Dr. Mathur's

Dental & Endodontic Hospitals


Root Canal Treatment

What is a root canal?
It is the blood and nerve supply, which runs along the centre of the tooth down to the tip of the root (also known as pulp).

What is root canal treatment?

Decay or a blow to a tooth can lead to infection of the root canal of a tooth. The cleaning and filling of an infected root canal is root canal treatment.

What happens if I don’t root canal treat a tooth?
If the tooth is infected the infection usually spreads resulting in a potentially dangerous swelling and loss of the tooth.

Does it hurt?
No. A local anaesthetic is used and it should feel no different to having an ordinary filling done. Sometimes it can be sore afterwards because of infection but antibiotics usually resolve this problem.

Will I need a crown afterwards?
It depends on how weak the tooth is. We generally advise that back teeth be crowned after root canal treatment. If you don’t crown a root canal treated back tooth, it has a 50% chance of breaking within 3 years.

What will my tooth look like after treatment?
In the past, a root filled tooth would often darken after treatment. However, with modern techniques, this does not usually happen. If there is any discolouration the tooth can be whitened, or crowned.

How successful is root canal treatment?
Very successful, the infection subsides 9 times out of 10. In 1 in 10 cases the root canal treatment has to be repeated or the tooth extracted.

WHAT DOES THE PROCEDURE INVOLVE?

The removal of the infected or irritated nerve tissue that lies within the root of the tooth. It is this infected pulp tissue that causes an eventual abscess.

The first step in a root canal is to obtain access to the nerve. This is accomplished by establishing a small access opening in the top of the tooth. It will be done under a local anesthetic.

The length of the root canal is determined and the infected pulp is removed.

At the same visit, the canal where the nerve is located will be reshaped and prepared to accept a special root canal filling material. The number of visits single or 2-3 visits necessary to complete your root canal will depend upon several factors including the number of nerves in the tooth, the infected state of the nerve, and the complexity of the procedure.

The final step in your root canal will be the sealing of the root canal with a sterile, plastic material called gutta percha. This is done in order to prevent possible future infection.

If treated early, root canal therapy need not be uncomfortable. With the use of local anesthetics, the entire procedure can be totally painless
Dr Mathurs Dental Hospitals are equipped with latest technologies for painless Root Canal Treatment and Dr. Suhas Mathur is specialized in Single Visit Rotary Endodontics.

The success rates for Root Canal Therapy have been reported to be as high as 95%.

Sometimes when there has been long standing infection or abscess, there may be some soreness associated with the root canal visit. If this should turn out to be true, you will be given specific instructions to follow to minimize the discomfort. When an infection is present, it may be necessary to take an antibiotic. If pain should be present, analgesics may need to be prescribed.

The tooth will then possibly need a post and core and a crown in order to re-establish normal form and function. This decision will be based upon several additional factors.

Who is an endodontist?

An conservative dentist and endodontist is a specialist, who is trained exclusively for three years, After completing his B.D.S degree to treat individuals with decayed and badly destructed teeth and also reliving patients suffering with pain.. By preserving the natural integrity of the tooth..he is also specialized in smile design and coreection using laminates crowns ..etc.
The specialist has to be an M.D.S (Master of Dental Surgery) in the specialty of Conservative Dentistry and Endodontics from a University recognized by Dental Council of India.

Who requires endodontic treatment?

An individual will require endodontic treatment if he has the following conditions.

  • Painful teeth
  • Decayed teeth
  • Malaligned teeth
  • For Improving your smile
  • For cosmetic enhancement
  • Replacement of missing teeth
Earlier, a badly infected tooth, or one that just had significant decay, was doomed to be extracted. Today, the majority of these teeth can be salvaged by the Root Canal Specialist, The Endodonist like Dr. Suhas mathur.

An extraction is truly the last resort!


Teeth Whitening



What causes discoloration of the teeth?
Teeth enamel discoloration can be caused by staining, aging, or chemical damage to teeth. Some of the common causes are medications, coffee, tea or cigarettes. Other factors like genetic, enamel, and disease are also related.

Why do L.E.D teeth whitening can help you?
Teeth whitening become the most popular procedures perform in the field of cosmetic dentistry over last 10 years. This is one of the quickest methods designed to reverse the effects of all teeth discoloration causes. The whitening gel is applied to the teeth and laser light is used to activate the crystals to absorb the energy from the light and then penetrate the teeth enamel to increase the lightening effect on the teeth.

How white can your teeth become?
You can expect at least 2-3 up to 8 shades improvement. This makes a significant difference in just about anyone's smile. However, your results may vary depending on the type of stain thickness of enamel.

How long does teeth whitening last?
Results can last for years assuming good hygiene and reasonable exposure to staining foods and beverages. However, actual results may vary due to individual differences to tooth structure and personal habits.

Is it harmful or painful?
Teeth whitening is totally safe and designed to anyone. The whitening gel ingredient has been used over 50 years and is recognized as safe and effective by dental community. Very small percentage may experience some sensitivity during procedure and all will be recovered within 24 hours.

Is there any difference between over-the-counter tooth whiteners and Zoom?
Yes! Consulting your dental professional is always the first step to whitening your teeth safely. Plus, over-the-counter tooth whitening strips, brush-on gels and toothpastes take weeks or months to whiten your teeth just a few shades. Zoom! is clinically proven to whiten your teeth an average of eight shades in one hour or six shades in just one weekend.* Only a dentist can get your teeth this white, this fast.

Contra-Indications for Tooth Whitening
We do not recommend bleaching for smokers. Smokers should stop smoking before having their teeth bleached. The smoking not only defeats the effect of whitening, but there is concern about the mixture of hydrogen peroxide with smoking having a potential effect on tissue damage already known to be caused by smoking. If you have pre-existing cosmetic dental restoration (bonding, porcelain tooth crowns or veneers) you may need to replace them after the whitening treatment in order to match your new, whiter smile. Stains in the grey family (such as from tetracycline) can be harder to remove, if not impossible. These stains can take up to six months or longer to whiten. The best candidates for whitening are those with stains caused by coffee, tobacco or aging. If you have trouble eating ice cream or drinking cold drinks, you may have a sensitivity response to this treatment. This can usually be eliminated by deceasing the time you wear your trays or by following our suggestions for sensitive teeth. Tooth whitening is not recommended for patients who are pregnant or lactating and is not indicated for use with children.

Porcelain Venners

Dental Veneer is a thin layer of restorative material which is placed over a tooth surface, to protect a damaged tooth surface or to improve the aesthetics of a tooth. For this, two main types of materials are used which includes composite and porcelain. A composite veneer can be placed directly or it is indirectly fabricated by a dentist, which is later bonded to the tooth with the help of resin cement. On the other hand, a porcelain veneer can only be fabricated indirectly.

Dental veneers come under the umbrella of cosmetic dentistry as it can result into a sparkling white smile with teeth beautifully shaped and aligned.

Dental Veneers have can solve many cosmetic dental problems, including genetic predisposition, wear and tear of the teeth, incorrect spacing of teeth and uneven teeth which might be a result of tooth grinding or basic wear and tear.

Dental Veneers serve as an inexpensive and effective restoration treatment for small chips, cracks in the teeth and has the potential to protecting the surface of a damaged tooth/teeth.

Dental Veneers costs vary drastically, across the globe. The cost depends on various factors such as the experience and the skill of the cosmetic dentist, the location of the treatment, the material used for veneers and the number of teeth involved in the treatment.

Dental Veneers procedure can be completed in two dental visits which is generally extended up to a duration of six-weeks.

How is Procelain Veneer Placed

Step 1

Procelain Veneer Step 1

Step 2

Procelain Veneer Step 2

Step 3

Procelain Veneer Step 3

Step 4

Procelain Veneer Step 4

Step 5

Procelain Veneer Step 5


Crowns & Bridges

  
Crown types

There are several types of esthetic crowns. The type of crown you and your dentist choose will depend on a number of factors, including the location of the tooth or teeth being crowned, the type and severity of the discoloration and the overall health of the surrounding gums.

A ceramo-metal crown

Advantages include: strongest type of esthetic crown, doesn’t fracture or chip as easily
as alternative esthetic type crown, and is usually the most economical.
Disadvantages include: metal may be visible if tissue shrinks or is thin, metal may affect the colour of the porcelain and there is a possible bluish tint to the gum, if gum tissue is thin and metal shows through.

A full gold crown

Advantages include: kind to the tissues and gums, strong, nothing chips or breaks off like with porcelain and composite crowns.
Disadvantages include: not as esthetic as other crowns.

Porcelain or composite

Advantages include: most esthetic throughout crown life, and metal does not show.
Disadvantages include: not as strong as ceramo-metal crown, margin may be more susceptible to chipping and more costly to make.

    The procedure:

Fitting a crown is a two-step procedure. During your first visit, your dentist prepares and reshapes your tooth by removing enamel and dentin to allow room for the crown. You will be given anesthesia before hand. Then an impression of the prepared tooth and surrounding teeth is taken. Before you leave the office, your dentist makes and applies a temporary crown to protect the prepared tooth between visits.

Expect to wait one week between visits while your crown is being made. Meanwhile, take
care of your temporary crown by avoiding hard or sticky foods. In the event the crown becomes loose, call your dentist so the prepared tooth won’t be damaged.
At your second visit, your dentist removes the temporary crown and fits the permanent
crown onto your tooth making sure it restores your tooth to its proper shape, look and comfort level.  If necessary, your dentist may have to adjust the crown by modifying the shape. Once the fit is adjusted properly, cement is applied and the crown is positioned securely onto your tooth.

If the crown needs further changes, additional visits may be necessary.

Living with your crown

Crowns are designed to look and feel like real teeth.  As with your original smile, care
must be taken to avoid tooth fracture and with good oral hygiene, your crown will
last longer. It is recommended that you:

  • brush and floss around your crowned tooth thoroughly to remove decay-causing
    germs
  • see your dentist regularly to help prolong the life of your crown
  • ask your dentist about special cleaning aids

You should know:

  • crowns can fracture
  • the procedure requires anesthesia
  • original tooth form is altered (possibly involving the nerve)
  • crowns are not permanent and may need to be replaced after 5 to 15 years
  • if tissue shrinkage occurs, it can expose the junction between the tooth and crown, allowing for the possibility of an unsightly line
  • crowns may not give the best aesthetic results for people with serious bit or gum problems

The greatest things about crowns are:

  • dentist can repair chipped or fractured tooth
  • teeth can be lightened to any shade
  • some realignment/straightening of teeth are possible
  • crowns can be shaped to esthetically fill gaps
  • longest life of any restoration

If you have any further questions regarding crowns or other procedures to improve your smile, please ask your dentist.

Metal crowns

 

Ceramic crowns

 
Braces

Should I Get Ceramic or Metal ? Which type of braces are best?
Ceramic braces, Invisalign, Traditional metal, Golden metal, Self-ligating brackets, Viazis Brackets or Lingual braces. These days, there are many choices available to adults, and it gets confusing which type of braces should you choose, or can you choose, or is it strictly up to your dentist. These are the questions which generally get it.

The type of braces you get depends on a number of factors: 

    • The severity of your bite or tooth crookedness problems
    • If extractions are necessary
    • If jaw surgery is necessary
    • If headgear or other special appliances are necessary
    • The amount of time you will need to wear braces

  • The preferences of your dentist or orthodontist
  • How much you are willing to pay
  • How long you will be in braces to correct your problems
  • What you, yourself desire. Would you feel embarrassed in metal? Are you only willing to straighten your teeth if Invisalign is used? Do you prefer the look of ceramic or sapphire? Or don't you care, as long as the outcome is good?

This section will try to answer some of your basic questions by presenting the pros and cons of each type of braces. Please remember, your final choice is a combination of your preferences and your orthodontist's technical expertise!

Ceramic and "Tooth Colored" Braces
Ceramic brackets are made of composite materials. They are very strong and generally do not stain. Three popular brands are Clarity and Transcend, made by 3M Unitek; and Mystique, made by GAC. Adults like to choose ceramic because they "blend in" with the teeth and are less noticeable than metal.

Pros Cons

They blend in with most teeth, particularly if they are not perfectly white. They are not very noticeable at a distance or in photos.
Some people feel that they are more comfortable than metal and irritate your gums less.

Contrary to what you may have heard, ceramic brackets do not usually break or come off your teeth. They are very strong, and if bound with a plasma light, stay on as well as metal brackets.

The clear or white ligatures (little elastics that hold the arch wire to the brackets) can stain, which defeats esthetics of the ceramic braces. But those are changed at your monthly adjustment.

Ceramic brackets are are usually more expensive than traditional metal brackets.
Treatment can take a few months longer in ceramic braces.

From a purely esthetic point of view, they are a bit larger than metal brackets.

If you have severe problems, your orthodontist will not use ceramic brackets in many cases, because they may not be strong enough to withstand the forces of some types of treatment. 

Clear Sapphire Inspire! Brand Braces

Inspire brand brackets, manufactured by Ormco, are made of pure monocrystalline sapphire and are very translucent. They are very strong and do not stain. If your teeth are already very white, then Inspire braces will look best on you and seem to "disappear" on your teeth. If your teeth are less than white, they may tend to stand out (in this case, the Ceramic brackets would be a better choice). The pros and cons for Sapphire brackets are the same as those for Ceramic brackets.

Invisalign Braces
Invisalign braces are great for people who do not have severe problems. The "braces" consist of strong plastic trays that are fabricated especially for you. They are indeed invisible. If your bite is not severely off and your teeth are not severely crooked, then Invisalign would be a good choice. You would be able to get your teeth straightened without anyone seeing that you are wearing "braces"! This appeals to many adults, especially people who wore traditional braces as children and then need more treatment later in life. However, if your bite is very bad, if you need extractions or require headgear or other appliances, then Invisalign will not work for you; you will need to wear traditional braces.
Pros Cons

They are virtually invisible, and nobody knows you're wearing them but you.

They are easier to clean than traditional braces.

They don't irritate your gums as much as traditional braces, so there is little (if any) need for dental wax.

They do not stain at all.

The aligners are numbered and worn for two weeks each, so your time in treatment is well established.

You'll get a computer simulation showing how your teeth will move during treatment, and see the projected final outcome.

 

They cost as much as traditional braces, and sometimes even more.

Treatment can take as long as traditional braces.

In some cases, you may still need traditional braces for a few months after your Invisalign treatment, to correct certain problems.

You will still have tooth pain, because your teeth will be moved by the Invisalign trays. Invisalign is not a pain-free treatment.

The plastic trays are computer-fabricated by Align Technologies. Your orthodontist only has some control over your treatment.

It takes 6 weeks for the aligners to arrive from the factory -- a long time to wait. You may need more aligners (i.e., enhancements) after the original set of aligners.

If you have severe problems, your orthodontist will tell you that you are not a candidate for Invisalign.

 

Lingual Braces

Lingual braces are placed behind your teeth, and are therefore virtually invisible to other people. Usually, lingual brackets are made of metal. 

http://www.archwired.com/images/lingual_2.jpg

The obvious benefit of this type of treatment is that no one will know that you are wearing lingual braces unless they look inside your mouth! For more information about lingual braces, visit Dr. Mathur's Dental Hospital.

Pros Cons

Other people can't see the brackets unless they look inside your mouth.

 

 

They tend to hurt your tongue and make it difficult to speak at first.

They tend to be more expensive than traditional metal,  because treatment is specialized.

Treatment can take a few months longer than traditional braces.

Your orthodontist must be specially trained in lingual treatment. Not every orthodontist does lingual treatment.

If you have severe problems, or need certain types of appliances, lingual treatment may not be applicable.

Metal Braces, Viazis Braces, and Self-Ligating Braces
http://www.archwired.com/images/metal_braces.jpg

Metal brackets can be silver or golden. The golden brackets look a bit more "jewelry-like" and are often a popular choice with young women.

Metal brackets are very strong and can withstand most types of treatment. At first they may irritate your gums, but after a few weeks, when your cheeks get "toughened up" they are not a problem anymore. Most traditional metal braces require an elastic o-shaped rubber band, called a ligature to hold the arch wire onto the bracket. Sometimes orthodontists use metal tie wires (little wires which are twisted around the bracket) in place of elastic ligatures.

In the "old days", metal braces were not just brackets, but bands that wrapped around the entire tooth. Nowadays, people wear small metal brackets that are glued to the front of each tooth (a big improvement!) Those old-fashioned bands are usually reserved for molars or teeth with fillings that spill to the outside surface of a tooth. Metal brackets tend to be less expensive than other types of brackets. In addition, you can make them colorful with ligatures that come on a rainbow of colors.

http://www.archwired.com/images/gold_braces.jpg
http://www.archwired.com/images/ViaziBracketOnTeeth.jpg A different type of metal bracket is called the Viazi (or Viazis) bracket, sometimes called "FastBraces." Viazis brackets are triangular and utilize a low-force square wire. The Viazis technique is reported to result in less pain and sensitivity, and complete treatment faster than traditional brackets
The patented braces system moves the crown and the root of the teeth at the same time, from the beginning of treatment, in one stage, with typically one square wire. Conventional braces systems typically move the crown of the tooth with round wires during the first year and the root of the tooth with square or rectangular wires during the second year

http://www.archwired.com/images/Viazi_bracket_braces.jpg
Pros
Metal brackets tend to be the least expensive of all the types of braces.
They tend to take the least amount of time among all the types of braces.
You can choose a darker ligature, which will not show curry, smoking, or black coffee stains.

Self-ligating brackets do not contain rubber ligatures, so staining will never be a problem.

They are strong and rarely break.

The golden brackets are different, novel,  and generally look nice.

Viazis Brackets and self-ligating brackets can complete treatment in a shorter time with less pain; however orthodontists need special training in these systems, and they not available everywhere.
 
What are Retainers?
Orthodontic treatment changes the shape of the jaws and position of the teeth. As these changes are not natural there are chances that the teeth can go back to their original position. To prevent this change and to retain the teeth in their corrected position, retainers are given to the patients. The older removable retainers are usually cumbersome and non aesthetic. Patients do not wear the removable retainers and thus it causes recurrence of the patient’s initial problem. We prefer fixed lingual (not visible from outside) retainers which are neat, reliable and patients friendly.
They do not cause any discomfort or any interference during speech/eating /brushing or in any day to day activities. According to current concepts permanent retention is necessary so as o prevent recurrence (relapse) of the patient’s previous problems.
 


Wisdom Teeth

Each individual wisdom tooth is unique and depending on how it grows, it can have different impact on bones and/or tissues. Their varied developments such as impaction, horizontal or slant placement may effect other teeth and cause troubles. They have to extracted out and is a highly skillful job being performed by our Maxillofacial surgeon.

The following 4 impactions are commonly found in patients cases.
If the impaction is between the third molar and part of the second molar, this kind is called bone impaction. It can subcategorized into vertical, horizontal, and angular depending on the way they are intersecting.

  • Bone Impaction (Vertical)
    Impaction would cause pathosis inside the cheek bone or jaw bone.
  • Bone Impaction (Horizontal)
    Besides leading pathosis, horizontal placement would hurt the hard tissue of the second molar to cause toothache and cavities.
  • Bone Impaction (Angular)
    Besides leading pathosis, angular placement would hurt the hard tissue of the second molar to cause toothache and cavities.

Vertical Bone Impaction

Horizontal Bone Impaction

Angular Bone Impaction


Left: Bone Impaction (vertical)
Middle: Bone Impaction (horizontal)
Right: Bone Impaction (angular)

The last one is called tissue impaction, because the wisdom tooth is directly breaking out of the tissue.

  • Tissue Impaction
    The wisdom tooth almost erupts out of gum, or its half erupts out of gum to cause pseudo-pocket. Besides leading pathosis, it easily tracts food debris and causes gum irritation.

Tissue Impaction

 

Only under the X-Ray can these impactions be clearly identified.

Removal of Impacted Wisdom Tooth
The following shows how to remove the impacted wisdom tooth (bone impaction).

the impacted wisdom tooth

Incise soft tissue

Suture the soft tissues

1. Locate the impacted wisdom tooth. (left)
2. Incise soft tissue to open. (middle)
3. Remove overlying bone to expose the tooth crown. (middle)
4. Extract the tooth out by whole or in pieces. (middle)
5. Suture the soft tissue back. (right)

This procedure is only needed when your wisdom teeth start to bother you, or upon your dentist recommendation.

Maxillofacial Surgery

What is Maxillofacial Surgery?
Oral and maxillofacial surgery is a specialty of dentistry concerned with the diagnosis and surgical treatment of congenital or acquired diseases, dysfunction, defects or injuries of the mouth, jaws, face, neck and associated regions. Maxilla refers to the jaws - lower maxilla or lower jaw is currently called the mandible and the term maxilla refers to the upper jaw. A specialty of dentistry that includes the diagnosis, surgical, and adjunctive treatment of diseases, injuries, and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial regions.

Orthognathic surgery combines orthodontic treatment with surgery of the jaw to correct or establish a stable functional balance between the teeth, jaws and facial structures. The goal of maxillofacial surgery is to treat any jaw imbalance and the resulting incorrect bite, which could adversely affect the cosmetic (esthetic) appearance as well as the proper functioning of the teeth. This involves diagnosis, treatment planning and execution of treatment, by combining orthodontics and oral/maxillofacial surgery to correct musculoskeletal, dento-osseous and soft tissue deformities of the jaws and associated structures.

Who goes for maxillofacial surgery?
Any individual with difficulty in the following areas should be evaluated for the surgery:
1. Difficulty in chewing, biting or swallowing
2. Speech problems
3. Chronic jaw or TMJ pain
4. Open bite
5. Protruding jaw 6. Breathing problems
Basic goals of maxillofacial surgery
Function:Normal chewing, speech, ocular (eye) function, respiratory function.

Esthetics: Establish facial harmony and balance

Stability: Avoid short and long term relapse

Minimize treatment time: Provide efficient and effective treatment

Evaluation and diagnosis of maxillofacial surgery
The most important aspect of overall patient management is thorough evaluation and diagnosis. Patient evaluation for Maxillofacial surgery can be divided into four main areas:
·  Patient concerns or chief complaints
·  Clinical examination
·  Radiographic and imaging analysis (x-rays)
·Dental model analysis   
After an examination by each of the orthognathic surgery team members (dentist, orthodontist and maxillofacial/oral surgeon), a diagnosis and coordinated treatment plan is prepared. The complete process usually takes place in several stages over the course of one to two years.

Process of Maxillofacial surgery
Any general dental maintenance, prevention or restoration should be performed prior to orthodontic and surgical intervention. Then, the first stage of treatment is the alignment of the teeth into a stable relationship with the underlying jaw by orthodontics, which prepares the dental arches for the surgical repositioning. This stage usually takes the longest, from a few months to over a year. At this stage, the abnormal bite (malocclusion) may become more noticeable. Once ready for the surgical procedures, the orthodontist and maxillofacial surgeon will review photographs, x-ray and dental models to finalize the surgical plan. The operation may involve a single jaw or both jaws (maxilla and mandible).The surgery may also be combined with other procedures, such as rhinoplasty (nose correction) or genioplasty (chin correction) to improve the general appearance of your face. The procedure may take 2-4 hours, depending on the complexity. Most patients are kept in the hospital for 2-5 days, again depending on the specifics of the procedure and post-operative condition.

Recovery after Maxillofacial surgery:
Most patients return to their normal activities within a week or two after their surgery. The surgeon will monitor the healing, and review the changes in your facial structures and occlusion (bite). The orthodontist will adjust the braces to fit the new repositioned jaw. Orthodontic treatment may continue for several months to ensure optimal positioning of the teeth.



Dental Implants

The clinic functions on the concept of providing expertise for the top most dental care to the patients with dental implants & fixed teeth. We specialize in all the basic & latest dental procedures including dental implants, to provide comfortable fixed teeth to the patients. It is the most effective treatment option to get rid of the dentures & have a quality of life. With Dental Implants, you get a better "SELF": S-Speak better, E- eat better, L-Look better & F-feel better. Maintaining the strictest quality controls in providing dental health care including Dental Implants, the effort is to provide the best possible dental care to our esteem patients.

What are Dental Implants?
It is simply titanium metal that replaces the root of the natural tooth. After an implant is placed into the underlying bone, artificial ceramic teeth are attached to it, enabling normal function.

                       Natural Tooth                        Denal Implant

Implants have many advantages over conventional RPD’s or FPD’s like.

  • Tooth Saving –You don’t need to get your healthy teeth cut adjacent to missing tooth.
  • Prevents bone loss (Replaces tooth root )
  • Improved  function – Chewing efficiency is greater than any other prosthetic replacement
  • You can replace missing teeth when all the back chewing teeth are missing
  • Better esthetics.
  • Fixed permanent tooth replacement solution.

Who is fit for dental implants? Where can they be placed?

Dental implants can be placed mostly in adults who are in good to moderate health. They are not typically placed in adolescents until they have reached their full expected physical maturity. Certain uncontrolled medical conditions may decrease the effectiveness of implant treatment, so be sure to discuss your full medical history with your doctor before beginning treatment. Approximately 70% of the Indian population is missing at least one tooth.
Multiple tooth Replacement with dental implants when more than one tooth is missing


Millions of people around the world are missing all their teeth in their upper or lower jaw. Many of them struggle to keep their dentures secure, particularly in the lower jaw. If you / your parents are one of them, you would be experiencing the inconvenience and embarrassment caused by slipping dentures and ineffective dentures adhesives, which in turn deprive you of enjoying delicious food which you love to eat. Fortunately, there is now a way to make your denture work the way it was intended: stabilization with dental implants.

How to replace missing teeth?
Replacement of missing teeth can be either fixed or removable. They are Conventional removable partial dentures, Cast metal dentures, Flexible dentures, Conventional fixed partial dentures and Implant Supported crowns & bridges.

When to replace missing teeth?

Literature shows that the amount of bone loss in the first year is 2mm-5mm which is very significant. Once you loose bone, you cannot get it back. So, the sooner is the better. Now Dental implants can be placed immediately after tooth extraction free of infection with good results – (Immediate implantation and immediate loading).


Gum Treatment

Periodontics is the branch of dentistry that deals with the periodontium. A Periodontist is a dentist whose prime area of interest is the periodontium. The periodontium simply means the tissue covering and supporting the tooth. The periodontium includes the gingiva, periodontal ligaments, root cementum, and the supporting alveolar bone.

Infection is the most common cause affecting the periodontium. These infections are caused by the accumulation of hard deposits clinging to the teeth. The deposits are saturated with disease causing bacteria resulting in the infection of tissues, surrounding and supporting the teeth. The consequence of these infections ranges from simple bleeding gums to early loss of teeth.

The role of a Periodontist is to prevent the occurrence, if not curb the actual spread of damage already caused by the infection. He specializes in a variety of surgical and non-surgical treatment to fulfill this role.

Non-surgical periodontal treatment is appropriate in the early and moderate stages of periodontal disease, otherwise known as periodontitis. If there is a great deal of bone loss, a situation known as moderate to advanced periodontitis, then surgical periodontal treatment is required.

Some of the common treatment modalities carried out by the periodontists are

  • scaling & root planning
  • Curettage
  • Gum surgeries
  • Cosmetic gum surgeries
  • Alveolar bone Surgeries
Periodontal disease is a chronic problem. Without ongoing treatment the infection and disease will reoccur, and each time it does, more bone can be lost, until eventually the teeth become loose and need to be removed. Therefore it is essential to visit the dentist with the right kind of training in this field for best results.


What is gum disease?
Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. Gum disease is the second most common cause of toothache.
What causes gum disease?
Gum disease is caused by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria.
What are symptoms of gum disease?
Early symptoms of gum disease include gum bleeding without pain. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of gum pockets. Bacteria in these pockets cause gum infection, swelling, pain, and further bone destruction. Advanced gum disease can cause loss of otherwise healthy teeth.
How is gum disease treated?
Treatment of early gum disease involves oral hygiene and removal of bacterial plaque. Moderate to advanced gum disease usually requires a thorough cleaning of the teeth and teeth roots called "root planing" and "subgingival curettage." Root planing is the removal of plaque and tartar (hardened plaque) from exposed teeth roots while subgingival curettage refers to the removal of the surface of the inflamed layer of gum tissue. Both of these procedures are usually performed under local anesthesia and may be accompanied by the use of oral antibiotics to overcome gum infection or abscess. Follow-up treatment may include various types of gum surgeries. In advanced gum disease with significant bone destruction and loosening of teeth, teeth splinting or teeth extractions may be necessary.

Periodontitis
It is a progressive inflammatory disease of the gums and the surrounding tissue around the teeth. It is commonly known as gum disease and was referred to as pyorrhea in the old days. It is estimated that up to 80% of the population above the age of 40 may suffer from this disease with the severity varying drastically from one person to another. Periodontitis is the number one cause of tooth loss after the age of 40.
Certain medical conditions or medications can make you more susceptible to gum disease. They include pregnancy, diabetes, epilepsy, and such medications as chemotherapy, birth control pills, antidepressants, and those for heart problems.
If you notice any of the following signs of gum disease, schedule an appointment immediately:

  • gums that bleed when you brush your teeth
  • red, swollen or tender gums
  • gums that have pulled away from the teeth
  • bad breath that doesn't go away
  • pus between your teeth and gums
  • loose teeth
  • a change in the way your teeth fit together when you bite
  • a change in the fit of partial dentures


Non-Surgical Therapy

  • Scaling and Root Planing: Manually removing the plaque and tarter from the root surfaces of your teeth below the gum line.
  • Antibiotics: Because bacteria cause periodontitis antibiotics may be prescribed as pills or as an Antibiotic fiber. The fibers are used in conjunction with scaling and root planing. They are placed directly into the pockets and are removed within 7-10 days later. Antibacterial mouth rinses may also be recommended to help plaque control.
  • Bite correction: An imbalanced bite may accelerate bone destruction. Your teeth may be adjusted for proper and better function. A Bite-guard (removable retainer fitting over teeth) may be required to protect teeth surfaces and relax tense muscles.
  • Splinting: This technique attaches weak teeth together, combining them into a stronger single unit, making them more stable and offering more comfortable chewing.

Surgical Therapy

  • Flap Surgery: Our periodontist separates the gum from the teeth creating a "flap" and accesses the infected pocket. It aims to reduce pocket depth and increase the ability to maintain the remnant pockets clean.
  • Gingivectomy: This procedure is performed when excess amounts of gum growth around the teeth have occurred. This results in false pocket formation and the inability to keep them clean.
  • Osseous (bone) surgery: This procedure is done to smooth shallow craters and defects in the bone due to mild or moderate bone loss. Guided Tissue Regeneration: This procedure is done in combination with a surgical flap operation where gum growth into a defect is barriered off to allow slower growing bone, cementum and ligament cells to populate a bony defect.
  • Bone Grafts: Tiny fragments of the patient's bone, synthetic bone or bone obtained from a bone bank are used to fill a bony defect around the teeth. These grafts act as a scaffold on or around which patients own bone is conducted or induced to grow.
  • Soft Tissue Graft: In cases of gum recession a graft is usually taken from the palate and transplanted onto the receding area to reinforce the thin gum and to inhibit further gum recession.

Flap and Bone Surgery
When gum is inflamed severely (periodontitis), alveolar bone will be absorbed, and defected. Periodontal ligaments which connect between the alveolar bone and the teeth will disappear. Sever bone lose will cause tooth moving and missing. Flap and bone surgery is order to contour the bone, deeply clean the tooth to reduce the inflammation, and promote bone re-growing and connections firm.
Detailed Procedures

Presurgical bone defect

Flap incision to make gum retracted

The bone is contoured

Gum is sutured back

healthy gum after periodontal surgery

Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5

1. Presurgical bone defect. Gum inflamed and reddish.
2. Flap incision to make gum retracted, and the bone shows out.
3. The bone is contoured, and remain tartar is removed.
4. Gum is sutured back.
5. After periodontal surgery, the bone defect disappears, and gum becomes healthy pink color.


Child Dentistry

Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents

Children who have their molar teeth covered by a sealant are less likely to have dental decay in their molar teeth than children without sealant.
Sealants are coatings applied by the dentist or by another person in dental care on the grooves of mainly molar teeth. These coatings are intended to prevent the growth of bacteria that promote decay in grooves of molar teeth. The review shows that after 4.5 years the sealed permanent molar teeth of children aged 5 to 10 had over 50% reduction in decay on biting surfaces compared to teeth without sealants. One study with longer follow up showed that after 9 years only 27% of sealed tooth surfaces were decayed compared to 77% of tooth surfaces without sealant.


  Pit and fissure sealants
 

What are sealants?

 
Sealants are a safe and painless way or protecting your teeth from decay. A sealant is a protective plastic coating, which is applied to the biting surfaces of the back teeth. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay. 
 
 

Which teeth should be sealed?

 
Sealants are only applied to the back teeth – the molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. Your dentist will tell you which teeth should be sealed after they have examined them, and checked whether the fissures are deep enough for sealing to help. Some teeth naturally form with deep grooves which will need to be sealed, others with shallow ones which will not need sealing.
 
 

What is involved?

 
The process is usually quick and straightforward taking only a few minutes per tooth. The tooth is thoroughly cleaned, prepared with a special solution, and dried. The liquid sealant is then applied and allowed to set hard – usually by shining a bright light onto it.
 
 

Will I feel it?

 
No, it is totally pain free, and the teeth do not feel any different afterwards.
 
 

How long do pit and fissure sealants last?

 
Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes the dentist needs to add or replace some sealant to be sure that no decay can start underneath them.
 
 

How do pit and fissures work?

 
The sealant forms a smooth, protective barrier, by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves. 
 
 

When should this be done?

 
Sealants are often applied as soon as the permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.
 
 

Do I still have to clean my teeth?

 
Yes. It is still vital that they do this. The smooth, sealed surface is now much easier to keep clean and healthy with normal toothbrushing. Using a fluoride toothpaste will also help to protect your teeth. Pit and fissure sealing reduces tooth decay and the number of fillings you might need.
 
 

Whom do I ask about the treatment?

 
If you would like to know more about the treatment, ask your dentist They will tell you if fissure sealing will help your teeth, and if it is the right time to do it. 

Pedodontics, or pediatric dentistry, deals specifically with the oral care of children. A Pedodontist, or pediatric dentist, receives training in child psychology, growth and development. They are an ideal choice for children with fears or behavioural problems that make visits to the regular dentist unproductive.

Babies are born with their primary teeth formed underneath the gums, but they don't start appearing until many months later, usually between six to seven months after birth; however, there is considerable variation in the timing.

 

Children's teeth begin forming before they are even born. The first primary, or baby teeth, to erupt through the gums are the lower central incisors. These are followed closely by the upper central incisors which come through around four months after birth. Although all twenty primary teeth have usually appeared by the time the child reaches three years old, the pace and order of eruption varies from child to child.

Oral care should begin soon after birth. Gums should be cleaned after each feeding. You should begin brushing your child's teeth as soon as they appear.

Permanent teeth start to come through around the age of six. This begins with the first molars and lower central incisors. This process continues until approximately age twenty-one.

Adults have twenty-eight permanent teeth, or up to thirty-two including the third molars (wisdom teeth).

 

Tooth-Eruption-Chart

Primary teeth are also called baby teeth, milk teeth, or first teeth. Baby teeth are very important as place holds for permanent teeth. There a couple of simple rules that usually applies to the eruption of baby teeth:

  • lower teeth usually erupt before upper teeth
  • girls teeth usually erupt before boys teeth of the same age
  • teeth usually erupt in pairs

Your child's first baby tooth is another milestone in the growth of a child. Parents love to celebrate the tiny, yet momentous steps that pave a child's healthy development. Keeping your child free of tooth decay is the goal. A little effort may reveal the secrets how dentists keep their own children cavity free. Pedodontics focuses heavily on preventative oral care to reduce the risk of future complications like thumbsucking in the children, thus possibly reducing the risk of overbite. A Pedodontist may also start interceptive orthodontic treatment to prepare a child's mouth for future orthodontic work.

By the child is nearly 18 months old, start keeping him from bottles by this age. Doing so will help prevent Baby Bottle Tooth Decay. By the time children are three years old, they usually have a full set of 20 primary teeth. Faulty brushing habits coupled with the consumption of sticky substances are generally responsible for triggering dental decay or dental caries in milk teeth.

Permanent teeth usually start to erupt about first grade. A special note here is that often the first molar, or six-year molar, erupts before the front tooth. Additionally, the first molar erupts behind the last baby tooth and does not replace a baby tooth as occurs for front teeth. Often lower front teeth come in behind, on the tongue side, and give the appearance for a while as if there are two rows of teeth.

If baby teeth are lost too early, the other teeth can drift out of their position and invade the empty space. This might cause permanent teeth to come in crooked or unable to erupt into the gum, which leads to malocclusion.

Children suck on things because sucking is one of a baby's natural reflexes and as infants get older it serves many purposes. Since thumbsucking is relaxing, it may help induce sleep. After the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. Some aggressive thumbsucking may cause problems with the baby (primary) teeth. It can also cause changes in the roof of the mouth.

Pacifiers can affect the teeth essentially the same ways as sucking fingers and thumbs. However, it is often an easier habit to break.

Tips:
Praise children for not sucking, instead of scolding them when they are.

  • Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to your child.
  • For an older child, involve him or her in choosing the method of stopping.
  • Your dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking.
  • If the above tips don't work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance.

    Preventive Dentistry
    Preventive dentistry is perhaps the singularly most important role the pediatric dentist can play in your child's life. Beginning dental visits early is the key to success, as it helps and assists us in recognizing and warding off potential problems before they become serious. Child should be thoroughly examined to detect any potential problem areas, diet counseling, and if necessary, fluoride recommendations by the dentist.

    Dental care - common conditions - 0 to 5 years
    Mouth ulcers affect 20 per cent of the population. The natural healing takes one or two weeks. In the event these are painful and accompanied by fever, consult the dentist/doctor. Meanwhile, citrus in all forms should be avoided; take less salty foods; and apply topical anaesthetic.