Halitosis is also known colloquially as “bad breath”. It is defined as unpleasant odors that emanate from the oral cavity. There is a growing social sensitivity about halitosis. Some people may be concerned about its connotations regarding their health and others about its social, personal, work implications, etc.

Factors that cause halitosis include: gastrointestinal tract conditions, lung conditions, use of certain medications, and ingestion of certain foods. However, in 90% of cases, the bad smell originates in the oral cavity itself.

The substances that cause mouth odor are a consequence of bacterial metabolic degradation. These substances are found in the gums, mucous membranes, in saliva and especially on the tongue.

There is an examination to diagnose the origin of the problem of bad breath and also some protocols and reviews to follow in order to treat it.

This protocol includes:

• Professional cleaning
• Oral hygiene instructions with the necessary tools according to the needs of each case.
• The use of specific antimicrobial agents: both toothpaste and mouthwash.
• Periodic reviews

We anticipate a very important tip: the use of the Lingual Scraper. If you want to know more about how to use it correctly, do not hesitate to contact us, our team will be happy to solve any questions you may have.

You can call us on +34 971 201 123

Or contact us here.

FULL MOUTH REHABILITATION WITH ALL ON FOUR AND ALL ON SIX

In the previous Blog we talked about “All-on-four and all-on-six” dental implant treatments. Now we want to share a patient experience with you…

We introduce you to our patient Roberto. He is from Madrid and we had the pleasure of meeting thanks to the recommendations of his friends, who are our patients. When Roberto came to us, his mouth was in very bad condition, with repetitive infections, discomfort when chewing, and generally very poor oral aesthetics.

The teeth that he kept in his mouth were very compromised and did not have a good prognosis, they were not maintainable. For this reason, we proposed to do a “Complete fixed restoration on implants” upper and lower (All-on-four and All-on-six).

Living in Madrid and having to travel to Mallorca for his treatment, we needed to organize everything very well. We made a treatment plan with appointments and times, so that we could all make the most of each trip. We managed to reduce the entire treatment to only 3 trips to Mallorca.

On the first trip:

• We performed a 3D Dental CT scan: to perfectly assess the quantity and quality of available bone and to plan the type of implants which will be ideal for him (their size, in what positions to place them and the possibility of placing the implants at the same time as dental extractions).
• We took photos to do a “DSD” Digital Smile Design, and plan everything before starting any treatment.
• We registered moulds to have study models: which we sent to the laboratory that same day to start making the first set of fixed prostheses that we will place immediately after the surgery. 
• We did a deep cleaning (oral-dental hygiene), so that the mouth is in the best possible condition (disinfected and deflated) at the time of surgery.
• The operation was done under Conscious Sedation (monitored by an anesthesiologist at our facilities). The dental extractions were performed and immediate implants were placed at the same time of the extractions.
• We applied Plasma in all the intervened areas to facilitate and accelerate healing.
• Once awake, after the surgery, we took new registers, this time with the implants, and sent them back to the laboratory to be able to finish Roberto’s immediate fixed prostheses that same day.
• Once the laboratory has finished the work, we adjust it in the mouth by fixing the teeth onto the newly placed implants. This is what is known as “immediate loading” or colloquially known as “fixed teeth in a day”.

This way, on Roberto’s first trip, he has already left with the surgery performed and with new fixed teeth, although they are still provisional.

3-4 months after the implant placement (which is the time it takes for the bone to integrate the implants as its own-also known as Osseo-integration), we organize the second trip to A2 Dental.

2nd trip to Mallorca:

• We disconnect the provisional fixed prostheses (upper and lower) to clean and re-evaluate the healing of everything.
• Since the gums are now fully healed, we take new moulds to start fabricating the definite prostheses.
• The laboratory prepared several tests to determine aesthetic parameters, such as: shape, size and color of the teeth, bite, etc.
• The patient returns home with his temporary teeth fixed.

3rd trip:

• With all the information and design that we have planned in the previous visit, the laboratory has been able to finalize the final prostheses.
• On this last trip we were able to place Roberto’s new teeth. Since we operated on him, he has never had to spend a day without teeth.
• He now has an ideal smile due to the planning, design and choice of materials that we used on the prostheses, as you can see in this link:

At A2 Dental we are very proud that people have travelled from far to be treated by us and trust us with their mouth.

We have explained the technical part of the story, here the story from Roberto’s point of view: 

If you want to learn more about some of the aspects described in this blog, we provide the following links:

• Implants at A2 Dental
• All-on-four / all-on-six
• 3D Dental CT Scan
• Plasma
• Digital Smile Design
• Dr. Rico– Implantologist at A2 Dental
• Implant Cases 

FULL MOUTH REHABILITATIONS WTIH IMPLANTS: ALL-ON-FOUR / ALL-ON-SIX

In which cases is a FULL REHABILITATION WITH IMPLANTS indicated?

• Cases where the patient has lost teeth in a whole arch (upper or lower jaw).
• Cases where all the teeth have been lost in the mouth (upper and lower).
• Cases in which the remaining teeth are not conservable and due to the poor condition in which they are in, and their poor prognosis, they must be extracted.

To rehabilitate an entire arch (upper or lower) with implants, it is NOT necessary to place as many implants, as teeth which need replacing. Usually placing either 4 and 6 implants per arch is enough. This is what is known as the All-on-Four and All-on-Six technique respectively.

Regardless of the number of implants to be placed to restore an entire arch, it is also important to distinguish between 2 types of prostheses:

1. FIXED Complete Restorations over Implants: The teeth that are placed on the implants are fixed and therefore are not removeable. It is the closest thing to natural teeth.
2. REMOVABLE Complete Restorations over Implants: The teeth are dentures which are retained on abutments which are attached to the implants. This way, when the prosthesis is placed, it does not move and it behaves like a fixed prosthesis, even though the patient can remove it at any time, since it is removable.

Below we will describe the 2 techniques with can be applied for Complete Rehabilitations with Dental Implants:

“ALL-ON-FOUR” technique:

It is a type of rehabilitation of an entire arch (upper maxila or lower jaw) supported by only 4 implants. It is a cheaper alternative, due to the small number of implants needed to support the entire arch.

To put a simile to facilitate the understanding of this technique: it would be like “a table supported by 4 legs”. It is the minimum that “the table” should have in order to stay upright.

Due to this, it is a very interesting alternative for many patients, but it is not always the ideal alternative for ALL cases.

There are times when, due to the patient’s available bone and other factors, it may be necessary to place more than 4 implants. These type of cases in which more implants are needed, usually can be solved with 6 implants, which is known as the All-on-Six technique.

“ALL-ON-SIX” technique:

This technique restores an entire arch on 6 implants. In this case, the type of prosthesis is usually, in most cases, a fixed, non-removable prosthesis, which is like natural dentition.

HOW DO I KNOW IF I NEED AN ALL-ON-FOUR OR ALL-ON-SIX TECHNIQUE?

There are 3 steps:

The first thing is to know is the patient’s medical situation: illnesses, medication and allergies.

Once the Medical History is detailed, the specialist in Implantology and Implant Prosthesis, Dr. Rico, will perform an oral examination to know the specific details of the mouth (the bite, the aesthetics, the dimension of the lower third of the face, and a series of tests to find out what the patient really needs in each specific case). This assessment by our specialist and the Medical History, has no cost for the patient.

Finally, it will be necessary to do a 3D Dental CT Scan. This is a digital 3D radiograph with minimal radiation (which we do at our Dental Clinic), which allows us to see the available bone in 3 dimensions and therefore allows us to assess the quantity and quality of bone that the patient has to place the implants. With this tool we can also decide the ideal size, type and position of the future implants.

With all this, the patient is explained all the available alternatives to rehabilitate their mouth: 

• If you can have a fixed and / or removable prosthesis.
• If it can be done with the All-on-Four technique or with the All-on-Six technique.
• All the specific details of the case that we have evaluated are explained, so that the patient understands the why of everything we propose.
• A quote of each alternative will be provided, so that the patient can study it and decide, without any type of compromise.

If you are interested in placing implants, do not hesitate to contact us, we can help you and we will provide you with all the information you need. If you want more information about implants in our Clinic, on these links you can get to know us better.

– Dental Implants at A2 Dental

– Implant cases in our patients 

– Dr. Rico, our implantologist

All our professional team, the doctors and oral hygienist, have obtained the certificate of the Spanish Dental Foundation that accredits them for the post-Covid reincorporation, controlling all the security measures against the Covid-19. These accreditations, together with all the security measures and new protocols that we have established at the A2 Dental Clinic, have allowed us to create a very highly safe space for our patients.

We are back as of May 11th.

For more information about our protocols, you can see a video in the previous blog entry.

This is for you, for our patients. We want to explain the new protocols that we are going to carry out so that you are familiar with them when you start coming to your appointments.

1. The first step at the clinic will be to disinfect your hands with hydroalcoholic gel for 30 seconds, following the instructions established by the World Health Organization.

2. We will provide you with shoe covers before passing to the clinical area.

3. Do not walk around the clinic, please wait in the waiting room until you are called.

4. Our team is equipped with all the protection measures recommended by the Spanish Dental Foundation, to avoid any possible doctor-patient contagion. This includes: Protective clothing, Double face-mask, Facial protection, Hat, Double gloves

5. When you sit at the dental chair, remove your face-mask and you will rinse with an effective mouthwash against the coronavirus for a minute, before starting the treatment.

6. Protective glasses will be placed on the patient, as we have always been doing in our usual protocols

7. After each treatment, in addition to the rigorous disinfection and sterilization protocols that we have always carried out, we will also do a comprehensive disinfection of the room and surfaces, with a disinfectant solution. The treatment room will be ventilated and we will space the appointment time between patients in order to carry out this whole process.

8. When you are at the reception, you will see a line in front of the counter indicating the minimum safety distance of 1.5 meters, in addition to the protection screen that will guarantee your safety outside the treatment room.

All these new measures are in addition to those we have always been carrying out. It is important to remember that we are a group of professionals who are used to treating patients with highly contagious diseases, such as Hepatitis C or HIV, and we have always done so safely. Every instrument or material that touches the mouth of our patients has gone through a sterilization process. Therefore, even though we cannot guarantee an environment completely free of possible risk, we have created a highly safe space for our patients.

We continue to attend DENTAL EMERGENCIES as usual and are now rebooking our patients little by little, with the new protocols. Looking forward to being with our patients soon.

In the case of a dental emergency, whether due to pain, infection or dental trauma, it is very common to require an antibiotic treatment, prior to clinical treatment.

In the case of having to take antibiotics, DID YOU KNOW THAT ANTIBIOTICS CAN ALTER YOUR INTESTINAL BACTERIAL FLORA?

Antibiotic treatment can alter the intestinal microbiota, causing a decrease in beneficial bacteria and promoting the growth of harmful bacteria, producing the so-called Antibiotic Associated Diarrhea (AAD). This can occur in 1 in every 3 people.

WHAT ARE THE SYMPTOMS OF AAD?

The main symptoms are: increased number of bowel movements and change in consistency.

Symptoms may appear during antibiotic treatment, but in most cases they appear between 1 and 10 days after finalising the treatment.

WHAT TO DO IN CASE OF AAD?

AAD can be prevented by taking specific probiotics if taken, together with antibiotic treatment.

These probiotics with benefits at the intestinal level can also help improve symptoms, since they reduce the duration of diarrhea, the number of bowel movements and normalise its consistency. In addition, in case you need rehydration due to the loss of fluids, it is convenient to combine the probiotic with rehydration salts.

Therefore, it is very important to combine antibiotic therapy with a PROBIOTIC. This way, we will maintain a correct balance of the microbial flora, which is so relevant for the proper function of the body.

If you have any questions, please do not hesitate to contact us, our team will be happy to solve any questions you may have.

You can call us on +34 971 201 123

Or contact us here.