When the process of decay causes a breach in the outer surface of the tooth, it results in the formation of cavity. Cavitations further leads to food and plaque accumulation which in turn helps the spread of decay. It is important to control the spread of decay with a suitable filling at this stage in order to prevent further tooth destruction.
There are varieties of fillings available, but the choice depends on the extent of cavity and patient’s desire for aesthetic treatment. Traditionally, cavities were treated with Silver Fillings. But most of our patients object to the metallic appearance of these fillings. At Smileoracles, we have options for treating such cavities with tooth colored filling materials. These tooth colored fillings are done using the bonding techniques requiring minimal cutting of the tooth.
Once the decay process forms a cavity in the tooth, it becomes the site for food and plaque accumulation which in turn accelerates the decay process. If left untreated, cavities initially lead to sensitivity in the tooth. And as cavity progresses and reaches close to the pulp (the region housing nerves and blood vessels inside the tooth), it may result in pain and swelling. This results in irreversible damage to the tooth requiring either extraction or root canal treatment to relieve the pain.
When the pulp (nerves and blood vessels inside the tooth) is irreversibly damaged or the bone surrounding the tooth (root tip) is damaged, RCT is undertaken as a last measure to save the tooth. RCT helps relieve the tooth pain by removing the pulp completely and disinfecting the root canal. This also results in the healing of the damaged bone around the root tip. Once the infection is controlled, a filling is placed inside the root canal to seal the space and prevent future infections.
It will be misleading to say that every root canal treatment can be done painlessly. Since the RCT procedures are done under local anesthesia, they are seldom painful. Most of the procedures are painless, but some cases of `hot` tooth may present with pain and require additional medication. Once the procedure is completed, there might be discomfort on biting onto the treated tooth or slight pain for sometime, but it can be easily controlled with medication. At Smileoracles, it is our endeavor to complete root canal treatment as painlessly as possible.
At Smileoracles, we do Single-visit as well as multiple-visit RCTs. Single-visit RCTs can be done only after proper evaluation of the tooth, in order to ensure long term success, as not all cases are indicated for single-visit treatment. Multiple-visit treatment will require at least two visits for completion. The duration of treatment will range from 1 day (1-2 hours) in case of single visit RCT to 1-4weeks (or more) in case of multiple visit RCT.
RCT is not 100% successful; however, the failure rate is extremely low. The signs of failure are persistent discomfort or pain on biting, tooth fracture, persistent infection in the bone surrounding the tooth, etc. We, at Smileoracles, follow strict sterilization regimen and proper treatment protocols, increasing the chances of success. I would like to warn my patients against the claims of 100% success guarantee, as these claims are unfounded in case of RCT. However, post-operative discomfort is common immediately after RCT and may persist for few days. This is not a sign of RCT failure as the pain/discomfort disappears in few days after treatment with proper medication.
RCT generally results in weakening of tooth due to large spread of decay or extensive cutting during the procedure. This makes the tooth prone to fracture if the patient bites onto hard foodstuff. In order to protect the tooth from fracture, it is usually recommended to place the cap after RCT treatment.
Preventive fillings are tooth colored restorations done on teeth surfaces, which are difficult to clean, and which are most likely to develop decay in the future. Through minimally invasive techniques, the tooth is designed to receive these plastic fillings, removing the chance of occurrence of pain and further complications on these teeth in the future.
Decay can be prevented by at-home self care as well as by certain procedures carried out by your dentist at regular intervals. At-home self care includes twice daily brushing with a fluoridated tooth paste, rinsing mouth after meals, avoiding in- between meals snacking and also minimizing frequent intake of sugary and sticky food substances. Dental floss must be used to clean surfaces between two teeth. Procedures to be carried out by your dentist include:
Oral prophylaxis – Cleaning/scaling (Once in every six months)
Topical Fluoride application and tooth rejuvenation
Pit and Fissure Sealant application
Preventive fillings Correction of crowding or tilting of teeth.
Kindly get a professional opinion by visiting your dentist for demonstration of homecare cleaning procedures for the child. In case of a new born, a soft muslin cloth wrapped around the fingers is useful in cleaning the gum pads. Baby toothbrushes (finger brushes) are available for cleaning the infant teeth.
The ideal age for child’s first visit to dentist is when his/ her first tooth starts erupting. The child’s first visit to a dentist should not preferably be delayed beyond 1 year of age. As dental problems often start early, the sooner the visit the better. To safeguard against problems such as baby bottle tooth decay, teething irritations, gum disease, and prolonged thumb-sucking, the dentist can provide or recommend special preventive care
Teeth at the back of the mouth, high and frequent intake of sugary and sticky foods and drinks, not brushing teeth or rinsing mouth, faulty or broken fillings, acidic juices and foods, medicines and conditions which reduce saliva production, improper feeding habits, and crowded teeth can all lead to cavity formation in the teeth.
While dietary Fluoride supplements are not advised for children, topical or local Fluoride applications should be done periodically from the age of three years to prevent the development of tooth decay. Smileoracles centers provide periodic Fluoride applications and amorphous calcium phosphate and calcium pyrophosphate applications for long-term protection of teeth.
Lack of thorough cleaning may cause yellow /orange/brownish stains due to plaque and tartar. Dark brown to black stains may be due to some medications/multivitamins /tonics/ ayurvedic preparations like chyavanprash etc or also due to decay. A child’s teeth (usually one or two) can also become discolored if they’re injured in a fall. If the child has a chronic illness or recurrent high fevers or is exposed to certain medications or to excess fluoride over long periods during their infant or toddler years, it will probably not affect his milk teeth but can cause his adult teeth to grow in discolored.
Yes. The biting surfaces of child’s teeth, i.e. the molars, contain grooves and areas, which are difficult to clean by brushing. The bacteria or food substances can accumulate and hide in these areas and lead to tooth decay. Sealants are flowable materials that seal these grooves and areas. These make the tooth surface smoother and easier to clean and stop decay from starting on the chewing or biting surfaces.
Tooth sensitivity is a result of irritation of the nerve by any hot or cold substance. The nerve of the tooth is generally covered and insulated by protective layers of tooth structure. Decay could eat away this protective layer and you might then have the problem of sensitivity. Sometimes the decay may not be visible because it may be out of the normal line of sight. The other causes could be receding gum tissue or wearing off / abrasion of the tooth structure. It normally happens as one ages, or due to faulty tooth brushing. As gum tissue pulls back away from teeth, the root of the tooth which is always covered becomes exposed. This again could result in sensitivity to hot and cold, or sometimes to sweet or sour food.
Yes, loose teeth can be fixed. Loosening of teeth is caused by weakening of tooth supporting structures (mainly the bone holding the teeth). There are many factors contributing to this disease process. This could be because of gum infection most commonly due to food getting stuck between the teeth. There are many diseases such as diabetes, which can result in loose teeth. Hence a detailed Medical history and thorough examination is required to ascertain the exact cause and institute proper treatment. Treatment generally consists of oral prophylaxis followed by root planing and curettage. Aesthetic tooth splinting may be initiated to provide further support for loose teeth.
Many pregnant women find that whenever their gums are swollen, red and tender and when they floss or brush the gums bleed. This is a sign of pregnancy gingivitis and is a common complaint from pregnant women. It is estimated that 50% of pregnant women are affected by it. This problem occurs due to higher progesterone levels that exist during pregnancy which cause inflammation of the gums. Research also points towards a link between Gingivitis, periodontal disease during pregnancy and low birth weight babies.
Normally, the gums are pink in colour. But when the gum gets infected, blood rushes to the gums to help fight the infection. This makes the gums bleed and appear swollen. This is a warning sign of gum infection. If left unchecked, it will result in mobile teeth and finally loss of teeth. Sometimes, such bleeding gums are also a sign of certain systemic conditions and deficiencies.
By brushing twice a day and flossing you are maintaining a very good level of oral cleanliness. But, it isn’t always humanly possible to keep all teeth surfaces adequately clean. A check up every 6 months helps identify these areas. The dentist can also identify decays which are just starting and address them.
Bad odour should never be ignored. It could be just from food rotting on a big decayed tooth. But more seriously it could be the result of gum infections and pus. When bacteria start to grow at rapid rate they secrete some sulphur compounds (hydrogen sulphides) which give the foul odour. If left unchecked this could result in loss of your tooth. There could also be some underlying systemic cause like diabetes etc. for halitosis.
Tooth jewellery is an innovative concept of adorning your teeth/smile with a glitter or sparkle, through a painless, non-invasive procedure of 10-15 minutes. These non-permanent jewellery are absolutely safe and do not involve cutting of the tooth. It is a latest fashion statement across the world, easily obtainable by all.
Yes, discoloured teeth can be whitened. Discolouration (yellowing or darkening of teeth) can be caused by either external stains or internal factors. Bleaching is the non-invasive procedure undertaken to whiten such teeth. We, at Smileoracles, undertake power bleach procedures to deliver results in single appointment for most of our patients. However in some cases, depending on the desired whitening multiple appointments may be required. Sometimes bleaching cannot produce desired degree of whitening in cases of internal staining. For such teeth veneers/laminates can achieve the desired result.
No, there is no harm if the procedure is done under professional supervision. Whiteners may cause hypersensitivity to cold or hot substances for sometime. At Smileoracles, evaluation for safety is done prior to tooth whitening, so that no harm is done to the tooth’s nerve.
Braces are used by dentists to correct and move teeth to desirable places. Yes, braces are used in adults. In young adults, braces are used mainly to correct and provide a pleasing appearance. In senior adults, misaligned teeth act as areas where food tends to collect and cause gum disease or decay. Hence braces treatment also serves to correct these anomalies and maintain the health of gums and teeth. There is no age limit for braces treatment. However bone remodelling may be slower in adult patients, resulting in slightly prolonged treatment duration
Traditionally metal braces were used for orthodontic treatment. Metal braces are still used effectively for treating many orthodontic cases, but they are fast losing popularity to newer more aesthetic options. New options that are available include clear braces, aligners, lingual orthodontics, etc. which provides the same treatment results without the ugly metal braces.
Duration for orthodontic treatment depends on the individual case. After the necessary diagnostic models and tests are done the orthodontist can tentatively predict the duration for orthodontic treatment.
There is no age limit for orthodontic treatment. However, if started at younger age, quicker results can be expected. It is advisable to consult your orthodontist at the age of 10-12 years (around the time permanent canines erupt) for the right time to start orthodontic treatment. However, if there is any developmental anomaly with the child e.g. cleft lip and palate, it is advisable to take an opinion at the earliest. In certain situations of obvious misalignment of teeth also, intervention at an earlier age might be useful.
The cost of orthodontic treatment depends on the complexity of the case and duration of the treatment. Other factors include the type of braces that are used for treatment. At Smileoracles, we provide individualized treatment plan and discuss the cost and duration before starting with the treatment.
Thorough cleaning of your teeth is even more important with fixed braces and you will need to spend more time on this. Ideally brush three times a day and carry a toothbrush which can be used after eating lunch. Pay close attention to the area where your teeth meet your gums. In addition to tooth brushing it is recommended to use an interdental brush to clean under the brace and between your teeth. A mouthwash may also be recommended. Inadequate care is likely to lead to damage of the enamel of your teeth.
Extractions are painless procedures generally carried out under local anaesthesia. In certain cases, our surgeon might decide to combine sedation with local anaesthesia or treat the patient under general anaesthesia. All the patient might feel during the routine course of extraction is the needle prick during administration of anaesthesia. However, we take care to minimize even that with the use of topical anaesthetic agents, narrow bore needles and the use of cartridge-system for anaesthesia delivery. The post-extraction period is made as comfortable as possible with the prescription of appropriate medications.
There is no need for routine removal of all third molars or ‘wisdom teeth’ as they are known. Earlier, a lot of surgeons used to advocate the same based on reasons like its ability to cause crowding of lower front teeth, weakening of jaw bone etc. However, now we refrain from carrying out such prophylactic removals routinely. If the third molar is a cause of some trouble like recurrent pericoronitis (pain in the gums covering the unerupted tooth), decay of the adjacent tooth, association with pathologies like cysts etc., then, we may have to consider their removal.
Smoking is known to have various deleterious effects. It is of course best to give this habit up altogether. However, if that is not possible from your side, the longer you can wait after the surgical procedure before you start smoking and the lesser you smoke during the first few days after the procedure, the better are the prospects of your wound healing well. The mechanical effect of taking a puff may bring about dislodgement of clot from a fresh post-operative wound within the mouth. Also, the chemical contents of cigarette smoke are known to adversely affect the body’s healing response.
Bite firmly on the pack for the next 1 hr. After that, gently remove the pack. In case of further bleeding, roll a clean tissue into a pad about the thickness of your finger to place over the socket/operated area and bite on it for 30 minutes. Use ice packs intermittently on operated side of face for first 3 hrs. From the next day, brush your remaining teeth gently and rinse 4-6 times daily with lukewarm salt water. Drink plenty of fluids and eat soft food. Take medications as directed. If you have received any stitches, kindly return to have them removed as instructed.
What not to do
If you have had a local anesthetic, try not to bite your lip or cheek within the first few hours. Avoid drinking liquids through a straw. Do not spit or rinse your mouth for the first few hours after the procedure. Do not drink any alcohol or smoke for 48 hrs. Avoid touching the socket/ operated area with your tongue/ fingers/ any foreign object. Avoid any hot, hard or spicy food for the next few days and try to use the non-operated side of your mouth during chewing etc. Avoid strenuous exercise, which may bring on bleeding.
A tooth can be replaced immediately after extraction in certain cases. There are various ways to do this. At times, we carry out tooth transplantation where we replace an extracted tooth with another tooth like an impacted tooth. We can also replace one or more teeth immediately after extraction with prosthesis known as immediate dentures. The most recent method of achieving immediate tooth replacement involves placement of immediate implants in fresh extraction sites. Such implants are generally capped with provisional or temporary crowns which are replaced with permanent crowns after the implants have osseointegrated. This is a sensitive procedure but the results are quite predictable in the hands of experienced clinicians.
It is extremely important to clean your dentures by using a denture brush and mild cleansing agent. Periodic denture soaks once or twice a week are also very useful. We recommend leaving your partials out of your mouth at least for 6 hours and soaking in water. Food particles that are trapped under the denture can cause the inflammation of the gums and sore spots. Food particles will stick to soft tissue of your mouth; it is beneficial to brush the roof of your mouth and your tongue daily. Massaging and stimulating those tissues will reduce the incidence of inflammation and sore spots.
Some of the common problems you might face with new dentures, and their solutions are discussed here. Sore Spots: Usually, your mouth will have a few “sore spots” after wearing the denture/partial for 24 hours. These areas can be relieved during your next appointment. Speaking: Learning to speak with your new dentures in place requires some patience and perseverance. Try reading aloud and give time for muscles to readjust. Chewing and Gagging: The new bite may not feel completely comfortable for several weeks. Cut food into small pieces, eat on both sides of your mouth and avoid sticky foods or biting on front teeth. Sucking on a piece of candy may help reduce gagging.
Caps/ crowns are a type of dental restoration that completely covers the part of the tooth that lies above the gumline. These can be made of various materials like base metal alloys, noble metals, porcelain fused to metal (PFM) and all ceramic. They are cemented or fixed into place using luting agents called dental cements. They are usually used to replace missing teeth or restore badly broken down teeth. We may also consider using them for cosmetic reasons during smile designing.
An all-ceramic crown is one which is completely metal free. These are fabricated using various forms of ceramic or techniques like aluminous porcelain, Empress, InCeram, Lava, Zirconia, Procera, EMax etc. These crowns may not always be as strong as porcelain fused to metal crowns (PFM) and may require greater amounts of tooth reduction. However, they generally offer excellent aesthetic results and the problems associated with PFM crowns like opaque appearance and appearance of unsightly dark line at the gum margins are effectively done away with.
It may take a few days to get used to the new bite. Sensitivity to hot and cold maybe possible for a few weeks. If the bite doesn’t feel normal or balanced, please report back to your dentist. Do not chew on the restoration for 24 hours after cementation. Avoid chewing hard, sticky or crunchy food on the crown/ bridge in future. The most susceptible area where a crowned tooth can decay is at the edge of the crown at the gum line. Regular check-up can detect problems at an early stage and treat them easily. Occasionally, porcelain crowns chip and may need replacement.
Dental implants are artificial structures made of titanium resembling tooth roots that are surgically inserted into the jaw bone. These form a microscopic bond with the adjacent bone by a process known as Osseointegration. Crowns are then placed over these implants to finally replace the missing tooth/ teeth. Alternatively, implants are also used to support dentures and provide them greater stability within the mouth.
We prefer to commonly do dental implants as a 2-stage procedure. In the first stage, the implant is placed in the bone and left to osseointegrate. After a few months, the patient is recalled for the second stage. Now we place a gingival former to help form the contours of the gum margin. This is followed by placement of an attachment over which a crown is finally placed. In certain cases, we can go for Immediate-Loading Implants. With these, we may be able to place the crown on the implant immediately after it is placed.
Night guard is an appliance worn on the teeth, mainly given to prevent the habit of night grinding or bruxism. This is also given in cases of faulty bites, full mouth porcelain crowns, in treatment of temporo- mandibular joint pains, severe headaches caused because of night grinding and gum problems relating to bruxism. These appliances help restore the muscular balance and prevent symptoms arising out of bad bites and teeth grinding. It also protects the teeth from cracking and fracturing.
If there is clicking or pain in your jaw joint, if the chewing surfaces of teeth have been worn off and are sensitive and usually associated with jaw joint pain or pain radiating to the ear, if you have a habit of night grinding/bruxism, you immediately need an evaluation and might require a night guard.