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Dental treatments

Root canal treatment

By symptoms

  • Persistent toothache
  • Presence of tenderness in your gums near a tooth
  • Presence of swelling in your gums near a tooth
  • A tooth that is partially or completely darkened following a trauma

The pulp can be damaged as a result of:

  • Untreated tooth decay – causing bacteria to spread into your tooth and infect the pulp.
  • Severe gum disease – causing gums to pull away from the teeth, thereby creating a gap called a periodontal pocket, which traps bacteria that can infect the pulp.
  • Injury – due to accident that affects and infects the pulp.

Root canal treatment.jpgIf left untreated it leads to the formation of an abscess, which is the collection of pus as a result of the multiplying bacteria, and it pushes beyond the root tips. As the abscess expands within the bone, the tooth rises slightly out of its socket making it feel tender when you bite down.

The aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection. Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist. At the first appointment, the infected pulp is removed. Any abscesses, which may be present, can also be drained at this time. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in and the tooth is left to settle. The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.

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, there are several treatments available to restore the natural appearance.

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Dental crowns

A crown is an artificial restoration that fits over the remaining part of a prapaired tooth, making it strong and giving it the shape of natural tooth.

A dental crown may be needed when at least one of the following occurs:

  • To protect a week tooth from breaking
    or to hold together parts of a cracked tooth.
  • To restore an already breaken tooth.
  • To hold a fixed dental bridge in place.
  • To cover a dental implant.
  • To cover a discoloured tooth (for example after a root treatment).

Dental crownsAt the first visit the dentist makes an x-ray to ckeck the roots of the tooth receiving the crown and sorrounding bone. If the tooth has extensive decay or if there is a risk of infection, a root canal treatment may first be performed. The dentist will prepare the tooth to the ideal shape for the crown.This will involve removing most of the outer surface, and leaving a strong inner core. Once the tooth is shaped, the dentist will take an impression of the prepared tooth. The impressions will then be given to the dental technician, along with an appropriate shade. You get temporary teeth as well. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about 5 days.

Dental crownsAt the second visit the dentist will check the fit and colour of the permanent crown. If everything is acceptable a local anaesthetic will be used to numb the tooth and the new crown is permanently cemented in place. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the sorrounding teeth.

Dental crownsYour newly crowned tooth may be sensitive inmediately after the procedure as the anesthesia begins to wear off. On average, dental crowns last between 10 and 15 years. The life spam of a crown depends on the amount of "wear and tear" the crown is exposed to, how well you follow good oral hygiene practise.

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Dental Implants

Implant with a porcelain crownA dental implant is a titanium metal root - a stable, totally resistant metal that is biocompatible and therefore well tolerated by the human body- which is placed into the jawbone.

It provides stable support for one or more artificial teeth. Dentures and bridges supported by implants won’t slip in your mouth, which is an important benefit when eating and speaking. This secure fit helps the dentures and the bridges feel more natural than conventional bridges and dentures.

Implants are a well-established, tried-and-tested treatment. 95% of modern implants last for at least 20 years depending on the location of the implant and the patient’s oral hygiene. You can have any number of teeth replaced with implants – from one single tooth to a complete set. The success of the operation depends on the state of the bone in your jaw. Using a combination of dental X-rays and a CT scan, your bone density and volume can be assessed, and information about nearby anatomical structures to avoid (such as nerves) can also be gathered.

Circumstances where implants may not be suitable, or situations that have an increased risk of implant failure, include:

  • Heavy smoking – this slows down and hinders the healing process.
  • Excessive alcohol intake – disrupts healing of the gums
  • Periodontal gum disease – all active gum disease must be treated prior to any implant procedure to ensure the long-term success of any treatment.
  • Periodontal disease is a major cause of bone loss, which would hinder the success of any implant procedure.
  • Immuno-compromised individuals (steroids, auto-immune disease, patients undergoing radiation treatment).
  • Teeth grinders (bruxism) – a night-time splint can be given to treat this.

Your dentist will arrange for a number of special tests to assess the amount of bone still there. For placing an implant you must have enoigh bone in the jaw and the bone must be healthy and strong enough.Normally, five or six implants are used to replace all the teeth in one jaw, as each implant can usually support two teeth. For a few missing teeth, two or three implants may be used.

The process

Dental implantsYour dental professional will examine you – panoramic X-ray, tests - to see if you are suitable to get an implant. When you get implants, more than one dental professional may treat you. The implants will be placed by an oral surgeon. A prosthodontist or general dentist will make your crowns, bridges or dentures, which will look like natural teeth. The surgeon will coordinate your treatment with your general dentist or prosthodontist to decide what implants to use, how many implants you need and where they should be placed.

Placing the implants requires a small operation. At our clinic it can be carried out only with local anaesthetic. You will not feel any pain at the time, but you may feel some discomfort during the week following the surgery.

According to the results of consultation and examination of the jawbone, the treatment is arranged in the following steps:

  • Placing the implant(s) in, starting to take antibiothics

Implants require a 3 to 5 day stay depending on the treatment needed. After implantation, a healing period is necessary (normally 3 to 6 months). During this time the bone grows around and bonds to the implant screw’s roughened surface. The implant thus becomes firmly fixed in the jawbone.

  • Healing of the gum
  • Opens the implant(s)
  • Impression taking
  • Building up crown(s) and bridge(s) or overdenture

Dental implantsIf the implant becomes loose during the healing period or just after, then it is easily removed and healing takes place in the normal way. Once the jaw has healed, another implant can be placed there. Or, the dentist can make a bridge, using the implanted false teeth that have ‘taken’.

An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants. It is a type of overdenture that is supported by and attached to implants. You can remove an implant-supported denture easily. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth. You will generally be able to eat foods you could not eat before. You can sleep without taking it out, you are supposed to take the denture out only by the daily cleaning.

  • No need for adhesives
  • Maintains facial structures by preserving the remaining bone
  • Minimizes wrinkles around the mouth by restoring lost lip support
  • Improves natural chewing capacity
  • Secure and comfortable

Dental implantsYour implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth. You generally will be able to eat foods you could not eat before. However, you will not be able to chew hard or sticky foods because they can damage the denture. If you have an implant-supported denture in your upper jaw, it will feel more natural than a regular denture because the denture will no longer cover the roof of your mouth.

At our surgery you can’t have the permanent tooth straight after placing the implant in. The implants need to bond (integrate) with the bone after they have been placed. This takes at least 3 months in the lower jaw and 6 months in the upper jaw. If you have complete dentures, then you can wear them throughout the healing period once they have been adjusted after the surgery. After the implants have integrated with the bone, you are ready for the second surgery and for building up the artificial tooth.

Dental implantsCleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. You care for your implants the same way you care for your natural teeth. It is important to brush and floss daily. You will need to visit your dentist for checkups regularly.

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Full dentures

Full dentures are needed when there are no teeth left in the upper or lower jaw. They are usually made of a plastic base carrying plastic or porcelain teeth. Full upper dentures cover the roof of the mouth. A very thin layer of saliva between the roof of the mouth and the denture creates suction which keeps it firmly in position. Over time, dentures may become loose and not fit as well. When this happens, some people prefer to use a fixative for a short time before having them replaced.

Complete denturesReplacing lost or missing teeth is very good for your health and appearance. A complete or full denture replaces your natural teeth and gives support to your cheeks and lips. Without this support, sagging facial muscles can make a person look older and they will find it harder to eat and speak properly. Dentures can be made to closely match your natural teeth so that your appearance hardly changes. Modern dentures may even improve the look of your smile and help fill out the appearance of your face.

Over time, your dentures will need to be relined or re-made due to normal wear or a change in the shape of your mouth. Bone and gum ridges can shrink, causing your jaws to meet differently. Loose dentures can cause health problems, including sores and infections, not to mention discomfort. A loose or ill-fitting denture can also make eating and talking more difficult. It is important to replace worn or poorly fitting dentures before they cause problems.

Even with full dentures, you still need to take good care of your mouth. Every morning and evening, brush your gums, tongue and the roof of your mouth with a soft-bristled brush. This removes plaque and helps the circulation in your mouth. If you wear partial dentures, it is even more important that you brush your teeth thoroughly every day. This will help stop tooth decay and gum disease that can lead to you losing more of your teeth. Your dentist may refer you to the hygienist to have your remaining natural teeth cleaned regularly.

Dentures are very delicate and may break if dropped. When cleaning dentures it is recommended that you do so over a folded towel or sink of water. When you are not wearing your dentures they should be stored in a container with enough water to cover them.

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the denture from moving. As you become more used to your denture, add other foods until you return to your normal healthy diet.

In constructing dentures the dentist will take impressions of the mouth, record the relation of the upper and lawer jaws (the bite), check this in conjunction with the patient, provide and insert the dentures.

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