What is the best way to keep your teeth healthy? Professor Dr Kurt Jäger, a specialist in implantology, general dentistry, periodontology, cosmetic dentistry, endodontics and orthodontics, knows this better than most. At the Argodentis Zahnmedizin clinic in Aarburg, where he serves as practice manager, people from the region receive high-quality treatment in areas such as implantology, dentistry and oral surgery – this is ensured not only by Prof. Dr med. dent. Jäger, this is ensured by, among others, co-director Dr. med. dent. MSc Christoph Vögtlin. All dental services are provided in Aarburg, and the specialists also place great importance on comprehensive consultation to ensure that patients can prevent dental and gum diseases through a personalized prophylaxis plan. The editorial team of the Leading Medicine Guide spoke to Professor Dr med. dent. Kurt Jäger about key issues relating to teeth and dental health.
“Looking after your teeth is the be-all and end-all!”
People with healthy teeth smile more than those whose visible teeth are discolored or decayed – or who are even missing some. Many people avoid regular visits to the dentist out of fear. However, today’s technology and modern anesthesiology are so advanced that even complicated treatments are virtually pain-free and yield excellent results.
Good dental care is one of the most important prerequisites for keeping teeth healthy. But is a standard manual toothbrush enough? Or should you opt for a high-tech model with all the bells and whistles, right down to a water flosser? Do I need dental floss? “During our preventive care and dental hygiene sessions, we recommend the electric sonic toothbrush, although technique is key: don’t scrub! The oral irrigator is pleasant, but not strictly necessary. Teeth should be cleaned three times a day, after every meal,” explains Professor Dr Kurt Jäger, outlining the best approach to brushing teeth.
The sonic toothbrush is a type of electric toothbrush whose brush head resembles a conventional manual toothbrush, i.e. it is elongated. The brush moves sideways, vibrates at around 31,000 oscillations per minute and emits a sound wave with a frequency of approximately 260 Hz.
Brushing your teeth three times a day may seem like a lot at first – you’d have to take everything with you to work… However, the recommendation follows the logic that teeth are primarily there to break down food, and we normally do that – at least – three times a day. And when we eat, plaque also builds up in the mouth – that is, dental plaque that can attack teeth and gums.
“If you’re on the go, you can of course use a conventional manual toothbrush,” adds Professor Dr Jäger, “but then you should use the Bass or Stillmann technique.” The Bass technique is based on small, almost on-the-spot vibrating movements with the toothbrush and is one of the most common tooth-cleaning methods, which also cleans the spaces between the teeth. The Stillman technique is recommended for people with both healthy periodontal tissue (gums) and receding gums (also known as ‘recessions’), which result in more sensitive tooth necks. With this technique, you brush from red to white, i.e. from the gums toward the tooth.
“Interdental care using dental floss or interdental brushes is just as important. Fluoride prophylaxis is also part of this – fluoride promotes remineralisation, hardens the top layer of enamel and inhibits bacterial growth!” recommends Prof. Dr Jäger. Unfortunately, many people neglect to use dental floss. Yet flossing is very helpful in oral care, as the floss can remove a great many harmful plaque-causing bacteria from between the teeth, thereby preventing gum inflammation.
With food comes plaque!
Of course, we eat several times a day, whether it’s proper meals or a snack in between, perhaps even something sweet like chocolate or cake. After all, we should be able to enjoy all of that. “Diet is, of course, important. A healthy, balanced diet is essential for general health. Teeth suffer from foods with a high sugar content. I recommend consuming as little sugar as possible and, if necessary, only with main meals. This also applies to sugary drinks. When it comes to food, care should be taken to ensure it is labeled as ‘tooth-friendly’,” says the specialist.
“Sugar-free does not mean that no tooth-damaging acids are formed,” Prof. Jäger cautions at this point. It must not be forgotten that ‘sugar-free’ often simply means ‘free from cane sugar, i.e. the common household sugar’. However, products may well contain fructose (fruit sugar), glucose (grape sugar), lactose (milk sugar) or maltose (malt sugar), which can ultimately also lead to tooth decay. You don’t have to give everything up, though; you simply need to be more mindful, whether when shopping or when eating.
If tooth decay has set in …
…then it must be removed. This is because tooth decay (from the Latin word caries, meaning rot or decay) destroys the enamel, the hard tooth tissue and the dentine. It develops with the involvement of microorganisms and is ultimately the result of an ecological change in the natural biofilm of the teeth. In its early stages, tooth decay can be stopped by using fluoride, provided that no cavity has yet formed. If the decay has progressed, the affected hard tooth tissue must be removed and the tooth filled with a filling material.
And what about amalgam fillings?
There are various filling materials: there is, for example, glass ionomer cement, a mineral cement that is usually only used as a temporary solution, such as for temporary fillings. There are composites, which consist of twenty per cent plastic and eighty per cent of a salt of silicic acid, as well as inlays made of gold or amalgam. The latter filling option once fell into serious disrepute. It’s good that we were able to speak to a dental expert here: “In its day, amalgam was a cost-effective, easy-to-work-with filling material that passed the long-term test with flying colors thanks to its good oral durability. However, modern tooth-colored composites have now replaced amalgam as a filling material. In rare cases, it can still be used to repair the margins of crowns.” Good to know!
“Amalgam is harmless; this has been scientifically proven time and again by conventional medicine,” explains Prof. Dr Jäger. Now, of course, we want to know which filling is recommended. “There are direct and indirect fillings. With direct fillings, the healthy tooth structure is preserved as much as possible today (formerly: ‘extension for prevention’). Modern composite materials are applied mechanically and chemically using acid-etching techniques to preserve the tooth. With indirect fillings, an impression is taken or a scan is made of the prepared tooth, and the filling, manufactured in the dental laboratory, is bonded into the tooth,” explains Prof. Dr Jäger.
Award-winning: Prof. Jäger was also awarded the Leading Medicine Guide seal in 2020
Implants are becoming increasingly popular, aren’t they?
We hear about the use of implants time and again. Are implants suitable for every patient? “As with all medical procedures, there are indications and contraindications, advantages and disadvantages, and risks that require proper explanation. Dental implantology is highly advanced and has a broad range of indications. If there is insufficient bone, bone can usually be built up using various techniques. Depending on the initial situation, the dental work required for implants may be more extensive. A commitment to good oral hygiene and giving up smoking promote long-term success,” says Prof. Dr Jäger.
A dental implant with a suitable prosthesis is advisable when a tooth and its root are missing. Nowadays, placing dental implants is a viable solution for replacing a tooth and thus permanently closing unsightly gaps.
Many people suffer from masticatory dysfunction
“Masticatory dysfunction is accompanied by jaw and facial pain, increased muscle tone, restricted jaw movement, clicking of the temporomandibular joint or joint pain,” explains Prof. Dr Jäger. This is often caused by clenching or grinding the teeth, for example in stressful situations, which also happens while sleeping. Rheumatic conditions or injuries can also play a role here. Headaches, clicking of the temporomandibular joint, muscle tension or tinnitus can result.
“The causes are multifactorial and interdisciplinary. The specialist dentist must recognize which therapeutic measures fall within their field of expertise and which do not. In the dental practice, oral physiotherapy can be prescribed, medication can be administered, or a bite splint can be fitted. The dentist is often the first point of contact for patients experiencing pain. It is important to arrive at the correct diagnosis based on medical history and symptoms, to treat what the specialist field permits, and to collaborate in a multidisciplinary manner. “For example, I take part in a multidisciplinary temporomandibular joint clinic at the Hirslanden Clinic in Aarau,” explains Prof. Dr Jäger, with a view to providing ongoing care for his patients.
Fear often comes along in the dentist’s chair
The older we get, the more vulnerable our teeth naturally become. In fact, only one per cent of people live without tooth decay, fillings or dentures. So rest assured! “The most important thing for the dentist is to gain the patient’s trust. Without effective anesthesia, treatment must not continue if it causes the patient pain. With anxious patients, the treating dentist must proceed slowly. Lasers can help here because they operate without physical contact. The unpleasant noises and vibrations are also eliminated. Hypnosis can also be used, or if that’s not possible at all, the dental treatment should be carried out under general anesthesia,” explains Prof. Dr Jäger, outlining his approach to anxious patients, and jokes: “With a patient who is afraid of the injection, I always bet them a cake or a bottle of wine that they won’t feel either the needle or the anesthetic. If you look at my figure, you can see who almost always wins!”
Dentistry requires sensitivity
“When I retire in just under three years’ time, I will have been practicing as a dentist for exactly forty years. It’s a wonderful profession if you enjoy carrying out manual tasks in a small-scale setting and have a passion for the medical field. Interaction with patients and staff, as well as among colleagues and stakeholders, is inspiring and enriching,” says Prof. Dr Jäger, who is very popular with patients thanks to his empathetic manner. And this is precisely where he continues: “Dentistry is constantly evolving in the technological sphere and is becoming fully digitised. Orthodontics is playing an increasingly important role. Individual practices are gradually disappearing in favor of group practices and dental centers. However, I hope that empathetic points of contact will remain, particularly for patients suffering from pain. Long-term treatment and care are very important for building trust. Every practice today must place a strong emphasis on prevention.”
Professor Dr Jäger, thank you very much for this insightful conversation!
The Aarburg branch of the St. Margarethen Clinic has been led since 1989 by Prof. Dr. med. dent. Kurt Jäger, who not only has extensive clinical experience in dentistry but is also active in research. Prof. Jäger has published around 200 articles and book chapters in national and international specialist journals and also teaches as a titular professor at the University of Basel. The Aarburg branch of the St. Margarethen practice also has its own dental training center.
