Dr. Albert Janse van Noordwyk

Conservative Dentistry is a branch of dentistry which is concerned with the conservation of teeth in the mouth. It embraces the practices of operative dentistry and endodontics, and includes various kinds of direct and indirect restorations of individual teeth in the mouth.

Conservative dentistry includes the diagnosis and treatment of dental caries and includes the techniques and procedures to restore the teeth to full function and appearance in an aesthetically pleasing manner with as little loss of healthy tooth structure as possible. It also involves performing root canal treatment and associated surgical procedures to rid the tooth of its offending malady. The treatment provided includes various fillings, root canal treatments, implants, bleaching, & management of traumatized teeth.

Here at Paarl Family Health, a cosmetic and aesthetic dental/facial practice we have state of the art equipment and technique to take care of your beauty.

Porcelain or Zirconia crowns/bridges, Metal free inlays/onlays, Plastic/metal/flexible dentures.

Missing teeth (gaps) can have a devastating effect on your smile.

Zirconium is a lustrous, grey-white, strong transition metal that resembles titanium (thus making it a very aesthetic metal to use for the substructure under the porcelain in crown and bridge productions compared to previous materials and techniques). Zirconium is used as an alloying agent for its strong resistance to corrosion. It is never found as a native metal; it is obtained mainly from the mineral zircon, which can be purified with chlorine.

When a tooth is missing the remaining teeth can move/drift to occupy the open space that may result in the opening of more spaces. Not only will your function be harmed, but the chances of jaw pain, gum disease and decay increase substantially. Missing teeth can be replaced by means of porcelain and zirconium bridges. If indicated, both teeth on the sides of the gap can be used to attach the bridge. Zirconium is very strong and durable and contributes to an aesthetically pleasing result. A bridge/crown is permanently bonded/cemented to your teeth and cannot be removed by a patient.

Crowns are a form of dental restoration otherwise known as “caps” that fit over your teeth. Teeth are prepared by your dentist, impressions of these are then sent to a laboratory where, through multiple processes, the crown “cap” is created, which is a covering fitted over the teeth. Crowns are used to improve the appearance of natural teeth that are malformed, mal-positioned, or discolored, because of fractures, broken down old fillings, chipped or sensitive teeth. .  
Crowns’ outer surfaces are made of natural looking porcelain and are made to improve your overall smile or to blend in with your own teeth. Zirconia crowns, on the other hand, have zirconium coping on which the porcelain is fused. These crowns are thus extremely durable and very aesthetic.

Some of the indications for a crown are:

• A previously filled tooth where there is now more filling than tooth. The existing tooth structure becomes weakened and can no longer support the filling
• Extensive damage by means of decay
• Discolorations and compromised aesthetics
• Fractures
• Root canal – After a root canal procedure, teeth tend to become brittle and are more apt to fracture. These teeth need to be protected by a crown.
• Bridges – When missing teeth are replaced with a bridge, the adjacent teeth require crowns in order to support the replacement teeth.
• Enhancing optimal aesthetic
• Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your teeth. Crowns can be made from different materials which include the full porcelain crown, the porcelain fused-to-metal crown and the all-metal crown. We offer porcelain, zirconium and ceramic crowns (all metal-free). These crowns look the most natural and are strong and durable

Inlays/Onlays are alternatives to normal tooth colored restorations and are thus an all ceramic restoration that is made of strong durable porcelain. These restorations are thus created outside the mouth either via a CEREC machine or through a qualified dental technician and cemented into the space/cavity on the tooth. Dentists make use of inlays/onlays due to the advantages it has above normal tooth coloured fillings.

Advantages are:

• The aesthetic results
• The dental margins that are precise
• No overhangs
• Wear characteristics as with normal teeth
• Durable and long lasting

Dentures are prosthetic devices that replace missing teeth. These devices are made of acrylic (plastic) or chrome (metal). We also offer partial dentures Acrylic/chrome or flex (a flexible plastic) for the replacement of selective missing teeth and immediate dentures. Thus we will ensure optimal aesthetics at all times and with immediate dentures allow you to walk around with teeth immediately after leaving our surgery.

Severe toothache keeping you up at night? Root canal treatment is just the option should you which not to lose your tooth.

Endodontic therapy is a sequence of treatments for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future microbial invasion. This set of procedures is commonly referred to as a “root canal”. Root canals with their associated pulp chambers are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Endodontic therapy involves the removal of these structures, the subsequent cleaning, shaping, and decontamination of the hollows with tiny files and irrigating solutions. Then sealing or closing the canals called obturation (filling) of the decontaminated canals with an inert filling such as gutta percha and a cement.

Root canal treatments are indicated for the following reasons:

• To get rid of an abscess starting due to carious teeth.
• To restore severely fractured teeth during accidents/sports etc.
• To restore teeth severely filled and unable to accommodate any filling without entering and obtaining retention within the canals of the roots

Dental implants are a great way to restore missing teeth with a permanent solution. By using titanium screws (implants) we can now place an implant into the bone which becomes fully integrated into the bone and provides a stable base in order to restore it by either a crown for a single missing tooth or with bridges should there be more teeth missing.

Are you suffering from loose full dentures constantly being painful in spite of padding? What a great way to restore your smile and function with fixed/removable dentures. As few as two to four implants will be enough to provide a firm base for a removable full denture. A bridge can be anchored to at least six implants in your jaw. Whatever your decision, your denture cannot come loose unexpectedly and place you in an embarrassing situation, allowing you to be able to eat, talk and laugh with confidence.

Severe toothache keeping you up at night? Root canal treatment is just the option should you which not to lose your tooth.

Endodontic therapy is a sequence of treatments for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future microbial invasion.

This set of procedures is commonly referred to as a “root canal”. Root canals with their associated pulp chambers are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Endodontic therapy involves the removal of these structures, the subsequent cleaning, shaping, and decontamination of the hollows with tiny files and irrigating solutions. Then sealing or closing the canals called obturation (filling) of the decontaminated canals with an inert filling such as gutta percha and a cement.

Root canal treatments are indicated for the following reasons:

• To get rid of an abscess starting due to carious teeth.
• To restore severely fractured teeth during accidents/sports etc.
• To restore teeth severely filled and unable to accommodate any filling without entering and obtaining retention within the canals of the roots

Dental bleaching, also known as teeth whitening, is a common procedure in cosmetic dentistry. As a child we all are born with naturally white looking teeth but as we age and develop our permanent teeth it starts to stray away from white towards a more yellow colour. As we age the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous. Teeth can also become stained by bacterial pigments, foodstuffs and tobacco or even certain antibiotic medications (like tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel. Oxidizing agents such as hydrogen peroxide or carbamide peroxide are used to lighten the shade of the tooth.

At Paarl Family Health we provide you with two methods of teeth-whitening:

• Chemical teeth whitening (custom-made trays for home use / an in-office procedure.)
• Photo-chemical teeth whitening (in-office procedure utilizing a catalyst such as a laser or blue light to whiten teeth)

For fast optimal results we recommend an hour in-office visit including the use of custom-made trays for home use. For those who dream of having a sparkling white smile, but are looking for a financially more viable alternative, why not consider our professional custom-made home kit package. Although it takes longer than the in-office hour-procedure, great results can be achieved and maintained.

Is it safe? Yes! The chemically activated formula allows your dentist to whiten your teeth without the bothersome heat or ultraviolet rays of a light. The chemically activated formula also contains potassium nitrate and fluoride, which help to improve oral health by strengthening enamel, decreasing sensitivity, and offering increased cavity prevention.

Mouth guards are coverings worn over teeth, and are often used to protect teeth from injury during grinding or during contact sports.

There are three types of mouth guards:

• Stock mouth protectors are preformed and come ready to wear.
• Boil and bite mouth protectors also can be bought at many sporting goods stores and may offer a better fit than stock mouth protectors.
• Custom-fitted mouth protectors are individually designed and made in our dental office based on your needs. First, we make an impression of your teeth and a mouth guard is then molded over the model using a special material. Due to the use of the special material and because of the extra time and work involved, this custom-made mouth guard is more expensive than the other types, but it provides the most comfort and protection

Generally, mouth guards cover your upper teeth only.

Bruxism is when you clench (tightly holding your top and bottom teeth together) or grind (sliding your teeth back and forth over each other) your teeth. One can clench and grind your teeth without being aware of it during the day or night, although sleep-related bruxism is often the bigger problem because it’s harder to control. Probably the biggest trigger of bruxism is daily stress. Whether or not bruxism causes pain, multiple other problems may already be present due to you bruxating.

Grinding is not something that can be left untreated as it will only become worse. The masseter (biting) muscle is responsible for mastication, but when it becomes excessively large (muscle hypertrophy), it may play a role in grinding. In such cases, Botox® may be administered into the deep belly of the Masseter muscle. This will relax the muscle and prevent the muscles from being able to grind, even at night time when we are not aware that we are grinding. An added benefit is the fact that the TMJ (temporomandibular joint) becomes relaxed.

Untreated bruxism may result in the following:

• Painful Jaws, migraines, cluster headaches, tension headaches
• Worn down front teeth
• Fractures in teeth and broken fillings
• Loose teeth as the bone becomes less and less
• Receding gums, due to the increased pressure on the gum line
• Nerve involvement, leading to sensitivity

Treatments for bruxism include:

• The custom-fitted Bite Plate – We will provide you with BiteSoft® splint. This splint design allows for easy comfortable wear
• Physiotherapy
• Hypnosis
• Botox® in the masseter muscles

Benefits of the BiteSoft® splint:

• Insulates teeth from wear and attrition
• Prevents cracking and chipping of teeth and restorations
• Protects expensive investments in crowns, veneers, implants and fillings
• Relieves jaw and neck pain
• Extremely comfortable to wear
• Avoids constant use of pain medication
• Does not interfere with sleep

As we are all aware of wisdom teeth becoming an all bigger problem in our teenagers’ lives, here at Paarl Family Health we provide removal of your wisdom molars either via normal local anesthetic in our surgery or for the more anxious patients under Conscious sedation. We also treat wisdom molar removal under general anesthetic in theatre.

Dental reconstruction and full rehabilitation of the mouth is a process where we strive to rebuild the teeth, gum and function as it should be and as it best suits your needs. This process will include a full oral examination by your dentist and include taking impressions, photos of your teeth and recording your bite in its current status. These recordings are then cast into gypsum models and allow your dentist and his dental technician to comprehensively examine these models even after you have left the rooms. This way a complete step by step treatment plan can be compiled in order to rehabilitate you mouth to normal function.

Treatment includes:

Teeth: The current status of your teeth will determine what restorative procedures may be needed, and can include normal restorations, root canal treatments, porcelain veneers, crowns, inlays or onlays, clinical crown lengthening and bridges or implants restored with a crown, etc.

Periodontal (gum) tissues: Your dentist will during your consultation look and measure any deep pockets around your teeth, assess excessive or insufficient gum tissue, record periodontal disease and bone density irregularities. Unhealthy gums will most likely need scaling and root planing to treat an underlying periodontal disease. Advanced periodontal conditions will require more intensive treatments such as soft tissue or bone grafts from a periodontist to ensure that your newly reconstructed teeth will have a solid foundation.

Temporomandibular joints, jaw muscles and occlusion: A bite in centric occlusion, thus a stable bite, is of utmost importance when it comes to full mouth rehabilitation. This bite is one which allows for normal tooth function and emits no pain upon closing nor causes tooth destruction and abnormal tooth wear during normal occlusal functioning.

Changes in the way you bite need to be taken into consideration when your dentist plans your restorations. Corrections may include orthodontics (dental braces) and the construction of a bite plate also known as a night guard. This will ensure that the treatment carried out will be stable and protected against abnormal wear.

Aesthetics: Every patient presents with different aesthetic needs and is thus determined by the color, shape and size of your teeth, and how they appear in relation to your face, gums, lips, mouth, and overall profile. This will be discussed with you in order to achieve realistic aesthetic needs.

These treatments fall mainly in the aesthetic category and are not usually treatments which the patient needs, but more treatments that the patient wants. Due to consumer demands and the demand for looking and appearing stunning, it is sometimes difficult to draw a line between patient needs and patient requirements. Smile makeovers will include the same basic principles as for a full rehabilitation but will focus mainly on the aesthetics component in order to achieve the best aesthetic result possible.

Also referred to as kids or children’s dentistry. Here we encourage parents to bring their young ones along even if it’s during the parents own visit to the dentist. This way your child will by himself familiarize with all the new sounds, smells, friendly staff and the dentist. This way his first encounter with our practice will be a positive one in which he experiences dentistry as it should be. We entertain children with movies, cartoons and even a children’s table where they can play draw and colour-in pictures.

We offer gum guards for contact sports, fillings, dental sealants, extractions and fluoride treatments and also conscious sedation for multiple dental procedures to be treated and completed in a single visit should it be necessary.

Teeth cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, and other gum diseases. Your oral health is directly linked to your general health. As a dentist we recommend that your teeth be cleaned professionally at least twice per year. This cleaning includes de-scaling of teeth, tooth polishing, and, if required, debridement in areas where too much tartar has built up followed by a fluoride treatment.

For many patients, tooth sensitivity can cause pain that affects quality of life. Gingival recession (receding gums) is the primary way in which dentin is exposed in the cervical region of the tooth (tooth neck). Once this area (also known as the root) is exposed, the protective layer of cementum is easily removed, resulting in open dentin tubules. Movement of fluid in open tubules caused by heat, cold air or pressure causes tooth hypersensitivity. This change in fluid-flow causes a pressure change within the dentin, which activates the intradental nerves causing a signal that is interpreted as pain.

Conscious sedation is the outcome for you if you are having nightmares about the idea of going to the dentist. This treatment is carried out by the anesthetist and is closely monitored by a computerized pulse oximeter which measures heart rate, blood pressure and oxygen saturation. It is an ever increasing treatment, demanded by patients, and we’ve treated numerous patients safely and comfortably.

Will I be out? please I want to be totally out? Yes! Most patients tend to fall asleep during the procedure and will be unaware of what is going on around them. You will be able to swallow, sneeze and cough on your own, some patients will also be able to respond to verbal commands.

Conscious sedation thus allows us:

• To do from simple cleaning to the more extensive procedures for the anxious patient now not being afraid of anything
• To treat children who require multiple visits to restore teeth in a single visit, thus reduces time in the dental chair
• It increases the effectiveness of anaesthetic
• It reduces the gagging reflex and muscle soreness
• Reduces time spent in hospital during general anesthesia, as well as post-operative nausea

Nothing can stop time passing whether we like it or not, we all grow older and inevitably it will show in our faces. We all know a healthy lifestyle includes regular exercise and a well-balanced diet but aging unfortunately will show up at your doorstep uninvited. Botox® also known as the “liquid facelift” will take care of that by smoothing out your skin in just a few days.

Botox® is a purified protein from Clostridium botulinum bacteria which is injected in minute quantities into the muscles of the face in order to relax them or soften the appearance of glabellar lines. The procedure takes about 20 minutes in which you will be asked to pull some facial expressions in order to understand your facial muscles.

The results will start to show over the course of 5-10 days in which you will notice the natural youthful effect of your Botox®. The effects of smooth skin will last up to 4 months, thus repeat treatment will be necessary to maintain the effect up to a point where the muscle relaxes without Botox®.

Botox® has been used for nearly 16 years in total and tested extensively for safety and efficacy. As with all medicines, Botox® can cause side effects and your practitioner will advise you about these. Choosing an experienced practitioner will minimize the risk of side effects. Most are linked to the injections, such as pain on injection, redness or swelling. Other side effects such as drooping of the upper eyelid can be caused by a spread of the injection into nearby muscles but are temporary in nature. Your practitioner will give you all necessary post treatment instructions to optimize your results.

We offer a wide variety of facial services, thus grab the opportunity to transform the way you look by making use of our reasonably priced services. Our procedures are non-invasive, fast, effective with little or no down-time.

We offer the following popular treatments:

• Frown lines
• Forehead
• Glabellar region
• Brow lift – non invasive
• Crow’s feet around the eyes
• Bunny lines on nose
• Gummy smile
• Nefertiti lift
• Platysmal bands on neck

Filler is an injectable gel that is made up of Hyaluronic acid (HA) – a naturally occurring substance in your skin that helps to add volume and hydration. The filler is gently injected under the skin to instantly restore your skin’s volume and smooth away facial wrinkles and folds. The skin is made up of three layers; each plays a vital role in maintaining healthy skin.

• The deepest layer is the hypodermis made up of fatty tissue that cushions and supports the two layers of skin above it.
• The middle layer is the dermis. It contains collagen and elastin for form, shape and elasticity, which are constantly renewed in young healthy skin. Older skin tends to sag and wrinkle because the collagen and elastin levels are reduced. This is also where the blood capillaries, hair follicles, sweat and oil glands are found. As we age, our oil glands become less active and our skin becomes drier and more prone to the formation of fine lines.
• The top layer or epidermis is where essential cell renewal takes place. In younger skin, cells are replaced about every 1-30 days; as we age, this process takes twice as long.

Here at our offices we use Juvederm® and Redensity® filler as it is biodegradable, safe and has the outstanding ability to look natural and beautiful. Not only will it smoothen a wrinkle, it will also add volume, creating a youthful appearance.

We offer the following popular treatment options:

• Deep and shallow frown lines
• Lip border definition
• Lip volume enhancement
• Nasiolabial folds
• Oral comissures/corners of mouth
• Smokers lines/peri-oral lines
• Cheek bone lift
• Tear-troph reduction/dark area around eyes
• Nose straightening / nose lift for minor deformities