Shop No.2, Gorai Mangalmurti C.H.S., Opp.Maxus Cinemas, Next to Gorai Bus Depot, L.T.Road,Borivali(W), Mumbai-400 091.
ROOT CANAL TREATMENT
Root canal treatment is a procedure to repair and save a badly damaged or infected tooth so that tooth removal can be avoided. The procedure involves removing the damaged area of the tooth (the pulp) and cleaning and disinfecting it followed by filling and sealing it. The common causes affecting the pulp are a cracked tooth, a deep cavity or trauma to the tooth. Diagnosis:Usually patient comes with the complaint of broken or painful tooth or trauma to the tooth. Clinical examination of tooth is done and x-ray is taken to confirm the diagnosis and to evaluate whether root canal can be done in order to save the tooth. Procedure:- Local anesthesia is administered to the affected tooth to numb the tooth and surrounding areas. The dentist makes an opening in the tooth to remove the infected or affected pulp, a procedure called a pulpectomy. Next, the pulp chamber and root canals are cleaned and shaped using various files and disinfecting agents. Once cleaned, the root canal is filed with biocompatible material (mostly gutta percha) and sealed in place with cement. Sometimes in case the infection is more, multiple visits are needed, where a temporary filling is placed in the opening to protect the tooth between dental visits. The temporary filling is then removed and the pulp chamber and root canals are filled with permanent material. Sometimes a metal or plastic rod is placed in the canal
is filed with biocompatible material (mostly gutta percha) and sealed in place with cement. for structural support. In the final step, a crown is placed over the tooth in order to strengthen the tooth and restore its natural shape and appearance.
Dental laminates are wafer-thin (usually 0.5 to 0.6 mm thick) shells made out of dental ceramic or dental composite resin that are bonded onto the front surface of teeth. The primary function of dental laminates is to improve the appearance of teeth. Laminates are routinely used to make colour, shape and position adjustments, so the teeth that are discoloured, worn, chipped, malformed, have spaces between them or are slightly misaligned, as well as those that have any
combination of these problems, can all be improved. Mostly, laminates are placed at the patient's discretion solely to enhance the appearance of their teeth, therefore an elective procedure. Placing laminates is a relatively conservative process compared to placing dental crowns as less tooth trimming is required. When done correctly, they provide excellent aesthetics. Direct vs. Indirect Laminates A) Direct Laminates Direct laminates or Composite resin laminates are applied using resin that is matched to the rest of your teeth. Additional layers of resin may be needed to correct the length and shape. The material will be shaped before being hardened with a laser or light. Once hardened, the composite material will be checked for bite and positioning before being polished to perfection. The greatest advantage of composite veneers is that it is an additive process that is reversible and can be removed and replaced as needed. It does not require any lab assistance therefore mostly done in a single visit. B) Indirect Laminates Indirect Laminates or Porcelain Laminates require removal of a thin thickness layer of the tooth’s enamel followed by the bonding of a thin sculpted porcelain laminate manufactured in the lab. Most important advantage of porcelain Laminates is the way they handle light is similar to natural teeth and hence give an exceedingly life-like appearance better than any other type of dental restoration. Porcelain laminates are extremely resistant to stain and chipping as compared to composite laminates. Indirect laminates can last for years if you practice good oral hygiene including brushing twice and flossing once each day. Being extremely thin, laminates are more susceptible to wear and tear or breakage if excess force is applied. People who clench or grind their teeth (referred to as bruxism by dentists) or have a bite where their front teeth come together edge-to-edge, don't make good candidates for porcelain laminates. The level of forces generated by these conditions can be substantial and can cause laminates to chip, break or debond. Therefore care should be taken while eating to increase the longevity of laminates.
Brushing and flossing are everyday ways to keep your teeth bright, white and healthy. Still, if you might feel like your smile is lacking some sparkle or is more yellow than it used to be then teeth whitening is what you should go for. Regardless of your stains, the natural colour (and genetic makeup) of an individual's teeth are set at birth. The only thing a whitening product can do is remove all the stains that have accumulated over time. Whitening products usually contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which make the colour less concentrated and your teeth brighter. When used as instructed, professional whitening is incredibly safe. The whitening process uses active ingredients to temporarily open pores in your teeth and lift stains. After each whitening session, your teeth naturally re-mineralize and rehydrate. Why does Tooth Colour changes Over time, your teeth can go from white to not-so-bright for a number of reasons: Food and Drink: Coffee, tea and red wine are some major staining culprits. They have ntense colour pigments called chromo gens
that attach to the enamel. Tobacco Use: Two chemicals found in tobacco create stubborn stains: Tar and nicotine. Tar is naturally dark. Nicotine is colourless until it’s mixed with oxygen. Then, it turns into a yellowish, surface-staining substance. Age: Below the hard, white outer shell of your teeth (enamel) is a softer area called dentin. Over time, the outer enamel layer gets thinner with brushing and more of the yellowish dentin shows through. Trauma: If there is trauma to the tooth, your tooth may change colour because it reacts to an injury by laying down more dentin, which is a darker layer under the enamel. Medications: Tooth darkening can be a side effect of certain antihistamines, antipsychotics and high blood pressure medications. Young children who are exposed to antibiotics like tetracycline and doxycycline when their teeth are forming (either in the womb or as a baby) may have discoloration of their adult teeth later in life. Chemotherapy and head and neck radiation can also darken teeth. Types of Tooth Whitening Stain Removal Toothpastes All toothpastes help remove surface stain through the action of mild abrasives that scrub the teeth. Look for whitening toothpastes that have additional polishing agents that are safe for your teeth and provide stain removal effectiveness. Unlike bleaches, these types of toothpastes do not change the colour of teeth because they can only remove stains on the surface. In-Office Bleaching This procedure is called chair side bleaching and usually requires only one office visit. The dentist will apply either a protective gel to your gums or a rubber shield to protect your gums. Bleach is then applied to the teeth. Home Bleaching Your dentist can provide you with a custom-made tray for home whitening. In this case, the dentist will give you instructions on how to place the bleaching solution in the tray and for what length of time. This may be a preferred option if you feel more comfortable whitening in your own home at a slower pace, but still with the guidance of a dentist. Home bleaching can take anywhere from a few days to a few weeks as the concentration of the gel is much milder than the gel used for in office whitening. Sensitivity after teeth whitening Many of us have naturally sensitive teeth. This is most often caused by genetics, thin enamel, or crack/damaged teeth. During the whitening process, it is completely normal for sensitivity to occur. The teeth become temporarily dehydrated which reduces their ability to insulate the nerve from changes in temperature. Sensitivity will disappear 12-36 hours after whitening. Dentists and hygienists recommend a post-whitening fluoride treatment to nourish the teeth and promote rehydration.
Pediatric Dentistry is the branch of dentistry that deals with children's teeth. The focus is not only on treating dental problems in children but also on preventing them by educating children and parents about oral hygiene maintenance and diet instructions. Children begin to get their baby teeth during the first 6 months of life. By age 6 or 7 years, they start to lose their first set of teeth, which eventually are replaced by permanent teeth. Even though baby teeth are temporary, they are still important for your child’s oral development. Baby teeth help shape your child’s face as well as them eat, chew, and speak. Baby teeth also reserve space and guide the permanent teeth to come in correctly.
Paediatric dentistry covers numerous dental procedures that include:
1. Dental Fillings: When a child has a cavity in the tooth, it may require a dental filling, which will prevent the infection from spreading. The decayed portion of the tooth is drilled and a cement or composite restoration is done.
2. Pulpectomy: It is the process by which infected pulp tissue in a tooth is removed, the canal is cleaned and a resorbable material is used to fill up the canal area. This material does not impede resorption of the roots and allows the milk tooth to fall out and be replaced by the permanent one. The tooth is then restored with a stainless steel crown.
3. Extraction: A tooth may need extraction if it is so badly decayed that even a root canal treatment won’t save the tooth. A tooth should also be extracted if it is crowding other teeth or fractured beyond repair. Depending on the age of the
child and location of the extracted tooth, a space maintainer may be placed.
4. Space Maintainers: A space maintainer is a custom-made appliance fabricated to keep the space open to allow the permanent tooth to erupt and come into place. Baby teeth are important to the development of the teeth, jaw bones and muscles and help to guide permanent teeth into position when the baby teeth are lost.
5. Fluoridation: Fluoride benefits both children and adults. Fluoride is a natural mineral that builds strong teeth and prevents tooth decay. The dentist provides professional fluoride treatments in the form of a highly concentrated rinse, gel or varnish. The treatment may be applied with a brush, tray, or mouthwash. The earlier children are exposed to fluoride, the less likely they are to develop cavities. Pediatric dentistry also involves educating the children about the importance of brushing twice daily, to demonstrate proper brushing techniques and guiding parents about dietary restrictions to follow for the children.
Oral prophylaxis (also widely known as Scaling) is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an excellent procedure that helps to keep the oral cavity in good health and also halt the progression of gum disease. Tartar (calculus) and plaque build up occurs on tooth surface, the bacteria from plaque colonize on the gingival (gum) tissue – either above or below the gum line. Even employing the proper brushing and flossing techniques, it is very difficult to remove debris, bacteria and deposits from gum pockets. They can cause serious periodontal problems if left untreated. These bacteria cause inflammation of gums which results downward (towards the root) shift of gum and bone tissue, making the teeth mobile or completely fall out. Prophylaxis is generally performed in several stages, which may need multiple sittings: X-ray and examination: X-rays can be extremely revealing when it comes to periodontal disease. X-rays show the extent of bone and gum recession and aid in identifying areas which require attention. Supragingival Scaling: The area above the gum line is cleaned thoroughly with scaling tools to
rid them of plaque and calculus. Subgingival scaling: Calculus from the beneath the gum line and gum pockets is cleaned. Root planing: The root portion of the tooth is smoothened to eliminate any remaining bacteria. This may be done under topical or local anaesthesia. Polishing: After the cleaning is done, a prophylactic paste (also known as polishing paste) is applied and teeth are polished using a rubber cup or brush. Polishing helps remove residual plaque from the surface of the tooth. In some cases where scalar tips are unable to reach a tooth surface (especially interdental areas), air polishers are used which effectively remove the stains. Medication: After scaling and root planing is done, an antimicrobial cream may be applied on the gums which help in healing and ease discomfort. In case of severe infections, medicines can be directly placed in the periodontal area to promote healing. Prophylaxis is recommended twice annually as a preventative measure, but can be performed every 3-4 months for patients suffering from recurrent chronic periodontitis. Though the damage already done to the tissues is difficult to reverse, routine scaling prevents further damage to the periodontal tissues. Oral prophylaxis also helps in improving aesthetics by removing stains making teeth appear brighter. The removal of plaque, calculus and bacteria (that cause bad breath) noticeably improves breath. Since prophylaxis involves a thorough examination of the entire oral cavity, other dental problems are recognised in their early stages and can be treated.
Orthodontic treatment is a dental treatment that corrects teeth and jaws that are improperly positioned. Teeth that do not fit together correctly are harder to keep clean, are at risk of tooth decay or periodontal disease and can also cause extra stress on the chewing muscles that can lead to TMJ pain or other muscular disorders. Teeth that are crooked or not in the right place can also affect appearance. Orthodontic treatment benefits in a healthier mouth, a more pleasing appearance, and increases general life of dentition. It also helps in improving speech and chewing ability.
Based on diagnostic tools that include a full medical and dental history, a clinical examination, models of your teeth, and specific X-rays and photographs a dentist can decide whether orthodontics are recommended and develop a treatment plan.
An orthodontic treatment includes use of a range of dental devices which mainly include braces (fixed appliance), aligners and other appliances.
1. Braces: These consist of brackets, wires, and bands. Bands are fixed firmly
around the teeth and serve as anchors for the appliance, while brackets are usually connected to the front of the teeth. Wires in the shape of an arch pass through the brackets and are fixed to the bands. As the arch wire is tightened, tension is applied to the teeth. Over time, this moves them into proper position. Follow-up involves monthly visits to adjust or tighten the braces. Treatment may last from several months to a number of years. Either metal or ceramic braces can be used.
2. Aligners: This alternative to braces is usually used in adults especially where aesthetics is very important. They are virtually unnoticeable by other people and can be removed to brush the teeth, floss, or eat. An aligner is used for 2 to 3 weeks and then changed for a tighter one.
3. Expander: This appliance is designed to make the arch of the upper jaw wider. It consists of an acrylic plate having screws which is placed on the palate (roof of the mouth). The screws put pressure on the area separating the bones in the upper jaw forcing them outward. This expands the size of the area in the roof of mouth. This is useful usually in children before the fusion of upper jaw bones.
Once the Orthodontic treatment is complete, Retainers are used to stop the teeth from moving back to their original positions. If modified, they may also be used to stop habits like thumb sucking, mouth breathing or tongue thrusting in children.
Tooth decay is an irreversible process. The decayed portion of the tooth is drilled out and a filling is done using an appropriate material in order to restore the normal anatomy of tooth. A dental filling helps restore both function and aesthetics. Fillings are also used to repair cracked or broken teeth or teeth that have been worn away by external factors such as teeth grinding or trauma.
Types of filling materials:
Depending on the extent of damage, location of the tooth in oral cavity, allergies to dental materials and costing; the filling material is chosen. Some of the most popular fillings include:
1. Amalgam (Silver) fillings: These were the most widely used fillings around a decade back due to its wear and tear resistance as well as low cost. But due to the dark colour, use of this filling has been greatly reduced since evolution of tooth coloured fillings (especially in front teeth).
2. Gold fillings: These are one of the best fillings available as gold is one of the most inert and long lasting materials. The colour and costing has restricted its use. 3. Tooth coloured fillings: These are the most commonly used fillings currently. They can be either Porcelain or Composite fillings.
A. Composite (plastic) resins are matched to be the same colour as your teeth and therefore give a natural appearance. The ingredients are mixed and placed directly into the cavity, where they harden. Composite fillings last generally from 3 to 10 years.
B. Porcelain fillings (called inlays or onlays) are fabricated in a dental lab and then bonded to the tooth. They can be matched to the colour of the tooth and resist staining. A porcelain restoration generally used when major portion of tooth needs coverage.
Usually, a dental filling is a painless process and generally does not need the use of local anaesthesia. It is always advisable to get fillings done when cavities are in their early stages. A deep filling can cause sensitivity to the tooth which generally gets reduced after some days. Proper oral care should be taken in order to prolong the life of your filling.
A dental bridge is one of most common means of replacing missing teeth. Dental bridges literally bridge the gap created by one or more missing teeth. A bridge is made up of two or more crowns for the teeth on both side of the gap (called abutment teeth) and false tooth/teeth (called pontics) in the middle.
These false teeth can be made from gold, metal alloys, porcelain or combination of these materials. Dental bridges are supported by natural teeth or implants. Bridges can restore your smile, restore the ability to properly chew and speak, maintain the shape of your face, help to distribute the forces in your bite properly by replacing missing teeth and prevent remaining teeth from drifting out of position.
Process of fabrication of a Dental Bridge:
During the first visit the abutment teeth are prepared. Preparation involves recontouring (shaping) these teeth by removing a portion of enamel to allow room for a crown to be placed over them.
Next, impressions of the teeth are made, which serve as a model from which the
bridge will be made by a dental lab. A temporary bridge can be given to the patient while the permanent bridge is being made.
During the second visit, your temporary bridge will be removed and the new bridge will be checked and adjusted to achieve a proper fit. Multiple visits may be required to check the fit of the metal framework and bite. Once fitting, bite and aesthetics are verified, the bridge is then cemented on the abutment teeth using dental cements.
How to maintain a Bridge:
It is important to keep remaining teeth healthy and strong as the success of a bridge mainly depends upon the solid foundation offered by surrounding teeth. Brushing twice a day and flossing help prevent tooth decay and gum disease that can lead to tooth loss. Keeping a regular cleaning schedule will help diagnose problems at an early stage when treatment has a better prognosis.
Advantage of Bridge over Denture:
Although dentures don't require grinding down adjacent teeth and are cheaper, they are not nearly as stable or comfortable as dental bridges and can affect speech and eating as the bite force is less than that of a dental bridge.