Specialist Dental Treatments

At Milltown Dental Clinic we provide a variety of specialist treatments and we are proud of the well-respected reputation we hold in this area of the industry.

Dr Thomas Munroe is a renowned cosmetic dentist with many years of experience. He currently runs two clinics in Dublin. At Milltown dental we treat issues such as TMJ, Sleep Apnea, Anti-snoring and are experts helping nervous dental patients

Nervous about the Dentist - What is Dental Phobia

According to nationalsmilemonth.org, almost half of UK adults have a fear of the dentist, and 12% of these suffers from extreme dental anxiety. Dental phobia is the fear of dentistry, dentist and or receiving any dental treatment. On the other hand, dental anxiety is a feeling of uneasiness when it’s time for dental appointments.

CAUSES OF DENTAL PHOBIA

There are many possible reasons why you may fear the dentist, a lot of these are quite personal. A lot of the reasons may be based on inaccurate views and impressions of what the dental visit or treatment will be like. The main thing is, we are here to help, and offer a solution for those who are genuinely nervous about the dentist.

  • Dental phobia is often caused by having a previous traumatic dental experience. This may be because they had their early dental appointments before many advances in the “pain-free” dentistry happened.
  • Someone might fear dental procedures due to frightening dental experiences told by a family, friend or relative. Most of these may be exaggerated as a visit to the dentist can be an enjoyable one.
  • The sense of embarrassment may be a cause of dental phobia. For some, the mouth is a private part of the body which make them feel ashamed or embarrassed when a stranger looks inside. They might be covering an illness or dental problem that they don’t want others to know.
  • “Fear of the unknown”. Some people, especially children, are terrified whenever something unfamiliar will be performed or placed inside their mouth.
  • Localised hypersensitivity when drinking cold beverages

HOW IT AFFECTS CHILDREN & ADULTS

Most people who have dental phobia don’t visit their dentist for regular checkups and cleanings. Often, they suffer from poor oral hygiene and even lower life expectancy because of this. As we all know, poor oral health affects the overall health of a person. An infection can spread to other parts of the body and cause medical problems such as heart diseases.

SIGNS & SYMPTOMS

People who are not nervous about Dental treatments will never full understand the feeling of fear and the level of stress that a nervous patient feels. Its important to identify if you are indeed a nervous patient, and attend a Dental Specialised in treating nervous patients such as Milltown Dental Clinic. Do you identify with the following?

  • You feel tense and can’t sleep the night before the dental appointment.
  • You are extremely nervous while you’re in the waiting area.
  • You feel like crying or will break down upon seeing dental instruments and dentists.
  • You feel nauseous.
  • Difficulty in breathing and excessive sweating while seated in a dental chair.

HOW TO OVERCOME DENTAL PHOBIA

At Milltown Dental here in Dublin, we are here to help you overcome your dental phobia and with your dental concerns. We aim to make every dental procedure pain-free for you and for your child with our sedation options. Here are some alternative methods of dealing with dental nerves:

  • Talk to your dentist about your dental phobia. We will be glad to discuss your treatment options and help you overcome your fear.
  • Try relaxation techniques like breathing exercises or listening to music during a dental appointment.
  • If your child has dental phobia, condition him/her at home before coming for a dental appointment. Parents can try to incorporate dental procedures in their playtime like role-playing as a dentist and patient.
  • As a parent, do not project any dental phobia or negative dental views to your child.

Local anaesthesia numbs the gums and teeth to be treated but does not let you sleep or settle down. Dental sedation is a method to make you at ease prior to and during the dental treatment.

TYPES OF DENTAL SEDATION

  • Laughing Gas is the most common dental sedation used in dental offices. This type of dental sedation is often given to children. It is also called as inhalation anaesthesia wherein a mask is placed in your nose to inhale the gas. Inhaling laughing gas doesn’t make you sleep but makes you relatively relaxed and anxious-free. During inhalation of laughing gas, most patients report that there is reduced discomfort during the administration of local anaesthesia to the gums.
  • Enteral Sedation is given in the form of a pill or liquid that you take through the mouth. It makes you relax, but not asleep.
  • General Anaesthesia is a type of dental sedation wherein you are asleep during the entire procedure. The sedative is injected directly into the vein and can be used in conjunction with laughing gas. Recovery time is needed before you can leave the dental office.

WHAT TO EXPECT

Come to Milltown Dental and see for yourself - patients under dental sedation are calmer during dental procedures. Also, the dentist will be able to perform dental procedures more efficiently.

And as you slowly overcome your dental fears, we will be able to do planned treatment for your dental needs more effectively.

As for the children, we will have their dental appointments pain-free to make them more cooperative with the succeeding dental treatments.

As a final point, a good oral hygiene is expected to be an outcome of a patient who fearlessly undergoes dental procedures needed to improve their smile!

Anti-snoring Treatment

Roughly 20-30% of women and 40-50% of men snore regularly. Snoring is a common cause of sleep deprivation. Snoring produces a sound while sleeping when breathing or respiratory structures vibrate and cause obstruction of air movement. To prevent snoring and its complications, an anti-snoring device should be used.

WHAT IS AN ANTI-SNORING DEVICE

Mandibular Advancement Devices are the most common anti-snoring devices made by dentists or physicians to treat snoring or Obstructive Sleep Apnea (OSA). Advancement devices open the airway by moving the lower jaw forward. As the lower jaw moves forward, the tongue is also moved forward preventing it from blocking the airway at the back of the mouth.

Also, the valve of the airway is held open by the forward movement of the tongue and other airway muscles.

CAUSES OF SNORING

Snoring occurs when there is obstruction of airflow due to several reasons like:

  • Decreased muscle tone of tongue and muscles of the mouth that collapse and fall back into the airway. It is an effect of alcohol consumption and use of sleeping pills.
  • Excess fat tissues at the neck or throat due to being overweight.
  • Children with large tonsils and adenoids.
  • Oversized tongue.
  • Long soft palate and/or long uvula that extends further at the back which makes the opening from throat and nose to be insufficient.
  • Nasal polyps.

SIGNS & SYMPTOMS

Snoring occurs when there is obstruction of airflow due to several reasons like:

  • Sore throat or dry throat upon awakening.
  • Chest pain at night.
  • Waking up in the middle of the night feeling breathless.
  • Shortness of breath.
  • Loud snoring that disrupts your partner’s sleep.

HOW SNORING AFFECTS CHILDREN & ADULTS

In children, it can cause behavioural problems and poor performance in school due to lack of sleep. Likewise, adults became temperamental due to lack of sleep.

TREATMENT OPTIONS

Depending on the reason for the snoring, there are many options towards possible treatments.

  • Behavioural changes - if snoring is caused by being overweight, losing a few pounds may improve snoring at night. Other changes such as avoiding alcohol and quitting cigarette smoking can halt snoring at night.
  • Nasal devices and medications - if the nasal tissue is swollen due to allergies, nasal sprays will help to clear airway. Nasal saline irrigation spray is used to clean and moisturise the nasal tissue from dust, pollen and smoke.
  • Nasal CPAP - CPAP or Continuous Positive Airway Pressure is a device used for patients diagnosed with obstructive sleep apnea. This device works by placing a nasal mask which provides constant, pressured air to prevent the airway from narrowing during inhalation and exhalation.
  • Surgical removal of nasal polyps - nasal polyps caused by allergies may enlarge over time and can obstruct the airway. If snoring is caused by enlarged nasal polyps, it can be removed surgically. It is performed in an operating room under general anaesthesia.
  • Surgical removal of the uvula- the uvula is the tissue hanging at the back of the mouth. It can be surgically removed if it obstructs the airway.
  • Dental devices - the most common anti-snoring device made by dentists is called Mandibular Advancement Devices.

ADVANTAGES OF MANDIBULAR ADVANCEMENT DEVICES

There are a lot of benefits in using mandibular advancement devices than other treatment options:

  • Mandibular advancement devices are much easier to use. You just have to put it in your mouth before going to bed.
  • It is comfortable to use because it is specially designed and custom-fitted for you.
  • Children with large tonsils and adenoids.
  • Unlike CPAP devices, it is small and transportable which makes it easier to bring in your travels.
  • It lets you sleep comfortably without worrying getting tangled to wires and face mask.
  • No noise, unlike CPAP machines.

EXPECTED RESULTS

A lot of people with snoring problems think there is nothing they can do to better their situation, this is quite untrue.

  • Anti-snoring devices lessen snoring by 70-90%.
  • IAccording to sleep-study.co.uk, treating OSA and snoring can increase life expectancy by around 8 years and reduces the risk of heart disease by 40%.
  • Uninterrupted sleep makes you more focused during the day.
  • Prevents sore throat or dry throat from developing.
  • Increased quality of life for the person treated and their family or partner.

WHAT IF NOTHING IS DONE

If snoring is left untreated, it can cause several problems not just to your own health, but to your partner as well.

Lack of sleep can make you distracted during the day due to daytime sleepiness. It can also make your partner awakened due to loud snoring.

Snoring can also increase the risk of developing high blood pressure and stroke.

The worst complication of snoring is death or cardiac arrest while sleeping. Since snoring is a sign that the airway is obstructed, you might experience cessation of breathing which causes the body to get insufficient supply of oxygen.

TMJ Treatment

WHAT IS TMJ

TMJ or Temporomandibular Joint is the hinge that attaches your lower jaw to the skull. It enables the jaw to move up, down and side to side. Each person has two temporomandibular joints located near each ear.

WHAT IS TMD

TMD or Temporomandibular Disorders is a condition where the joints get out of line or they don’t function properly which also affects the muscles used in moving the jaw.

CAUSES OF TMD

It is always advisable to come see our specialist at Milltown Dental Clinc, so they can fully assess your situation. There are numerous possible causes of Temporomandibular Joint Disorders.

  • Excessive grinding and clenching of teeth, which puts a lot of pressure on the joint.
  • Unnecessary movement or displacement of a part of the joint (joint disc).
  • Arthritis or Inflammation of the joint.
  • Stress which can cause you to clench unknowingly.
  • Poor posture
  • Bad bite caused by uneven restorations

SIGNS & SYMPTOMS OF TMD

Most often, people are not aware that they have Temporomandibular Disorder because one or all signs and symptoms may occur. If you experience any of the listed signs & symptoms below, visit our dental clinic for proper diagnosis.

  • Clicking or popping sound when your jaw opens and closes.
  • Pain in the face, jaw or ears.
  • Difficulty in opening and closing mouth.
  • Restricted opening of mouth.
  • Jaws “lock” or get stuck in the open-and-close motion.
  • Swelling on one side or both sides of the face.
  • Frequent unintended cheek, tongue and lip biting.
  • Jaws feel tired when chewing.

HOW IT AFFECTS CHILDREN & ADULTS

According to TMJ.ORG, approximately 12% of the population in the United States are affected by TMD.

Children and adults with temporomandibular disorder tend to be cranky when facial pain is felt. They also have trouble in speaking and eating. It will also be hard for them to undergo long dental procedures because the joint will feel tensed.

Since the temporalis muscle is attached to the jaw joint and head, severe clenching and teeth grinding can cause intense headache that might affect the performance of children and adults in school or work.

WHAT IF NOTHING IS DONE

If temporomandibular disorder is not managed during earlier stages, it can cause several problems or difficulties to the patient..

  • You will have trouble in speaking and eating because the jaw joint can be painful at times.
  • You will have a hard time opening your mouth for several minutes during dental procedures.
  • The jaw may get stuck or “locked” which will disable you from opening or closing your mouth.
  • Frequent headaches may interfere with your everyday activities.
  • In worst cases, opening and closing of the mouth will be very limited.
TMJ Options & Process

There is no single treatment to eliminate temporomandibular disorder. The dentist may recommend one or more of the following:

Home remedies can help relieve TMD symptoms such as:

  • Taking pain relievers like ibuprofen and naproxen.
  • Applying warm or cold ice pack to affected side can relieve pain and swelling. It is applied for 10 minutes every hour until the swelling subsided.
  • Eat soft food (i.e. yoghurt, mashed potatoes, scrambled eggs) and avoid food that requires opening the mouth widely.
  • Avoid extreme jaw movements like yawning widely and chewing ice.
  • Don’t rest your chin on your hand.
  • Avoid clenching.

Traditional Treatments

  • Medications - the dentist might need to prescribe higher doses of painkillers or anti-anxiety medications to prevent excessive clenching.
  • Dental Splint and/or TMJ Night Mouthguard - mouthguards are custom-fitted appliances used to protect the teeth from getting damaged due to excessive clenching or teeth grinding. Dental splints are worn the whole day while TMJ nightguards are worn during sleep. Teeth grinding can cause excessive stress to the jaw joint and even to teeth. Mouthguards are made by taking a mould or impressions of your upper and lower teeth. These moulds will be used to make a stone model of your teeth where a mouthguard will be designed and fabricated to ensure accurate fit.
  • Dental Restorations - the dentist will repair or replace old restorations that cause improper contact of upper and lower teeth when biting. Improper bite or malocclusion increases tension to the muscle around the jaw joint or even displacing a segment of the jaw joint. Also, gaps caused by missing teeth will be replaced with dentures or fixed bridges to prevent tilting, drifting or overeruption of remaining teeth which can cause bite problems.
  • Orthodontics Treatment (i.e. braces) - may be placed to correct malocclusion of teeth.

OtherTreatments

  • TENS, or transcutaneous electrical nerve stimulation - uses a low-level electrical current to prevent pain relief by relaxing jaw joint and muscles.
  • Trigger point injections - these are made by administering local anaesthesia to relieve pain caused by tensed muscles around the jaw joint.

EXPECTED RESULTS

Every patients symptoms and level of results differ, that being said the expected results are:

  • Taking pain relievers like ibuprofen and naproxen.
  • Performing home remedies and using TMJ mouthguards can lessen the complications (like frequent headaches) and eventually prevent temporomandibular disorder from worsening.
  • Locking of jaws will be prevented.
  • Ease in speaking and eating.
Dental Mouthguards

According to WHO, dental trauma affects up to 40% of schoolchildren in European countries due to unsafe playgrounds, unsafe schools, road accidents, violence and even sports. Most injuries can easily be prevented by wearing mouthguards.

Mouthguards are flexible appliances used to cover and protect teeth from damaging during physical activities, contact sports or teeth grinding.

WHY YOU WOULD NEED A MOUTHGUARD

Teeth are prone to damage during physical activities like skiing, contact sports like boxing or nighttime grinding of teeth. Traumatic dental injuries such chipped tooth, cracked tooth and knocked out tooth are the most common consequences of not wearing mouthguards.

Our teeth may appear to be tough and secured to the bone, but it is highly susceptible to injury when hit with excessive force. Mouthguards do not protect just the teeth, but as well as soft tissues in the mouth like cheeks, lips and tongue. These tissues are prone to be nipped by the teeth during traumatic incidents.

Night mouthguards are necessary for someone who grinds teeth while sleeping. Ask your partner or someone who sleeps with you to check if you grind teeth at night. Excessive forces of teeth grinding can cause chipped or cracked teeth.

Chipped or cracked tooth may look like a minor problem, but it is not! The damage can extend up to the central canal (pulp) of the tooth where blood vessels and nerves are located. Injuries to the pulp can cause the tooth to die or become non-vital.

FOR WHAT SPORTS WOULD I NEED A MOUTHGUARD

It is advisable to wear a mouthguard for any sport that has a strong chance for physical contact with other participant or hard surfaces such as (but not limited to the following):

  • Basketball.
  • Softball.
  • Football.
  • Wrestling.
  • Boxing.
  • Soccer.
  • Lacrosse.
  • Rugby.
  • Skating and Skiing.
  • Martial Arts.
  • Skateboarding.
  • Biking.

DIFFERENT TYPES OF MOUTHGUARDS

There are different types of mouthguards, and our dentists will consider what type of mouthguards works best for every patient.

  • Stock mouthguards - this type of mouthguards are readily available in sports shops and will fit almost all sizes of the jaw. It is affordable and preformed already. However, this type of mouthguard is not recommended since it does not fit properly to the teeth. It provides less support and can cause difficulty in breathing and talking.
  • Bite and Boil mouthguards - this type of mouthguard is also available in sports shops. It is a thermoplastic material that is placed in hot water until it gets soft. Once soft, it is placed on the teeth by using tongue and finger pressure to mold it around the teeth. The drawbacks are poor fit and temperature-sensitive.
  • Custom-fitted mouthguards - this type of mouthguard is the most recommended by dentists. It is custom made in every patient to ensure proper fit and stability of the material. Custom-fitted mouthguards guarantee the protection of all teeth and soft tissues.

ADVANTAGES

Mouthguards are worn to protect your teeth, whether this is from a strong impact playing sport, or grinding your teeth when sleeping, its job is to prevent tooth damage.

  • It prevents chipped or cracked tooth during physical activities, sports or sleep teeth grinding.
  • It protects soft tissues like gums, lips, cheeks and tongue from getting nibbled when teeth clashes.
  • It lessens the risk of having a tooth knocked out of the bone.
  • It prevents serious injuries such as jaw fractures by helping to avoid situations where the lower jaw gets jammed into the upper jaw.

COMPLICATION OF NOT WEARING MOUTHGUARDS

Your mouth and teeth can be severely damaged in certain circumstances if you do not wear a mouthguard. Considering the price of a Dental Implant, or tooth replacement, its advisable that you aim to protect your teeth.

  • Cracked or chipped off tooth.
  • Knocked out tooth/Lost of tooth.
  • Endodontic problems (i.e. tooth becoming non-vital).
  • Excessive bleeding or bruising of soft tissues (lips, cheeks, tongue, palate).
  • Locked jaw when the lower jaw snaps.
  • Jaw fractures.

PROCEDURE GETTING A MOUTHGUARD

The dentist will take mould or impressions of your upper and lower teeth to make a casted model. Then, a mouthguard will be designed according to your mouth shape. The dentist will process the mouthguard using a pressure thermo-forming machine.

Once the mouthguard has been created, you will have to try it into your mouth. The dentist will check the fit to ensure that you can speak and breathe properly.

CARING FOR YOUR MOUTHGUARD

Your mouthguards should last about two years with proper care and handling.

  • Wash your mouthguards with cold water or mouthwash before and after each use.
  • Keep your mouthguards in its respective case when you need to remove it.
  • Keep your mouthguards away from high temperatures like hot water, hot beverage, hot surface or direct contact with sunlight.
  • Check your mouthguards for any tear or holes that can decrease its strength.
  • Don’t bend your mouthguards.
  • Don’t let others wear your mouthguards.
  • Call your dentist if you feel any discomfort or problems in wearing your mouthguards.
Sleep Apnea

Sleep apnea is a possibly severe disorder that occurs when a person’s breathing is disturbed while sleeping. If the body does not get enough oxygen while asleep, people with sleep apnea can stop breathing repeatedly.

TYPES OF SLEEP APNEA

  • Obstructive Sleep Apnea - this is the most common type of sleep apnea and is also known as OSA. This happens when soft tissue in the back of the throat blocks the airway during sleep.
  • Central Sleep Apnea - unlike OSA, there is no blockage of the airway. Instead, the brain center fails to signal muscles to breathe. It is caused mainly by the instability of breathing control center.

CAUSES OF SLEEP APNEA

Sleep apnea can be caused by several factors such as:

  • Muscular Changes - muscles relax when we are asleep and usually does not affect inhaling and exhaling; however, with sleep apnea, these muscles hinder air from coming in and out of the airway.
  • Physical Conditions - thickened tissues and excessive stored fats can block the airway during sleep.
  • Brain Function - the neurological control for breathing is faulty which causes failure to breathe properly. It is usually linked to medical conditions like heart disease.

RISK FACTORS OF SLEEP APNEA

There are several risk factors that can promote the development of sleep apnea such as:

  • Sleeping flat on back.
  • Obesity – increased fat deposits in the neck can block the airway.
  • Chronic Sinusitis or infection of air space.
  • PCOS or Polycystic Ovary Syndrome – women with PCOS are prone to obesity.
  • Menopause.
  • Large tonsils – it can narrow airway.
  • Smoking.
  • Genetics or family history of sleep apnea.

SIGNS & SYMPTOMS OF SLEEP APNEA

Some of the symptoms of Sleep apnea are listed below, if you are worred that you or a loved one may have sleep apnea, please get in touch with us today:

  • Loud snoring.
  • Episodes of breathing interruptions as witnessed by another person.
  • Waking up accompanied by shortness of breath.
  • Difficulty concentrating.
  • Dry mouth or a sore throat when you wake up.
  • Insomnia or difficulty to sleep.
  • Awakening with a severe headache.
  • Hypersomnia or excessive daytime sleepiness.
  • Heartburn.

IF SLEEP APNEA IS LEFT UNTREATED

Snoring is often ignored by several people. If snoring is caused by sleep apnea, it is important that you consult a doctor for treatment options. If nothing has been done to treat sleep apnea, several complications may arise such as:

  • Heart problems: There is a higher risk of developing high blood pressure since the oxygen levels drop during sleep apnea which can strain the cardiovascular system. OSA increases the risk of stroke and recurrent heart attack.
  • People with sleep apnea have a higher chance of developing Type 2 diabetes.
  • People with sleep apnea tend to develop a nonalcoholic fatty liver disease.

TREATMENT OPTIONS FOR SLEEP APNEA

If you are diagnosed with sleep apnea, we recommend that you quit smoking and try to lose weight if you are obese. Also, there are certain devices which you can use to keep the airway open while you sleep.

  • Continuous Positive Airway Pressure or CPAP is a machine that delivers uninterrupted air pressure through a mask placed over your nose while you sleep. It provides a greater amount of air than that of surrounding air to prevent the closing of the airway. Although some people are uncomfortable sleeping with a CPAP.
  • Expiratory Positive Airway Pressure or EPAP is a small, single-use device placed in each nostril to keep the airway open.
  • Dental Appliances for Sleep Apnea may be worn to keep the airway open. There are several dental appliances, and the dentist will determine which type will be appropriate for you.
  • Surgery might be needed for severe type of sleep apnea. Removing tissues at the back of your throat (tonsils, adenoids, excess fats) may be the last treatment option to prevent blocking of the airway.
  • Jaw repositioning, also known as maxillomandibular advancement, is done by moving the jaws forward to enlarge the space behind the tongue and soft palate. This is a more extensive treatment option if all the other options don’t work.

HOME REMEDIES FOR SLEEP APNEA

There are some changes you can make to your lifestyle which may help you deal with sleep apnea. Its advisable that you come in to see our specialist here in Dublin so we can fully assess your health issues, and make a proper diagnoses of your problems.

  • Lose excess weight. In some cases, sleep apnea is reversed as you return to your healthy weight. Losing excess weight can relieve constriction of your throat.
  • Avoid alcohol and certain medications (such as contraceptive pills, sleeping pills) that can cause your throat muscles to relax which can interfere with breathing.
  • Sleep on your side of abdomen instead of sleeping flat with your back. When you sleep flat, your tongue and soft palate rest at the back of your throat which blocks the airway.
  • Stop smoking. It can just worsen sleep apnea.

If you have any queries in relation to any of these specialist treatments, then do not hesitate to contact Dr Tom Munroe at ( SMILE@milltowndentalclinic.ie).

MILLTOWN DENTAL CLINIC

Milltown Centre,
Bóthar Bhaile an Mhuilinn,
Dublin 6

Eircode: D06 E8W2
View Map

Office Hours: 01 260 3741
Emergency: 086 801 2940

E-mail: SMILE@milltowndentalclinic.ie

Opening Hours:
Monday 08:30 - 17:30
Tuesday 08:30 - 13:00
Wednesday 08:30 - 17:30
Thursday 08:30 - 17:30
Friday 08:30 - 13:00

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