Your new mouth guard

A mouth guard provides protection to the teeth and masticatory system (jaw joints and muscles) and is, usually, worn while you are asleep. In severe cases, your dentist will provide two mouth guards, one for the upper jaw and one for the lower jaw.

A mouth guard has several positive effects:

  • Reduces teeth wear and tear: Instead of grinding away teeth you grind the mouth guard.

  • Relieves tension in the jaw joints. Many people suffer from pain in the jaw joints. Sometimes the jaw will lock or produce a loud annoying sound when being used. The mouth guard relieves tension built up in the jaw.

  • Stabilises the bite (occlusion). The design of a mouth guard provides maximum protection to the individual teeth. As it stabilises the bite, it helps the muscles and joints to relax more. If the overload on the teeth is extreme we sometimes see teeth being moved out of their position. A mouth guard will, in most cases, prevent this movement.

 

Things to consider

A mouth guard is worn during sleep. In some cases, it is recommended during the day as well. A patient may use the guard for longer than the recommended duration.

The length of the treatment period varies. If the main objective of the treatment is to get rid of pain, we often see that 3-4 months will suffice. When the objective is to prevent wear and tear of teeth, we recommend longer usage.

The mouth guard is custom-made to suit your bite. It may ache when you begin using it. This will wear off after a few days. The effect of the mouth guard will kick in once it feels comfortable in your mouth. If you feel tension and pain after the first couple of weeks it is important to contact your dentist.

If you stop using the mouth guard for a while, you can experience problems when you try to fit it again. This is because your teeth could have moved slightly over time. In this case you must contact your dentist.

When you remove the mouth guard in the morning your bite will feel peculiar. This is because the jaw muscles have been relaxing all night. The bite will adjust itself after a short while. Rarely do we need to make a bite adjustment.

Initially when using a mouth guard you may experience increased saliva production. It usually returns to normal levels in a few days.

While using a mouth guard it is very important to have good oral hygiene. Brush your teeth before inserting the guard. Floss your teeth daily. The actual mouth guard needs to be cleaned twice daily. When not in use store it in freshwater. When travelling keep it in a plastic bag with some wet wipes.

Always bring the mouth guard to any dentist appointment.

If you have any problems or queries please contact us.

Veneers

Teeth can become discoloured for different reasons. This means that bleaching is not always the best solution. Some teeth cannot be bleached. Old fillings have visible borders that become more pronounced when bleached, making it unsightly. To avoid these problems, your dentist might recommend using a crown made from ceramic. This is particularly helpful if most of the tooth is either filled or damaged, where bleaching would be unsuitable. However, if the tooth is healthy, crowns are not recommended, as much of the healthy tooth would have to be destroyed to make way for the crown.

Veneers
A modern alternative is a veneer. A veneer is a very thin shell made of porcelain and customised to fit individual patients’ teeth. It will be glued to the outer surface of the tooth, forming a strong bond. The appearance is natural because the veneer mimics the layers of enamel.

 
This patient was unhappy with the colour of her teeth and the old fillings (yellow). 

First, all her teeth were bleached. Then, veneers were placed on the front four teeth. Veneers allow you to alter the shape of the teeth. So this patient requested an increase in length of her front teeth.

A natural look
Enamel is a relatively thin and transparent layer on the surface of the tooth. Under the enamel is the dentine, which is darker and coloured. The veneer is glued to the enamel and masks the darker underlying dentine. The porcelain used for veneers is very similar to enamel, making the appearance natural – almost like a new layer of enamel.

 
A tooth gets its natural colour from reflections of light through the different layers of the tooth. In order to create a natural appearance, the dentist will try to mimic the natural construction of the tooth. Veneers are highly precise, very thin shells of porcelain. They are customised to fit each individual patient and tooth. The veneer is glued to the outer surface. It mimics the natural appearance of the tooth, almost like a new layer of enamel.


This patient’s front tooth was broken in an accident and repaired with composite (above). Over time, it  turned slightly yellow. This was fixed using a porcelain veneer (below).

It is not necessary to remove any tooth substance if you choose to increase the size of a tooth with the veneer treatment. However, your dentist might need to remove a thin layer of enamel – usually 0.5mm – to accommodate the veneer. Next, your dentist will take an impression of your tooth and create a cast. Our dental laboratory will then make your customised veneer and your dentist will schedule a fitting. If the fit and appearance are to your liking, the veneer will be “cemented” (glued) in place, and you can enjoy your new smile.


This patient had veneers made for six front teeth.

At Snö, our dental technician works like an artist to craft veneers in-house. During an inlay, onlay or crown procedure, we can usually fabricate it on the same day or the next. To make aesthetic veneers usually takes a few more days due to the customisations. 

Thanks to our advanced digital scanners, we also save you from the discomfort of taking tooth impressions. A two-minute scan is all we need to get all the information of your teeth in full detail and the highest resolution. The crown is cemented to the tooth – aesthetic, durable and strong.

The quality and lifespan of the veneer has a direct relation with the technique and time spent on the treatment and oral hygiene going forward.

A treatment can look and feel good, but can still have quality concerns. At Snö, we always document everything during treatment in order to insure our high quality standard. This applies to veneers too. The veneer treatment also carries a two-year warranty. If you follow our protection plan you can get up to five years of warranty.

Amalgam problems

Continuous wear
Tooth wear is based on the environment. In the same way that cars used for races require more repair than those used for display purposes, tooth wear depends on what we expose our teeth to. For instance, if you grind your teeth during night (bruxism), they will wear over time without you being aware of it.

An intact tooth is the best
The most durable tooth is one without any fillings. Most people have amalgam fillings which function fine. However, with age, the amalgam filling changes its form so it does not fit the tooth anymore.


A cavity alongside the fractured amalgam filling

 

Amalgam cannot bind itself to the tooth. A dentist will usually make the cavity wider at the bottom than at the top so that when the amalgam sets, it swells and becomes “trapped” in the cavity. Amalgam is good at resisting bite forces, but over time small cracks in the tooth are created, increasing the risk of fracture. The bigger the filling, the greater the risk.


A side view of a tooth with caries (left), detected during a routine dental examination. The tooth (right) with the caries and bacteria removed. If the tooth were to be filled with amalgam at this stage, the amalgam would simply fall out.

 


The dentist is, therefore, forced to remove healthy tooth substance in order to make the cavity bigger at the bottom.

 


A cavity filled with amalgam (left). Over time the amalgam swells up (right), creating a risk of fracture to the tooth.

 


A tooth with a large old amalgam filling. A crack is visible and the wall of the tooth will soon fall off (left). Another example (right) where the wall has broken off. A crown or dental onlay will greatly reduce the risk of fracture. Tooth fractures also quite often lead to root canal treatment.

 

The first time a cavity is filled with amalgam, it usually lasts a long time – 20 years is not uncommon. When an old filling needs to be redone, the prognosis is not always as good. Even the unfilled parts of the tooth are often damaged, forcing the dentist to remove more of the tooth. The longevity is now greatly reduced. A crown or dental inlay/onlay will improve the prognosis of the tooth.


Molars in the lower jaw with big, old amalgam fillings.


After treatment with bonded ceramic crowns/onlays.

Modern techniques make it possible to restore teeth back to how they originally looked, putting a smile on the patient’s face again.

In the early stage of a cavity, composites are much better, and more aesthetic than amalgams. At Snö we do not provide amalgams as an alternative.

Tooth sensitivity

Your tooth is complex
A tooth consists of a crown and a root. The root is attached to the surrounding bone by thin threads. The gum surrounds the lower part of the crown, covers the bone and functions as a protective barrier against bacteria in the mouth.

Tooth sensitivity can be caused by many things like, caries, overload, inflammation, infections. A common cause is that the gum recedes and exposes the root surface. Inside the root is the pulp tissue and it consists of nerves and blood vessels. The outer surface of the crown is protected by enamel, but there is no enamel protecting the root surface.


With age the gum recedes, but behaviour like teeth clenching or periodontitis and even the wrong cleaning technique can make it worse.

Sensitivity is annoying but mostly harmful
If we magnify (below) the exposed root surface we can see it consists of small canals. The canals are narrow and filled with liquid. If the root is exposed to heat, cold, sweet, dryness, the liquid will move. This causes the nerve to react which manifests as a sharp, icy sensation. It can be painful, but is not harmful. In some rare cases, a root canal might be necessary to treat the pain.


The root surface consists of millions of microscopic canals. The canals are filled with liquid that stimulates the nerve when there is a change on the surface (heat or cold). Caries builds easier on the softer root surface than the enamel covered crown.

Bone recession
When the root surface is exposed it is because the bone underneath has receded. The bone can recede for various reasons. The most common ones are:

  • Load: Overload, caused by teeth grinding at night may result in bone recession.
  • Oral hygiene: If cleaning – especially in the area between the teeth – is compromised, the gums respond with inflammation, swelling and/or bleeding . This may cause the bone to recede. In some cases, the bacteria build-up may lead further bone loss and eventually tooth mobility and tooth loss (periodontitis). This can be prevented by practising proper oral hygiene.
  • Old fillings and crowns: Fillings and crowns with bad fits can cause bacteria to accumulate and initiate the reaction described above (oral hygiene).

What to do about tooth sensitivity
In some cases, the icy sensation can be a sign of possible tooth damage. You dentist will look for signs of damage, but if the condition worsens, your dentist might ask you to visit the clinic again and prescribe a topical fluoride treatment. Certain toothpastes, like Sensodyne and Zendium, might be effective at closing the canals on the root surfaces so that the nerve is not stimulated. In most cases the pain from tooth sensitivity gradually disappears. If it persists, please contact your dentist.

If the symptoms are not severe and the dentist does not find a reason, it is not harmful to wait. Occasionally the reason surfaces later, but in most cases it is just a temporary sensitivity that gradually diminishes. However, if it worsens, do contact the dentist.

A root canal treatment will remove the icy pain, but the modern approach to dentistry is to keep the teeth alive as long as possible.

Tooth loss (Periodontitis)

Slow progress
Periodontitis is an inflammatory disease affecting the tissues that surround and support the teeth. Periodontitis is generally a slow progressing problem. Left untreated, it will eventually lead to tooth loss. Symptoms, such as swelling and pain, often only appear at the last stage of the disease.

Healthy or inflamed
The root of a healthy tooth is almost entirely submerged in the bone and is connected by microscopic fibres. The gum tissue around the tooth acts a protective barrier to the root and bone. Healthy gum tissue doesn’t bleed when brushed on a regular basis.

However, if a daily routine isn’t followed, a build-up of plaque/tartar occurs. The plaque causes an inflammation in the gum tissue. An inflamed gum turns dark red, swells, bleeds easily and becomes sore. It also fails to properly protect the root and bone.


The connection between the tooth and the body is a complex one. The tissues involved are constantly being attacked by bacteria. A normal pocket is measured by the dentist or hygienist to around 3-4mm.

Plaque
Plaque is a thin sticky layer consisting of bacteria and food debris. There is an almost constant supply of food and bacteria in the mouth. If not removed, the plaque can mineralise and create an inflammation in the gum. Mineralised plaque is called calculus.

The gingival crevice or gum pocket in a healthy individual is between 1-3mm. However, if plaque is left on the tooth, it will eventually spread down to the gum pocket. When it becomes calculus, it will show on an x-ray.


Calculus (in this case on the back of the lower front teeth) cannot be brushed away. A dentist or hygienist has to remove it.


Calculus/plaque left in the pocket is visible on an x-ray if left to accumulate over longer periods of time.


A thorough charting of a patient’s periodontal status as it is always done at Snö. Regular charting is essential to monitor the development of a patient’s condition, both for treatment purposes and prophylaxis. Your dentist will provide you with this information if you move or change dentists.

A vicious circle
Bacteria thrive in calculus. Bacterial waste breaks down the tissue and bone. Gradually, the gum pockets deepen. As a result, calculus and plaque can spread deeper, making it even more difficult to remove. This, in turn, leads to further bone loss, which eventually results in loose teeth. There is also increased swelling in the gums and causing pain and discomfort. Eventually, the body will treat the affected tooth as a foreign body and reject it, leading to tooth loss.

Don’t go untreated
Bad oral hygiene, calculus, smoking, stress, age, and certain diseases are all factors that can worsen periodontitis. 

Scientific studies show that a majority of people over 50 suffer from some degree of periodontitis while nearly 15 percent of this age group have severe periodontitis. In cases of people above the age of 65, 13 percent of people are left with no teeth.

If periodontitis is diagnosed and treated at an early stage, there is a very good chance of full recovery. Modern dentistry always keeps an eye out for signs of periodontitis.

Stages of periodontitis, beginning to the end…

The gum is inflamed, bleeds a little and hurts occasionally. Bone level is unchanged. With regular cleaning and scaling of the teeth, the inflammation disappears after a couple of weeks. If the routine is not kept then the inflammation will soon return.


The pockets have deepened and bone loss is evident. Tooth mobility increases. Calculus builds up in the deeper pocket due to poor ability to clean in pockets. Regular treatments, as well as cleaning, is essential if the tooth is to be saved. Good oral hygiene is very important.


The tooth is now very loose an the patient will sense this in the mouth. There is an increased risk of local infections with or without fistula involvement. Prognosis is now very poor and treatment will now include surgery. In more severe cases tooth removal may be the best solution.

Prophylaxis is the foundation
During your Snö dental exam, we will measure the pocket depths. We will also occasionally take x-rays of all the teeth along with a visual inspection. Both methods help detect signs of gum disease. Together, it gives your dentist an accurate status of your gums’ condition, along with other signs like mucosa.

Treatment of periodontitis, if detected early, consists of cleaning and scaling on a regularly basis, either by a dentist or a hygienist. You will also receive oral hygiene instructions. 

At Snö we use Guided Biofilm Therphy (PERIO-FLOW®) a powerful, yet controlled jet of water, air and fine powder that not only polishes all the surfaces of a tooth, removing plaque, discolouration and soft deposits, but also reaches deep into periodontal pockets (if you have any) up to a depth of 5mm. It is far more efficient than a traditional scrape-and-polish treatment at removing the damaging biofilm that develops when dental plaque is colonised by bacteria, and can cause periodontitis and peri-implantitis. Air flow polishing is completely safe to use with dental implants, veneers, crowns and bridges.

Studies have shown that air polishing is much faster at removing stains and plaque than traditional methods. This means less time in the chair for the patient and, therefore, fewer interruptions. Teeth are cleaned in a much less abrasive manner than scraping and polishing which also causes less damage to the teeth. And its much more comfortable for the patient. Sometimes we also complement this with laser treatment – all included in the normal treatment.

For more advanced stages of periodontitis there are a variety of treatments available depending on the severity. Occasionally, your dentist might recommend using a local anaesthetic to make the treatment more comfortable.

Scientific studies have linked oral infections like periodontitis to heart attacks and strokes. Pregnant women with periodontitis have a greater risk of giving birth to premature babies.

It is not evident why or how strongly periodontitis affects other parts of the body. However, it is always important to treat an oral infection with or without symptoms, especially when treatment is readily available in modern dentistry.

If you have any questions relating to your gums, don’t hesitate to ask any member of the dental team at Snö Dental Clinic.

Warning signs

  • Gums bleed easily and may feel tender
  • The tooth feels loose
  • Gums between teeth change appearance
  • Bad breath/halitosis
  • Swollen gums with pus
  • Occasionally no symptoms

Provide good care for your body

  • No smoking
  • Good oral hygiene – even between the teeth
  • Regular visits to the dentist/hygienist

Caries

The environment present in the mouth, referred to as the oral environment, is tough. Teeth are exposed to strenuous activity every day but are built to resist them. The most common reason for damage to a healthy tooth is caries. So, what is caries?

Caries is caused by a chemical reaction. If you feed bacteria with carbohydrates, they will begin producing acids. In order to maintain a neutral pH in the oral environment, calcium is “borrowed” or released from the teeth, resulting in a local decalcifying of the tooth and caries is formed.

The mouth does have defence mechanisms against this chemical reaction. One of them is saliva, which flushes away acid and bacteria. Saliva also contains substances which can repair small cavities in a tooth.      


A tooth consists of a very durable layer of enamel. Below the enamel is the softer dentine and in the center of the tooth is the pulp tissue.


When a caries lesion reaches the pulp, the tissue deteriorates and dies (necrosis), causing bacteria to continue through the root canal system. Often, but not always, this is associated with pain.

It is difficult for the acid to “dissolve” the enamel. But once a cavity is created, the process accelerates. The acid corrodes the dentine, which is softer than the enamel. If the caries reaches the pulp tissue, it deteriorates and dies, and bacteria can continue through the root canal system.

Young teeth are softer
In younger teeth, the enamel is softer, but over time substances are stored in the enamel making it stronger. That is why most caries occurs before the age of 20 years. However, in older age, the saliva production can decrease, which in turn increases the risk of caries. Fluoride (as in toothpaste) is the main reason that kids nowadays have fewer cases of caries. Fluoride strengthens the enamel and can help “heal” small lesions.

Oral hygiene is important to fight caries but diet is more important
If you do not clean your teeth twice a day, bacteria and food debris will form a layer on the surface of the teeth, called plaque. Plaque is not always visible. If you also eat a sugar-rich diet, especially over several meals a day, the plaque will become extra sticky and acidic, increasing the risk of caries formation.

The acid attack starts when you eat
The acid attack begins the moment you start eating. All carbohydrates contribute to acid formation. It is not so much what you eat but how often. Many small meals, over the day, do not give the mouth the chance to neutralise the oral environment and increases the risk of caries.

 
Caries builds in areas where bacteria (and plaque) can accumulate, like in the deep grooves of the chewing surfaces, between the teeth or near the gum line. The joint between old fillings or crowns is also a weak point.

Occasionally, caries is clearly visible like in these pictures, but often an x-ray is required.

The Snö dental team is trained to discover if you are a high or low-risk caries patient. We will work together with you to prevent caries from building further. If caries occurs, the treatment approach today is a lot less invasive and focuses on preserving tooth substance.

Caries detection without X-ray
At Snö, we have invested in DiagnoCam, a technique that can be used to find and follow caries without the need for many x-rays. A laser light and a specially designed camera can see through the tooth and detect specific types of caries.


A photograph from DiagnoCam where we can spot the caries cavity without an x-ray.

Worth thinking about (also good for other risks like periodontitis and bad breath)

  • Brush your teeth twice a day with fluoride toothpaste.
  • Clean the space between the teeth every day. You only need to clean between the teeth you want to keep:).
  • Rinse your mouth after meals with water. This reduces the acid attack.
  • No eating in-between meals (one or two intakes is normally acceptable between meals; note that it is not the amount you eat, but the frequency). No matter how good you are at cleaning, many small meals will increase the risk of caries.
  • Extra fluoride treatment should be used, but only when we recommend it.  We will top it up by local, topical treatment when necessary. Fluoride will be layered in the enamel, thereby strengthening it.
  • Visit the dentist and hygienist regularly (depending on your risk assessment between 3-18 months). Listen to our recommendations. We are specialised in helping you keeping tour teeth healthy for the rest of your life. Remember that our goal is to drill as little as possible, and not to do root fillings and large restorations. The goal is to keep you caries free all your life. The best treatment is the one we never need to do.

Replacing missing teeth

As we go through life, we risk losing teeth to caries, fractures or gum disease.

Caries
Tooth decay is treated with traditional fillings or crowns. However, if a patient has waited too long before visiting a dentist, the decay could be severe resulting in the need to extract the tooth.

Fractures
Accidents could lead to loss of teeth. While healthy teeth may be affected, teeth that are already filled or treated are most likely to be knocked out.

Gum disease (periodontitis)
Periodontitis is a slow progressing condition that can go undetected for a long time by the patient. Today, dentists are very skilled at diagnosing periodontitis in time. As it affects a great part of the population, there are many patients with untreated gum disease that will eventually lead to loss of teeth.

Several alternatives
Dentists today have many options and a lot of experience choosing the appropriate treatment to replace lost teeth. The most common treatments are implants or a bridge. In some cases a removable appliance is chosen, like a denture.


The bridge treatment requires the neighbouring teeth to be filed down. This is to allow the bridge to fit correctly. In order for the bridge to be a success, the neighbouring teeth must be solid. If they are loose or filled/repaired, the long term prognosis is not optimal. At the same time, if the neighbouring teeth are perfect, it would be a shame to file them down. If a patient is missing more teeth in a row, it can also be difficult to make an adequate bridge as the span is simply too long. Before implants were available, the only alternative was to have a partial denture made. Dentures take some getting used to as many complain it is loose in the mouth, covers the taste buds, makes chewing difficult, doesn’t look good, etc.

It is not often we do these kind of removable dentures any longer thanks to implants.

Today we can offer dental implants
In the 80s, a Swedish dentist from Gothenburg, Per Ingvar Brånemark (Nobel Biocare is still the world’s leading brand, and used by Snö) pioneered the idea of dental implants. He realised that the metal titanium is not rejected by the body, but is easily accepted as a natural part of the body. This means the titanium implant will integrate with the bone it is put in. This is called osseointegration. There are numerous people around the world with ‘new’ teeth using this method.

 

The bone quality is paramount
The number of implants the dentist will fit depends on the bone quality and the available bone. In a completely edentulous (lacking teeth) jaw, six implants are sufficient. On these six implants it is possible to place 12 new porcelain teeth. One implant can also used to replace one tooth. The possibilities are many.

When you lose a tooth, the bone in that cavity usually resorbs. This is because without teeth there is nothing to stimulate the bone. When you chew, the pressure stimulates the tooth and subsequently the bone. When an implant is placed we can avoid the resorption of bone. But if one waits too long before inserting an implant, there might not be enough bone left.

In cases where a lot of bone has been lost it is possible to transplant bone from another part of the body. This may seem like a lot to overcome, but when the alternative is a denture, it is worth it.

What is the prognosis?
The success rate for implants is very good. A long term study shows that more than 90 per cent of implants placed work very well. Regular visits to your dentist and hygienist will help ensure that your implants continue to work well. With time, the teeth on the implants will wear just like normal teeth and may require replacing. But in most cases, the implant will not need to be changed. If you lose an implant, it is possible to have a new one put in after a healing period.

At Snö we have a long quarantee on implant treatments, no matter what happens. Read more about implant treatments here.

Bad breath – Halitosis

We can all suffer from bad breath, or halitosis, from time to time and the reason for it varies from person to person. A common view is that bad breath stems from the stomach (digestive processes), which is rarely the case. Most often it originates from the mouth (oral cavity). People with bad breath are seldom aware of the fact that they have bad breath. When it comes from the mouth, your Snö dentist will be able to diagnose the problem and treat it.

At Snö we can quickly measure if you have bad breath or not

How do I know if I have halitosis?
A common test is to breathe into the palm of your hand. Although common, this is not a very reliable test, as people get used to their own odours. Only occasionally will you be able to detect a difference with this test. A better method is to use a piece a dental floss between your teeth at the back of the mouth. If the floss smells it would be a similar odour as your breath. Alternatively, you can lick your arm, leave the saliva to dry and then do a smell test. You can also ask your friends and colleagues to honestly tell you if you have bad breath. 

What causes halitosis?
Eating foods like garlic can cause bad breath. The digested food eventually gets absorbed by the lungs and the gas molecules get released while breathing. 

The most common “bad breath chemicals” produced by normal bacteria in the oral environment are volatile sulfur compounds (VSC — hydrogen sulphide, methyl mercaptan, dimethyl sulphide). Snö Dental Clinics use equipment that can measure this directly from your breath in a matter of seconds.

The mouth is always full of bacteria – this is normal. They serve an important purpose, especially in digesting food. When you eat food, debris gets stuck to your teeth and the surrounding gums. Together with bacteria, this build-up is called plaque. Left undisturbed, plaque will develop a foul odour comparable to rotten eggs. As mentioned earlier, you may not notice this yourself as you get used to your own odours. The Snö team will inform you if you have plaque causing halitosis and help you remove it.

If plaque is not treated, you will not only suffer from bad breath but also gum disease, with potential loosening of your teeth. This means that bad breath can also be linked to gum disease. The same bacteria causing bad breath also breaks down the supporting tissue and bone around teeth. With regular check-ups, the dentist will be able to detect and prevent this from happening.

If you suffer from dry mouth (xerostomia) you can easily get bad breath. While saliva helps in ‘washing’ away bacteria and food debris, it also helps prevent plaque build-up. So, the less saliva the more bacteria (as in the case with dry mouth), hence greater potential for bad breath. The causes for xerostomia can be illness, medicine use or even simply breathing primarily through the mouth instead of the nose. If you think you have xerostomia, visit your dentist.

Smoking will always give you bad breath. It will also discolour your teeth, reduce the sensitivity of your taste buds and irritate the soft tissues. Smoking will also increase the risk of gum disease (periodontitis), as well as developing cancer. Your dentist will always monitor any smoking-related illness.

Different diseases relating to the airways can also cause bad breath. As will diabetes and stomach problems. If your dentist does not see any tooth-related issues, they may refer you to a doctor for further exams.

You should look after your oral hygiene!
Good oral hygiene is mandatory to avoid odours. This becomes even more important when there is gum disease.

If you believe you have had bad breath over a long period, it can be a helpful for your dentist to write down what you eat during the week. Always inform your dentist about any medication you might be taking or if you have received or are receiving treatment by doctors. Regular visits at Snö includes cleaning with Guided Biofilm Therapy (PERIO-FLOW® ) a powerful, yet controlled jet of water, air and fine powder that not only polishes all the surfaces of a tooth, removing plaque, discolouration, and soft deposits, but also reaches deep into periodontal pockets up to a depth of 5mm.

Brush your teeth twice daily using fluoridated toothpaste. Bad breath can rise from the back of the tongue, so brushing the tongue can also help prevent bad breath. We have special tongue cleaners to use at home if the problem doesn’t go away. Use dental floss or inter-dental brushes at least once a day, ideally at nighttime. If you wear dentures, make sure to take them out at night (unless instructed otherwise).

Mouthwash has little to no effect on bad breath. They can even have a worsening effect if used improperly. There are, however, certain cases where we temporarily prescribe mouthwashes. Your dentist will give you instructions on proper brushing technique, and recommendations on toothbrushes. Instructions in the correct use of mouthwash (and the right one) can help kill bad breath-causing bacteria. You may also be instructed to chew sugar-free gum, especially if you suffer from dry mouth. The chewing will stimulate saliva production even more if the gum has a sour flavour.

Together with your dentist, we will come up with the ideal defence against halitosis.

Tooth colour

Not all teeth are white
The colour of your teeth varies. Not everyone has white teeth. In fact, many people have shades of yellow.


The enamel protects the tooth. Underneath is the darker dentine. The reddish core consists of pulp tissue, nerves and blood vessels.

Enamel is lighter
The enamel is usually the whitest part of the tooth. It is actually a transparent substance. The dentine below it is more yellow and not as transparent as enamel. As a result, the colour of the dentine reflects through the enamel, giving the tooth a yellowish tinge. The more yellow the dentine, the more colour the tooth has, and vice-versa. This is the natural appearance of the tooth.

  
When light reaches a tooth, it is reflected through the transparent enamel. The underlying dentine gives the tooth its colour. If the dentine is lighter the tooth will appear lighter and whiter.

Can you paint the teeth white?
Painting a layer of white on a tooth would make it appear unnatural due to the loss of the enamel’s natural transparency.

The colour of our teeth changes over time. Even though the enamel is hard, there are microscopic cracks that allow substances to enter the tooth. Sometimes, the gum recedes and exposes the root surface that consists of dentine and cement. This makes the tooth appear more yellow, especially in the part closer to the gum line.


The natural colour of a tooth is created by a reflection of light travelling through the transparent enamel. The colour of the tooth is a combination of its different layers, including the dentine. If a dentist painted one tooth white it would appear white, but completely unnatural.


At the gum line there is no enamel. If the gum recedes, the more yellow dentine becomes visible.

 
Crowns made of an opaque inner core (as above to the left with gold below the ceramic material) often get a dark halo around the border towards the gum (arrows). This I because the light that should pass through the tooth and reflect doesn’t get through and hence makes the area appear darker. To the right the metal ceramic crown has been changed to a full ceramic crown with a more translucent core that reflect the light more natural (arrows). 

Mimicking a natural look
A repair or replacement of a damaged tooth must mimic the layers of enamel and dentine. Certain materials like ceramics are better at mimicking a natural tooth.

Alternatives
Today, bleaching procedures help rectify yellow and discoloured teeth. Your dentist will be able to guide you on what is possible and best for your dental health.

Wisdom teeth

Archaeological findings have proven that our ancestors used to have bigger and more powerful jaws. With time, these gradually became smaller, similar to our jaws presently, appears we are developing smaller jaws, most likely due to the shift in our way of living and eating. While we now have smaller jaws and less space for teeth to grow, the size and number of teeth forming have not changed. Wisdom teeth are the last to erupt and often will not have the space needed.

  
Side view: Occasionally, wisdom teeth are completely buried in the bone. In that case it is sufficient to observe the situation on a regular basis (left). Upper wisdom tooth (right) has fully erupted while the lower one hasn’t. Because there is no opposing tooth, we can expect the top tooth to over erupt. This can lead to other problems.

 
Close up of partly erupted wisdom tooth in lower jaw.

This can give the patient intermittent pain, often without additional symptoms. However, it is difficult to maintain good oral health in the region. Even if the patient doesn’t experience pain, the bacteria has easy access to the crown of the tooth. Lodged food debris can lead to inflamed and swollen gums, in the area. Antibiotics or painkillers can provide relief to acute symptoms, but cannot resolve the underlying cause.

  
X-rays are vital in detecting problems with wisdom teeth. In this case the patient waited too long to get a check up and there is a caries attack on the neighbouring tooth.

At Snö we have the latest low radiation 3D x-ray (cone beam) to identify and examine impacted teeth. With today’s dental techniques and anaesthetic drugs available, it is possible to remove wisdom teeth in a painless manner. Left in for too long there is an increased risk of caries and bone loss.

Things to consider
The area around the wisdom tooth is often difficult to keep clean. This can lead to gum problems caused by the increased amount of plaque and bacteria build-up. Pockets will develop and the risk of infections around the wisdom tooth increases. If bone loss occurs, it is important to have the tooth extracted.

The risk is minimal if the tooth is completely buried in the bone. It only requires regular observation using x-rays. Occasionally, a cyst could develop around the buried tooth. If the cyst grows too big, thus affecting the bone negatively, it must be removed.

Generally speaking, it is a good idea to remove wisdom teeth early, especially those that potentially can lead to problems later on. If a dentist is in doubt whether to extract or not it is imperative to keep it under close observation.

 
Crowding of the front lower teeth is common with age (left). Many people (and dentists) believe this is caused by wisdom teeth that push the other teeth forward. This is untrue, and we have scientific evidence that removing wisom teeth in such circumstances is unnecessary. A removable orthodontic appliance (Inman Aligner) placed by Dr Gun, has helped this patient regain a corrected, natural smile (right).

The Snö dental team has comprehensive knowledge dealing with problematic wisdom teeth and is adept at fixing any complication related to them. Feel free to contact your dentist if you have any additional questions.