- MY CHILD WAS PLAYING AT SCHOOL, SHE FELL AND HAS KNOCKED HER FRONT TOOTH OUT COMPLTELY.WHAT SHOULD I DO?
HOW OFTEN SHOULD I GET MY TEETH CHECKED?
A thorough dental and oral check is advised once every 6 months. Your dentist will not only check your teeth but your gums and soft tissues of the mouth as well.
Early incipient cavities can be spotted early to prevent further spread of the decay.
Early lesions such as pre cancerous/benign lesions of which you were unaware, will be dealt with promptly.
This is a simple procedure, which is carried out using an ultrasonic scaler. Its tip vibrates to remove tartar and other deposits from your tooth surface. This does not damage the tooth enamel. Polishing your teeth follows this procedure. Scaling and Polishing is recommended ideally once every 6 months.
Regular cleaning and polishing prevents gum disease and cavities from forming. You will also be shown the correct technique of brushing your teeth and maintaining good oral hygiene at home.
NUMBER OF APPOINTMENTS: Usually one, sometimes 2, depending upon the amount of tartar present.
Extracting the tooth is the last resort! Save it with a Root Canal Treatment.
In this type of treatment the decayed part of the tooth is cleaned following which, the nerves from within the tooth and its root, are removed. The canals within the root are subsequently shaped and cleaned to free them of offending debris and bacteria. These are then filled with a special inert material.
After the root canal filling a core filling is done. Depending on the case a ‘post’ may be placed in the root canal space to hold the core filling in place.
Placing a protective cap over the tooth, for which a measurement needs to be taken, follows this procedure.
NUMBER OF APPOINTMENTS: One to four, depending upon the case.
If bacteria remain in a root canal system following completion of the treatment, this could result in failure of the root canal treatment. You may or may not suffer from certain symptoms, such as swelling in the gums adjacent to the tooth, a draining sinus present adjacent to the tooth or pain on biting down on that particular tooth. An X-ray may reveal a black shadow around the roots. Such a tooth will need a repeat root canal procedure in order to clean out the old filling and the root canal system thoroughly, fill it and keep it under review for 6 months. Alternatively the tooth may need to be extracted and restored with a dental implant at a later date.
This is a simple and convenient procedure, which dramatically improves your smile by changing dull and yellow teeth to bright and white teeth.It is a safe treatment and can be done several times without damaging your teeth.
It does not require anaesthesia and is well tolerated.
WHAT CAUSES TOOTH DISCOLOURATION?
- Smoking/ Tobacco/Tea/Coffee/Red wine
- Medication like tetracycline taken at a very young age
- Fluorosis (Increased exposure to fluoride in drinking water at a young age
- Dental Infection/ Faulty or old fillings/ Non vital (Dead) teeth
ADVANTAGES OF BLEACHING
The cost of bleaching is less when compared to other full mouth cosmetic treatment options e.g. Laminates/Veneers/Crowns.
HOW IS BLEACHING DONE?
Prior to bleaching, your teeth will be professionally cleaned and polished. There are 2 ways of bleaching teeth.
In-Office Bleaching: Your teeth are exposed to a higher concentration of bleaching agent with or without a special light. This will take approximately 45 to 60 minutes for both arches.
Home Bleaching: Special soft trays and a lower concentration of bleaching agent are given to you to carry out this procedure at home.
Verbal and written instructions will be provided.
No More Black!!
Now the cavity in your tooth can be filled with a special type of filling material called ‘composite resin’. When applied to the tooth it is soft so that it can be moulded in place. It hardens when exposed to a special blue light.
WHY USE COMPOSITE?
With newer composite filling materials only the affected (decayed) part of the tooth needs to be drilled and cleaned, as these filling materials tend to ‘bond’ to the tooth like glue.
They come in different hues that can be matched exactly with the corresponding colour of your tooth. The filling will have the look and feel of your original tooth, sometimes making it hard to distinguish between the two.
TIME TAKEN FOR EACH FILLING: 20 to 45 minutes per filling.
WHAT ARE IMPLANTS?
This is a treatment option to replace a missing tooth.
A dental implant is made of titanium and is screwed into your bone in place of the missing tooth root. This is done under local anaesthesia and is therefore a painless procedure. The titanium implant fuses with the bone over the course of 3-4 months. This locks the implant in place. This area is then re-entered to facilitate fabrication of the crown. A mould is taken to make a new crown over the implant.
This crown will look, feel and function like your other natural teeth.
WHY GO FOR AN IMPLANT, NOT A BRIDGE?
Dental Implants have been proven to provide comfortable, permanent and attractive tooth replacements as an alternative to removable dentures and conventional bridges, without involving support of the neighboring teeth.
NUMBER OF APPOINTMENTS: This will vary from case to case.
OUCH! MY WISDOM TOOTH HURTS! WHEN SHOULD I GET IT REMOVED?
Wisdom teeth are the last teeth to develop in your jaws. There are 4 third molars (wisdom teeth). They grow through your gums between the ages of 18 and 25 years. As these are the last teeth to emerge they will have to make do with whatever little space is available in the jaw bone.
This can sometimes result in these teeth getting impacted at an angle against the adjacent tooth in front or less commonly against the bone at the back of the jaw.
They are therefore either partially or totally trapped within the jaw bone.
PROBLEMS ASSOCIATED WITH IMPACTED WISDOM TEETH
Infection: Food can get trapped under the gum flap around the impacted tooth. This area under the gum flap is hard to reach with a toothbrush and hence cannot be kept clean, leading to infection. The resultant pain is proportional to the extent of the infection. In severe cases the face can swell resulting in spasm of the jaw muscles.
Decay: The wisdom tooth and or the adjacent tooth can decay due to the inability in keeping it clean. This can cause toothache and can damage the otherwise healthy adjacent tooth.
Cyst Formation: A sac called the Dental follicle covers the top of the unerupted/ buried tooth. Rarely this sac can become filled with fluid and enlarge causing a cyst. If large such cysts can hollow out and weaken the jaw. Buried teeth need to be kept under regular review through X Rays.
SHOULD ALL WISDOM TEETH BE REMOVED?
Generally speaking it is advisable that disease free wisdom teeth be kept under review and only be extracted if they are doing harm in ways mentioned above.
HOW ARE WISDOM TEETH REMOVED?
Impacted wisdom teeth are surgically removed under local anaesthesia. A small cut in the gum adjacent to the wisdom tooth is made. Bone surrounding the tooth is taken away with a drill. The tooth itself may have to be cut into a few pieces that are then individually removed.
A stitch or two in place following surgery facilitates excellent healing, which usually takes one week. Depending upon the type of stitch in place it may or may not have to be removed (One week later).
TIME TAKEN FOR WISDOM TOOTH REMOVAL:
Approximately 45 minutes for one lower and upper third molar on the same side of the jaw after giving local anaesthetic.
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WHITE PATCH IN MY MOUTH! DO I NEED TO WORRY?
Although the white patch in your mouth is painless, it is always better to rule out any sinister condition.
Numerous conditions manifest as white patches in the oral mucosa, some of these being transient, e.g. Thrush (fungal infection) or a chemical burn. More are persistent and these need to be examined further.
SHOULD A BIOPSY BE PERFORMED, WHY?
As a general rule, all white lesions in the mouth merit a biopsy, reasons being:
- To confirm / exclude mouth cancer
- If not malignant, to determine the risk of malignant transformation (Dysplasia)
- To identify long standing fungal infection if present
- To help identify specific conditions and causes for the lesion
HOW IS A BIOPSY PERFORMED?
After administering local anaesthetic, a small part of the lesion and adjoining normal tissue is excised carefully and put in a bottle of formalin. A stitch or 2 is placed to arrest bleeding.
You will be prescribed pain relief tablets and warm salt mouth rinses to aid rapid healing. The biopsy specimen is sent to a pathologist for study and a written report will be made available for your reference in 3 working days.
TIME TAKEN TO PERFORM A BIOPSY
Approximately 20 minutes, depending on the case. You may be required to come in 7 days later, for removal of stitches.
MY CHILD WAS PLAYING AT SCHOOL, SHE FELL AND HAS KNOCKED HER FRONT TOOTH OUT COMPLETELY.WHAT SHOULD I DO?
- Check that your child is otherwise alright and that there are no other serious body/head injuries that need to be attended to more urgently.
- Is your child up to date with her tetanus injection?
- Is the tooth, which has come out, intact?
WHAT SHOULD I DO NOW THAT I HAVE CHECKED THE ABOVE?
Keep the tooth wet, preferably in a cup of cold milk.
Rinse the tooth gently under cold running water for 10 seconds to remove dirt. Hold the tooth only by its crown. Do not touch or scrape its root.
If you can, re-implant the tooth straight away. The speed with which the tooth is re-implanted is the most important factor in determining a favourable outcome.
Go to a dentist as soon as is possible even if you have re-implanted the tooth.
Your dentist will splint this tooth against the adjacent teeth. This will remain for 7-10 days. A Root Canal Treatment will be required just before removing the splint.
Long-term follow up is recommended to determine its prognosis.
The aim of Re-implanting an avulsed tooth is to maintain the tooth for as long as possible in the child patient thus delaying the need for a prosthetic replacement. While there is no frank sepsis or overt discomfort, the original tooth is the ideal space maintainer.
IS THE SAME TREATMENT APPLICABLE IF MY CHILD HAS KNOCKED OUT HER BABY TOOTH?
No attempt should be made to re-implant a knocked out primary (deciduous) tooth.
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Your molar teeth, which are situated at the back of the mouth, have grooves that may be hard to keep clean. Hence a pit and fissure sealant may be indicated to prevent tooth decay. The sealant acts as a barrier and keeps out plaque and food.
AT WHAT AGE IS A SEALANT RECOMMENDED?
It is recommended that sealants be applied as soon as the tooth in question erupts. Therefore this is applicable in children and teenagers and especially in those who have experienced a high level of dental decay in their primary dentition.
HOW ARE SEALANTS APPLIED?
This is a painless procedure. The tooth to be treated is first cleaned and prepared to accept the sealant. The sealant is then made to flow into the grooves following which a light is applied to make it harden. Sealants are generally clear or white and cannot be seen when you smile or talk.
DOES THIS PROCEDURE HAVE TO BE REPEATED?
It is important to have the sealants placed in your mouth checked once every 6 months. In general sealants can last several years. If required the procedure may have to be repeated.
NUMBER OF APPOINTMENTS: 5 minutes per molar
WHAT IS A CROWN AND A BRIDGE?
A bridge is a fixed replacement of your missing tooth/teeth using the adjacent healthy teeth for support.
A crown is recommended on your root canal treated tooth that is now restored with a very large filling which makes it prone to fracture. Crowns also help close gaps and restore teeth that are worn down, decayed or fractured.
NUMBER OF APPOINTMENTS: Depending on each case, two to four.
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This is a form of minimally invasive cosmetic treatment usually done for the front teeth. These help close gaps, cover discoloured teeth, restore fractured teeth, modify the shape of existing teeth to appear more aesthetically pleasing.
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WHAT IS A SPACE MAINTAINER?
This is an appliance, which is used to maintain the space of a missing deciduous tooth. This is done to prevent drifting of the adjacent teeth into the space of the missing tooth. Should this drifting occur in the absence of a space maintainer, the permanent tooth underlying the missing deciduous tooth will be blocked out and will be forced to erupt out of the arch causing malocclusion. This is not healthy for the dentition, functionally and aesthetically.
NUMBER OF APPOINTMENTS : 2
A mould of the teeth is taken on the first appointment. On the second appointment, the space maintainer is cemented (glued) in place.
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There are various types and causes of recurrent mouth ulcers.
Some of the causes include, Iron deficiency anaemia, gastrointestinal disease, allergy to certain foods e.g. Potato wafers, Vitamin deficiency, Stress, sharp edge of tooth, restoration or denture. Have you noticed these ulcers anywhere else on your body?
There may be an underlying systemic cause, which if corrected, will lead to relief from mouth ulcers. Smoothening of a rough edge of a denture or tooth will also help the ulcer to heal.
Remember that if the ulcer has not healed for 2 weeks, see your dentist urgently to rule out mouth cancer. The only factor that assists prognosis of mouth cancer is its early detection.
NUMBER OF APPOINTMENTS: Depending on each case, three to five.
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This treatment is done to correct misaligned teeth to improve the bite, which in turn facilitates better health, aesthetics and function of the dentition.
It is recommended that children undergo regular dental check ups. This will allow the dentist to diagnose any anomaly or tendency for malocclusion. Necessary steps taken at the appropriate time to correct this will allow for the best possible outcome.
All photographs used represent the doctor’s own work.