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FAQS

What to Look For When Choosing a Dentist

Finding the right dentist for you and your family can be as taxing as finding a parking space in a crowded shopping center. With thousands of dentists practicing all over the country — with their own specializations, specific locations and office hours — how do you narrow your search down to that one dentist who’s right for you? Since dental practitioners assume such a vital part in your oral wellbeing picking a dental specialist is vital. Possibly you have worked with a similar dental practitioner all your life yet you move and need to pick another one. Possibly you are not happy with your present dental specialist so you need to change. Here are some questions to help you choose a dentist for your family once you’ve narrowed the choices in your area to a few options.You can contact each dental clinic directly for answers to your queries. Check out their dental qualifications. The basic dental degree is a Bachelor of Dental Surgery (BDS) or Master of Dental Surgery (MDS).

Why are you seeing a dentist?
If you’re concerned about your family’s oral health, you might choose a general dentist.

General dentists often use the monikers “cosmetic dentist” or “family dentistry” to indicate that they offer cosmetic dental treatments or can treat your whole family but these aren’t officially recognized dental specializations.

Keep in mind, however, that many general dentists do perform some of the same treatments as dental specialists, such as wisdom teeth extractions and root canals along with dental crown and dental bridge procedures.

If you’ve got young children, you may need a dentist who specializes in treating young children ( Pedodontist).

If you’re older you might need to choose a dentist who offers bridges or dentures (prosthodontist).

If you’re concerned about the way your smile looks or if your teeth are stained, you could choose a cosmetic dentist.

If you’re in pain because of gum disease, you may need to see a periodontist, or an endodontist or an oral surgeon.

If you want correction of crooked or proclined teeth, you may need to see an orthodontist.

  1. What location is convenient for you?

Think about when you might schedule dental visits. Will you go to appointments in the morning from home or after work? Will you take your children to the dentist during school hours or after school? This can help narrow down the area /location for choosing a dental clinic.

  1. Information to know about the dental clinic: • How long has the dentist been practicing? • What type of education and certifications does the dentist have? • What type of equipment does the practice have? • What type of procedures do they perform? • How do they educate patients about oral health? • What are their hours? • How do they handle emergency situations?

• What are their fees?

  1. Who recommends their practice?

The best source of information is somebody who knows about the practice. Does the dentist have testimonials from satisfied patients? Do you have family, friends or neighbors who are patients?

Before your final decision you should visit your top three dental clinic choices. Take a look around, meet the staff, and spend some time with the dentist. Ask about any special needs you have.

Why is it Important to Visit a Dentist Regularly

Before you think about who to see as your dentist, it’s important to know why you should visit a dentist. Even in tough economic times, investing in your health is important. Regular dental visits can help prevent problems as well as find small problems before they become large. If you wait too long between dental visits, your dental issues will only get worse. By the time you seek help, you may need to see a dental specialist which could cost you even more money in the long run.

Benefits to You of Regular Dental Appointments

• Regular dental check-ups can spot and treat problems early on. Professional cleanings by a dental hygienist will help keep your teeth looking great and prevent the build-up of tartar and plaque that can lead to gum disease.

• Healthy teeth help you eat healthy:If your teeth are strong and healthy you’re more likely to eat a wide variety of foods that are healthy for you. If your teeth are loose or missing, your diet becomes severely restricted and you start skipping the foods that keep you healthy.

• Seeing a dentist helps keep you healthy:There are links between oral health and overall health. Poor oral health can lead to gum disease and infections which can spread throughout your body, sometimes leading to cardiovascular disease and strokes.

• Seeing a dentist helps keep your baby healthy:Growing evidence shows that gum infection may play a role in premature birth, as well as inhibit the growth and development of your unborn baby.

• Early detection of oral cancer:If found too late, oral cancer can be a killer. But many dentists have tests available to aid in the early detection of this disease. When spotted before it becomes advanced, oral cancer is highly treatable.

• Diseased teeth look and smell bad:If you’ve got bad teeth, chances are you’ve also got bad breath. Stained or yellow teeth can be unpleasant to look at and may make you self-conscious about your smile.

Seeing a dentist regularly can help keep your teeth and your body healthy.

How to choose dental implant specialists?

There’s a major difference between surgical specialists and a physician who has taken an abbreviated course on dental implant surgery.Many of them have never encountered problems like dental implant failure and other complications. For surgical specialists, these challenges are routine and they’ve been trained to handle them..But patients are not always aware of this difference. It’s easy to be mislead by advertisers and information found on the Internet.Patients who choose a less-qualified physician experience complications that may have been avoided had they chosen a surgical specialist.

Although dental implant surgery is performed frequently and has a high success rate, there are risks involved with all surgical procedures, extractions and cosmetic periodontal surgery. Many people assume that these procedures are very simple, when in fact they are not.The success rate of dental implant surgery is attributed to skilled surgical specialists. During any given surgical procedure, patients benefit from their:

• Knowledge of surgical techniques

• Ability to diagnose problems

• Ability prevent or treat complications

Are You Considering Dental Implants? Make an Informed Decision

Protect your oral health – make an informed decision when considering dental implants or any other surgical procedure. Ask your physician these questions when seeking a procedure.

  1. What’s your specialty?
  2. How much experience do you have in dental implant surgery?

Ask about:

• The number of implant cases they have performed and how often.

• Their continuing education and contributions to scientific literature.

• Their training in dental implant surgery and treatment of complications

• Speaking to their patients.

• How much the staff knows about dental implant surgery (their support is valuable).

• Photos of successful dental implant procedures they have performed

How to Choose an Endodontist

What Does an Endodontist Do?

You would choose an endodontist when you need a dental professional who specializes in root canals or other treatments which may involve the inside of the tooth, the pulp. An endodontist may use advanced technologies, such as digital imaging, operating microscopes and ultrasonic equipment in the diagnosis and treatment of dental issues in your mouth. An endodontist may also treat facial trauma. An endodontist will:

• Examine, diagnose and treat diseases of the pulp and dental tissues in your mouth.

• Develop a treatment plan to address and repair the diagnosed issues.

• Treat exposed pulp by capping or removal it.

• Fill the empty pulp chamber with endodontic materials to replace the pulp which has been removed.

• Where possible, the endodontist will reinsert and restore any teeth knocked out during an accident or collision.

• On occasion, the endodontist will bleach discolored teeth to maintain an even appearance of color in your mouth.

How to Choose an Endodontist

• Find out if the endodontist is using the latest technology and procedures to minimize pain and maximize your results.

How to Choose a Periodontist

What Does a Periodontist Do?

A periodontist specializes in treating diseases of the gums and soft tissues. If you have severe gum disease, inflammation or bone loss, or persistent bad breath you may need to choose a periodontist. Sometimes this dental specialist may become involved if your case involves a large number of dental implants. A periodontist may treat dental diseases such as gingivitis and may also perform certain cosmetic procedures. A periodontist will:

• Examine, diagnose and treat infections and inflammations of the bone and soft tissues surrounding your teeth.

• Perform a deep cleaning of the teeth to eliminate irritating filling margins and correct occlusions.

• Remove diseased tissue and use cosmetic procedures to restore the appearance of the gum line around the teeth.

• Install dental implants or mini-implants to serve as an anchor for crowns or false teeth. This may require bone augmentation procedures if the patient has suffered bone loss.

• Restore lost bone and gum support by performing bone regenerative procedures.

• Help in the oral care and treatment for patients with certain diseases such as diabetes.

• Provide education on proper oral care techniques.

How to Choose a Periodontist

• Find out if the periodontist is using the latest equipment and procedures to minimize pain and maximize results.

How to Choose A Pedodontist

What Does a Pedodontist Do?

If you’ve got small children, you may want to choose a pedodontist or pediatric dentist for dental care. Oral hygiene can begin as soon as you bring your newborn home from the hospital. You should schedule the first dental appointment as soon as baby teeth appear, but definitely by the first birthday. Similar to a pediatrician who meets the health needs of children, a pedodontist specializes in meeting the special needs of working with the teeth of toddlers and adolescents. A pedodontist has special skills and knowledge about working with the mouths of developing children. The pedodontist may perform all the activities of a dentist such as filling cavities, extracting teeth, and diagnosing dental disease, but with a special focus on performing these treatments in the smaller mouths of younger patients. A pedodontist is also important in the early education of younger patients regarding lifetime oral wellness and proper dental hygiene techniques. A pedodontist will:

• Examine, diagnose and treat dental issues in pediatric patients.

• Make space maintainers as necessary to maintain proper alignment in adolescent teeth.

• Treat primary and secondary teeth to insure proper alignment and placement as the child’s mouth grows.

• Manage and treat children with special dental needs and requirements.

• Advise parents and caregivers on dental concerns.

• Provide preventive dental care through fluoride or sealants where applicable.

• Provide the child and parent with an education regarding the need for proper oral hygiene.

How to Choose a Pedodontist

• Ask about the special techniques the practice uses to care for children.

• Find out if the practice is using the latest equipment to minimize pain and maximize results.

• Find out if they have any additional patient education information for children such as a newsletter or website page.

How to Choose an Orthodontist

What Does an Orthodontist Do?

You might think only about choosing an orthodontist to work on your teenagers’ teeth, but more adults today are having orthodontic procedures. An orthodontist typically uses dental braces to restore alignment in your teeth and mouth. Braces aren’t the traditional “metal mouth” any more, and now come in a variety of fun colors. Conditions which may call for treatment by an orthodontist include a crowded mouth, misaligned or crooked teeth, or an underbite/overbite/crossbite. Restoring a proper bite and tooth alignment can help you by aiding in proper chewing, improving your speech patterns, and reducing the possibility of chipping your teeth. The orthodontist will use braces, retainers and dental appliances to gradually apply pressure and bring your teeth back into alignment. Choose your orthodontist wisely because you’ll spend a lot of time together. There are regular visits in the first few months for adjustments during the treatment phase and you may also be required to wear a retainer after treatment to help maintain the new alignment of your teeth. An orthodontist will:

• Examine, diagnose and treat misalignment of your teeth and any jawbone abnormalities.

• Develop a treatment plan to restore dental alignment in your mouth.

• Design and fabricate dental appliances to help bring your teeth back into alignment and restore normal functioning.

How to Choose an Orthodontist

• Find out if the orthodontist is using the latest technology and procedures to minimize pain and maximize results.

• Find out if they have any additional patient education information such as a newsletter or website page to help you protect those realigned teeth.

• Ask about pricing, payment plans and are there more cost-effective options to the proposed procedure? Can complex procedures be broken down into steps and spread out over a period of time?

How to Choose a Prosthodontist

What Does a Prosthodontist Do?

As you get older and begin losing teeth and jaw structure, you may need to choose a prosthodontist to perform dental work. A prosthodontist is a dental specialist who focuses on installing full or partial dentures, dental crowns, dental implants or dental bridges to replace missing teeth. The cases seen by a prosthodontist are usually more complex and may involve several missing teeth or damage to the jaw bone. The goal of the prosthodontist is to restore your appearance, facilitate your ability to eat and speak, and preserve the structural integrity of your jaw. The prosthodontist installs artificial teeth in place of any missing or diseased original teeth in your mouth. A prosthodontist will:

• Examine, diagnose and treat you in order to replace missing or diseased teeth and restore integrity to your jaw.

• Measure your jaws and make impressions for any artificial replacements.

• Construct bridges, full or partial dentures, or other appliances to replace your missing teeth.

• Restore optimum functioning to your teeth and mouth.

• Fit and modify dentures and oral prostheses, repair and replace dentures and oral prostheses as needed.

• Fabricate specialty items such as mouth guards or anti-snoring prostheses

How to Choose a Prosthodontist

• Find out if the prosthodontist is familiar with the latest technology and procedures to minimize pain and maximize results.

• Find out if they have any additional patient education information such as a newsletter or website page to help you protect any remaining teeth.

• Ask about pricing, payment plans and more cost-effective options to the proposed procedure? Can complex procedures be broken down into steps and spread out over a period of time?

How to Choose an Oral Surgeon

What Does an Oral Surgeon Do?

For some very serious dental reconstruction, you may need to choose an oral surgeon. An oral surgeon performs oral surgery on patients and may also be involved in difficult tooth extractions. The oral surgeon may perform surgery on the mouth, jaws, or other related areas of your head and neck. You might see an oral surgeon for temporomandibular joint (TMJ) problems, repair of broken bones in the face or jaws, birth defects of the face or mouth, or surgery to repair damage caused by oral cancer. An oral surgeon may work in an office environment or may sometimes work in a hospital environment in conjunction with other medical professionals. An oral surgeon will:

• Examine, diagnose and treat you for multiple tooth and jaw problems.

• Perform difficult or multiple tooth extractions that cannot be performed by your family dentist.

• Determine the need for, and administer, different types of anesthesia during your dental surgery.

• Diagnose, remove and examine any lumps, tumors or unusual growths.

• Perform any necessary surgery to prepare your mouth for the installation of any type of dental prosthesis such as dentures or bridges.

• Correct any abnormal jaw structures.

• Treat and repair jaw fractures.

How to Choose an Oral Surgeon

• Ask your family dentist for referrals to a qualified oral surgeon.

• Find out if the oral surgeon is familiar with the latest technology and procedures to minimize pain and maximize results.

Tooth whitening

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, you’re not alone.

Why Did My Teeth Change Color?

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. What do they have in common? Intense color pigments called chromogens that attach to the white, outer part of your tooth (enamel).

Tobacco Use

Two chemicals found in tobacco create stubborn stains: Tar and nicotine. Tar is naturally dark. Nicotine is colorless 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 you’ve been hit in the mouth, your tooth may change color 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.

How Does Teeth Whitening Work?

Teeth whitening is a simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which makes the color less concentrated and your teeth brighter.

Does Whitening Work on All Teeth?

No, which is why it’s important to talk to your dentist before deciding to whiten your teeth, as whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will not work on caps, veneers, crowns or fillings. It also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.

What Are My Whitening Options?

Talk to your dentist before starting. If you are a candidate, there are four ways to put the shine back in your smile:

Stain Removal Toothpastes

All toothpastes help remove surface stain through the action of mild abrasives that scrub the teeth. These toothpastes have additional polishing agents that are safe for your teeth and provide stain removal effectiveness. Unlike bleaches, these products do not change the color of teeth because they can only remove stains on the surface.

In-Office Bleaching

This procedure is called chairside 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.

At-Home Bleaching from Your Dentist

Your dentist can provide you with a custom-made tray for at-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. Out-of-office bleaching can take anywhere from a few days to a few weeks.

Over-the-Counter Bleaching Products

You may see different options online or in your local grocery store, such as toothpastes or strips that whiten by bleaching your teeth. The concentration of the bleaching agent in these products is lower than what your dentist would use in the office. If you are thinking about using an over-the-counter bleaching kit, discuss options with your dentist.

Are There Any Side Effects from Teeth Whitening?

Some people who use teeth whiteners may experience tooth sensitivity. That happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. In most cases the sensitivity is temporary. You can delay treatment, then try again.

Overuse of whiteners can also damage the tooth enamel or gums, so be sure to follow directions and talk to your dentist.

Tooth Bonding

Tooth Bonding is a popular treatment option because it provides a successful attachment between the filling material and the tooth’s original enamel and dentin. It looks like the original tooth and functions like it as well.

Direct composite bonding is used to recreate a smile in an additive manner, where little or no tooth reduction is needed. Direct bonding, in the hands of a skilled operator, is less costly than porcelain veneers and dental crowns and can be long-lasting with proper maintenance.

BENEFITS OF BONDING

Dental bonding provides patients with cosmetic benefits. Bonding can repair a broken or chipped tooth or close gaps between teeth without the need for lengthy orthodontic treatments. Typically your dentist can use dental bonding to improve the appearance of your smile in just one visit to the dentist office. Dental bonding can also be altered and patients are able to choose a more permanent cosmetic restoration in the future.

• Requires less removal of tooth enamel

• Repairs damaged or broken teeth

• Can close gaps in teeth

• Durable, lasting material

• Can be molded and color matched to adjacent teeth

• Natural looking results

• Can be altered in the future

• Ideal for developing smiles

Transitional bonding is used for anything from a mock-up to a full-mouth rehabilitation. It’s called transitional because it allows the patient to transition into more permanent dentistry as he or she can afford, or as the treatment sequence demands, and it allows the dentist time to work out any bite-related and esthetic issues.

Veneers

Dental veneers are made from a high-quality dental porcelain that reflects light like natural teeth. The semi-translucent appearance helps veneers blend with your smile for natural results. Veneers are long lasting, beautiful, and create a smile patients feel proud to share.

With veneers—as opposed to crowns—your natural teeth remain largely intact with only a minimal amount being altered to fit the veneer. Dental veneers require up to a millimeter of tooth enamel to be removed to make room for the shell-like veneer. Removing less tooth structure, dental veneers help to support the stability of your natural teeth and bite.

Dental veneers fit over the front and sides of the tooth covering any visible blemishes. Dental veneers are as highly durable and lasting as dental crowns, making them a viable option for patients looking to improve the aesthetics of their smile.

For many patients, dental veneers can be used to address minor cracks, chips or brakes. Dentists may also recommend veneers to quickly fix minor twists, overlaps, and small gaps between teeth.

DENTAL BONDING VS. PORCELAIN VENEERS

Dental bonding is a comparable alternative to dental veneers and ideal for young patients looking for a less permanent option for improving the aesthetics of their smile. Dental bonding is typically more cost-effective than dental veneers for patients looking to treat cosmetic concerns on a budget. Dental bonding requires less tooth enamel removal than porcelain veneers. Dental bonding allows patients to revisit their cosmetic concern at a later date when they are ready for a permanent dental veneer.

COSMETIC INLAYS AND ONLAYS

Inlays and onlays are indirect restorations that can be used to help an otherwise healthy tooth with a large filling. Inlays are placed within the grooves between the cusps (points) of a tooth, whereas onlays are placed within the grooves and over the cusp tip. Inlays and onlays can be used to replace old filings, and are more esthetically pleasing because they can be made to match a tooth’s natural color. Aside from improving a tooth’s appearance, inlays and onlays can strengthen the structure of a tooth because of their durability and longevity.

Dentures

PARTIAL DENTURES

For many years, partial dentures have been used to replace groups of teeth or a few teeth scattered across the lower or upper jaw. There are a variety of removable partial dentures available to patients and each one comes with its own set of benefits and disadvantages. All partial dentures attach to remaining teeth and have a gum–colored portion meant to blend into the existing gum, with prosthetic teeth to replace the missing teeth.

FULL DENTURES

Full dentures are similar to partial dentures in that they are prosthetic teeth and gums used to replace missing teeth. The main difference between full and partial dentures is that full dentures are a total replacement system for either upper or lower teeth and, in some cases, both.

OVERDENTURES

Overdentures are a newer alternative to dentures, combining traditional denture technology with modern advancements in dental implants.

Overdenture is able to sit securely in place to instantly increase retention, stability, and comfort. This is especially important in lower-jaw full-denture situations where traditional dentures tend to have less adhesion due to a limited foundation and the tongue muscle dislodging the prosthetic teeth.

Another benefit of overdentures compared to traditional dentures is the limited amount of bone loss where the implants are placed, making the procedure more successful in the long run and helping to preserve facial structural integrity.

Overall, when considering full dentures for the lower jaw, an overdenture should be discussed with your dental professional as it can provide the most effective, satisfying, and longest-lasting alternative. Traditional full and partial denture options should be explored, weighing their benefits and pitfalls carefully to find the right dentures for your tooth loss.

Benefits of Dental Implants

Are you missing teeth? Are you looking to restore your beautiful, natural looking smile?

Dental implants for missing teeth provide exceptional esthetic results. Made from high-quality dental materials, dental implants look, function and feel just like your natural teeth. Dental implants can be used to replace a single missing tooth or to secure a bridge or denture for replacing multiple missing teeth.

If you are missing teeth, dental implants are the most natural way to replace them. High-quality dental porcelain is used to create a customized dental restoration that will be supported by the surgically implanted dental implants.

DENTURES VS. DENTAL IMPLANTS

Using dental implants to secure a dental restoration for missing teeth can improve the apperance of your smile. Traditional dentures can appear too big, bulky or loose. Dentures can slip while eating or speaking causing embarrassment. Patients feel self-conscious of their smile, and hide their teeth behind their lips or hands. Dental implants provide added bite stability and support long-term oral health. Implant secured dentures help stabilize the jaw bone.

PREVENTING FACIAL RECESSION

Missing teeth can lead to facial sagging and premature aging. Without the support of the tooth root, the jaw bone begins to break down. As the jaw bone weakens, the facial structure can become compromised. Patients with missing teeth often see a gradual shifting of their jawline.

Dental implants stimulate natural bone regeneration and prevent the deterioration and regression of the jawline. Implants are surgically implanted into the jaw and help to support the structure of the face and bite. Replacing missing teeth with dental implants can prevent facial sagging and help to make patients look and feel younger.

Crown

Porcelain dental crowns are an excellent choice when recreating the form and function of a damaged tooth, because a crown basically replaces the entire external portion of the tooth down to the gum level. Crowns are not limited to simply replacing the original tooth, but can be designed to create an even better esthetic appearance.

The dentist will examine your teeth and in some cases will immediately see that a tooth crown is the best option.

POTENTIAL CROWN DOWNSIDES

Porcelain dental crowns do require some laboratory time to be created and times vary according to the laboratory and its distance from your dentist, so expect to be fitted with a temporary, or provisional, crown for a while.

Some patients may experience sensitivity to hot and cold temperatures after porcelain crowns are attached. It’s best to consult with your dentist for more information about your individual case.

While porcelain crowns are very durable, they do not have the flexibility of natural teeth, so avoiding certain foods may be necessary. Chronic tooth-grinders and jaw-clenchers will need to be fitted with a nighttime mouth guard to protect the porcelain from unnecessary and excessive pressure and use.

MAINTENANCE OF A PORCELAIN CROWN

Maintaining porcelain dental crowns is actually quite simple. Much like your original teeth, they require routine brushing with non-abrasive fluoride toothpaste and regular flossing.

A follow-up appointment will be scheduled to evaluate the crowns shortly after they’re placed, so the dentist can review the work and see how your mouth is reacting to the crowns. Even if you think the crowns are successful, this follow-up appointment is an important part of your future oral health.

PORCELAIN FIXED DENTAL BRIDGE

A porcelain fixed dental bridge is very useful when replacing a tooth or a couple of teeth that are no longer viable. The porcelain can be sculpted to replicate the look of natural tooth enamel and using this durable material gives your bridge a strong base to rely upon.

Porcelain is so flexible in its design capabilities that it can be used not only to replace lost teeth, but also to improve the original appearance of those teeth and create a flawless replacement.

There are different ways to replace missing or damaged teeth, so a dentist should be contacted if this is a problem you are facing.

A porcelain fixed bridge replaces missing teeth by using the surrounding teeth as a foundation. This creates a literal “bridge” between the remaining teeth and the missing teeth.

Dental porcelain is a great product because it can be shaped to replicate original teeth and fit comfortably within the established bite pattern. Porcelain is also very durable, will withstand most natural tooth functions, and can vividly mimic tooth enamel with its glass-like whiteness and translucence, which allows light to penetrate and scatter as it does with natural organic teeth.

MAINTENANCE OF A PORCELAIN FIXED BRIDGE

Maintaining a porcelain bridge is actually quite simple. Treat your bridge in the same manner as you would original teeth, with routine brushing with non-abrasive fluoride toothpaste and regular flossing.

A follow-up appointment will be scheduled to evaluate your bridge shortly after it’s placed, so the dentist can review his or her handiwork and see how your mouth is reacting to the treatment. Even if you think everything feels perfect, this appointment is vital to your future oral health.

Periodontal surgery

Periodontal surgery is designed to restore form and function to the gum tissue, periodontal ligament, and the bone that supports your teeth or an individual tooth. The real long-term goal of any periodontal surgery is to increase the life expectancy of the teeth and their usefulness; it is not a cure for periodontal disease. Basically, periodontal surgery removes tissue that has been transformed by the disease and then reconstructs the gums and surrounding tissues to better support the teeth and to recreate a normal appearance.

PERIODONTAL DISEASE

Periodontal disease is diagnosed when gingival or gum tissue attachment to the teeth is abnormal and bone changes may be evident through x-rays. A dentist will determine the degree of periodontal disease by examining “pockets” between the gum and tooth to see how much detachment exists and then will thoroughly examine the x-rays. Your dentist and you can discuss treatment procedures once a periodontal disease diagnosis has been made, beginning with conservative behavioral changes and extending to periodontal plastic surgery.

TREATING PERIODONTAL DISEASE

Periodontal disease does not always respond to conservative measures taken before and after diagnosis. While surgery may be necessary in the end, knowing what steps you can take to prevent disease from forming, and from progressing, is very important.

Behavioral Change– When periodontal disease is detected, your dentist will first recommend a few behavioral changes including an enhanced oral hygiene program,quitting smoking, and possibly some additional lifestyle changes.

Tartar Removal– A regular and thorough professional tartar or calcified plaque removal program will become an essential part of your oral hygiene routine. Typically this is a painless procedure but, in some extreme cases, pain medication may be required for a few days.

Bite Therapy– Bite disorders can be treated after periodontal disease is diagnosed and treatment has begun. This may prevent future problems and will make your mouth an all-around more hospitable environment.

Surgical Therapy– In cases of severe periodontal disease, surgery will be necessary to repair and regenerate the soft and hard tissues and replace any missing teeth. The goal of surgery is to eliminate pockets between the gum and tooth and attempt to encourage reattachment and normal function and esthetics to the patient. There have been many advances in this field in both soft-tissue and hard-tissue replacement and regeneration, and a skilled periodontal plastic surgeon can restore an affected mouth to a pre-disease appearance.

PREVENTING PERIODONTAL DISEASE

While steps can be taken to alleviate the ravages of periodontal disease, the best step is prevention. Remove plaque and bacteria through daily brushing, flossing, and regular oral hygiene. Routine visits to a dental professional for cleanings are also essential. Quitting smoking has proven to be very helpful in preventing the onset of periodontal disease.

ORTHODONTICS

When patients think about orthodontics, braces are the first thing to come to mind. However, orthodontics is more than just braces. Orthodontists are concerned with the position of the teeth, what has caused them to arrive at their current position, and what future movement may be needed so that a patient’s bite is fully functional.Some orthodontic options available to straighten your teeth, ranges from conventional braces (with wires and brackets) to invisible braces (clear orthodontic aligners). Each method ranges in price and treatment length, and will vary by patient. Ask your dentist about which treatment is right for you.

CLEAR ORTHODONTICS ALIGNERS

Clear orthodontic aligners can straighten a dental patient’s teeth without the wires and brackets of traditional braces. The aligners consist of a sequence of clear, removable trays that fit over the teeth to straighten them. Each tray must be worn by the patient for a specified amount of time—usually around 20 hours a day for two weeks–before the patient can progress to the next tray. In most situations, the aligners can straighten teeth in anywhere from six to 18 months.

Clear orthodontic aligners are suitable for patients with mild or moderate crowding, or minor spacing issues. They may not be appropriate for patients with severe crowding or spacing. While the aligners can correct a mild malocclusion, patients with severe underbites, overbites or crossbites may require more advanced orthodontic treatment.

Unlike traditional braces, the trays can be removed for brushing, flossing, and eating. Because the trays are clear, patients can undergo this type of orthodontic treatment without the usual discomfort associated with regular braces.

Although treatment prices for aligners are normally set by the individual dentist or orthodontist, they can be more expensive than braces. If a patient fails to wear the trays properly, or loses them, additional costs may be incurred if new trays or impressions of a patient’s teeth are needed.

LASERS

Lasers have been used in dentistry since 1994 to treat a number of dental problems. Uses of Lasers in Dentistry

Laser Treatment for Gum Disease

This cost-effective, non-invasive procedure offers better results. People who cannot get surgeries done like those suffering from hypertension, diabetes, cardiac problems, organ transplant and epileptic, they can go for this.

Laser Teeth Whitening

By using laser in whitening, discoloration and stains better results can be achieved using a laser. This process might take as less as one sitting

Laser Root Canal Treatment

Many times, a root canal becomes unsuccessful because of incomplete removal of tissue from the canals but when the laser tip is inserted within the canals, it burns any tissue that is left and thus, the chances of failure are reduced.

Laser Gingivectomy

Laser can remove the problem of Gingival hyperplasia that is caused by anti hypertensive and anti epileptic drugs.

Laser surgery for tongue tie

Lingual frenectomy through laser can treat speech difficulties in people with tongue tie.

Aesthetic Laser Dentistry

Gummy smile often lowers down one’s confidence. The patient can have aesthetic recontouring of the gums, improving crown length giving back natural smile.

Laser Frenectomy

Space in upper and lower anteriors because of high frenal attachment can be relieved painlessly with laser.

Laser Procedure – Vestibuloplasty

With the use of laser, sulcular deepening and creation of a greater retentive area becomes less and thus, there is a quick healing with less of pain.

Laser Pericoronal Flap Removal

Pericoromal flap removal can be done easily in just a few minutes using lasers with the least amount of pain and no infection.

Laser for treatment of Aphthous Ulcers

With the use of laser ablation, painful oral ulcers can be treated effectively.

Laser-Assisted Oral Surgery

Laser Surgery for Oral Submucous Fibrosis :

It is possible to get effective mouth opening after cutting fibrotic band as using laser with less of bleeding and pain.

Laser Treatment for White spots on Teeth

By use of laser surgical process, Leukoplakia or Lichenplanus can be treated.

Dental Laser Biopsy

Benign tumor removal, Cystic lesion and soft tissue cutting can be done by lasers easily.

What Are the Pros and Cons of Using a Laser in Dentistry?

Pros

Compared to the traditional dental drill, lasers:

• May cause less pain in some instances, so reduces the need for anesthesia

• May reduce anxiety in patients uncomfortable with the use of the dental drill

• Minimize bleeding and swelling during soft tissue treatments

• May preserve more healthy tooth during cavity removal

Cons

The disadvantages of lasers are that:

• Lasers can’t be used on teeth with fillings already in place.

•Lasers can’t be used to fill cavities located between teeth, around old fillings, and large cavities that need to be prepared for a crown. In addition, lasers cannot be used to remove defective crowns or silver fillings, or prepare teeth for bridges.

• Traditional drills may still be needed to shape the filling, adjust the bite, and polish the filling even when a laser is used.

• Lasers do not eliminate the need for anesthesia.

• Laser treatment tends to be more expensive — the cost of the laser is much higher than a dental drill.

LASER TREATMENT FOR GUM DISEASE

Lasers can be used to treat periodontal disease. Current controlled studies have shown that similar results have been found with the laser compared to specific other treatment options, including scaling and root planing alone. Scaling and root planing is a traditional non-surgical therapy used to treat periodontal diseases.

CAN THE USE OF LASERS IN PERIODONTAL THERAPY HARM PATIENTS?

Yes and no. Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if a laser with an inappropriate wavelength and/or power level is used during a periodontal procedure.

DOES THE RESEARCH ON LASERS SUPPORT THEIR USE IN PERIODONTICS AT THIS TIME?

At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.

CAN I TRUST THE CLAIMS IN AN AD FOR PERIODONTAL THERAPY PERFORMED WITH A LASER?

It is important to beware of advertising that sounds too good to be true because it very well may be. A dental professional can help you separate fact from hype.

GUM GRAFT SURGERY

Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

WHAT ARE THE BENEFITS OF GUM GRAFT SURGERY?

A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

SCALING AND ROOT PLANING

Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health.

REGENERATIVE GUM PROCEDURES

Procedures that regenerate lost bone and tissue supporting your

teeth can reverse some of the damage caused by periodontal disease.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue.

Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you’ll increase the chances of keeping your natural teeth – and decrease the chances of other health problems associated with periodontal disease.

DENTAL CROWN LENGTHENING PROCEDURE

You may have asked your periodontist about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure. During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.

Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

PERIODONTAL POCKET REDUCTION PROCEDURES

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.A periodontal pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it’s important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.

What is tooth whitening?

Tooth whitening can be a very effective way of lightening the natural colour of your teeth without removing any of the tooth surface. It cannot make a complete colour change, but it may lighten the existing shade.

Why would I need my teeth whitened?

There are a number of reasons why you might get your teeth whitened. Everyone is different; and just as our hair and skin colour vary, so do our teeth. Very few people have brilliant-white teeth, and our teeth can also become more discoloured as we get older.

Your teeth can also be stained on the surface by food and drinks such as tea, coffee, red wine and blackcurrant. Smoking can also stain teeth.

‘Calculus’ or tartar can also affect the colour of your teeth. Some people may have staining under the surface, which can be caused by certain antibiotics or by tiny cracks in the teeth which take up stains.

What does tooth whitening involve?

Professional bleaching is the most usual method of tooth whitening. Your dental team will be able to tell you if you are suitable for the treatment, and will supervise it if you are. First the dental team will put a rubber shield or a gel on your gums to protect them. They will then apply the whitening product to your teeth, using a specially made tray which fits into your mouth like a mouthguard.

The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, oxygen gets into the enamel on the teeth and the tooth colour is made lighter.

How long does this take?

The total treatment can usually be done within three to four weeks. First, you will need two or three visits to the dentist. Your dental team will need to make a mouthguard and will take impressions for this at the first appointment. Once your dental team has started the treatment, you will need to continue the treatment at home. This means regularly applying the whitening product over two to four weeks, for 30 minutes to one hour at a time.

However, there are now some new products which can be applied for up to eight hours at a time. This means you can get a satisfactory result in as little as one week.

What other procedures are there?

There is now laser whitening or ‘power whitening’. During this procedure a rubber dam is put over your teeth to protect the gums, and a bleaching product is painted onto your teeth. Then a light or laser is shone on the teeth to activate the chemical. The light speeds up the reaction of the whitening product and the colour change can be achieved more quickly. Laser whitening is said to make teeth up to five or six shades lighter.

How long does chair-side power whitening take?

Your dentist will need to assess your teeth to make sure that you are suitable for the treatment. Once it has been agreed, this procedure usually takes about one hour.

How much does tooth whitening cost?

Charges will vary from practice to practice and region to region. Laser or power whitening will be more expensive than professional bleaching. We recommend you get a written estimate of the cost before you start any treatment.

How long will my teeth stay whiter?

The effects of whitening are thought to last up to three years. However, this will vary from person to person. The effect is less likely to last as long if you smoke, or eat or drink products that can stain your teeth. Ask your dental team for their opinion before you start the treatment.

What are the side effects?

Some people may find that their teeth become sensitive to cold during or after the treatment. Others may have discomfort in the gums, a sore throat or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days of the treatment finishing.

If any of these side effects continue you should go to your dentist.

What about home whitening kits?

There are many home whitening kits available, including paint-on whiteners and strips. How effective these are depends on the amount of whitening agent they contain.

Regulations on the sale of these vary from country to country and some of the products on the market are not effective. Always ask your dental team for advice before trying to whiten your teeth at home.

What about whitening toothpastes?

There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining. Therefore, they may improve the overall appearance of your teeth. Whitening toothpastes may also help the effect to last, once your teeth have been professionally whitened.

Can a single tooth which has been root filled be whitened?

Yes. Sometimes dead teeth go discoloured after a root filling. If the tooth has been root treated, the canal (which contained the nerve) may be reopened. The whitening product is applied from the inside to whiten the tooth.

When might tooth whitening not work?

Tooth whitening can only lighten your existing tooth colour. Also it only works on natural teeth. It will not work on any types of ‘false’ teeth such as dentures, crowns and veneers.

If your dentures are stained or discoloured visit your dental team and ask for them to be cleaned.

How can I look after my teeth once they have been whitened?

You can help to keep your teeth white by cutting down on the amount of food and drinks you have that can stain teeth. Don’t forget, stopping smoking can also help prevent discolouration and staining.

We recommend the following tips to take care of your teeth:

• brush your teeth last thing at night and at least one other time during the day, with a fluoride toothpaste

• cut down on how often you have sugary foods and drinks

• visit your dental team regularly, as often as they recommend.

Treating Sensitive Teeth After TEETH WHITENING

Sometimes after whitening treatments, teeth can be sensitive. If this occurs you have options to reduce the pain.

• Use a sensitivity toothpaste – sensitive toothpastes are formulated with ingredients such as potassium nitrate to relieve the pain associated with tooth sensitivity

• Chew gum – scientists have found that more saliva is produced when chewing gum. And the act of chewing may distract people from the pain.

• Avoid whitening for a while – give your teeth a break and stop using whitening products.

Tips to Prevent Tooth Discoloration After TEETH WHITENING

Once you’ve completed a whitening treatment, there are a few steps you can take to maintain your whiter smile.

• Avoid stain-causing foods and beverages – coffee, tea, wine, sports drinks, hard candy, berries and tomato sauce are all foods that can cause tooth discoloration.

• Use a straw – when drinking beverages, use a straw to keep stain-causing dyes away from your teeth.

• Quit smoking – smoking tobacco can cause teeth to become discolored. Eliminating tobacco can help keep your teeth bright.

How does laser work in contrast to trays?

Contrary to the high-tech notion that the lasers themselves may blast the dirt off from your teeth, the laser itself doesn’t do the cleaning. Dentists have to apply a peroxide paste–either hydrogen peroxide or carbamide peroxide, both in higher doses than normal–across your teeth, and then heat it up with an argon or CO2 laser.

With whitening trays, the peroxide itself releases oxygen molecules that seep into the outer layer of your tooth, called enamel, and break down stains over a few hours. Lasers are different because they heat up the oxygen process more quickly.

While you would bring a tray home and wear it nightly for a few days or weeks (depending on the severity of your discoloration), laser bleaching purports to remove all stains after 2-4 thirty minute applications (1 per 10 days).

Pro’s &Con’s of Laser Teeth Whitening

• 2-4 treatments

• 15-60 minutes per application

• Under dental supervision in case of extreme sensitivity

• Must space applications out 1-2 weeks each

• Must set dental appointments and take time out of your day for treatments.

• Increased likelihood of tooth sensitivity

• May damage tooth pulp

• Annual maintenance expensive

Pro’s &Con’s of Teeth Whitening Trays

• Exact match to your dental structure

• Use while sleeping

• Clear, thin, and not invasive

• Annual maintenance lesser than laser

• Trays last for 2-5 years

• End results = to laser teeth whitening

• Cost 90% less than laser teeth whitening

It’s tough to list any cons associated with teeth whitening trays other than it requires more applications than laser teeth whitening. In fact this “con” is cancelled out when you factor in the 2-3 visits for laser whitening must be spaced out with 1-2 week gaps. Taking the gaps into consideration laser whitening actually makes the process longer than whitening with trays.

Are dental x-rays harmful?

An X-ray allows your dentist to see bones, tissue, and hidden surfaces of your teeth that he or she can’t see with the naked eye. The downside is that X-rays expose you to radiation. Four bitewing X-rays, which is what many people get in a routine exam, give about .005 millisieverts of radiation. That’s about the same amount of radiation you get in a normal day from the sun and other sources. A panoramic dental X-ray(OPG), which goes around your head, has about twice that amount of radiation.

While those are small amounts of radiation, there’s no such thing as a completely safe exposure, and radiation is cumulative over your lifetime. Children are particularly vulnerable, since they’re small and their cells are dividing rapidly. The thyroid gland, which gets zapped in a dental X-ray unless it’s shielded, is also quite vulnerable to radiation. If you have a lot of decay or other dental problems, you’ll likely need more X-rays than other people. But if you have a healthy mouth and aren’t at high risk for decay, you don’t necessarily need X-rays every year.

Can x-rays be taken if you are pregnant?

Make sure to tell your dentist. During your pregnancy, you may need to have X-rays taken as part of your treatment plan for a dental disease. Use of the leaded apron and thyroid collar will protect you and your fetus from radiation exposure. Dental X-rays do not need to be delayed if you are trying to become pregnant or are breastfeeding.

Will Dental X-Rays Affect Me Over my Lifetime?

No. A responsible dentist will not allow you to have more x-rays than your body can handle, and the amount of radiation you are exposed to is very low. The average person is exposed to more radiation from the sun over a year than from an x-ray.

Can You Get Cancer From Dental X-Rays?

Generally no, as long as your dentist is following the current guidelines for dental x-rays. It’s recommended that adults receive dental x-rays every two or three years. In this case, the amount of radiation is minimal and won’t cause any long-term harm.

Are There Safer Forms of Dental X-Rays?

A bitewing x-ray, the most common form of dental x-ray, produces 0.005 millisieverts of radiation, the equivalent of a day in the sun. But you can get twice that dose of radiation from a panoramic X-ray, which goes around your head.

Since bitewings have lower radiation, they may technically be safer — but as long as you aren’t getting any type of x-ray frequently, the increased radiation in panoramic x-rays shouldn’t be cause for concern.

CBCT in dentistry:

CBCT (cone beam computed tomography) uses systems that are ideal in capturing images of hard tissues especially in the maxillofacial region. One benefit of this technology is its ability to provide submillimeter resolution in terms of images. The images provided are also high in diagnostic quality. CBCT is now also used by a lot of dental professionals because of its short scanning period. It only takes about 10 to 70 seconds to complete scans.

Radiation dosages were also reported as being 15 times lower than conventional CT scans. Increased use of this system can help dental clinicians in receiving imaging modalities that have the capacity of offering three-dimensional (3-D) representation of a patient’s maxillofacial skeleton. CBCT performs this function with the least amount of distortion. This makes it a truly useful system for numerous professionals practicing dentistry.

A glimpse of what takes place during a CBCT session

In most cases, a single CBCT appointment or session involves a variety of procedures that can be completed in less than one hour. These include registration, scanning, positioning, reconstruction, and verification of the scan. CBCT technology is a three-dimensional system used for the correct diagnosis, planning of treatment, and management of the present condition of the maxillofacial complex and jaws..

For dental implants

CBCT works in immediately spotting or locating anatomic structures, incisive canal, submandibular fossa, mandibular canal, and maxillary sinus. It is also helpful in the correct assessment of the shape and size of the ridge as well as the quality and quantity of bones. It is valuable in assessing the required number of implants identifying the need for a sinus lift or bone graft, and determining the importance of using implant planning software.

For maxillofacial and oral surgery

CBCT is useful in spotting the relationship between mandibular canal and third molar roots. It also helps in foreign objects and impacted teeth localization, orthognathic surgery planning, and facial fractures and asymmetry assessment. it is also useful in identifying maxillofacial and oral pathology. It is valuable in localizing and characterizing lesions found in the jaw. It also evaluates how lesions affect the jaw in third dimensions especially those effects related to bilateral symmetry, cortical erosion, and expansion.

For orthodontics treatment and TMJ

CBCT is useful in planning orthodontic treatments for complex cases. For patients who have cleft palate, root resorption and angulation, and impacted tooth. CBCT systems are also useful in dealing with temporomandibular joint (TMJ). The systems are effective in the accurate assessment of the TMJ’s structures, thereby guaranteeing its correct diagnosis and treatment.

Benefits of using CBCT systems

One of the benefits of CBCT is low radiation doses compared to medical CT. It also adds a level of comfort for patients. It makes them feel at ease because it is conducted in an open environment in a relaxed seating position while also facing out.

The scan takes about 20 seconds and allows the immediate availability of images on screen. These images can be imported into another software. All the benefits provided by CBCT, especially in achieving safe and reliable results when performing a number of dental procedures, makes it a truly valuable tool in the field of dentistry.

Endodontic advantages of CBCT imaging

Endodontic radiographic diagnosis is based on many factors, including anatomical limitations such as thickness of the cortical bone; positioning of the apical abscess to the cortical bone; and is complicated by proximity to other anatomical structures including the zygomatic bone, sinus, and proximity of neighboring teeth. With 2-D images, these structures are often superimposed on a planar image.

3-D output, with its associated geometric accuracy in all three planes, offers tremendous advantages in these situations. 3-D images deliver accurate visualizations of the complex relationships and boundaries between teeth, related anatomical features, and their associated pathology. Other key benefits include assessment of internal tooth morphology, periodontal ligament space, the presence or absence of periapical lesions in association with critical anatomical structures, and maxillary sinus involvement.

CBCT also offers speed and versatility to the practitioner and patient alike. Within a few minutes of acquiring the scan, the dentist may fully explore the patient’s 3-D image. The image can then be rotated, color-contrasted, and slices can be isolated and further analyzed — even down to a single voxel size of 76 microns in thickness. Anatomic structures including nerve canals can be traced and highlighted for easy recognition. Moreover, each root and its surrounding structures can be evaluated, eliminating the need for exploratory surgery.

CBCT imaging provides significant advantages in the detection of apical periodontitis, diagnosis of endodontic failures and complications, perio-endo lesions, and as part of pre- and postsurgical assessment. CBCT also allows for detection of more periapical lesions than conventional radiographs — particularly in the second maxillary posterior teeth where CBCT has been found to be far more effective than conventional radiography. High resolution focused field CBCT has also been shown to provide 100% sensitivity and specificity in the detection of artificially created periapical lesions in dry human mandibles.

When assessing dental trauma, CBCT of adequate resolution can be used to detect horizontal root fractures and cortical bone fractures, which may otherwise have required multiple periapical radiographs for detection. In treating teeth with unusual anatomy, CBCT can help reveal the actual number of canals present in teeth, as well as the true nature and exact locations of lesions, the “portal of entry” of a resorptive lesion, and previously undetected lesions.

CBCT makes it easy to analyze specific areas of interest and provides the highly detailed anatomical information necessary for making confident treatment decisions. It also facilitates earlier and more accurate diagnosis, resulting in more predictable management and significantly higher treatment success rates.

Wisdom teeth removal

Your dentist says it’s time to remove your wisdom teeth. He may refer you to an oral surgeon, who will do the procedure in his office. It should only take a few days for you to heal and feel back to normal.

Why Take Them Out?

Wisdom teeth are a third set of molars in the back of your mouth. They usually come in between the ages of 17 and 25, and they’re spotted on X-rays. Most people have them removed for one of these reasons:

            •             They’re impacted. Because they’re so far back in your mouth, wisdom teeth may not come in normally. They can be trapped in your jawbone or gums, which can be painful.

            •             They come in at the wrong angle. They may press against your other teeth.

            •             Your mouth isn’t big enough. Your jaw has no room for an extra set of molars.

            •             You have cavities or gum disease. You may not be able to reach your wisdom teeth with your toothbrush or dental floss.

What are signs and symptoms of an infected wisdom tooth?

Pericoronitis is one of the most common indications for emergency extraction of a wisdom tooth and typically happens when there isn’t enough room for all of the teeth in the lower jaw. Infection symptoms are red, swollen gum tissue behind the last visible molar, bad taste/smell, pain with biting in the back teeth, and sometimes pus oozing and draining from the area. Occasionally, the infection will lead to swelling of the gum tissue, cheek, or other area around the affected side of the jaw. Swelling can cause pressure on adjacent structures and can radiate to the ear causing an intense earache. Sometimes an ear infection or a sinus infection can cause pain that radiates to the teeth as well, so it is very important to get examined whenever there is suspicion of infection.

What if the wisdom teeth hurt and they cannot be extracted right away?

If there is swelling, infection, difficulty swallowing or breathing, fever, or intense pain, priority needs to be given to getting the wisdom teeth out as soon as possible. Antibiotics may be prescribed to help keep an infection from getting worse or spreading for a very short while. Warm saltwater rinse or antibacterial mouth rinse and OTC painkillers can be used as short-term remedies for tooth pain until more definitive treatment can be obtained. Some large dental schools may offer emergency evaluation and/or tooth extraction.

Before Surgery

You’ll meet with the oral surgeon to talk about the process. At this appointment, make sure you:

            •             Talk about any health problems you have.

            •             List any drugs you take on a regular basis.            

          •               Ask any questions you have about the surgery.

            •             Discuss what type of anesthesia you’ll have. You can either be numb or asleep during your surgery.

            •             Plan time off from work or school to have your surgery and rest afterward at home.

During Surgery

Your surgery should take 45 minutes or less.

You’ll get one of these types of anesthesia so you don’t feel pain during the removal:

            •             Local: Your doctor will numb your mouth with a shot of Novocaine in your gums.You may also breathe nitrous oxide, or laughing gas, to relax or even doze during surgery. You should feel alert again shortly afterward.

            •             IV sedation: The surgeon will numb your mouth and also give you drugs through a vein in your arm to make you drowsy. You might sleep during the whole procedure.

            •             General: You’ll either get drugs through a vein or breathe gas in through a mask. You’ll be asleep the whole time and might not wake up for an hour or so after the surgery.

Your doctor may have to cut your gums or bone to get the teeth out. If so, he’ll stitch the wounds shut so they heal quickly. These stitches usually dissolve after a few days. He may also stuff gauze pads in your mouth to soak blood.

After Surgery

Everyone responds differently to anesthesia. If you had a local anesthetic and feel alert, you might be able to drive home to begin your recovery. You might even be able to go back to work or do your normal activities. If you had general anesthesia or still feel drowsy, you’ll need someone to drive you home.

Most people have little to no pain after surgery. You’ll likely have swelling and mild discomfort for 3 or so days. Your mouth may need a few weeks to completely heal.

Follow your doctor’s instructions for a quicker recovery. Here are some tips for the first 3 days after surgery:

Dos:

            •             Use an ice pack on your face to curb swelling or skin color changes.

            •             Use moist heat for a sore jaw.

            •             Gently open and close your mouth to exercise your jaw.

            •             Eat soft foods like pasta, rice, or soup.

            •             Drink plenty of fluids.

            •             Brush your teeth starting the second day. Don’t brush against any blood clots.

            •             Take the drugs your doctor prescribes to ease pain or swelling.

            •             Call your doctor if you have a fever, or if your pain or swelling doesn’t improve.

Don’ts:

            •             Don’t drink through a straw. Sucking may loosen blood clots that help your mouth heal.

            •             Don’t rinse your mouth too harshly. Your doctor may suggest rinsing gently with saltwater.

            •             Don’t eat hard, crunchy, or sticky foods that may scratch your wounds.

            •             Don’t smoke. Smoking can slow your healing.

How Much Does Wisdom Teeth Removal Cost?

The cost of wisdom tooth extraction depends on a number of factors, including:

            •             The experience of the dentist.

            •             The location of the dentist.

            •             The type of dental insurance you have.

            •             The extent of the procedure.

Wisdom teeth removal can range in price from Rs.2000- 4000 per tooth. This cost range does not include fees associated with sedation, X-rays, possible oral surgery necessities, or the proximity of the wisdom tooth to surrounding teeth and nerves. Extraction costs for impacted wisdom teeth are significantly higher than for erupted wisdom teeth.

Pros & Cons of Removal :

The dental community knows more than ever before about the consequences of not extracting impacted wisdom teeth. If impacted wisdom teeth are not extracted, the following may occur:

Teeth Shifting: Impacted wisdom teeth may shift surrounding teeth, causing bite irregularities and pain.

Bone Loss and Jaw Expansion: Impacted wisdom teeth may play a role in bone loss and expansion of the jaw.

Congestion: Wisdom teeth may contribute to sinus congestion and headaches.

Cysts and Tumors: Impacted wisdom teeth may be a factor in the development of bone destroying tumors or cysts, including cyst formation in the surrounding gum tissue.

Gum Tissue Irritation: Gum tissue surrounding impacted wisdom teeth tends to be more susceptible to gum irritation. If wisdom teeth do not fully erupt and become crooked, it may become difficult to adequately clean the gums.

Periodontal Pockets, Cavities and Bone Loss: Difficulty cleaning gums makes it easy for debris to be lodged, creating the perfect setting for bacteria. The resulting bacteria may produce periodontal pockets, create cavities and lead to bone loss.

Changes in Orthodontia and Dentures: For children, wisdom teeth may adversely affect the results of orthodontia. For the elderly, wisdom teeth may undermine the functionality of dentures.

Dry Socket

Dry socket is caused by improper formation or premature loss of the blood clot in the extraction site; it can be quite painful and results in delayed recovery.

To prevent dry socket, avoid smoking cigarettes and using straws for as long as possible after extraction. Because high estrogen levels lead to higher incidences of dry socket, it is recommended that women schedule extractions toward the end of their menstrual cycle when estrogen levels are lower to reduce the associated risk.

Dry socket may also occur due to improper diet following extraction. Foods such as popcorn, nuts and pasta should be avoided for at least three or four days after extraction because their food particles can interfere with the clotting process. Hot liquids and foods also should be avoided, since the heat may cause the clot to dislodge.