OFTEN taken for granted, our teeth are actually one of our most precious features, which we only tend to pay attention to when something goes wrong. HT spoke to practising dentist Eeva-Maija Ahtiainen about the changing face of dentistry and how to look after those pearly whites.
Q: Dentistry has changed a lot during the last 30 years. You’ve been practising in Helsinki for 34 years after graduating from Helsinki University’s Faculty of Dentistry. What has changed during this time?
When I got my licence I first worked with a dentist who was very experienced. She was interested in periodontal (gum) diseases, so I needed to take care of very difficult cases. While she did the periodontal surgery, I took care of the calculus (hardened dental plaque) by cleaning the teeth. I made new restorations and tried to prevent cavities by teaching the patients to take good care of their teeth. I also saw what would happen if the treatment (prophylaxis) didn’t work.
For me, the way I treat the patient has not changed much over the years, but the techniques have. For example, now I can make more beautiful fillings that actually look like part of a tooth whereas, back when I started, only amalgam fillings and the golden or metal ceramic crowns were available for the back teeth. With these materials, I could only take care of the tooth’s shape and polish it well but everybody could see that there was a restoration in the mouth. Now, I use composite materials that are more enamel-like and, when I make the restorations, I can use different shades of colours in order to make it look as natural as possible.
Q: And amalgam is now becoming history…
In Finland, some colleagues think that amalgam is strong. It’s easy to make and it tolerates more moisture during the filling procedure, but I would say that amalgam is history. It is a material with which we saved people’s teeth here in Finland because they couldn’t afford crowns all over the mouth. That’s why I started using composite on the back teeth in the 80s and I’ve used them for over 25 years. Amalgam is not forbidden these days, even for children, but it is not recommended.
Q: The general population is getting older – do they still have their own teeth?
It’s a big challenge but I have a long experience with old patients who still have their own teeth, the oldest being 99 years old. To help with this, I prefer seeing the patient every 6 months, but if it’s needed they visit me more often for cleaning or cavity treatments. When you get older the amount of saliva decreases and its quality also changes but there’s no reason why people can’t keep their teeth for as long as they need them. When young people visit me, I tell them the importance of a proper diet for their teeth, the desired frequency of cleaning, how to use dental floss, and to avoid fizzy drinks and smoking. If you start flossing at an early age and brush your teeth at least 3 times a day with toothpaste that contains fluoride, then you’ll have no dental problems when you’re in your middle age. Think about the future! There are now over 1000 different types of bacteria that have been found in the mouth cavity, but not everyone has them all. If you’re not infected by the bad bacteria by the time you turn two years old, then the good ones will take control.
BETH MORTON, ANNI RAJASTO
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