FAQ - Aditi Dental Care | Multi-speciality Dental Clinic, Sarjapur Road - Bangalore's best dentists

Root canal treatment involves the removal of the nerve from the tooth by drilling a hole in the top surface of the tooth. The inside is cleaned out with disinfectants and needle-like instruments. The root canal is then dried and a rubber filling placed down the inside of the tooth,therby sealing the pulp space & preventing bacteria from entering the space again.

With the removal of nerves and blood supply from the tooth, it is best that the tooth be fitted with a crown which increases the prognosis of the tooth by six times.

Single Visit Endodontics or Single sitting root canal treatment refers to cleaning, shaping & disinfection of the root canals of the tooth followed by obturation, all carried out during the same visit.

Tooth anatomy and root canal treatment

Our teeth have their own circulation and nerves. The veins and nerves running inside the teeth can be damaged by various factors (such as deep decay or trauma). Inside each tooth is a pulp chamber that contains the nerves and blood supply for the tooth. When the pulp becomes infected due to decay or injury to the tooth, the pulp must be removed from the center of the tooth and the canals of each root. Once the infected pulp is removed, the remaining chamber is filled with a rubber-based material to seal it off.

All teeth that have had root canal therapy must be protected with a tooth-like artificial covering known as a crown (see crown section). This is because teeth that have had the pulp removed are more susceptible to fracture.

Does it hurt?

The mention of "root canal" evokes images of severe pain. In truth, however, root canal treatment is maligned unfairly. Advances in technology, and the experience of specialists(endodontist) have made root canal treatment far less painful than its reputation suggests. Ironically, root canal is designed to minimize the pain from an infected tooth; it does not produce the pain.Moreover the procedure is done under local anaesthesia.

When is root canal treatment necessary?

Root canal treatment becomes necessary when the pulp inside your tooth gets infected. The pulp is the soft tissue inside your tooth, home to connective tissues, blood vessels and nerves. The pulp goes from the crown of your tooth to the tip of the root in your jawbone. Normally, the tooth itself protects the pulp, but if the tooth is damaged by a very deep cavity, or a crack, or trauma from repeated repairs, bacteria can reach the pulp. Then the bacteria grow from the crown towards the root, pus accumulates at the root tips, and the mouth becomes painful and sensitive to hot and cold. Not all pulp infections bring pain; sometimes they spread so slowly that the patient feels nothing.

How is root canal treatment performed?

Root canal treatment occurs in three stages: First comes the diagnosis. Next comes the root canal itself, in which a dentist or an endodontist (a dentist who specializes in treating the inside of the tooth) removes the pulp (and thereby also the infection), and cleans the inside of the tooth preparatory to filling it, sometimes applying antibiotics to prevent further infection. A temporary filling is placed at the crown opening. Finally, during a subsequent appointment, a crown is installed to seal the tooth and protect it from further damage or infection.

What results can I expect?

With successful root canal treatment, the tooth will no longer cause pain. However, because it does not contain an internal nerve, it no longer has sensitivity to hot, cold, or sweetness. These are signs of dental decay, so the patient must receive regular dental check-ups with periodic x-rays to avoid further disease in the tooth. The restored tooth could last a lifetime; however, with routine wear, the filling or crown may eventually need to be replaced.Excellent oral hygiene after your root canal can help ensure success and prevent reinfection. Keeping your original teeth should always be your main objective. An untreated infection inside a tooth will only worsen over time; the pulp cannot heal itself. Without treatment, you may eventually lose the tooth, and require a bridge or other costly restoration. Protect your teeth by getting treatment as soon as you learn that you need it.

What complications can I expect?

Signs of a failed root canal treatment are:

  • Mild to severe tooth pain
  • Slight to more pronounced tenderness or swelling in the gums in the area near the tooth that can either be in a persistent or transient mode following root canal treatment.

Factors influencing the failure of the treatment

  • Shape of the tooth's root canals
  • If they have branches or forks they may be difficult to detect and therefore are overlooked during treatment.
  • Unexpected number of root canals
  • When a tooth has root canals that are tiny they may be overlooked during treatment
  • Undetected cracks in the root of the tooth
  • Defective or inadequate dental restoration allowing bacteria to seep into the inner core and recontaminate
  • Disintegration of the tooth seal with the passage of time causing bacteria to recontaminate the tooth
  • Tooth structure that has broken as a result of the treatment and require restorative work for stability
  • The treated teeth are not impervious to tooth decay and gum disease, in which case if extra hygiene is not maintained it can result in the loss of the teeth
  • Poor response of certain bacteria to the root canal treatment

What are the other complications associated with root canal treatment?

  • Breaking off of the dental instruments or files in the root canal while cleaning the pulp chamber. This can be removed later but only by a specialized endodontist.
  • Infection as a result of incomplete treatment or filling as a result of the root canals being complex or not being detected on the X-ray
  • Poor response of certain bacteria to the root canal treatment

Single sitting root canal treatment

Single Visit Endodontics or single sitting root canal treatment refers to cleaning, shaping & disinfection of the root canals of the tooth followed by obturation, all carried out during the same visit. Traditionally root canal treatment was done in multiple sittings.Recent advances in diagnostic techniques,emergence of new material/equipment and advanced technology have made it possible to do the root canal procedure in a single sitting.

Endodontics is no longer “blind treatment”, based only on the touch and the experience of the clinician. The emergence of new canal preparation instruments, of means to electronically determining canal length,the use of Apex locater, of the use of ultrasound in endodontics and, last but not least, of the endodontic surgical microscope have all led to an increase in treatment possibilities and indications and in success rates.

Is it different from the tradional root canal treatment

The steps of the procedure remain the same,except that the entire procedure is completed in a single visit

Advantages

  • Faster,less time consuming
  • Prevents recontamination of the root canals between successive appointments.
  • Less dose of anaesthesia?(only once)

If you have a broken or weakened tooth, a crown or "cap" can give the tooth a new lease of life. A dental bridge is made up of artificial teeth which are permanently fixed to healthy supporting teeth by crowns. Non-metallic options are also available. more about crowns and bridge.

What are crowns?

If a tooth has been broken, or weakened by a lot of decay or a large filling, a crown can be fitted. Your dentist will match the crown’s shape and color to your other teeth so it will look natural. The crown will last for many years, depending on the health of the tooth underneath. A temporary crown is put over the tooth until the permanent crown is prepared.

What are bridges?

A bridge consists of crowns which are permanently fixed to healthy supporting teeth. It is used to replace missing teeth, restoring appearance and function. A bridge can be made of either porcelain, porcelain fused to metal or zirconia When preparing a conventional bridge, the dentist needs to shape the teeth either side of the gap so that they will successfully hold the bridge.A typical bridge is illustrated below. The natural teeth either side of the space have been prepared to have crowns fitted. These crowns are permanently fused to an artificial tooth in the centre.

What is the process for obtaining a crown or bridge?

The process of fitting crowns and bridges requires two visits. During the first session our dentist takes X-rays to assess the health of your mouth. In case of crowns the tooth receiving the crown is trimmed. In case of bridges the supporting teeth are trimmed. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. A shade guide is used to select the correct colour of porcelain.

Impressions are taken of the prepared teeth and the teeth of the opposite jaw. A temporary bridge or crown may be bonded to protect the prepared teeth between visits (you must also avoid hard or sticky food and keep the temporary bridge or crown clean). During the second session: the temporary bridge or crown is removed. The permanent crown or bridge is checked for colour and fit. If you and your dentist are happy with your crown or bridge, it is permanently fixed in place with dental glue.

How do I care for my crown or bridge?

While a crowned tooth does not require any special care, you should continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day - especially around the crown area where the gum meets the tooth.

Bridges are cemented in place, so they cannot be removed for cleaning. To keep the teeth healthy, the gap under a bridge must be cleaned daily using special dental floss - an ordinary toothbrush will not do the job. Your dentist will demonstrate how to use floss under your bridge.

What materials are used for crowns and bridges?

Our dentists work with permanent crowns and bridges of porcelain fused to metal or porcelain fused to gold and also offers metal-free crowns and bridges.the latest in crown aesthetics is the ZIRCONIA crown.

Porcelain-fused-to-metal dental crowns and bridges are colour matched to your neighboring teeth.

Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like natural teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth. In case of front teeth the dentist can use aesthetic shoulder porcelain to cover the mentioned dark line, this way they can achieve a far better aesthetic result.

All-ceramic or all-porcelain dental crowns and bridges provide a better natural colour match than the metal fused ones. However, they are not as strong as porcelain-fused-to-metal crowns and bridges and they wear down opposing teeth more than metal crowns. All-ceramic crowns are a good choice for front teeth.

Post and core is a procedure to rebuild a tooth in order to provide proper support for a crown. The post will act like an anchor for the placement of crown. Posts are usually recommended in case of inadequate support for a crown. A post is placed within the body of the root of a tooth that has already treated with root canal treatment.

What is a post and core?

A post is a metallic structure that is placed within the body of the root of a tooth that has had previous root canal therapy. It can only be placed in a tooth that has had endodontic therapy ( root canal ) since once the dentist enters the nerve, the nerve dies. Root canal therapy prevents further infection and discomfort. During root canal therapy, the space previously occupied by the nerve is filled. The part of the post that shows is called the core. It is upon this core that can anchor a cap or crown. The post is cemented into your tooth usually separate from the crown. The crown ( or cap ) is then ready to be placed.

How does the dentist insert the post and core?

In fabricating your post,the dentist removes some of this plastic material making sureto leave the last two to three millimeters to seal the end of the root. This space that is fabricated is necessary in order to anchor the post within the root of the tooth. There are different types of posts. The type that is chosen for you will depend upon a number of factors. The post can either be 1) prefabricated or 2) it can be cast at the dental laboratory. In either case, the result of anchorage for a crown is the same. Although posts are usually recommended when there is minimal support for a crown, they are not always necessary. The use of a post will be determined on an individual basis based upon support and structural requirements.

Porcelain veneers are ultra-thin shells of ceramic material, which are bonded to the front of teeth. This procedure requires little or no anaesthesia, and can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolorations, to brighten teeth and to improve a smile. more about veneers.

What is the process of the treatment?

Trimming: The enamel on the front side of the tooth is trimmed back. Usually the dentist's goal is to trim the tooth about the same amount as the thickness of the veneer that will ultimately be bonded in position. This way the overall size of the tooth will not be dramatically changed.

Impression: Once the proper amount of enamel has been trimmed, your dentist will need to make a copy of your tooth. It will be from this copy that your porcelain veneer will be fabricated.

Temporary Veneers: Your dentist can create a temporary veneer for you to wear during the period while the dental laboratory is creating your porcelain veneer.

Bonding: Once you and your dentist have determined that the shape and shade of your veneer is appropriate it can be bonded in position.


First the porcelain veneer will be cleaned and prepared for cementation, or adhesion. Your tooth will also be cleaned, usually by polishing it. The enamel surface of your tooth will be etched with a mild etching gel. This etching, on a microscopic level, roughens the surface of the tooth, just like glass that has been etched has a "frosted" texture. This enamel roughness aids in the cement's ability to form a strong bond with the tooth, and it is a hallmark of dental bonding technique.

Cement will now be placed on the veneer and the veneer will then in turn be placed on your tooth. Your dentist will ensure that the veneer is in its proper place and then cure or set, the cement, usually by shining a special light on it. This light (which is often blue) passes through the translucent veneer to the cement which lies underneath. The light activates a catalyst in the cement, causing it to cure in just a few moments. At this point, the porcelain veneer is securely bonded in position. There will probably be at least a little excess cement present at the edges of the veneer that your dentist will need to trim off and polish down.

You and your dentist will also need to evaluate the veneer's precise contours and trim or reshape them as you feel is best. Your dentist will also spend time evaluating your bite and making sure that the veneer is adjusted appropriately for it.

Orthodontic interventions are mechanical preventive or therapeutic techniques to achieve or maintain appropriate alignment of the teeth for aesthetic and/or functional reasons.

People with malocclusion usually have crooked or crowded teeth, and may also have disproportionate jaw relationships. Malocclusion can be inherited or acquired. Teeth can be straightened or moved with the aid of different appliances, commonly known as braces, to improve appearance and function by spreading the biting pressure over all the teeth.

Orthodontic treatment can also control and modify facial growth during childhood and puberty. The most commonly treated orthodontic problems are crowding, protruding teeth, deep overbite, open bite, spacing and cross bite.

Benefits of Orthodontic Treatments

Orthodontic treatment can be useful for the long-term health of teeth. Crowded or crooked teeth are harder to keep clean than straight teeth and are more likely to be affected by tooth decay and gum disease. Malocclusion can lead to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on the jaw joint, resulting in chronic headaches and facial or neck pain.

Orthodontic problems can also affect a person’s self-esteem. A pleasant, attractive smile can contribute to one’s self-confidence and improve psychic health. See some of our patients who successfully completed their treatment with us.

Appliances

Orthodontic appliances can be removable or fixed, which are custom-made. They can be made of metal, ceramic or plastic, and work by applying gentle pressure to move the teeth. Having an appliance fitted will feel strange at first but does not hurt. Teeth may feel sore for a few days once the braces are on. The lips, cheeks and tongue may also be irritated until they become accustomed to the surface of the braces. While wearing an appliance, a patient must take extra care to ensure oral hygiene.

Braces can trap food lead to plague build-up damaging teeth permanently. Teeth and the appliance must be brushed and flossed several times daily, and sugary, sticky and hard foods should be avoided. Damaged braces make treatment last longer and should be fixed as soon as possible.

Replacing missing teeth is essential to your overall dental hygiene as a gap leaves the remaining teeth unsupported. These may drift along the jaw line, making brushing and flossing more difficult. Missing teeth can change the shape of your face and make you look older and less healthy. So, if you have missing teeth, it is advisable to have tooth replacement treatment as soon as possible.

What are dental implants?

A dental implant is essentially a substitute for a tooth's natural root and is commonly screw or cylinder shaped. Dental implants are usually made of titanium, a metal that is well-tolerated by the body. Over time, the jawbone becomes firmly united with the implant. A small attachment at the top of the dental implant emerges through the gum. Crowns, bridges or dentures can then be attached to the implant by screws or clips. In some cases (but not every) before implantation sinus lift and bone substitution need to be performed.

A dental implant is an artificial tooth root replacement and is used in prosthetic dentistry to support restorations that resemble a tooth or group of teeth.

Important: Implant means root replacement (located inside the jawbone) without any "teeth" (prosthetic devices i.e. crowns/bridge/denture) on top of them.

Why have implants?

  • Implants are an alternative to conventional bridges and partial dentures.
  • If you find that your full dentures move around a lot, implants will help to anchor the denture in place.
  • When teeth are lost, the jawbone may start to shrink. Implants can help slow this process down.
  • Your dentist may recommend using implants to support a bridge rather than cut into healthy teeth either side of a gap.

Replacing missing teeth is essential to your overall dental hygiene, as a gap leaves the remaining teeth unsupported. If left unsupported, the remaining teeth may drift along the jaw line, reducing the spaces between them; they may become weaker, making brushing and flossing more difficult. Missing teeth can jeopardize the integrity of the jaw line and change the shape of your face. Missing teeth can make you look older and less healthy.

What are the different types of implants?

There are several implantation systems that our doctors use:

Nobel Biocare Replace System (Swedish) (lifetime guarantee on material defects)

NobelReplace is the implant of choice for users of all levels.

NobelReplace is ideal for single-tooth restorations, fixed partial dentures as well as full arch fixed and removable solutions such as implant bridges. Furthermore, NobelReplace can be used for immediate extraction sites, if a specific case allows.

Who is suitable for dental implants?

While increasingly popular, implants are not appropriate for everyone. You need to be medically fit and have healthy gums and a sufficient thickness of jawbone. Your dentist will assess the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may not be possible to place implants without grafting bone into the area first.

If I do not have enough bone, what can be done?

Bone substitution is a term that is used to describe the procedure to "build" bone so that dental implants can be placed. These procedures typically involve grafting (adding) bone or bonelike materials to the jaw, and waiting for the grafted material to fuse with the existing bone over several months. After a bone-substitution procedure we usually wait 6 – 8 months before placing implants except for certain cases when bone substitution and implantation are possible at the same time.

What is a sinus lift?

In the upper jaw above the back teeth, it is possible to increase the height of bone available. This procedure is called ‘sinus augmentation or sinus lift’ and it involves lifting the sinus membrane and completing the gained space by bonelike material. Without this process many patients would be unable to have implants in a part of the mouth where teeth are so commonly missing.

How long does implantation take?

From the time of implant placement to the time of placing the first teeth, treatment times can vary between 2 weeks and 6 months. Your dentist will be able to give you a personalized timetable before the treatment begins.

Stage 1: Implantation The procedure itself takes 10-15 minutes/implant. The dentist exposes the bone in the jaw where the tooth is missing, then he drills a hole and inserts the implant into the bone. This is usually done under local anesthesia but other means of sedation can be used at extra cost. The gum is then stitched and it is left to heal while the bone grows around the implant, making it secure. A temporary healing abutment is often placed on the implant to allow the gum tissues to heal. If the treatment is carried out in Budapest you can leave the day after the operation.

Stage 2: Stitches removal The stitches are removed approximately a week later.

Stage 3: Implant exposure After a 20-week healing period a small cut is made in the gum and a healing abutment is placed on top of the implant. The healing abutment is a screw that helps the gum form perfectly before placing the final solution.

Stage 4: Final fitting The dentist takes an impression and the laboratory starts preparing the final solution. Following several tries, provided the dentist and the patient are both satisfied the final solution will be fitted on the abutments. This stage requires a 5-10-work-day-visit in Budapest or several shorter visits in London. As technology evolves in more and more cases the final solution can be fitted on the implants immediately after implantation.

Will I be toothless?

Between operations you will not be left toothless but will be fitted with temporary teeth.

What else can be placed on dental implants?

If you have no teeth in the lower jaw, and are not yet ready for multiple implant placements, a conventional lower denture can be considerably improved with two implants placed beneath the front section - this is called an ‘overdenture’ or retained denture. The same overdenture concept when used to treat the upper jaw, will usually require more implants as the bone is generally softer. Implant-supported overdentures, just like conventional dentures are still removed for daily cleaning, however, once back in the mouth, the implants make them much more stable.

What can I expect after implantation?

Following surgery, there will probably be bleeding, controlled by biting down on some gauze. Swelling may be controlled using an ice pack. Gums are generally sore after the surgery for 7 – 10 days. Antibiotics and painkillers will be provided. You will be able to drink but eating might be difficult for 24 hours after the implantation.

How do I care for my implants?

To help maintain your implants you need to thoroughly brush and floss regularly. Your dentist will give you specific advice on caring for your implants. He or she will ask you to attend regular check-ups.

What are the risks of implantation?

Implant surgery is a safe procedure; however, as all surgeries it carries an element of risk. Before deciding whether or not to have implants, you need to be aware of the possible side-effects and the risk of complications. Smoking, alcohol consumption, diabetes may effect tissue healing and may limit the success of the implant. Our dentists will advise you so you can make an informed decision.

Important: Smoking automatically means limited guarantee. Uncontrolled diabetes and neglected oral hygienie also leads to the forfeit of guarantee.

What are the possible side effects of implantation?

Examples of side-effects include feeling sick as a result of the anesthesia or sedation and some swelling and discomfort around the implant area.

What complications can occur?

The complications of any surgical procedure can include excessive bleeding, an unexpected reaction to the anesthetic or infection. If necessary you will be prescribed antibiotics and an antiseptic mouthwash to reduce the risk of your implant becoming infected. Your lower jaw contains nerves, which supply feeling to your tongue, chin, lower lip and lower teeth. In a small percentage of cases during implant surgery in the lower jaw the nerves may be bruised and may cause a tingling or numb feeling in your tongue, chin or lip. The chance of complications depends on the exact type of procedure you are having and other factors such as your general health.

The procedure is usually done under local anesthesia by an oral and maxillo facial surgeon in the dental clinic under cover of antibiotics and painkillers. To remove the wisdom tooth, the surgeon will open up the gum tissue over the tooth and take out any bone that is covering the tooth. He or she will separate the tissue connecting the tooth to the bone and then remove the tooth. Sometimes the dentist will cut the tooth into smaller pieces to make it easier to remove.After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have to be removed after a few days.

Impacted wisdom teeth (i.e., those that have failed to erupt through the gum line) fall into one of several categories. A wisdom tooth, in humans, is any of the usual four third molars. Wisdom teeth usually appear between the ages of 17 and 25. Most adults have four wisdom teeth, but it is possible to have fewer (hypodontia), or more, in which case they are called supernumerary teeth. Wisdom teeth commonly affect other teeth as they develop, becoming impacted or "coming in sideways." They are often extracted when this occurs. About 35% of the population do not develop wisdom teeth at all.

Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life that has been called the Age of Wisdom.

Anthropologists note that the rough diet of early humans resulted in the excessive wear of their teeth. Normal drifting of the teeth to compensate for this wear ensured that space was available for most wisdom teeth to erupt by adolescence. The modern diet, which is much softer, and the popularity of orthodontic tooth straightening procedures produce a fuller dental arch, which quite commonly doesn’t leave room for the wisdom teeth to erupt, thereby setting the stage for problems when the final four molars enter the mouth.

What is an impacted tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. A tooth may be partially impacted, which means a portion of it has broken through the gum, or totally impacted and unable to break through the gum at all.

How serious is an impacted tooth?

Impacted and partially impacted teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots. More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it

Must the tooth come out if it hasn’t caused any problems?

Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it. As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, partially or totally impacted wisdom teeth are more likely to cause problems as patients’ age. No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.

What happens during surgery?

It is especially important to let the doctor know about any illness you have and medications you are taking. The relative ease with which a wisdom tooth may be removed depends on several conditions, including the position of the tooth and root development. Partially or totally impacted wisdom teeth may require a more involved surgical procedure. Most wisdom tooth extractions are performed under local anesthesia. This will essentially eliminate any pain felt during surgery.

What happens after surgery?

Following surgery, you may experience some swelling and discomfort, which are part of the normal healing process. Cold compresses help decrease the swelling, and medication we prescribe can help manage the discomfort. You should limit your diet to soft foods following surgery and later progress to food that requires more chewing.Prescribed medication should be taken on time.


Tips to help speed your recovery after a tooth extraction.

  • Bite gently on the gauze pad periodically. Call your dentist or oral surgeon if you still have bleeding 24 hours after your surgery.
  • While your mouth is numb, be careful not to bite the inside of your cheek or lip, or your tongue.
  • Do not lie flat. This may prolong bleeding. Prop up your head with pillows.
  • Try using an ice pack on the outside of your cheek for the first 24 hours.
  • Eat soft foods, like curdrice or a thin soup. Gradually add solid foods to your diet as healing progresses.
  • Do not use a straw for the first few days. Sucking on a straw can loosen the blood clot and delay healing.
  • After the first day, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain. You can make your own salt water by mixing a pinch of salt in a medium-sized glass of warm water.
  • Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. Also, smoking decreases the blood supply and can bring germs and contaminants to the surgery area.
  • Avoid rubbing the area with your tongue or touching it with your fingers.
  • Continue to brush your teeth and tongue carefully.
  • Your dentist will remove the stitches after a few days, if needed.

What To Think About

If your wisdom teeth are not causing problems, it may be difficult to decide whether to have these teeth removed to prevent possible dental problems later in life. Think about the following:

  • You may never have any problems with your wisdom teeth.
  • It is rarely harmful to your health to have your wisdom teeth removed, but there are slight risks involved with any surgery.
  • In younger people (late teens and early 20s), the wisdom tooth's roots are not fully developed and the jaw bone is not as dense, so it is easier to remove the tooth. The easier it is to remove the tooth, the easier your recovery is likely to be.
  • Most problems with wisdom teeth develop between the ages of 15 and 25.
  • If you are older than age 40, you have only a small risk of having problems with your wisdom teeth. Few people older than 40 develop problems that require removal of their wisdom teeth.
  • If you have a medical condition that may get worse over time and your teeth may cause problems, consider having your wisdom teeth removed while you are healthy.
  • Possible complications include dry socket (alveolar osteitis), infection, bleeding, and numbness.
  • Women on birth control pills who decide to have their wisdom teeth removed should try to schedule the surgery for the end of their menstrual cycle (usually days 23 through 28). There seems to be less risk of dry socket during this time

After a wisdom tooth is removed, you may have or notice:

  • Pain and swelling in your gums and tooth socket where the tooth was removed.
  • Bleeding that won't stop for about 24 hours.
  • Difficulty with or pain from opening your jaw (trismus).
  • Slow-healing gums.
  • Damage to dental work, such as crowns or bridges, or to roots of a nearby tooth.
  • A painful inflammation called dry socket.
  • Numbness in your mouth and lips after the local anesthetic wears off, due to injury or inflammation of nerves in the jaw. Numbness will usually go away, but in rare cases it may be permanent.
  • Dental surgery may cause bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. People who have difficulty fighting off infections may need to take antibiotics before and after dental surgery. Such people include those who have artificial heart valves or were born with heart defects.

Tooth whitening refers to a number of techniques including chemical whitening and mild acid whitening that are used to correct discoloration of the teeth by removing brown and yellow staining. To whiten stained or discoloured teeth, we use one of the many special types of bleach that have been developed for this purpose, varying the strength of the bleaching agent according to the condition and sensitivity of the teeth.First of all we will examine your teeth and gums since it is important to ensure the healthy condition of the oral cavity. Old fillings may need changing; carious teeth will be filled and treated.

Benefits

Teeth whitening makes your smile brighter, often providing a noticeable cosmetic improvement. Age, smoking and drinks such as red wine, coffee and colas can stain or darken tooth enamel. Teeth grinding often causes the bitten edges to have a discoloration. Teeth whitening can help to lighten and brighten the teeth and transform a smile.

Effects

Teeth whitening is not permanent. It is a temporary lightening and brightening of the teeth's enamel. In order to maintain the brightness, repeat treatments are necessary. There are also side effects (most often temporary) that can come along with tooth whitening. These include chemical burns, sensitive teeth and over-bleaching.

Warning

People with receding gums, sensitive teeth or sensitive gums should discuss the use of a teeth-whitening system with their dentist prior to using a product to whiten their teeth. Additionally, anyone allergic to peroxide---the bleaching product used for teeth whitening-should avoid the process. Most importantly, overuse of teeth bleaching and whitening agents can result in tooth enamel damage.

Considerations

Teeth whitening may not work on all teeth. Brownish teeth do not bleach well. Grayish teeth bleach even less well. If you have bonded or tooth-colored fillings, bleaching will not lighten those areas. In fact, it may cause these areas to stand out.

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available -- complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Complete Dentures

Complete dentures can be either "conventional" or "immediate." Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.

Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.

Partial Dentures

A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed (permanent) bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This "bridge" is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.

Are There Alternatives to Dentures?

Yes, dental implants can be used to support permanently cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth. Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants.

How Are Dentures Made?

The denture development process takes about three to six weeks and several appointments. Once the PROSTHODONTIST (a dentist who specializes in the restoration and replacement of teeth) determines what type of appliance is best for you, the general steps are to:

  • Make a series of impressions of your jaw and take measurements of how your jaws relate to one another and how much space is between them.
  • Create models, wax forms, and/or plastic patterns in the exact shape and position of the denture to be made. You will "try in" this model several times and the denture will be assessed for color, shape, and fit before the final denture is cast.
  • Cast a final denture
  • Adjustments will be made as necessary.

Problems associated with new dentures

Most new dentures have to go through an initial period of adaptation or breaking in. In the beginning, you may experience some ofthe following:

  • A feeling of fullness. Itis normalto feel different and awkward at first with your new dentures. Your appearance has most likely undergone a slight change. With time, patience, and some training of your facial muscles, things will soon begin to feel more natural.
  • A gagging sensation. Many times dentures and partials give difficulty in the beginning stages while swallowing. With time,this will improve.
  • Difficulty in speaking. Careful practice and repetition in pronouncing those hard to say words willmake yourtransition period easier. Youmust also learn to control a tendency to tongue‐thrusting, whichmay dislodge the denture.
  • Difficulty eating. Start with softfoods or those that are easy to chew. More difficult foods that are fibrous or hard (apples) willrequire a gradual learning curve. To bite foodsthat normally require the frontteeth, such apply pressure backward against the front when closing.
  • Possible Soreness. Soreness from uneven pressure on the gums due to healing or irregularities may develop at anytime and is not unusual. This can be corrected with a simple adjustment appointment.
  • Excessive salivation.

Cleaning your Dentures or Partials

Cleaning your denture or partial should be an everyday habitto keep yoursmile beautiful. Plaque and tartar buildup can formon denturesjustlike it does on your naturalteeth. Failure to remove your denture for proper cleaning can result in staining ofthe teeth, mouth odor, or possible gumirritation. Here are a few simple tipsthatmay help:

  • Dentures can break,so alwaysfillthe sink with water, and clean them over the sink, justin case you drop them.
  • Don’t use hot or boiling water;the denture material may warp.
  • Don’t use rough household products,such as bleach, vinegar, orsoap to clean your dentures. These products sometimes contain abrasive particles thatmay scratch your denture or partial.
  • Don’t use abrasive regular tooth paste. It could scratch the prosthesis resulting in poor cosmetics. While you sleep at night,soak your denture or partial in a cleansersuch as Fixodent, or any other denture cleaner.
  • Brush your gums,tongue, and palate with a regulartoothbrush to remove plaque, bacteria, and to stimulate good circulation.
  • Be sure to have your dentures checked atleast once annually as changesin the mouth,such asshrinkage and bone loss will occur. Careful maintenance and routine checkups will help to slow down these changes. If you have a partial and some remaining teeth, an exam and cleaning should be scheduled every 6 months.

Worried about bad breath? Bad breath can get in the way of your social life. It can make you self-conscious and embarrassed. Fortunately, there are simple and effective ways to freshen your breath.



Brush and floss more frequently.

One of the prime causes of bad breath is plaque, the sticky build-up on teeth that harbors bacteria. Food left between teeth adds to the problem. All of us should brush at least twice a day and floss daily. If you're worried about your breath, brush and floss a little more often. But don't overdo it. Brushing too aggressively can erode enamel, making your teeth more vulnerable to decay.



Scrape your tongue.

The coating that normally forms on the tongue can harbor foul-smelling bacteria. To eliminate them, gently brush your tongue with your toothbrush.



Avoid foods that sour your breath.

Onions and garlic are the prime offenders. "Unfortunately, brushing after you eat onions or garlic doesn't help" ,says dentist Richard Price, DMD, a spokesperson for the American Dental Association. "The volatile substances they contain make their way into your blood stream and travel to your lungs, where you breathe them out." The only way to avoid the problem is to avoid eating onions and garlic, especially before social or work occasions when you're concerned about your breath.



Kick the habit.

Bad breath is just one of many reasons not to smoke. Smoking damages gum tissue and stains teeth. It also increases your risk of oral cancer.



Rinse your mouth out.

In addition to freshening your breath, anti-bacterial mouthwashes add extra protection by reducing plaque-causing bacteria. After eating, swishing your mouth with plain water also helps freshen your breath by eliminating food particles.



Skip after-dinner mints and chew gum instead.

Sugary candies promote the growth of bacteria in your mouth and add to bad breath problems. Instead, chew sugarless gum. Gum stimulates saliva, which is the mouth’s natural defense mechanism against plaque acids which cause tooth decay and bad breath.

Worried about bad breath? Bad breath can get in the way of your social life. It can make you self-conscious and embarrassed. Fortunately, there are simple and effective ways to freshen your breath.

When is a scale and polish necessary?

Despite our best efforts, brushing twice a day does not remove all the plaque in our mouths, plaque that remains in the mouth will eventually harden and form calculus or tartar. Manual tooth brushing will not be able to remove this tartar and it must be removed by the dentist only.

How is this done?

This is done by the dentist with a high frequency vibration scaler that ultrasonically removes the tartar from the tooth surface. This can also be done by hand, for those with very sensitive teeth and gums. The teeth are given a polish with an abrasive paste to make them smooth and to prevent plaque from adhering to the teeth.

What happens if I do not get a regular cleaning done?

The results of not having regular cleanings done will not be immediately apparent, but if tartar is left on the teeth, it thickens over time, becomes a bacteria trap and starts causing gum disease.

What Causes Gum Disease?

Plaque is the primary cause of gum disease. However, other factors can contribute to periodontal disease. These include:

  • Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.
  • Illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body's ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease and cavities.
  • Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.
  • Bad habits such as smoking make it harder for gum tissue to repair itself.
  • Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
  • Family history of dental disease can be a contributing factor for the development of gingivitis.

Gum disease symptoms includes:

  • Sore and bleeding gums
  • Bad breath
  • Metallic taste in mouth
  • General sore mouth
  • Inflamed gums
  • Loose or mobile teeth.

As gum disease progresses, it starts affecting the tissue holding the teeth in the jaw and progresses to periodontitis. The gums become red and inflamed, may bleed while brushing or even spontaneously, the gum begins to ‘shrink’ or recede and teeth may become mobile due to loss in bone height.

How is gum treatment different from scale and polish?

A scale and polish is a simple procedure that is usually done in one appointment and involves the removal of superficial tartar build-up around the teeth and gums. The tartar build-up at this stage has not caused much damage to gums and bone.

With gum treatment, inflammation of the gums will mean that the treatment will need to be done over several appointments. Depending on your level of discomfort, you may or may not need an anaesthetic for the procedure. Sometimes, with cases of very severe gum disease or very heavy tartar build-up, the dentist may decide to clean one half of your mouth per visit.

Gum treatment involves clearing plaque and tartar from the deep tissue pockets to help the gums regenerate.

What can be expected after a scale and polish or gum treatment?

Initially, your gums may feel sensitive, and your teeth may feel "empty". Sensitivity is normal and the sensitivity should subside after a few days, using a fluoridated tooth paste will help with this. The empty feeling will pass as well, and this sensation is usually the result after the tartar between the teeth is removed.


How can I avoid gum disease?

    Ways to prevent gum disease include
  • 1. Brush twice a day
  • 2. Floss regularly
  • 3. Mouthwash should be used half an hour after brushing
  • 4. Visit your dentist regularly and have a regular scale and polish
  • 5. Avoid smoking
  • 6. Eat a balanced diet

Treatment of Gum Disease

There are a variety of treatments for gum disease depending on the stage of disease, how you may have responded to earlier treatments, and your overall health.Treatments range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.

Treatments for gum disease that don't involve surgery include:

Professional dental cleaning. During a typical appointment we will remove the plaque and tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above and below the gum line of all teeth. If you have some signs of gum disease, we may recommend professional dental cleaning more than twice-a-year.

What is root planing and deep curettage?

Scaling and root planing. This is a deep cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if you have plaque and calculus (hardened plaque, also called tartar) under the gums that needs to be removed.

Gum Surgery (Surgical Treatments for Gum Disease)

What is Flap surgery

During this procedure the gums are lifted back and the tarter is removed. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. The gums are then placed so that the tissue fits snugly around the tooth. This method reduces the size of the space between the gum and tooth, thereby decreasing the areas where harmful bacteria can grow and decreasing the chance of serious health problems associated with periodontal disease.

What are Bone grafts.

This procedure involves using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by gum disease. The grafts serve as a platform for the regrowth of bone, which restores stability to teeth. New technology, called tissue engineering, encourages your own body to regenerate bone and tissue at an accelerated rate.

What are Soft tissue grafts.

This procedure reinforces thin gums or fills in places where gums have receded. Grafted tissue, most often taken from the roof of the mouth, is stitched in place, adding tissue to the affected area.

What is Guided tissue regeneration.

Performed when the bone supporting your teeth has been destroyed, this procedure stimulates bone and gum tissue growth. Done in combination with flap surgery, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow to better support the teeth.

What is Bone surgery?

This procedure smoothes shallow craters in the bone due to moderate and advanced bone loss. Following flap surgery, the bone around the tooth is reshaped to decrease the craters. This makes it harder for bacteria to collect and grow.

In some patients, the nonsurgical procedure of scaling and root planing is all that is needed to treat gum diseases. Surgery is needed when the tissue around the teeth is unhealthy and cannot be repaired with nonsurgical options.

What's the Difference Between Gingivitis and Periodontitis?

Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). However, it is important to know that not all gingivitis progresses to periodontitis.

In the early stage of gingivitis, bacteria in plaque build up, causing the gums to become inflamed and to easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.

When gingivitis is left untreated, it can advance to periodontitis. In a person with periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line.

Toxins or poisons -- produced by the bacteria in plaque as well as the body's "good" enzymes involved in fighting infections -- start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults.

What are receding gums

Gum recession is the process in which the margin of the gum tissue that surrounds the teeth wears away, or pulls back, exposing more of the tooth, or the tooth's root. Receding gums may be one of the first signs of gum disease. When gum recession occurs, "pockets," or gaps, form between the teeth and gum line, making it easy for disease-causing bacteria to build up. If left untreated, the supporting tissue and bone structures of the teeth can be severely damaged, and may ultimately result in tooth loss.

Gum recession is a common dental problem. Most people don't know they have gum recession because it occurs gradually. The first sign of gum recession is usually tooth sensitivity, or you may notice a tooth looks longer than normal. Often a notch can be felt near the gum line.

Why Do Gums Recede?

There are a number of factors that can cause your gums to recede, including:

  • Periodontal diseases
  • These are bacterial gum infections that destroy gum tissue and supporting bone that hold your teeth in place. Gum disease is the main cause of gum recession.

  • Your genes
  • Some people may be more susceptible to gum disease. In fact, studies show that 30% of the population may be predisposed to gum disease, regardless of how well they care for their teeth.

  • Aggressive tooth brushing
  • If you brush your teeth too hard or the wrong way, it can cause the enamel on your teeth to wear away and your gums to recede.

  • Insufficient dental care
  • Inadequate brushing and flossing makes it easy for plaque to turn into calculus (tartar) -- a hard substance that can only be removed by a professional dental cleaning -- and build up on and in between your teeth, causing gum recession.

  • Hormonal changes
  • Fluctuations in female hormone levels during a woman's lifetime, such as in puberty, pregnancy, and menopause, can make gums more sensitive and more vulnerable to gum recession.

  • Tobacco products
  • Tobacco users are more likely to have sticky plaque on their teeth that is difficult to remove, which can cause gum recession.

  • Grinding and clenching your teeth
  • Clenching or grinding your teeth can put too much force on the teeth, causing gums to recede

  • Crooked teeth or a misaligned bite
  • When teeth do not come together evenly, too much force can be placed on the gums and bone, allowing gums to recede.

How is Gum recession treated

Mild gum recession may be treated by deep cleaning(scaling and root planing) the affected area.

If your gum recession cannot be treated with deep cleaning because of the excess loss of bone and pockets that are too deep, gum surgery may be required to repair the damage caused by gum recession.