Services
Dental consultation
What is dental consultation and why is it important?
A consultation is essentially an evaluation of one’s dental condition, an assessment of one’s oral health.
Beside the role teeth play in one’s facial aesthetics, they’re an important part of digestive system. Any problem in your teeth might be the result of your eating habits, dental care routine or any pre-existing condition. Any habit, routine, or condition you might not notice yourself might cause problems for your teeth, gum, oral, or overall health, not to mention the impact they’ll have on your dental structure and eventually the shape of your face. This is something you should be aware of and consult with a dentist at least once a year.
Your oral health includes not only the health of your teeth but also the gums and roots, bones and even the jaws. A great dental care will definitely improve one’s quality of life and an additional annual dental consultation or checkup will relieve you of any concern about a mild or severe problem should there be one. In addition, you can take care of it before it becomes progressive or even life threatening. Depending on your dental condition, your general dentist might have to refer you to a specialist like an Endodontist, periodontist, orthodontist, dental surgeon or esthetic dentist.
It’s never late to start a checkup routine with a dentist and get ahead of your dental care if you don’t have one already. However, it might interest you to know that your dental care actually started at infancy! with tooth cleaning advice from your pediatric dentist!
When a baby is around 6 years old their baby teeth gets replaced by permanent teeth. At this time the dentist can see the development of teeth before the permanent teeth erupt. Some dentists prefer to start their patient’s treatments at this point before the permanent teeth and jaw shape is determined and the bones are still flexible to be trained. Flexibility of jaws and dental structure is why young adults are more susceptible to dental problems because aside from genetics, eating habits that can easily be avoided might affect the natural and symmetric development of the jaws.
How often should you go to the dentist?
If you are not genetically blessed, you might only need to get a dental consultation once or twice a year just to be sure. However, if you have been diagnosed with diabetes, gum diseases, dental infection or if you have compromised immune system, or had gone under organ transplant or you’ve oral cancer, you will have to see your doctor seasonally. Of course if you are having an orthodontic treatment you’d have to see your dentist more frequently to get your braces adjusted.
Should you get your wisdoms teeth pulled out?
Your dental consultation might be for the extraction of wisdom teeth. These are the last teeth to erupt and in adulthood (between 17 to 25) if you get them. Wisdom teeth might not need extraction all the times, but just because they’re not painful now doesn’t mean they won’t cause pain or other complications later. You should have your wisdoms teeth monitored and make sure they are healthy, aligned and erupted, but to prevent the risk your dentist may suggest that you extract them since wisdom teeth are potentially prone to decay they might cause misalignment, damage other teeth, cause jaw problems, sinus pressure or inflamed gums.
Root canal therapy
What is root canal therapy?
Why would you need root canal therapy?
Root canal therapy or Endodontic is necessary when the center of the tooth called pulp tissue (nerves and blood vessels) is infected, injured or becomes irreversibly inflamed and the nerve cannot heal itself. The procedure requires to remove the infection from the pulp since the infection is not treatable otherwise, and it can cause pain, gum sensitivity, bad breath and abscess. This infection, if not treated, moves from the root to jawbone and creates abscess there, which might spread even more and infect other organs and cause fever, headache, face or gum swelling, stomach pain, vomiting, heart disease or stroke.
A dental abscess can also travel to the brain, and create an abscess in your brain which is extremely dangerous and life-threatening.
In root canal therapy, performed by a general dentist or endodontist, the soft center of the tooth consisted of nerves, connective tissue and blood vessels that help the tooth grow, is removed. This is necessary since the infection should be completely eliminated, that is why, the procedure is done in two visits, during which the tooth will be completely cleaned out and sealed. After the procedure the tooth is dead because the nerve tissue along with the infection has been removed and the patient won’t feel any pain as a result.
What are the symptoms of a damaged tooth pulp?
symptoms of a damaged pulp include persistent pain, sensitivity to heat and cold, inflamed gums, abscess, tooth discoloration and tooth mobility which could be the results of extreme damage, deep decay as a result of an untreated cavity, an injury to the tooth like a chip or crack or having multiple procedures done on the same tooth. In these cases, your dentist will examine the tooth and the x-ray results and confirms the diagnosis.
What is the alternative to root canal therapy?
although this treatment requires removal of the pulp, deep cleaning and the tooth will essentially be dead but preserving the structure of a tooth is the best ways to preserve the dental structure. According to the American association of endodontists, saving the tooth this way is practically incomparable, to the alternative way of replacing it with an artificial implant.
Root canal procedure
How is root canal therapy done?
With the help of anesthetics and modern techniques root canal procedure is painless and it’s done while the patient is awake. Numbing medication is applied to the gum and once it takes effect anesthetic will be injected into the gum. The treatment includes three stages.
Extirpation and Instrumentation: Initial cleansing. through the small opening in the top of the tooth, the infected pulp, including connective tissue, blood vessels and tooth nerve, will be carefully removed and all the pathways in the tooth will be cleaned out
Obturation: thorough cleaning. In this stage the area will be covered with antiseptics to kill the persisting infection to prevent further infections. then the tooth is sealed with paste like material called gutta-percha.
Final filling: Root canal filling. The opening in the top of the tooth is also sealed with a filling material to protect the canals from saliva.
Alternatives to root canal treatment
What are the alternatives to root canal therapy?
Direct pulp capping
This treatment, an alternative to root canal therapy, is used when a severe decay has exposed the pulp of the tooth but the pulp itself is healthy and there is no sign of inflammation or infection in the pulp. This treatment would mostly be suitable to young patients, when the exposure is minimal and the pulp is healthy. In this procedure a material such as calcium hydroxide or mineral trioxide aggregate (MTA) is place directly on the pulp to protect thee pulp and help it heal. This is called capping after which the tooth gets filled.
Pulpotomy
In this procedure the inflamed pulp except the tooth nerve is removed, then antibacterial and healing agent materials including zincoxide eugenol, calcium hydroxide and MTA are injected inside the pulp to prevent bacterial growth. After that the inside of the tooth is filled, to restore the tooth decay a crown is used. Plupotomy is done on baby teeth in children or underdeveloped adult teeth. In adults however, this cannot be considered as an alternative treatment since it can only be used to relieve the pain in patient before the root canal therapy in performed.
Tooth extraction
If the pulp is infected and the decay and damage to the structure of the tooth is severe and the tooth cannot be repaired with any other treatment such as root canal or crown, the tooth should be extracted. In some cases, the extraction is simple and can be done by a general dentist, in other cases, it should be done by an oral surgeon, and might require breaking the tooth to pieces to enable extracting. After extraction tooth replacement therapy methods such as dental implant, dental bridge, and partial dentures can be used to replace the missing tooth.
Implant treatment
There are three options for tooth replacement:
- Dental implant
- Fixed dental bridge
- Complete denture or partial denture (removable denture)
What is the dental implant treatments?
Dental implant surgery replaces a tooth, all or several damaged or missing teeth with artificial teeth with screw like roots to restore function of the teeth and aesthetic of a full smile. Implants are very stable, the artificial teeth are designed to look and feel like natural teeth and they would increase patient’s quality of life.
Dental implants are permanent procedure that surgically places prosthetic teeth into the jawbone. Most implant are made of titanium. Titanium is a strong, corrosive-resistant and best of all biocompatible; which means while the tooth is anchored in place, the bone will fuse with it within few months.
Who is not suitable for dental implants?
This treatment while having the high success rate of 95%, might not be suitable for some patients since implant can get infected or cause gum recession, nerve and tissue damage. Patients with diabetes, blood clotting disorders, cancer patients who take certain medications, steroids or drugs that suppress immune system or people who grind their teeth are not suitable candidates for this treatment since their preexisting condition might cause persisting infection, delayed bone healing, prolonged bleeding, jaw fracture or damage to other teeth.
What is the dental bridge treatments?
For people who cannot get implants, or have lost more than one consecutive teeth, dental bridge might be a better solution, because this procedure is cheaper, quicker and less invasive and it won’t require surgery. Dental bridge is also a permanent procedure in which artificial teeth, or pontic teeth, are attached to the teeth on the sides of the gap. These teeth will be shaved and adjusted so that they’ll be prepared for the bridge that replaces missing teeth. Bridges are usually made of porcelain fused with metal, or zirconia. The procedure might require more than one tooth to hold the bridge and these teeth need to be strong and healthy.
What are the disadvantages of bridge treatment?
One of the disadvantages that bridges have over implant is that they are supported by the teeth; so if the supporting teeth aren’t strong enough it might become loose, unlike implants that are supported by bone. if the bridge isn’t fitting appropriately it’s possible for the tooth under the crown to decay or even damage surrounding teeth.
What type of dentures are there?
basically there are two types of dentures complete (traditional), and partial dentures. Traditional dentures are a complete set of prosthetic teeth for upper and lower jaw that rest on the gums and can be easily removed. Partial dentures, however, are specifically designed for patients who haven’t lost all their teeth. These dentures will replace the missing teeth so they can regain the use of their teeth and confidence to their smile.
What are the disadvantages of removable dentures?
Dentures (Removable dentures) are the cheapest and least desirable option for replacing missing teeth. Aside from the discomfort they cause to your gums, and the constant care they require, dentures would limit the wearer to certain soft food that certainly cannot replace a person’s previous diet, and the malnutrition due to this can cause bone and muscle frailty.
what are implant supported dentures?
much like every other dental procedure, dental implants are not exclusive. The main usage of implant procedures is tooth replacement, however, they can also be used to support dentures and provide more stability to them.
For patients who suffered from a gum disease or a decay that cost them all their teeth, there is an option with minimal implants to secure artificial denture, an example of this application is the “All-on-4” method. this procedure requires 4 implants in upper or lower jaw to support the entire denture. these implants are screw in strong positions in the jaw and are able to support a comfortable, realistic and aesthetic dentistry.
types of dental implants
Endosteal Implants
Endosteal implant are most common, frequently advertised implant that are directly inserted in jawbone, and once it fuses with the bone, a specialized attachment gets placed on top of implant which will hold the artificial teeth.
These implant are used for varied applications in dentistry; They can support a single crown, provide support for a bridge work or stabilize a removable denture.
Mini Dental Implants
These implants also have the screw like roots but unlike the endosteal implants they consist of a very small, one-piece screw that includes a round end, made for denture attachment. These implant are very useful for patients who have narrower bone width or ridge. This design is a great alternative for aforementioned patients who will benefit from same advantages of endosteal implants without suffering the disadvantages of subperiosteal implants.
Zirconia Dental Implants
These implants are an alternative to titanium implants. Although titanium implants have a very high success rate, these implant have shown great results in biocompatibility, response to soft tissue and since this metal is tooth colored it’s an aesthetic alternative for titanium especially for replacing front teeth. However, these implants are more complex to place and they require training, and since fewer practitioners are familiar with them, they’re more expensive.
Dental Techniques
Snap-In Overdenture
In this method, denture is secured by two implants in the lower jaw to prevent the denture’s movement. This method is the least invasive method to keep the dentures comfortably stable in the mouth during eating or talking.
Multiple Implant Cases
This is a treatment for patients who don’t want removable dentures and prefer a more natural looking restoration. Number of implants in this method depend on the structure and strength of the jaw.
The All-on-4 Technique
Four implants are placed in canine areas and in the back of the jaws to completely support the denture making this treatment a great procedure for patients with small arch.
All-on-4 with Angulated Implants
If the patient’s bone structure won’t support the implant in the conventional way, longer posterior implants are used to achieve better distancing between implants. This basically allows the chewing forces to distribute over a wider area and preserve bone structure from excessive pressure in certain places.
Dental filling
Dental filling is a treatment to repair cracked or broken teeth, tooth decay or cavities; which are the permanently damaged parts on the surface of the teeth that can develop into small holes if they’re not taken care of at the beginning stages. Fortunately, this shouldn’t be a problem if you visit your dentist at least once or twice a year; since cavities can be reversed at the initial stages, by improving oral care, such as; daily brushing and flossing, fluorides, deep teeth cleaning or gum therapy.
However, cavities can occur by a number of factors including poor oral hygiene, unhealthy diet consisting of food high in sugar or acidic drinks, or stomach acid. Cavities are not contagious but they can be a great indicator that your oral health is not in a good condition and your other teeth might develop cavities if you don’t take action to improve your dental care and eating habits.
Tooth fillings is a procedure to restore natural appearance and function of a damaged tooth to prevent further decay. this treatment is needed when bacteria penetrates the tooth and infects the tooth. In this procedure the damaged part of a tooth is removed and the cavity is filled with replacement material. Dental fillings might need refilling after a while depending on your condition and the type of filling you choose.
For people who have soft enamel on their teeth, it’s more likely that bacterial infection penetrates the tooth.it takes the bacteria from six months to couple of year to create cavity, depending on the condition of oral health, and your diet, but it’s best to seek treatment as soon as you notice any symptoms. It’s also possible to replace dental filling multiple times without problem. But large fillings, _when the filling materials become more than natural tooth material_ weaken the tooth and it will no longer have the strength to support fillings. In this cases a crown or in severe cases root canal therapy might be needed to treat the damaged tooth.
Dental filling procedure
How do dentists fix a cavity?
To fill a tooth, the dentist will numb the area around the teeth, and then remove the decayed part of the tooth. after the decay is removed, the cavity is cleaned and filled with temporary filling material to make sure the tooth is no longer infected and painful. your dentist might also use a liner (made of glass ionomer, and composite resin) to protect the nerve. then proceed to finish the procedure by putting in the filling and polishing it.
Tooth colored fillings are applied in layers, meaning your dentist with apply a thin layer of filling then use a special light to harden the layer and then apply the next layer until the cavity is filled. after this process is done. he or she will proceed to polish, trim and basically shape the composite material into final restoration.
There are several types of fillings and they each have their own pros and cons. the type of filling you can eventually choose, aside from the cost, your budget and insurance coverage, is based on the type of the damaged tooth and the extent of decay it had suffered which you should consult with your dentist.
4 Types of tooth filling materials
1. Silver amalgam fillings
What are the advantages and disadvantage of silver amalgam filling?
Silver amalgam, despite being the least expensive material for filling is still quite popular since it’s strong, sturdy, durable and can last up to 10-15 years. it’s a combination of sliver, zinc, copper and mercury. One of the disadvantages of this filling is its silver color; which isn’t aesthetically ideal for some people, besides the silver color might even change the color of the tooth to a grayish hue. Silver amalgam filling is also responsive to temperature. Meaning, it will contract or expand in temperature changes which can cause a gap between the filling and tooth, and might cause cavities itself or worse, create cracks or fractures in the tooth.
2. Composite fillings
Why should I choose composite filling?
These fillings are made from plastic and resin and the color can be adjusted to match natural teeth color which makes them very popular among patients, especially in case of filling the front teeth. One of the other advantages of these fillings is that composite fillings are also used to repair chipped or broken teeth they bond with tooth structure and provide further support. But unfortunately these fillings don’t last long and will need replacement after 5 to 10 years, they cannot endure chewing pressure as well as silver amalgam fillings and as a result might chip the tooth. The procedure to fill the tooth with these fillings take longer, since they are applied in layers which is also the reason that they might require more visits.
3. Ceramic fillings
Why ceramic fillings are the best for your teeth
Ceramic fillings are made of porcelain material which makes them the best option for dental restoration. They are neutral to temperature; so there is no risk of them cracking your teeth. In fact, these are made from the same material often used to fill the chip or crack in the tooth. Ceramic fillings are biochemical; which means they can bond with the tooth, and unlike composite resin they don’t get stained. The great advantage of ceramic fillings is that they are tooth colored and cosmetically appealing and almost as durable as gold fillings. however, if these material are use in small portion they might be brittle. So it’s best to use this material in large cavities.
4. Glass ionomer fillings
What are the advantages of glass ionomer filing?
These fillings are usually used for temporary fillings, filling a cavity under gum line and baby teeth. These are not natural looking since they’re made of silicate glass powder. And compare to composite resin or ceramic they’re prone to fracture and wear, lack strength and they won’t last more than 5 years. But these fillings are a good option for baby teeth, and the fact that they release fluoride might be an extra incentive for dentists to suggest this filling.
Indirect Fillings
While direct fillings can restore a minor damage in a single session, indirect fillings can treat more severe cases. These treatments are similar to direct fillings, with the exception that these fillings are made in dental laboratory and completing the treatment requires two visits.
In the first visit the old filling is removed and replaced with a temporary filling. Then an impression of the old filling is sent to the lab. The cavity is then filled with a temporary filling, which will be removed and replaced with the permanent filling during the second visit.
There are two types of indirect fillings
- Inlays
Dental inlays are a type of fillings that are used to fill the cavities inside the tooth (into the grooves, between the cusps) rather than outside edges of the tooth (cups).
- Onlays
These are the filling done on the outer edge of the tooth called cusps. compared to crown, onlays are preferred since they’re less expensive, and less of the natural structure of the tooth needs to be removed to place the onlays.
Inlays and onlays are much more durable than traditional fillings and can last up to 30 years. They’re made of tooth-colored ceramics. Onlays can also protect the tooth as they cover the top of the tooth and distributed the chewing forces around the tooth.