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Middle-aged dental problem solving

Middle-aged dental patient with severe teeth loss - dr adel zakhary

If you are between 40-60 years old, have some broken teeth, have some that are missing or lost due to time, this piece will give you insights on how we decide what to do in your case.

Middle-aged dental patient showing complete loss of teeth - dr adel zakhary

Broken teeth only?

People usually become busy with life and its toll, and with getting married and having kids. I remember once, as a 16 years old, I witnessed my dad breaking one of his teeth trying to pry open a knot on a plastic bag with his teeth. Its a fact of life that at some point, your teeth shall give in. Like most organs do, and people turn older, and become less active, so does the body and the teeth are no exception. Thus the majority of cases that do show up, tend to have any of these problems. 

To save, or not to save?

During dental examination, middle-aged dental patients because lets face it, often more than not, patients want the quick way out. Most ladies and gentlemen we see at our clinic come with a myriad of problems ranging from gums that are receded, bad breath, broken teeth, minor alignment issues, reaching record highs of having one tooth inside that they just want it pulled out to have a pair of dentures made. 

The dilemma in chosing the correct treatment lies in two things:

  • Is the tooth restorable?
  • Is the teeth good enough in quality for subsequent prosthetics?

And that is just to name two of the decision making questions we have to answer and involve our patient in. 

Middle-aged dental patient with minor tooth loss - dr adel zakhary

The knowledge?

Often times when we get cases like these, we like to gently get the feel for their knowledge. Surprisingly, more often than not, these guys and girls in bad shaped teeth surprise us with profound knowledge of the issues they have. Being in the loop with your doctor is the best strategy to stay healthy with teeth and avoid the need for fastidious and costly types of treatment. 

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Dental consultation

Dr Adel Zakhary dental examination
Walking in, the crooked tooth is immediately noted. Flips on the notepad and clicks the pen. Spot the not!

What do we do when checking your teeth?

If you ever wondered what do dentists look for in your teeth when you show them your mouth and open up, this article is for you.

Hygiene of your mouth

Presence of caries

Position of caries

Depth of caries

Extent of caries

Involvement of root canals with caries or not

Alignment of teeth

And that is just to name a few. In fact, the comprehensive list goes way beyond these perplexing parameters, and by force of habit, all those items are simultaneously checked to every tooth, as soon as you walk in for the first time. For example, did you know that with each patient, we like to know if they have underlying systemic conditions, for example there could be allergies to Latex from gloves or Nickel in the metal braces. I personally had the unfortunate experience of getting rashes and puffy eyes by Latex sensitivity back while I was still in college, before even going into dental school. 

dental consultation online dr adel zakhary
A discolored tooth doesn’t mean the root canal work is bad. The listen and feel.

What happened to the adage of “Look, Listen, and Feel”?

In the days leading to our graduation, one of our doctor teachers told us that we shouldn’t run a list. We should look, listen and feel our patients. When we look at teeth, we also have to listen not only to our patient concern but to the tooth. Furthermore, we have to feel the tooth. If we listen to the tooth, it may sound dull on tapping, or it may sound like the neighboring teeth. The significance of which can be interpreted by the lack of bone or the abundance of bone around said tooth, denoting a periodontal problem in the former case. The feel part is when we grip the tooth, does it move as easily or does it stay firm? If its the former case, now we must listen to our patients saying that they might have a Type I Diabetes Mellitus, or that they dont brush as often as they want to. The picture becomes clearer with these investigations.

Nowadays, there is less emphasis on the listen and feel, and more emphasis on x-rays, and the looks of teeth. How can one omit that half the tooth can not be seen? And more, how can one overlook, that the tooth is not only their resposible domain, but also its neighboring structures, which includes bones and soft tissues, like the tongue, the cheeks, the lips, the nose, essentially, the face.

Therefore, one must always know that not all dental consultations involve taking photos and xrays to the mouth, but also, emergency dictates a physical examination to ensure the root cause of any problem is tackled.

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Ever wondered when you were a child how your teeth all of a sudden split at the front? How about teeth that you suddenly grow high up near your eyes? And why specifically do these teeth matter? What makes them behave that way? If you want to know how can braces solve that problem in children and young teens, read some more.


The Canines, also named “Fangs“,”Eye teeth“, or just Canines (not that beautiful pet of yours), are the teeth that look like daggers at the front of your mouth. They are the teeth that begin to erupt around the age of nine years, sometimes a little earlier, sometimes a little later. They form what we call the corner of the smile, and rightly so, because they occupy the middle, transitional position between the cutters (your front teeth), and the chewers (the back teeth). They are pivotal to getting your smile arc, your facial bones supported, and thus, your age looks. Canines normally erupt, gliding on roots of the neighboring teeth.

The Gaps

Normally, your teeth erupt to become close together, so there shouldn’t be any gaps between your teeth. If there are gaps, you know what happens with food – it gets lodged in these gaps. Bad for your teeth. So when the canines start to erupt, the teeth start to fan apart, almost creating big spaces between them. That is because the canines are trying to get into their normal positions, because they are considerably bigger than the front teeth (they do have also the longest of roots in your teeth). So when they glide, they push on the aforementioned teeth roots, in a side direction, thus creating the “ugly duckling” appearance most children get harassed about. Sometimes, the spaces to accomodate these daggers are so small, that they get stuck where they originated (near the eyes, hence the term “eye teeth”). They may even not get a chance to erupt and appear if they are sufficiently big, or if the jaw is deficiently small to accomodate. We call this an “impacted” canine

The Solution

The parents are advised to conduct a checkup for their children when their children pass the eight years old mark, so we can check and monitor the presence, the position, and the possibility of eruption of canines. What we do at this critical time, saves the child from undergoing a terrifying experience at school from their peers. X-rays are taken to check the canines, and if needed, a brace is put in place to start correcting the teeth, and make space for the canines to erupt. However, if the canines are not to be seen, usually they are exposed and pulled by braces to their correct position, while starting buried. 

The Rub

As a parent, its advised to visit your dentist and have them check on the teeth count and specially the canines. Often times, the surgery required to expose the teeth can be mitigated by having an early look at the teeth with an X-ray. In their right, the canines roots being the longest, cause them to usually be the teeth stuck at the late childhood.
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Things to know when putting on braces

Braces onboard

If you are giving thoughts to braces and are on the fence, here are a few things from your orthodontist (who happens to be fathered by an orthodontist as well, yep that is two generations of braces doctors talking, listen up!).

I had my braces back in 2000. My dad did a full course of treatment on me. Some of the things I wanted answered were questions in my mind. As an early teenager, you are just baffled by the fact that these things even exist, and, being of that age group, you know, with all the peer pressure, seeing your friends having these metal things in their mouths, you take the plunge and get your first brace. I’ve compiled a list of the most common questions I could think of, and even was asked as an orthodontist. If you have braces, these are for you:

What is it

Braces are small attachments that are attached to your teeth with special purpose glue, and are connected together with a wire.

What it does

Obviously, move teeth, so that you can look better and even smile better. Myriad of benefits to wearing your braces. You might want to check our DSB below to find out what can braces solve.

How long does it take to put on?

Putting on the braces can take anywhere between 15 minutes to 45 minutes, depending on how good the dentist is, and how difficult the case might be. Sometimes, we tend to want to make additional steps in the installation, for example, if our patient is producing too much saliva, or if they have difficulty breathing.

Does it require an injection?

No, No, NO! No injection whatsoever! Normally we use injectors for numbing teeth if we are doing fillings, or root canal treatments. But braces, never!

What is that blue gel on my teeth, and why does it taste bad?

Its what we use to prepare the tooth to receive the glue used to attach the braces on. The stuff is mostly acidic, so that also explains why you should NOT swallow it, and why it tastes bad. The dentist will rinse alot after this one, in order to make sure it doesnt stay inside your mouth. You might also want to rinse repeatedly after it.

Ok I feel a little bit of pain, what is going on?

Well pain is your body telling you that “I can detect the teeth moving”. It is normal in the first day or even few days later following braces installation. It is also because teeth are normally without pain. So pain is a very good sign that your teeth are in face moving. Congratulations!

Can the pain go away with braces?

As your teeth start to take shape and align, they start to feel less pressure, since they are closer to the corrected position. And you already know what pressure feels like. So the pain also reduces. However, you could be prescribed painkillers for a few days following the installation. It is important to check with your doctor and tell them if the pain can be bearable, or if it lingers alot to cause a disturbance in your lifestyle.something is grasping my lip when I talk, what to do?

Something is grasping my lip or poking my cheek. What to do?

It could be the wire sticking out back. If its the lip, you can use the wax provided to cover the rough edges of the braces. The wire itself can be tucked away if you are away. If you can arrange an appointment with your dentist, that would be all the better.

What are those colors on the braces?

Those colors are what probably caused you to put them on, right? Well you are in luck. The color is basically rubber ties that activate your braces. Every visit to your orthodontist, you will get that color changed, or replaced (as you wish).

I ate Snickers and my braces broke, what can I do? is there something I shouldn’t eat with braces?

Normally, you would schedule an appointment if the braces are broken. Sometimes, the broken braces can leave a tiny bit of the wire poking at the back, and to that you can either cut the wire if you can’t visit your doctor, or place a ball of wax at the end.

Some foods, like hard and sticky foods (and Snickers are no exception!) should not be eaten with braces. However, its just that one time, right?

How often should I clean my teeth with braces?

Normally, following every meal, and we explained why that is very important.

How do I clean my braces?

Normally, you would use the regular toothbrush with soft bristles to clean your teeth parts not having braces, like the back, sides, and top. Gummy areas and areas of braces are a little more challenging, and require that special brush to reach in and clean thoroughly. Sometimes, it helps if you have a Waterpik, or a Jet brush. The point is, make it a habit to not leave food over your braces, especially in Covid-19. For the invisible aligner types of braces (Invisalign), regular brushing and flossing will do the trick. You might as well be prescribed a mouthwash with your choice of alcohol content (not for consumption!).

Why is it important to get your teeth cleaned with braces?

Braces.. the food magnet.

That pretty much sums up the article. Just kidding! Actually, its a little more complicated than that, but we will see to it that you grasp why the practice of regular brushing needs to be enforced, why cleaning is important with braces, and why not cleaning your teeth can hurt your cosmetics on the long run. Like any rough object, it catches stuff. 

metal orthodontic bracket dr adel zakhary dental

Because braces are rice grain sized, its very difficult to clean them. A brace is composed of brackets that are attached to the teeth (or glued on, if you will), and wires that connects these brackets in unison. When the bracket is attached to the tooth, the back of the bracket has these sharp objects called (hooks), and wings. It is probably what grazed your lips, or hurt your cheeks if you never had braces on before. Now when you think about that rice-grain sized object, think about how easy is it for food to get stuck to it.

Ceramic bracket dr adel zakhary dental side view

The rough edges collect the food over time, and the food starts to build up over the bracket, and when it runs out of places to build up, it starts to collect at the tooth-bracket interface, and then when that is occupied, it then starts to collect over the tooth itself. Imagine the size of the object required to clean that very small, fraction of a millimeter gap between the tooth and the bracket. That “pocket”, where food collects. 
Food over time on the tooth surface causes a myriad of problems. From tooth decay to staining and calculus.  However, when food is combined with a trapping roughness on the tooth surface, it causes the appearance of what we call WSL – White Spot Lesion. That is, tooth decay, so bad, that it caused the tooth surface to turn white! 

ajodo wsl white spot lesion armstrong 2010

That causes the tooth to look bad after the braces are removed. So now you are left to contend with white spots that form circles on top of your teeth. And that is just the tip of the iceberg! In the next article, we shall take a look at what happens in the back, where these rings are fixed. If you like our content, consider subscribing to receive it as it is publishes!

What happens on the first day of braces?

Ever wondered what people feel when they receive their first brace? We have a few replies from our first cases, some of which are funny, others are just to feel for. Lets dive in!

I feel I got stung.

My corners hurt so bad. 

Just a little headache

A little funny I guess. Hurts me a little when smiling.

My lips are getting caught in something

I keep rubbing my tongue over my teeth, but can’t feel them

 My cheeks hurt 

I cant eat

That is just a few of the feedback we often get with our patients getting their braces. So what exactly causes all these reactions? Well, braces are designed to move teeth. So teeth that are anchored to the bone need some force to start moving. Like moving a little chess piece takes some of your strength (albeit not that much!)

When teeth start movement, the nerves underneath the teeth encased also with the blood vessels supplying the teeth are compressed. If you sit on your arm for a while, sometimes you can move after and get a tingling sensation. Neither painful nor joyful. You just cant know to laugh or cry. That is because the nerve endings in your arm have had something choking them- you. When you rest on your arm, this causes the nerves to become choked because normally you would be moving your arms, interacting with objects and such. 

Same thing happens with teeth. When a tooth is subjected to the pulling (or pushing) force of the brace, the nerves get compressed, and that translates to pain mostly. That pain is cyclic in nature. It starts off usually in the first night or second day from installing the braces. And because humans are not all alike, therefore, the ability to withstand the pain generated is dependent on you also. Our general rule is, when you get a headache, take a pill, and its working. It, being the braces, actually starting to work and form pressure on teeth, like its designed to.

With a new object in your mouth, you start to also lick around your teeth more often, sometimes, you can feel a bit of a lump where the teeth where. That is because the braces have added to the size of your teeth. Can you imagine having a grain of rice on top of your teeth? The same. Most people can cope with braces as a strange object, usually taking a few days to get to their presence. Very few people cant cope with braces and sometimes, have to come over and get them undone, seeking other types. 

A few reads ago, we pointed that braces could look weird and have things sticking out of them. These also could get in the way of your smile, or your tongue, lips, cheeks, or all of the above. Usually the orthodontist will give a proper size for your teeth and match it with a proper sized brace, so it wont feel bigger or strange. As well as getting tangled, having strange things, and some pain, you could also sometimes develop red spots. These could be from Nickel sensitivity, as braces have a percentage of Nickel in their composition. Around 17% of women and 3% of men suffer from allergies related to metals.

Usually your doctor would perform an AT – Antigen Test, a test where sensitivity to Nickel and other metals is determined to prevent this from happening. If it does, its mostly by chance! Fret not, for there are other alternatives to metal braces. There are plastic aligners, ceramic, and even plastic braces to help with these sensitivities. 

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Debunking myths: Single jaw braces

Often times in our practice, we meet patients who desire to only fix teeth in either of their jaws, but not both jaws. Proponents of the treatment often say it cuts down on the total treatment time by half, while others claim that the teeth moved do not sit nicely with the opposing teeth and sometimes, the patient is left with a less than desirable outcome.

What is single jaw braces? It is when teeth on one jaw are more crooked than the other jaw, giving the patient an impression that only these teeth need fixing. Its a type of treatment where the patient perceives teeth in one jaw fixed, without the necessary need for the teeth to meet the other teeth opposing them.

Why is it important that teeth meet each other? Teeth are designed to chew food, support the face, and reduce food to digestable material, for absorption (or intake of benefits from food into the body, from amino acids, proteins, carbohydrates – the basic needs of the body). Teeth meet eachother in unison, under a specific design, called CLASS I (ONE) design. This design is where the teeth should land and hit eachother with every bite, so the food is propely reduced. It is also why the teeth are arranged so they give the best smile, the best support for the face.

Therefore Class I relationship between the teeth, offers also the most stable position the teeth can be in, because they fit eachother so well, there is little chance for one tooth to just veer off the pack and strike where it shouldn’t on closing. How is that possible? If you played Abacus as a child, you would know that the beads in the middle are positioned by the rest of the beads at the ends.

Lets consider these beads if we had two rows of them closing normally on eachother. The bead would likely go in the space between the opposing beads. Think about it. If you wanted to crush something between the beads, would it not be more efficient if the beads had little spaces between them? Mind you, the beads would function alot better if they had alternating pattern, like a gear!

Class I is when the teeth are “geared” to reduce the food. Can we bring about one set of gears to interlock and “teeth” another gear, without moving both? It may be possible but not in the majority of cases. But what if the gears had stopped on one hand and the other gear moved. Trouble! One of the gears eats the other and the clock is now stopped. So much for that timepiece!

Back to our teeth, when a patient asks us to fix and move one tooth in a whole jaw, that is like warping gears! Imagine how hard that might be! To warp a perfectly formed gear so that one tooth can get in line with the others! Isnt that bad? The gear, is kaput.

So is it correct to fix teeth on one jaw, while purposefully neglecting the teeth on the opposing jaw, just because the patient felt like it? Yes! Absolutely yes! Its their teeth!

Convincing the patient that both sets of teeth needs to move and align is another matter. What is even more important, is that the patient needs to know that while the teeth are moving, the movement happening at this diet of treatment has a toll on the teeth moving. And is it not better to be tolled once as teeth, with all the pain and time it takes to get into that new position, than to be tolled twice to fit the teeth together on a second diet? Yep.

That is where we as practitioners must arrive with the patient, BEFORE having their braces installed. Before anything!

In summary, single jaw treatment is feasible, as long as predictable results can be made, and the patient must understand the risks of undertaking such treatment, in both the complexity and time, as well as the disadvantage to the left out jaw.

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ما هو سر ارتفاع اسعار علاج تقويم الاسنان

غالبًا ما يتساءل الكثير من الناس عن سبب تكلفة تقويم الأسنان. لنوع اختياري من العلاج. لماذا يوجد فرق كبير في التكلفة بين أنواع تقويم الأسنان المختلفة؟ لماذا يتقاضى الأطباء الكثير لوضعهم؟ ما الذي يتحكم في أسعار تقويم الأسنان؟ لماذا يعمل الصنف غير المكلف بدرجة أقل مثل الصنف باهظ الثمن إذا كان نفس الشيء بالضبط؟

أولا دعونا ننظر في الأطباء أنفسهم. تتطلب الأقواس في معظم أنحاء العالم خبرة في وضعها. يمكن لطبيب الأسنان المتخرج أن يلتصق بها على قدم المساواة مثل أخصائي تقويم الأسنان المحترف ، وربما يمكن للقرد أن يلتصق بها بشكل أفضل من كليهما. ومع ذلك ، فإن أطباء الأسنان المتخرجين مقيدون جدًا بفهم كيفية عملها.

الزوايا والأرقام المعنية. العلم. هذا هو السبب في أنه يكلف الكثير لتصبح محترفًا مدربًا فقط لهذا العلاج. إن فتح عيادة طب الأسنان يكلف ثروة في الوقت الحاضر مقارنةً بالعودة إلى اليوم ، ناهيك عن تكاليف التشغيل والتسويق. تكاليف التشغيل في ارتفاع مستمر ، والتي تشمل تكاليف المواد ، وتدريب الموظفين ، ومواد الدعامة والمواد اللاصقة المستخدمة ، والكهرباء والنفقات العامة الأخرى ، والوقت الذي يستغرقه لصقها ، والوقت الذي يستغرقه عملهم و الحصول على نتائج ملحوظة ، والوقت الذي يستغرقه المريض للاستجابة للعلاج ، والأخطاء التي تتطلب تصحيحًا والوقت اللازم لتصحيحها ، والوقت اللازم لخدمة مريض واحد ، والتحقق من آخر ، والتأكد من أن المواد تتصرف كما ينبغي.

الأمر الأكثر إثارة للقلق هو المادة نفسها. عادة ما يتم صب الأقواس في اليوم باستخدام جهاز طرد مركزي ، وهو النوع المستخدم في تشكيل روابط السلسلة والملحقات المصنوعة يدويًا ، أو طحنها من كتل من الفولاذ المقاوم للصدأ ، أو القطع بالليزر. بفضل التكنولوجيا ، فإن الطريقة الأكثر شيوعًا والتي تنتج نتائج متسقة في الوقت الحاضر هي القولبة بالحقن. يجب أن تكون المادة نفسها متوافقة مع البشر ، وبالتالي يجب أن تحتوي على نسبة ضئيلة من التيتانيوم. تصنع بعض الأقواس عادة من الذهب المصبوب بسبب توافقها مع الأنسجة البشرية وتقليل احتمالية التسبب في حدوث تهيج ، وأيضًا لأن الذهب يعتبر معدنًا ثمينًا ، فلا عجب أن تكون المواد باهظة الثمن.

كما أن ميزات التصميم ذات الصلة بالمواد يجب أن تتطابق مع معايير محددة صارمة للغاية ، بحيث يمكن وضع الأسنان بشكل صحيح والتحكم فيها بشكل متوقع. على سبيل المثال ، يجب أن تحتوي بعض الأقواس على خطافات بارزة لأنها تؤدي وظائف محددة أثناء العلاج ، مثل قلع الأسنان أو دفعها. الفتحة حيث يتم تشغيل السلك تحتاج أيضًا إلى أن تكون بحجم وشكل معينين ، وأن تكون الزاوية لوضع ما يعرف بالزاوية على الأسنان أو عزم الدوران ، لجعلها أقل انحناءًا. ميزات التصميم هذه تكلف الكثير بالنسبة إلى دعامة صغيرة بحجم حبة الأرز. هذه الميزات مجهرية إن لم تكن مرئية للعين البشرية. خطأ واحد ويستغرق تصحيحه الكثير من الوقت والتكاليف. لذلك فإن جزء ضمان الجودة من الإنتاج يتولى زمام الأمور. هذه عمالة ماهرة وتتطلب مهنيًا مدربًا للغاية لاكتشاف الأخطاء في تصميم مجموعة المعادن التي تلتصق بالأسنان. لتدريب هذا الفرد ، فإنه يكلف المال. لمنحهم راتبا هو أمر آخر. تخيل أن تمر 4000 من هؤلاء يوميًا!

في الوقت الحاضر ، مع المسح بالليزر ، قلل من عبء فحص الجودة لكل قطعة معدنية على حدة بحثًا عن العيوب. المعدن معدن ، إذا كان سيئًا ، قم بإذابه وإعادة تدويره. لا شيء يذهب سدى. هذا هو نظرة مادية بحتة في المادة نفسها. بالحديث عن ذلك ، هذا هو السبب في وجود تدهور بشكل عام في جودة العلاج مع الأقواس سيئة التكوين ، والتي تكون متاحة بشكل عام لعامة الناس ، وحتى في بعض الأحيان ، يتم تسويقها كأقواس أصلية. تأتي هذه الأقواس بشكل عام في أشكال العلاج المدعومة لأولئك الذين لا يستطيعون تحمل أنواع الأقواس الأكثر تكلفة والتي تخضع للتحكم في الجودة.

بعد ذلك يأتي وقت تركيب المعدن المذكور في فم المريض. أولاً ، يجب استيفاء المعايير الصارمة للمادة اللاصقة التي تربط السن بالمعدن للعمل. حاول تجفيف فمك. سوف تكتشف مدى صعوبة ذلك! تخيل أنك ستضطر إلى العمل في منطقة رطبة. يديك تتشقق بعد فترة. يحدث نفس الشيء مع المرفقات المعدنية بحجم الأرز ، إلا أنها لا تستطيع البقاء على الأسنان إذا كان هناك الكثير من الرطوبة في المزيج. يتطلب تجفيف السن وقتًا ، وإبقائه في الحالة الجافة يتطلب مهارة. المهارة هي صفة قابلة للتلف في البشر تحتاج إلى تدريب مستمر للحفاظ على مستوى محدد وحتى تحسينها.

لذلك يحتاج الأطباء إلى الحفاظ على هذا المستوى من المهارة ، من خلال أخذ ورش عمل ودورات دراسية ، ما يسمى (التعليم المستمر). بالإضافة إلى ذلك ، يعد وقت العلاج عاملاً حاسمًا في تحديد المبلغ الذي يجب أن يتحمله المريض. تستغرق معظم الحالات البسيطة التي قد يكون فيها أحد الأسنان على سبيل المثال خارج مكانها ما بين شهرين إلى ثلاثة أشهر من العلاج. في مجال عملنا ، يمكن أن تمتد الحالات إلى أربع سنوات أو أكثر ، اعتمادًا على مدى تعقيد القضية. هذه المرة هي التي ترفع تكلفة العلاج. يمكن أن يستغرق متوسط موعد التعديل ما بين أربع إلى 20 دقيقة. في بعض الأحيان ، قد تطول الإجراءات المساعدة هذه المرة. على سبيل المثال ، قد يضطر المرضى الذين ربما لم ينظفوا أسنانهم جيدًا بعد الوجبات باستخدام الأقواس إلى الحصول على تعليمات التنظيف من أخصائي تقويم الأسنان أو أخصائي صحة الأسنان. أو المرضى الذين كسروا الدعامات ، قد يحتاجون إلى وقت إضافي لإصلاح الأجزاء المكسورة. هذه الديناميكية في تخصيص الوقت هي عامل رئيسي في التسعير.

تضيف صيانة العلاج أيضًا إلى قيمة السعر الإجمالي للعلاج. في طب الأسنان ، هناك نوعان رئيسيان من العلاج ؛ الاختيارية والطوارئ. في حين أن معظم أعمال طب الأسنان تنتهي عادة في غضون شهرين إلى ثلاثة أشهر ، فإن تقويم الأسنان عادة ما يستمر لفترة أطول حتى سنوات. لا يقوم الطبيب بإجراء العلاج فقط ، ولكن بعد ذلك يقوم الطبيب بإجراء ما يسمى بمرحلة “المداومة”. فكر في الأمر على أنه خدمة ما بعد البيع. إذا اشتريت سيارة ، يرسل الوكيل رقم VIN الخاص بك إلى مركز الخدمة المعتمد. يتواصلون معك خلال فترة الضمان لإبلاغك بالمرات اللازمة لفحص سيارتك وإجراء صيانة للمسافات المقطوعة. في تقويم الأسنان ، يستدعيك الطبيب كل ستة أشهر للتحقق من محاذاة أسنانك وإجراء فحوصات على حالة أسنانك ولثتك ونظافتك وكل شيء آخر.

في علاقاتنا مع مرضانا ، ونظرًا لأننا نأخذ وقتًا في عملنا لتحقيق النتائج ، فإننا نبني نوعًا ما علاقات شخصية مع مرضانا. ليس غريباً أن المريض الذي عالجناه منذ عدة أقمار قد يظهر في يوم من الأيام مع عمره تسع سنوات ويطلب منا فحص الأسنان والقيام بما هو ضروري. إنه أفضل شيء في هذه الوظيفة. نصبح جزءًا من حياة مرضانا ، وكذلك يصبحون جزءًا من حياتنا!

هل اعجبك المقال؟ قم بالاشتراك اسفل ليصلك كل جديدنا

The costs of putting on braces

Many people often wonder why the braces cost so much. For an elective type of treatment. Why is there a huge difference in cost between the different types of braces? Why do doctors charge so much to put them on? What controls the prices of braces? Why do the inexpensive variety work much less like the expensive variety if its the same exact thing?

First lets consider the doctors themselves. Braces in most parts of the world require expertise to be placed. The graduate dentist could stick them on equally like the trained professional orthodontist, and maybe a monkey could stick them on even better than both of them. However, graduate dentists are very limited to understanding how it works.

The angles and numbers involved. The science. That is why it costs alot to become a trained professional only to this treatment. To open up a dental practice costs a fortune nowadays compared to back in the day, let alone running and marketing costs. The running costs are in constant climb, which includes material costs, the staff training, the bracket material and the adhesives used, the electricity and other overhead expenditures, the time it takes to glue them on, the time it takes for them to work and produce noticeable results, the time it takes for the patient to respond to the treatment, errors that require correction and the time to correct them, the time to serve one patient, check another, and ensure material is acting like it should.

What is even more troubling is the material itself. Braces were usually casted back in the day using a centrifuge machine, the type used to forge chain links and handcrafted accessories, or milled from blocks of stainless steel, or laser cut. Thanks to technology, the most common method which produces consistent results nowadays is injection molding. The material itself has to be compatible with human beings and therefore must incorporate a tiny percentage of Titanium. Some braces are usually made from casted gold because of its compatibilty to human tissue and the less irritation it is likely to cause, also because gold is considered a precious metal, its no wonder the material costs so much.

Also, equally relevant to the material is the design features which must match specific, very strict criteria, so that teeth could be positioned correctly and controlled predictably. For example some brackets must have hooks that stick out because they serve specific functions during treatment, like pulling the teeth or pushing them. The slot where the wire runs also needs to be made to a specific size and shape, and angled to put what is known as angle on the teeth or torque, to make them become less crooked. These design features cost alot to a tiny, rice grain sized brace. These features are microscopic if not visible to the human eye. One fault and it takes alot of correction time and costs to correct. Therefore the quality assurance portion of production takes over. This is skilled labour and takes a very trained professional to spot errors in the design of the batch of metals that stick on to teeth. To train this individual, it costs money. To give them a salary is another matter. Imagine going through 4,000 of these per day!

Nowadays, with laser scanning, it has reduced the burden of having quality inspection check each individual piece of metal for defects. Metal is metal, if its bad, melt it and push it back into the circulation. Nothing goes to waste. That is purely material look into the material itself. Speaking of which, that is why there is generally a degradation of the quality of treatment with poorly formed braces, which are generally readily available to the general public and even sometimes, marketed as authentic braces. Its these braces that generally come in the subsidized forms of treatment to those who can not afford the much more expensive, quality controlled types of braces.

Next comes the time to install said metal into the patients mouth. First, the strict criteria for the adhesive that joins the tooth to the metal to work must be met. Try to dry your mouth. You will discover how difficult it is! Imagine having to work in a damp area. You hands get cracks after a while. The same thing happens with the metal rice sized attachments, only they just cant stay on the tooth if so much as any hint of moisture is in the mix. To dry the tooth costs time, and to keep it in the dried state takes skill. Skill is a perishable quality in human beings that needs constant training to keep at a specified level and even improve upon it.

Therefore doctors need to maintain this level of skill, by taking workshops and coursework, what is termed (continuing education). Additionally, the time of treatment is a critical factor in deciding the amount to charge to the patient. Most simple of cases where for example one tooth may be out of place, takes between 2-3 months of treatment. In our line of work, cases could stand well into four years or more, depending on the complexity of the case. This time is what raises the cost of treatment. The average adjustment appointment can take anywhere between four to 20 minutes. Sometimes, adjunctive procedures might elongate this time. For example, patients who might have not been brushing very well their teeth after meals with braces on, might have to get cleaning instruction from the orthodontist, or the dental hygienist. Or patients who broke the braces, extra time might be needed to repair the broken parts. This dynamicity in time allotment is a major factor in pricing.

The upkeep of treatment adds also to the value of the overall price for treatment. In dentistry, there are two major types of treatment; elective and emergency. While most dental work is usually finished in the course of two to three months, orthodontics usually lingers far more into years. The doctor not only conducts treatment, but later, after treatment conducts what is termed the “maintenance” phase. Think of it as the aftersale service. If you purchased a vehicle, the dealership sends your VIN to the authorised service centre. They contact you during the warranty to advise you of times to check up on your vehicle and conduct mileage maintenance. In orthodontics, the doctor recalls you every six months to check up on the alignment of your teeth and conduct checks on the condition of your teeth, your gums, your hygiene, and everything else.

In our relationships with our patients, and because we take time with our work to produce results, we sort of build personal relationships with our patients. It is not strange that a patient we treated many moons ago, might one day show up with their nine year old and ask us to examine the teeth and do what is necessary. It is the best thing about this job. We become part of our patients lives, and so do they become part of ours!

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Who are we? A brief overview about Dr. Adel Zakhary. Mission Statement from our CEO.

We are a team of family dentists operating in our own practice, started by our father, Dr. Atef Zakhary who is a NYU graduate in orthodontics specialty. We have a combined knowledge and expertise from both American and British orthodontic education, as well as recognized degrees from local universities of Egypt. We are dedicated to elevate the standards of dental care in Egypt and not just stick braces on. With a combined knowledge that spans well over 40 years and cumulative ever since the time of our great Grandfather, Dr. Zakhary Morkous from Athens, Greece, who was the King Farouk chief dental therapist back in 1912, it is no wonder the flame kept going all these years, with passion kindled to the field of dentistry.

We admire to be held accountable and stake our reputation to always achieve the best compromise our patient desires. We also have excellent niche of clients dating back as far as 1985. We are located in a very active and busy area of Cairo, Heliopolis. We cater our area of Heliopolis and the surrounding areas as well, and believe competition to be the best motive to improve services and dentistry in particular.

Its our intent to keep good standards in the field and actively compete in quality dental work. We also believe that a customer is always right and have the capacity to correct any mistakes if any and be professional as possibly can. We also believe that a well motivated patient and a satisfied customer brings in more customers and thus we strive to please our people.