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									                DENTAL CROWNS, BRIDGES AND DENTURES

Dental crowns and bridges offer a        The bone in the jaw surrounding the
solution to missing teeth. Cost          missing tooth or teeth continues to
depends upon the quality of the skill    recede, and this can lead to a
of the dental surgeon in preparing       gradual collapse of the lower profile
and fitting the work, the quality of     of the face.
the dental laboratory used and the
quality of materials used to
manufacture the unit. Dental Crowns
are caps made to fit over an existing
tooth. They are often recommended
following a root canal filling to
protect the remaining tooth whose
strength is often compromised by
the extensive decay and infection
that may have been present. Bridges
are units of false teeth that are
fixed by a dental surgeon to
remaining natural teeth to fill a gap.
A bridge may take the place of one
or more missing teeth and the
results can be excellent with good
function and aesthetic results. With
careful maintenance a well-made
bridge can last many years. The bone
in the jaw surrounding the missing
tooth or teeth can continue to
recede. Dentures remain a cost
effective method by which a dental
surgeon may replace missing teeth
by providing the patient with a
removable appliance. Dentures can
provide patients with a reliable
biting and chewing function and
acceptable appearance. The main
disadvantages with the dentures are
they are sometimes difficult to
tolerate. A    denture    will    also
be subject to slippage during speech
and normal movement of the mouth.
                                TEETH WHITENING

Tooth bleaching, also known as tooth
whitening, is a common procedure in
general     dentistry    but    most
especially in the field of cosmetic
dentistry. Many people consider
white teeth to be an attractive
feature of a smile. A child's
deciduous teeth are generally whiter
than the adult teeth that follow. As
a person ages the adult teeth often
become darker due to changes in the
mineral structure of the tooth, as
the enamel becomes less porous.
Teeth can also become stained by
bacterial pigments, foodstuffs and

The procedure to bleach teeth uses          damaged tooth surface. There are two
oxidizing agents such as hydrogen           types of material used in a veneer,
peroxide or carbamide peroxide to           composite and porcelain. A composite
lighten the shade of the tooth. The         veneer may be directly placed (built-up
oxidizing agent penetrates the              in the mouth), or indirectly fabricated
porosities in the rod-like crystal          by a dental     technician in a dental
structure of enamel and oxidizes            laboratory, and later bonded to the
interprismatic stain deposits; over a       tooth, typically using a resin cement. In
period of time, the dentin layer, lying     contrast, a porcelain veneer may only be
underneath the enamel, is also              indirectly fabricated. The advantages of
bleached. The effects of bleaching          using a veneer to restore a tooth are
can last for several months, but may        numerous. Very good aesthetics can be
be shortened by cigarette smoking,          obtained, with minimal tooth preparation
and tea and coffee consumption.             (i.e. drilling). Traditionally, a reduction
                                            of around 0.5 mm is required for a
     PORCELAIN LAMINATES                    porcelain veneer. Composite veneers are
                                            becoming more popular as they are easy
In dentistry, a veneer is a thin layer of
                                            to repair, whereas porcelain veneers
restorative material placed over a tooth
                                            have a tendency to fracture. It can be
surface,   either    to   improve    the
                                            very difficult to match the shade of an
aesthetics of a tooth, or to protect a
individual veneer to the remaining teeth,            on the face they may appear to stand
hence placing several veneers is common.             out and push out the lips. The effect
                                                     may be enough to give the patient a full
There are some newer veneers which do
                                                     or chipmunk appearance when the lips
not require any drilling in order to
                                                     are     closed.    Veneers   must   also   be
                              remove         tooth
                                                     created such that the patient bites into
                              structure. Instead,
                                                     them with minimal force. Otherwise,
                              these veneers are
                                                     they may chip off. So, patients whose
                              constructed to be
                                                     lower jaw protrudes out farther than
                              placed on top of
                                                     their upper jaw, otherwise known as a
                              teeth. As a result,
                                                     class    III      bite, may not     be good
                              treatment is less
                                                     candidates for veneers because the
invasive and may be less time-consuming.
                                                     teeth of the lower jaw may bite into the
On the other hand, since the teeth are
                                                     teeth of the upper jaw such as to
not reduced in size the veneers may
                                                     dislodge the veneers.
appear too large or bulky unless the
material       used      is    extremely     thin.
Therefore,         the   success       for   these               WHITE FILLINGS
veneers is best when limited to specific

Veneers may be used cosmetically to                  Composite fillings are a mixture of
resurface teeth such as to make them                 glass or quartz filler in a resin
appear straighter and possess a more                 medium that produces a tooth-
aesthetically pleasing alignment. This               colored filling. They are sometimes
                                                     referred to as composites or filled
may be a quick way to improve the
                                                     resins. Composite fillings provide
appearance of malposed teeth without
                                                     good durability and resistance to
need to use orthodontics. However, the
                                                     fracture      in   small-to-mid    size
amount of malposition of teeth may be
                                                     restorations that need to withstand
such that veneers alone may not be                   moderate chewing pressure. Less
enough        to    correct      the    aesthetic    tooth structure is removed when the
imbalance. Instead, orthodontics would               dentist prepares the tooth, and this
need     to    be     used,     or   orthodontics    may result in a smaller filling than
combined with veneers. The dentist who               that of an amalgam. Composites can
places veneers must be careful since                 also be "bonded" or adhesively held
veneers could increase the thickness of              in a cavity, often allowing the dentist
the front face                                       to make a more conservative repair
of the teeth.                                        to the tooth.
If the teeth
are too thick
The cost is moderate and depends on the size of the filling and the technique
used by the dentist to place it in the prepared tooth. It generally takes longer
to place a composite filling than what is required for an amalgam filling.
Composite fillings require a cavity that can be kept clean and dry during filling
and they are subject to stain and discoloration over time.


Invisalign can help you get the great       proven effective in both clinical
smile you've always wanted because          research and in practices nationwide.

Invisible, so no one can tell you're
straightening your teeth. So now you can
smile more during treatment as well as
after. Removable, so you can eat and
drink what you want while in treatment,
plus brushing and flossing are no

Comfortable, because it has no metal to
cause      mouth     abrasions     during
treatment. And no metal and wires
usually means you spend less time in
your      doctor's     office     getting
adjustments. Invisalign also allows you
to view your own virtual treatment plan
when you start, so you can see how your
straight teeth will look when your
treatment is complete. Invisalign is the
invisible way to straighten teeth using a
series     of    custom-made,      nearly
undetectable aligners. And it's been
                             How Does Invisalign Work?
* You wear each set of aligners for about 2 weeks, removing them only to eat, drink,
brush, and floss.

* As you replace each aligner with the next in the series, your teeth will move - little by
little, week by week - until they have straightened to the final position your
orthodontist or dentist has prescribed.

* You'll visit your orthodontist or dentist about once every 6 weeks to ensure that your
treatment is progressing as planned.

* Total treatment time averages 9-15 months and the average number of aligners worn
during treatment is between 18 and 30, but both will vary from case to case.

                               PEDIATRIC DENTISTRY

It is fairly possible to encounter
various tooth and gingival problems
in children which are frequently seen
in adults. Pedodontics is a scientific
branch that solves oral and tooth
health in children between 0-14
years of age. Spite that the
community assumes that milk tooth
would change by time and therefore
dental care for milk tooth would not
need specific care. Conversely, milk
tooth is important and has a certain
impact on the formation of the other
teeth and on the childs physical

Just as it is for adults, as we behave in a different form during our
communication with grown-ups, we must also behave different and considered a
special approach when children undergoes dental therapy. Therefore, as a
specially designed division, our physicians and dentists employed at our clinic are
specialists and we aim to train children as conscious grown-ups who understands
that there is nothing to be afraid of during their visit to the dentist. From this
point of view, it seems rather important for us to communicate with their
parents in a regular manner. All information related with children dental health,
routine oral-dental controls and prevention of dental and gingival diseases and
the habit of brushing tooth regularly and daily are very important issues and will
require support and collaboration from the parents.

Diagnosis and Therapeutical Methods:

All diagnostic methods applied on adults are also applied on children. The first
stage of oral examination begins by visual and manual examination. But such kind
of limited examination is never adequate to diagnose the disease. At this point
oral x-rays are very helpful. Sometimes 2 types of small periapical films are
obtained according to the condition of the case where a single problem exists
for a single tooth. However if oral examination indicates multiple problems
diffused entirely in the mouth then panoramic films which shows the entire
internal structure of the mouth shall be requested.


Periodontal diseases are caused by
certain types of bacteria in plaque,
the sticky, colorless film of bacteria
that constantly forms on teeth.
These     bacteria    create    toxins
(poisons) which irritate the gums and
result in a break-down of the
attachment of gum tissues to teeth.
Over time, these toxins can destroy
gum tissues, allowing the infection to
progress to bone loss.
In addition, plaque that is not
removed can combine with other
materials and harden into a rough,
porous    deposit    called  calculus
(tartar). Calculus on the root
surface, below the gums, makes
removal of new plaque and bacteria
more difficult. Unlike plaque, which
you can remove, only a dentist or
dental hygienist can remove calculus.
Types of Periodontal Diseases
While there are many forms of gingival and periodontal diseases, the most
common types are gingivitis and adult periodontitis:
Gingivitis is the earliest stage, and affects only the gum tissue. At this stage,
the disease is still reversible.
Periodontitis is the more advanced stage of periodontal diseases. The gums,
bone and other structures that support the teeth become damaged. Teeth can
become loose and fall out - or may have to be removed. At this stage, the
disease may require more complex treatment to prevent tooth loss. Here is a
step-by-step illustration of the progress of gingivitis and periodontitis:

                                Healthy gingiva (gum tissue) and bone anchor the
                                teeth firmly in place.
                                                           Gingivitis develops as
                                                           toxins     in   plaque
irritate     the       gums,                               making them       red,
tender, swollen and likely to                              bleed easily.

                            Periodontitis occurs when toxins destroy the
                            tissues that anchor the teeth in the bone. Gums
                            become detached from the teeth, forming pockets
                            that fill with more plaque. Tooth roots are exposed
to plaque and become susceptible to decay and sensitive to cold and touch.

                                Advanced periodontitis is present when the teeth
                                lose more attachment because the supporting bone
                                is destroyed. Unless treated, the affected teeth
                                frequently becomes loose, may fall out or require
                                removal by a dentist.

Other Factors Contributing to Periodontal Disease
Although periodontal diseases are caused by plaque, a number of other factors
can increase the risk, severity and speed of development of the condition.
People who smoke or chew tobacco are more likely to have periodontal diseases.
Poorly fitting bridges, malocclusion (badly aligned teeth or defective
restorations (fillings), can all contribute to plaque retention and increase the
risk of developing periodontal diseases. Excessive biting forces on your teeth,
such as clenching or grinding, may also accelerate the rate at which supporting
bone is lost. Poor diet may cause periodontal diseases to progress more rapidly.
Pregnancy or use of oral contraceptives increases hormone levels which can
cause gum tissues to react more sensitively to the toxins in plaque and
accelerate growth of certain bacteria. The gums are more likely to become red,
tender and swollen and to bleed easily. Systemic diseases, such as AIDS or
diabetes, can lower the tissues' resistance to infection, making periodontal
diseases more severe. Medications - steroids, some types of drugs, cancer
therapy drugs, some calcium channel blockers and many others - affect the
gums. Schedule regular dental visits. Professional cleaning is essential to prevent
periodontal diseases.
If you notice any of the following signs, see your dentist immediately:

   •   Gums that bleed easily.
   •   Red, swollen or tender gums.
   •   Gums that have pulled away from the teeth.
   •   Pus between the teeth and gums when the gums are pressed.
   •   Persistent bad breath or bad taste.
   •   Permanent teeth that are loose or separating.
   •   Any change in the way your teeth fit together when you bite.
   •   Any changes in the fit of partial dentures.

Most people do not experience any pain due to periodontal diseases so it is
important to have regular dental checkups, including a periodontal exam.

Diagnosing Periodontal Diseases
With regular dental visits, dentists        to determine if any bone has been
can detect developing periodontal           destroyed.
diseases early, before the gums and
the bone around your teeth are
irreversibly damaged. So don't wait
till it hurts! During checkups, your
dentist will examine your gums for
periodontal problems. An instrument
called a periodontal probe will be
used to determine if there is any
breakdown in the gum tissue
attachment or development of
pockets between your gums and
teeth. The depth of pockets can be          Periodontal Probe
measured with this device. Your
dentist may also need to take X-rays
Treating Forms of Periodontitis
The method of treatment of periodontal diseases depends upon the type of
disease and how far the condition has progressed.

            Subgingival Scaling                             Root Planing

                                        remove plaque and calculus deposits
                                        beneath the gumline. In some cases,
                                        the occlusion (bite) also may require
1. Presurgical bony defect

The first step is usually a thorough
cleaning which may include scaling to
                                        Surgery may be required when
                                        deeper pockets (over 4 to 6 mm) are
                                        found. Patients can seldom, if ever,
                                        keep them clean and free of plaque.
2. Flap incision allows      gingival   Allowing pockets to remain may
   tissue to be retracted               invite    infection    and     bone

When pockets are deep and bone has
been destroyed, flap surgery may be
necessary to allow the dentist to get
access to the roots of the teeth in
order to thoroughly remove calculus,    3. Gingival tissue is sutured into a
plaque and any diseased tissue.         new positio
Osseous (bone) surgery sometimes accompanies flap surgery. In osseous surgery,
some of the bone around the tooth is reshaped. In certain cases, a bone area may
be employed to replace lost bone. Splints or other appliances may be used to
stabilize loose teeth temporarily and may be necessary after completion of
periodontal therapy as well.

4. After periodontal surgery

Other effective procedures are also available for replacing gum tissue and bone
destroyed in advanced stages of the disease. These procedures are used for
specific periodontal problems. Talk with us about the treatments that may be
right for you.

Having Dental Implants is quite a lengthy process. It is accomplished in two phases,
which must be separated by a ‘healing period’ of several months. During the first
phase of treatment you will be thoroughly checked-over and a panoramic X Ray of
your mouth will be taken. This will enable you and the Dentist to plan your
treatment in detail. Next comes the actual implantation procedure. Depending on
how many implants you are having you will be given either a local or general
anaesthetic. If you have a local anaesthetic you will be given a sedative as well. The
implantation operation is carried out under strict hygienic conditions. The Dentist
will open the gum at the site of the implant and, using a low speed drill will make a
hole in the jawbone.
The implant is screwed into place. A temporary healing cap is placed in its centre.
The site of the implant is closed and sutured. The Dentist insists on making post-
operative checks over the next couple of days and after the wound is healed will
remove the stitches. This completes the first phase. A healing period now follows.
This is necessary so that the living bone can ‘ossify’ around the implant so that the
anchor is really ‘set’ in place and better able to withstand the pressures exerted on
it once the crown is attached. After three / six months the second phase can
begin. First the dentist makes a small opening in the gum to uncover the implant.
The healing cap is removed and an ‘abutment’ or post is screwed into the implant.
After a day or two castings and impressions of your teeth and gums are made. The
dentist takes a great deal of trouble to get a really accurate set of impressions.
These are then sent to the dental lab who will use them to make the crowns or the
bridge to your exact measurements.

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