopefully, to save your teeth,” he says.‘‘Extirpation of the tooth would remove the pain and get you back up and running within 24 hours, and a temporary filling would be placed there until you get a more permanent solution.” When a tooth does need to be removed, dental implants are often Dr Moid’s recommended replacement, rather than a removable denture or a fixed bridge.Implant surgery requires integrating a titanium screw into the bone to provide a base for a freestanding tooth, without involving or cutting away other teeth.“The reason why this [procedure] is in demand is you don’t need to go into the neighboring teeth,” says Dr Moid. “Historically, other procedures involve going into other, healthy teeth to fill the gap left by extractions. I work under a Leica M320 surgical microscope that allows 10 to 40 times human sight magnification. It’s what I use for simple procedures like a filling or a clean and I also use it for more advanced procedures, like bone grafting and placement of an implant.” Of course, not all teeth complaints are so severe that they require extractions and implants. Having whiter teeth is a common cosmetic concern for many and has led to a range of toothpaste and whitening products appearing on supermarket shelves. Dr Moid’s advice for anyone wanting whiter teeth is not to ‘‘self-diagnose”, as many over-the counter products contain strong chemicals that can be damaging to gums. “Go to a professional and ask them about whitening, because many factors go into trying to whiten your teeth,” he says. Any surgical or invasive procedure carries risk. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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