- Diagnostic and oral medicine
- Oral and Maxillofacial Surgery
- Crowns and Bridges
- Dental Scaling
- Gum Treatment
- Root Canal
- Tooth Filling
- Tooth Whitening
- Wisdom Tooth Extraction
- Laser Dentistry
- Dental Implant
Diagnosis forms the foundation for any treatment. Oral diagnosis such as toludene blue to detect oral pre-cancer and cancer are used. Other dyes to detect and demonstrate oral plaque for patient education is also employed.
Other diagnostic tools such as pulp testers to test the vitality of teeth are also employed, common chair side investigation like the fremitest , the tongue blade test are also used.
Oral manifestations of systemic diseases are diagnosed and treated appropriately including comprehensive medical care to tackle the underlying diseases.
Oral potentially malignant disorders like such mucous fibrosis, leukoplakia etc are diagnosed and managed.
Other oral diseases such as blistering diseases like pemphigus, pemhigoid etc, aphthous ulcers, lichenplanus and many more such conditions are comprehensively diagnosed and treated.
Oral and Maxillofacial Surgery
Oral and Maxillofacial Surgery is a branch of surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is a recognized international surgical specialty and it is one of the nine specialties of dentistry.
It involves a number of surgical procedures, which include
- Removal of wisdom tooth
- Treatment of temporomandibular joint disorders
- Bone grafting
- Treatment of facial trauma
- Treatment of oral pathological lesions
- Dental implants
Removal of Wisdom Tooth
Wisdom tooth is the last tooth in the arch and is also the last one to erupt. If they are aligned properly in the arch then they need not be removed. But if they grow sideways, or emerge partially or remain trapped inside the bone it is necessary to remove them. They may cause infection which would result in swelling and pain. They can also affect adjacent tooth. Not only this, they may also disturb the natural alignment of other teeth. Therefore, an early removal of wisdom tooth is recommended.
An X-ray is first needed to evaluate the position and depth of wisdom tooth. Then during the procedure, first, anaesthesia is given to numb the area. Tooth is removed. Sutures are then given. Medication is then recommended for few days.
Temporomandibular Joint Disorders
TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. The following are common symptoms.
1. Headache: which is often made worse while opening and closing the jaw. Exposure to cold weather or air-conditioned air may increase muscle contraction and facial pain.
2. Ear pain: Ear pain and do not have signs of ear infection. The ear pain is usually described as being in front of or below the ear.
3. Sounds: Grinding, crunching, or popping sounds, medically termed crepitus, are common for patients with a TMJ disorder. These sounds may or may not be accompanied by pain.
4. Ringing in the ear (tinnitus): For unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing in the ears (tinnitus). Of those patients, half will have resolution of their tinnitus after successful treatment of their TMJ disorder.
These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. It is important to note that joint noise is not always indicative of a TMJ disorder and quite frequently requires no treatment at all.
These problems may result due to stress, temporomandibular joint injury, arthritis, infection, tightening of jaw muscles or repeated clenching or grinding of teeth.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation.
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthodontic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
Bone grafting is a surgical procedure in which synthetic material is placed beneath the gums which are then sutured back. After several months of healing bone becomes a part of patient’s jaw. After this, dental implants can be placed inside the bone. Bone grafting thereby gives chance to restore function and facial appearance.
Bone grafting can also be used to treat cases of trauma, tumour or congenital defects.
Facial trauma includes any one of the following injuries
- Facial lacerations (cuts).
- Removal of tooth from socket.
- Fracture of facial bones.
- Fracture of jaws.
- Cuts or bruises inside the mouth.
- Soft tissue injuries can be treated by suturing.
- Injuries to teeth can be treated by splinting, that is, stabilizing the teeth by wiring or bonding together.
- In certain cases of fracture of jaws wiring of jaws is needed.
- For some fracture cases, placement of small screws or plates might be needed.
A special type of mucosa is present inside the mouth which is smooth and coral pink. Any alteration in the normal structure indicates pathology.
Any of the following symptoms if present need treatment
- A reddish/ whitish patch.
- A sore that does not heal.
- Difficulty in chewing/swallowing food.
- A lump or thickening on skin living inside the mouth.
- Reduced mouth opening.
However, it is important to know that pain does not always occur in pathology.
CROWNS AND BRIDGES(Caps)
A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
There are many types of crowns, porcelain and metal are the most commonly used. Porcelain crowns are tooth colored and the most popular. Crowns are highly durable and long lasting, but like most dental restorations may need to be replaced. All crowns are made to match the size, shape and color of your natural teeth. Zirconia and all ceramic crowns ensure a more natural–looking and beautiful smile.
Reasons for crowns:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
- Teeth with root canals
What does getting a crown involve?
A crown procedure usually requires two appointments. Your first appointment will include taking impressions/digital impressions that will be used to create your temporary and custom crowns. While the tooth is numb, the dentist will prepare the tooth by removing any old fillings or decay. The dentist will shape the tooth to properly fit the crown, and take a highly accurate impression/digital impression for your new crown. While your crown is being made by our professional laboratories your temporary crown will be in with a temporary cement. Your crown will be ready in a few weeks. At your second appointment your permanent crown will be inserted with a permanent cement.
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.
There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.
Reasons for a fixed bridge:
- Fill space of missing teeth.
- Maintain facial shape.
- Prevent remaining teeth from drifting out of position.
- Restore chewing and speaking ability.
- Restore your smile.
- Upgrade from a removable partial denture to a permanent dental appliance.
What does getting a fixed bridge involve?
Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.
At the second visit, your permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.
You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
Benefits of Crowns & Bridges Procedure:
Tooth restoration: The procedure will help to restore the teeth. You will get good and better teeth after this.
Natural appearance: Even after undertaking the procedure, you will not feel any artificiality and it will give you a more natural look.
Healthy teeth: You will get healthy teeth after undergoing the procedure. You will get good and strong teeth after the procedure.
Tooth support: You will get tooth support after undergoing the procedure.
Long lasting: The treatment will provide long lasting look of your teeth and support.
What Is Dental Scaling?
Dental scaling is the most common nonsurgical way to treat gum disease, which is also known as periodontitis.
If your disease is moderate, but not severe, our dentist may recommend scaling to treat the disease and keep it from getting worse. But if you have severe periodontal disease and your condition may require gum surgery, your dentist and periodontist may recommend a scaling and root planing before the surgery, as well as a thorough teeth-cleaning prior to the procedure.
The sticky, bacteria-filled plaque that causes gum disease tends to accumulate in the area along and just below the gum line. If you have gums that are slightly receded from your teeth, you may be at increased risk for gum disease and your dentist may recommend scaling. Scaling is nonsurgical, but it is a different type of procedure from a standard dental cleaning because it involves cleaning the areas of the tooth below the gum line.
There are two types of scaling instruments and some dentists or dental hygienists may use both:
Scaling with HAND-HELD INSTRUMENTS.
Your dentist or periodontist will use a dental scaler and curette to manually remove (scale) the plaque from the teeth. Because the dentist or dental hygienist can't see the plaque, they rely on touch to identify areas of tartar buildup and rough spots.
Scaling with ULTRASONIC INSTRUMENTS
Ultrasonic scaling instruments clean plaque from the teeth with a vibrating metal tip that chips off the tartar and a water spray to wash it away and keep the tip cool. Ultrasonic scaling is the process of using a special tool to comfortably remove accumulated dental plaque between teeth and gum tissue. Ultrasonic scalers work by generating rapid vibrations through a thin attachment at the tip which is gently moved along the gum and tooth pockets. The ultrasonic scaler easily disrupts the dental plaque and rinses it away from the area with a gentle stream of sterile water.
HOW THEY WORK
The main action of power scalers is mechanical, the high vibrational energy crushes and removes calculus. Other actions include: creating shockwaves that disrupt bacterial cells, or using turbulence to disrupt biofims, and irrigation - the therapeutic washing and flushing of the periodontal pocket and root surface with cooling water.
- They are as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm.
- They are very effective in disrupting biofilm from root surfaces and from within periodontal pockets making them especially helpful when patients require frequent maintenance (cleanings).
- Specially designed tips can penetrate deeper into periodontal pockets than manual instruments and are more effective at cleaning difficult nooks and crannies like furcations, (areas where roots join each other in multi-rooted teeth).
- When used correctly they are kinder to tooth structure, which is especially important with repeated cleanings.
- Coolant sprays provide irrigation (flushing of the area), which improves healing by removing bacteria and their bi-products as well as the hygienist's ability to see when scaling.
- They require less time than manual instruments for the same job.
- Their smaller tips cause less tissue distention and require very little pressure, thus making it more comfortable for the patient.
Dentures are devices used to fill in the gaps created by missing teeth. Missing teeth are common among adults and elderly people, and can be caused by various things such as decay, periodontal disease, inadequate oral hygiene, or accidents caused by sport or other injury. Dentures are used to restore the function of your jaw, and your appearance.
There are two main types of dentures: Complete and Partial. Your dentist will help you choose the type of denture that's best for you based on whether some or all of your teeth are going to be replaced and the cost involved.
Full dentures : These are pictures of dentures where there are no natural teeth left, and the denture is what we call a "full" denture. After replacing the teeth, there is also gum-colored acrylic that sits over the gums, and holds the teeth in place. It also can replace some of the gum where the gum has shrunk. This helps to build up a " fallen in "appearance, by pushing out the lips and cheeks into their normal positions.
Partial dentures. These are dentures that replace some missing teeth, where you still have natural teeth. Partial dentures are usually held in place by small clips or clasps. These look like little bits of wire that wrap around a natural tooth, gripping it firmly.
Below picture of dentures show a very sophisticated partial denture, which has small hidden attachments to hold it in place, rather than clasps or wires. The attachments are the little yellow tubes visible on the left and right of the denture.
What are dentures made of ?
Dentures are comprised of a plate, metal or acrylic, designed to fit over the bone and soft tissues of your jaw. Ceramic or acrylic false teeth are attached to the plate, matching any remaining teeth to create as natural a look as possible.
Benefits of Dentures
Reduces Sagging Facial Muscles : Without teeth in the jaw your cheeks do not have as much support to combat the force of gravity. Toothless gums can result in your cheeks sinking inwards or downwards and cause facial wrinkles that may make you appear older than you are. Having dentures fitted can actually help to reverse this process by giving your cheeks and the skin on your face the support it needs to retain a young shape.
Healthy Lifestyle : They can help you to chew food properly, and thus obtain the full amount of nutrients that it needs. If your teeth have been crumbling and rotting you may not have wanted to eat harder foods like raw fruit and vegetables. Dentures can give you back control of your diet and improve your overall physical health.
Makes You Look Good : From a cosmetic prospective, they can greatly enhance your looks. Makeover shows often focus on teeth as a key area for improving self confidence. A brighter, more smile can make you look younger and feel confident. As well as being straighter than your original teeth and filling in any spaces where before there were gaps, dentures can be made to be whiter than the original teeth (if you had problems with discoloration before). A radiant smile can brighten your whole face.
Periodontics is the branch of dentistry that deals with diseases related to gums. It is usually a microbial infection, which gradually destroys the tissue surrounding and supporting natural teeth. The bacteria in our mouth along with saliva and other food particles constantly form a sticky, colorless “plaque” on teeth. Proper brushing and flossing can remove plaque. Accumulation of excessive levels of plaque results in hardened substance called tartar. Only a professional cleaning by dentist or dental hygienist can remove tartar.
Maintaining good oral hygiene is an important aspect to prevent gum disease. Treating gum disease at an early stage is essential. If left untreated, it may lead to:
- Loss of teeth
- Medical conditions such as diabetes may worsen
- Increased chance of heart disease or stroke
Gum disease can be treated by proper consultation with dentists at Yashas Dental Health Care . The treatment procedure usually includes scaling, root planing and comprehensive teeth cleaning.
Risk Factors for Gum Disease
There are some risk factors that can make you more susceptible to developing gum disease. These include:
- Failure to maintain good oral hygiene on a regular basis
- Using any type of tobacco
- Other people in your family have gum disease
- Medical conditions that weaken your immune system (AIDS, leukemia or diabetes)
- Failure to eat a healthy diet with adequate vitamins and minerals
Symptoms of Gum Disease
When your gums are healthy they look pink and remain firm, don’t bleed easily and fit up snug to the teeth. Each type of gum disease has its own set of symptoms. The signs of gingivitis include:
- Swollen, tender or red gums
- Bleeding while brushing or flossing
Gingivitis is not very painful and sometimes symptoms are overlooked and no treatment is sought. The symptoms of periodontitis are more apparent and include:
- Gums that are pulling away from the teeth
- Persistent bad breath
- Pus coming out of the gums
- An obvious change in the way you bite felt in the way the teeth fit together
- Teeth that become loose
Who can get Gum Disease ?
The primary cause of periodontal disease is Plaque, but some other factors which can increase the risk and severity of gum disease are:
Stress - Stress lowers down your body’s immune system to fight infection, including gum disease.
Grinding teeth - Due to excess force on the teeth, the rate of destruction of the supporting tissues of the teeth increases with time.
Diabetes - Diabetic patients are more prone to get infections and are at higher risk for developing periodontal disease.
Smoking - It is one of the most significant risk factors associated with the development of gum diseases. Smoking can lower the chances of success in some treatments. The percentage of periodontitis in smokers is seven times more than in nonsmokers.
Genetic factor - Some individuals are more prone to get severe gum disease than others.
Hormonal changes in girls/women - Hormonal changes make gums sensitive and easier for gum diseases to develop.
Medications - Some drugs like anti-depressants, anti-convulsion and some anti-angina medicines, reduces the amount of saliva flow and this can affect your oral health as saliva plays a protective role on teeth and gums.
Illnesses - Diseases that interfere with your immune system such as AIDS or cancer can also affect the oral health.
Common Measures for Treating Gum Disease :
Scaling and Root Planing : Professional cleaning means scraping off the tartar from above and below the gum line of teeth, and Root planing gets rid of irregular spots on the tooth root where the germs collect, and helps remove bacteria that contribute to the gum diseases.
Curettage - Scraping away of the diseased gum tissue in the infected pocket, which allows the infected area to heal.
Medications - are used to destroy the microbes that cause periodontitis or hold back the destruction of the tooth's attachment to the bone. In some cases, a dentist will recommend a mouth rinse containing a chemical called chlorhexidine to help control plaque deposition. There are also antibiotic gels, fibers or chips, which are directly applied to the infected pocket.
What is a root canal treatment?
In simple terms, root canal treatment is the removal of the infected soft tissue(nerve) within the tooth and its replacement by an artificial inert ‘filling’ material.
The tooth is made of three layers:
- The enamel or the outer layer
- The dentin or the inner layer
- Pulp or the nerve.
The decaying of a tooth first starts with the outer layer and progresses on to the inner layers. When the pulp gets decayed, it causes severe pain. Root canal often becomes the only way to save the tooth. It cleans out the infected pulp and repairs the damage.
Some symptoms when a root canal is needed include :
- Spontaneous pain or throbbing while chewing
- Sensitivity while eating hot and cold food
- Severe decay or an injury that creates an infection in the bone
What does RCT Involve?
Before commencement of the treatment, an X-ray is taken to find out how the roots of the tooth are & whether the treatment is possible. The treatment is usually carried out in two visits. At the first visit the nerve is reached by drilling though the tooth & cleaned – this has to be done under the effect of local anesthesia unless of course the nerve is already dead. The root canal is cleaned thoroughly & a medicine is placed. In the subsequent visits after making sure that the nerve is completely removed & that the tooth is comfortable, the root canal is filled
Step 1: The tooth area is made numb by using anaesthesia and an opening is made through the enamel and dentin to reach the pulp.
Step 2 : The depth of the root canal is determined
Step 3 : The infected pulp is removed. The canal is cleaned, enlarged and shaped.
Step 4: The canal is filled and sealed. A metal post may be added for structural support or to retain restorative materials.
Step 5: The tooth is sealed with a temporary filling. A crown is then added to protect the natural tooth.
Do you deaden the tooth by RCT? Does it affect other nerves on that side?
A ‘dead tooth’ is one which has the supporting tissues also ‘dead’. The tooth after RCT has only lost the pulp (nerve & blood vessels) from within the tooth & is called pulp less or nerveless tooth. You will not have sensation in this tooth. Otherwise it is like any other tooth.
Is a crown necessary after root canal treatment?
After a root canal treatment, a tooth will become brittle and will not be able to withstand the forces of biting and chewing. A crown acts as a protective covering on the tooth and prevents any breakdown of tooth structure. So it is mandatory to crown any tooth that has been treated by root canal.
What Is Tooth Filling ?
A filling is a material that our dentist use to fill a cavity after he/she removes any tooth decay.
What is The Procedure For Tooth Filling ?
To fill a tooth, our dentist will
* Numb your teeth, gums, tongue, and surrounding skin. Our dentist will first put a substance that feels like jelly directly on the area to start the numbing process, and then inject an anesthetic to complete it. You will be given nitrous oxide gas (laughing gas) to reduce pain and help patients relax.
* Sometimes we use a small sheet of rubber on a metal frame (rubber dam) to target the decayed tooth and to stop liquid and tooth chips from entering your mouth and throat.
* Finally we drill out all the decay and replace it with a filling.
What kind of materials can be used as Filling ?
Amalgam : This is the easiest material for a dentist to use. It is the fastest and least costly choice. Amalgam is a mixture of mercury, silver, tin, or other metals.
Composite resins : They are tooth-colored fillings. Composite resin is easier for the dentist to work with and are asthetically appealing.
Glass Ionomers : They are tooth-colored materials that dentists often use for small cavities or cavities between teeth. Some ionomers release small amounts of fluoride, which may help you if you often get cavities.
Why is Tooth Filling Done ?
You need a filling when tooth decay has caused a hole or cavity to form on a tooth surface. If filling is not made, the cavity will get worse. It may cause pain and then an abscess. This may lead to more severe problems, such as bone loss with time.
What To Expect After Treatment ?
After the dentist has filled the cavity, patients may have little discomfort on chewing which usually settles after a couple of days. Some cases may also have sensitivity which needs minor adjustments to be made by the dentist.
How Well Filling Works ?
A filling repairs the tooth and stops tooth decay. Over a long period of time, patient may need to replace a worn-out filling. The filled tooth may be sensitive to heat and cold for days to weeks after you get the filling.
What is Tooth Whitening ?
Tooth whitening lightens teeth and helps to remove stains and discoloration. Whitening is among the most popular cosmetic dental procedures as it greatly improve how your teeth look. Most dentists perform tooth whitening. Whitening is not a one-time procedure. It will need to be repeated from time to time to maintain the brighter color.
Why Tooth get Stained ?
The most common reasons for teeth to get yellow or stained are:
- Using tobacco
- Drinking dark-colored liquids such as coffee, cola, tea and red wine
- Not taking good care of your teeth
- Aging makes teeth less bright as the enamel gets thinner and the dentin becomes darker.
It is also possible to have stains inside the tooth. These are called intrinsic stains. For example, intrinsic stains can be caused by exposure to too much fluoride as a child while teeth are developing. Other causes include tetracycline antibiotics. Trauma may also darken a tooth. Tooth whitening is most effective on surface (extrinsic) stains.
How is Tooth Whitening Preparation made ?
Cavities need to be treated before teeth are whitened. That's because the whitening solution can pass through decayed areas and reach the inner parts of the tooth. If gums have receded, the exposed roots of teeth may appear yellow or discolored. Whitening products will not make them whiter.
If patient have tooth decay or receding gums, whitening may make teeth sensitive. Whitening does not work on ceramic or porcelain crowns or veneers.
Our dentist will photograph your teeth first. This step will help dentist to monitor the progress of the treatment. Our dentist will also examine the teeth and ask questions to find out what caused the staining.
Next step is the dentist or a dental hygienist cleaning patients teeth. This will remove the film of bacteria, food and other substances that build up on your teeth and contribute to the staining. Once this is done, the whitening procedure begins.
How is Tooth Whitened ?
There are two main types of whitening procedures.
Vital whitening : This is performed on teeth that have live nerves.
Non-vital whitening : This is done on a tooth that has had root-canal treatment and no longer has a live nerve.
Procedure For Vital whitening :
The most common type of vital tooth whitening uses a gel that is applied directly to the tooth surface. This product contains some form of hydrogen peroxide. Dentists use a specialized light or laser activates the gel and allows bleaching to happen faster. This type of whitening usually takes 30 to 90 minutes and one will need 1 to 3 appointments. The number of appointments will depend upon the method used, how severe stains are and how white patients want their teeth to be. Different types of stains respond differently to the treatment.
Our dentists will apply a substance that covers and protects the gums around the teeth. Then, the whitening agent will be placed on the teeth. Some whitening agents are activated by a laser light, special lights or by the heat from these lights. After the whitening agent is applied, the dentist will shine the light on your teeth. If they are badly discolored, our dentist may suggest that you continue the bleaching process for a few days or weeks.
Procedure for Non Vital Whitening :
Vital whitening don't improve the appearance of a tooth that has had root-canal treatment because the stain is coming from the inside of the tooth. In such cases, our dentist will use a different procedure that whitens the tooth from the inside. He/she will place a whitening agent inside the tooth and put a temporary filling over it. The tooth will be left this way for several days. You may need this done only once, or it can be repeated until the tooth reaches the desired shade.
Whitening is not a permanent solution. The stains will come back. If one smoke or consume a lot of staining foods or drinks, one may see the whiteness starting to fade in as little as one month. By avoiding these sources of staining, may not need another whitening treatment for 6 to 12 months.
Wisdom Tooth Extraction
What is Wisdom Tooth Extraction ?
Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth, the four permanent adult teeth located at the back corners of your mouth on the top and bottom.
If a wisdom tooth doesn't have room to grow (impacted wisdom tooth) and results in pain, infection or other dental problems, you'll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.
To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren't currently causing problems.
Why is Wisdom Teeth Extraction done ?
Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally just as their other molars did and cause no problems. Many people develop impacted wisdom teeth, i.e., teeth that don't have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.
An impacted wisdom tooth may:
- Grow at an angle toward the next tooth (second molar)
- Grow at an angle toward the back of the mouth
- Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone
- Grow straight up or down like other teeth but stay trapped within the jawbone
What are the Problems with impacted wisdom teeth
You'll likely need your impacted wisdom tooth pulled if it results in problems such as:
- Trapping food and debris behind the wisdom tooth
- Infection or gum disease (periodontal disease)
- Tooth decay in a partially erupted wisdom tooth
- Damage to a nearby tooth or surrounding bone
- Development of a fluid-filled sac (cyst) around the wisdom tooth
- Complications with orthodontic treatments to straighten other teeth
During the procedure
Our dentist or oral surgeon may use anesthesia, they administer local anesthesia with one or more injections near the site of each extraction. Before you receive an injection our dentist or surgeon will likely apply a substance to your gums to numb them. You're awake during the tooth extraction. Although you'll feel some pressure and movement, you shouldn't experience pain.
During wisdom tooth extraction, our dentist or oral surgeon
- Makes an incision in the gum tissue to expose the tooth and bone
- Removes bone that blocks access to the tooth root
- Divides the tooth into sections if it's easier to remove in pieces
- Removes the tooth
- Cleans the site of the removed tooth of any debris from the tooth or bone
- Stitches the wound closed to promote healing, though this isn't always necessary
- Places gauze over the extraction site to control bleeding and to help a blood clot form
Instructions to be followed after Wisdom Tooth Extraction
Bleeding : Some oozing of blood may occur the first day after wisdom tooth removal. Excessive spitting should be avoided not to dislodge the blood clot from the socket. Gauze should be replaced over the extraction site as directed by our dentist or oral surgeon.
Swelling and bruising : Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.
Food : Eat only soft foods, for the first 24 hours. Eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
Cleaning your mouth : Don't brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Resume brushing teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
Stitches : You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out
Lasers have been used in dentistry since 1994 to treat a number of dental problems.
Gum disease : Lasers are used to reshape gums and remove bacteria during root canal procedures.
Biopsy or lesion removal : Lasers can be used to remove a small piece of tissue (called a biopsy) so that it can be examined for cancer. Lasers are also used to remove lesions in the mouth and relieve the pain of canker sores.
Teeth whitening : Lasers are used to speed up in-office teeth whitening procedures. A peroxide bleaching solution, applied to the tooth surface, is ''activated" by laser energy, which speeds up of the whitening process.
How Do Lasers Work in Dentistry?
All lasers work by delivering energy in the form of light.
When used for surgical and dental procedures, the laser acts as a cutting instrument or a vaporizer of tissue that it comes in contact with.
When used for "curing" a filling, the laser helps to strengthen the bond between the filling and the tooth.
When used in teeth-whitening procedures, the laser acts as a heat source and enhances the effect of tooth-bleaching agents.
What are the Advantages and Disadvantages of using Laser in Dentistry ?
- May cause less pain in some instances, so reduces the need for anesthesia
- May preserve more healthy tooth during cavity removal
- May reduce anxiety in patients uncomfortable with the use of the dental drill
- Minimize bleeding and swelling during soft tissue treatments
- Lasers can't be used on teeth with fillings already in place.
- Lasers can't be used in many commonly performed dental procedures. For example, lasers can't be used to fill cavities located between teeth, around old fillings, and large cavities that need to be prepared for a crown. In addition, lasers cannot be used to remove defective crowns or silver fillings, or prepare teeth for bridges.
- Traditional drills may still be needed to shape the filling, adjust the bite, and polish the filling even when a laser is used.
- Lasers do not eliminate the requirement for anesthesia.
What is Dental Implant ?
A dental or endosseous implant (endo means inside, osseous means bone) is actually a root replacement, but unlike the root of a tooth it becomes anchored in the bone of the jaw, formerly occupied by a tooth or teeth. Teeth essentially can be thought of as having two main parts, the crown, the part above the gum tissues, and the root, the part that is suspended in the bone by the periodontal ligament (peri means around, odont means tooth) which keeps the tooth in place. which is then cemented onto the abutment.
Which material is used in Dental Implant ?
Currently used dental implants are actually fused with, or “integrate” into the bone. This process is known as “osseo-integration” (osseo means bone, integrate means to become part of). They are for the most part made of commercially pure titanium, a metallic substance used for many years in medicine and dentistry because it is not rejected by the body, being osteophilic (bone loving). The actual process of osseo-integration is essentially a biochemical fusion of living bone cells and bone substance to an oxide layer that forms on the surface of the titanium.
Types of Implant Restorations:
Single tooth replacements: Use one implant and as the name suggests support a single crown.Fig 1: Illustration showing an example of a full crown restoration placed on an individual implant.
Multiple tooth replacements: Here multiple missing teeth can be replaced with multiple implants supporting fixed bridgework as small as a 3-unit bridge supported by two implants, or with multiple implants supporting a greater number of teeth. Usually a minimum number of 4-8 implants are needed to replace a full arch (jaw) of teeth, 10 or more crowns by fixed bridgework.Fig 2: Illustration showing an example of a 3-unit bridge with a pontic (replacement tooth) placed between two implant crowns.
Combinations of fixed and removable bridgework: Generally where implants are used to support a section of fixed bridgework, to which is attached a removable section.Fig 3: Illustration showing an example of a permanent bridge supported by multiple implants which has attachments for a removable partial denture
Over-dentures: Here two or more implants, either standard or mini-implants, are placed to provide stabilization of the denture and preserve the underlying bone. Whereas most traditional full dentures press directly on the gum and bone causing bone loss by resorption, implant supported over-dentures protect the bone. Over-dentures are now considered the standard of care by the American Dental Association for the patients who have lost all of their teeth in one or both jaws.Fig 4: Illustration showing an example of two implants for attachment and stabilization of the mandibular denture protecting the underlying bone
Anchorage for tooth movement (orthodontics): Implants, either standard, mini, or micro-mini implants, are now being used to provide very stable and non-movable anchor units to allow quicker and easier tooth movement.Fig 5: Illustration showing an example of a how an implant can be used for anchorage during orthodontic therapy to straighten tipped teeth.
Temporary bridgework: Utilize micro-mini implants which are later removed when the permanent implants are healed and teeth permanently replaced. They ensure that at no time will a person be without teeth and can therefore be socially comfortable and functional.Fig 6: Illustration showing micro-mini “temporary” implants providing a non-removable temporary bridge while permanent implants attach to the underlying bone.
Our dentist will select the type of implant that has been evaluated for bio-compatibility, supporting research and to provide tooth replacement.
Orthodontic treatment is needed to correct improperly positioned teeth and jaws. If the jaws are not properly aligned it can cause temporomandibular joint disorders.
Reasons for orthodontic treatment:
- 1. Crowded or misplaced teeth.
- 2. Sucking the thumb or fingers or other oral habits.
- 3. Speech difficulty.
- 4. Protruding teeth.
- 5. Facial asymmetry.
- 6. Inability to close lips.
- 7. Front teeth that do not meet.
At first, an assessment of patient’s teeth is made by using X-ray and making plaster models. The orthodontist then decides the need for either removable, or functional or fixed appliance.
In some cases, it might be necessary to remove a tooth to correct the position of other teeth. Retainers are often used near the end of orthodontic treatment. They hold newly fixed teeth in place while the adjacent gums and bone adjust to new position of teeth.
Types of Orthodontic Treatment
Orthodontic appliances can be both fixed and removable. Many different types of appliances, both fixed and removable, are used to help move teeth, retrain muscles and affect the growth of the jaws. These appliances work by placing gentle pressure on the teeth and jaws. The severity of your problem will determine which orthodontic approach is likely to be the most effective.
Fixed appliances include:
» Braces — the most common fixed appliances, braces consist of bands, wires and/or brackets. Bands are fixed around the teeth or tooth and used as anchors for the appliance, while brackets are most often bonded to the front of the tooth. Arch wires are passed through the brackets and attached to the bands. Tightening the arch wire puts tension on the teeth, gradually moving them to their proper position. Braces are usually adjusted monthly to bring about the desired results, which may be achieved within a few months to a few years. Today's braces are smaller, lighter and show far less metal than in the past. They come in bright colors for kids as well as clear styles preferred by many adults.
» Special fixed appliances — used to control thumb sucking or tongue thrusting, these appliances are attached to the teeth by bands. Because they are very uncomfortable during meals, they should be used only as a last resort.
» Fixed space maintainers — if a baby tooth is lost prematurely, a space maintainer is used to keep the space open until the permanent tooth erupts. A band is attached to the tooth next to the empty space, and a wire is extended to the tooth on the other side of the space.
Removable appliances include:
» Aligners — an alternative to traditional braces for adults, serial aligners are being used by an increasing number of orthodontists to move teeth in the same way that fixed appliances work, only without metal wires and brackets. Aligners are virtually invisible and are removed for eating, brushing and flossing .
» Removable space maintainers — these devices serve the same function as fixed space maintainers. They're made with an acrylic base that fits over the jaw, and have plastic or wire branches between specific teeth to keep the space between them open.
» Jaw repositioning appliances — also called splints, these devices are worn on either the top or lower jaw, and help train the jaw to close in a more favorable position. They may be used for temporomandibular joint disorders (TMJ).
» Lip and cheek bumpers — these are designed to keep the lips or cheeks away from the teeth. Lip and cheek muscles can exert pressure on the teeth, and these bumpers help relieve that pressure.
» Palatal expander — a device used to widen the arch of the upper jaw. It is a plastic plate that fits over the roof of the mouth. Outward pressure applied to the plate by screws force the joints in the bones of the palate to open lengthwise, widening the palatal area.
» Removable retainers — worn on the roof of the mouth, these devices prevent shifting of the teeth to their previous position. They can also be modified and used to prevent thumb sucking.
» Headgear — with this device, a strap is placed around the back of the head and attached to a metal wire in front, or face bow. Headgear slows the growth of the upper jaw, and holds the back teeth where they are while the front teeth are pulled back