DENTAL IMPLANTS

IMPLANTS IN DENTISTRY:

IMPLANTS :

 

Implants are devices that replace the roots of missing teeth.

 

 

Overview

A dental implant is a titanium post (like a tooth root) that is surgically positioned into the jawbone beneath the gum line that allows your dentist to mount replacement teeth or a bridge into that area. 

An implant doesn't come loose like a denture can. 

Dental implants also benefit general oral health because they do not have to be anchored to other teeth, like bridges.

Oral Care Specific to IMPLANTS

If you are considering implants, you must have healthy gums and adequate bone to support the implant. 

If your bone is too thin or soft and unable to support an implant, you may require a bone graft. 

Or if there is not enough bone height in the upper jaw or the sinuses are too close to the jaw, you may require a sinus lift.


Implants are devices that replace the roots of missing teeth. 

They are used to support crowns, bridges or dentures. 

Implants are surgically placed in your jawbone. 

Most of the time, implants feel more natural and secure than other methods of replacing missing teeth, such as dentures.
 
There are many reasons it's important to replace missing teeth:

• Having all of your teeth can make you more self-confident. You don't worry that people notice that you have teeth missing.
  
• When teeth are lost, the area of the jawbone that held those teeth starts to dissolve. Implants help to preserve the bone and the shape of your jaw.
• Tooth loss affects how well you chew and what foods you are able to eat. Some people who have missing teeth have poor nutrition, which can affect overall health. Raw fruits and vegetables require more chewing. Someone who finds it difficult to chew may avoid them. Other options, such as blending, pureeing and juicing, are not always considered.
• The loss of teeth can change your bite, the way your teeth come together. Changes in your bite can lead to problems with your jaw joint, called the temporomandibular joint.
• Losing teeth can lead to changes in your speech. This also can affect your self-confidence.
  

There are several types of implants, including:

• Root form
• Subperiosteal
• Mini

 
Root-form implants are the most common type used today. 

A root-form implant is made of titanium. 

It looks like a small cylinder or screw. 

After an implant is placed in the jawbone, a metal cylinder called an abutment eventually is attached to it. 

The abutment serves as a base for a crown, denture or bridge.


 The key to the success of all implants is a process called osseointegration. 

This is how the bone in the jaw grows into and around the implant. 

Titanium is a special material that the jawbone accepts as part of the body.


The ability of titanium to fuse with bone was discovered by accident. 

In 1952, a scientist named Per-Ingvar Brånemark was using titanium chambers screwed into bones as part of his research. 

He was trying to learn about how bone healed after an injury. 

When he tried to remove the titanium chambers, he found they had become integrated with the bone.


Dr. Brånemark then did further research into how titanium implants might work. 

In 1965, the first root-form implants were placed in people. 

Other types of implants also have been used for the last 30 to 40 years. 

Many implant systems are available from various dental manufacturers. 

Success
 
Studies indicate that surgical placement of root-form implants is successful more than 90% of the time. 

When these implants fail, the problems usually occur within the first year after surgery. 

After that, only about 1% of all implants fail each year.


Implants have become increasingly popular since the American Dental Association (ADA) endorsed them in 1986. 

Between 1986 and 1999, the number of implant procedures tripled.

 It is now estimated that more than half a million implants are placed every year in the United States.

Implants vs. Alternatives

Depending on your particular problem, implants can be more expensive than the alternatives (denture or bridge). 

A basic implant plus a crown can cost between $2,000 and $5,000. 

The fees will depend on many factors and vary considerably. 

A few insurance companies cover implants, but may have low annual dollar limits. 

You should always check with your insurer.
 

The upfront cost for implants can be more than for other types of restorations. 

But the investment can pay off in the long run. 

You may not need an implant for every missing tooth. 

Your dentist can discuss how many implants you will need.

Other benefits of implants include: 

• Feel — Because implants are embedded in your bone, they feel more like your natural teeth than dentures.
• Convenience — You will not need to worry about denture adhesives or having your dentures slip, click or fall out when you speak.
  
• Nutrition — You may be able to chew better with implants. Chewing can be difficult with regular dentures, especially ones that don't fit perfectly. A regular upper denture also covers your palate, which can reduce your sense of taste.
  
• Self-esteem —Because implants are so much like your natural teeth, you will think about them less. Your self-esteem and confidence will be improved because you will not have to worry about denture problems or people noticing that you have missing teeth. Regular dentures also can affect your speech. This can make you less self-confident when talking.
  

TEETH ERUPTION AND SHEDDING IN CHILDREN

Eruption Charts:

Teeth vary in size, shape and their location in the jaws. 


These differences enable teeth to work together to help you chew, speak and smile. 

They also help give your face its shape and form. At birth people usually have 20 baby (primary) teeth, which start to come in (erupt) at about 6 months of age. 

They fall out (shed) at various times throughout childhood. By age 21, all 32 of the permanent teeth have usually erupted.

ANESTHESIA IN DENTAL TREATMENTS

ANESTHESIA IN DENTAL TREATMENTS:

LOCAL ANESTHESIA:

 

 

Overview

 
Anesthesia is administered prior to a procedure to help dull pain or sedate a nervous or 

anxious patient. The most common form is local anesthesia, meaning that it dulls pain in all 

or part of the mouth during dental work, but does not cause the patient to go to sleep.

On occasion, patients undergo general anesthesia, in which drugs cause a temporary loss 

of consciousness. General anesthesia may be recommended in certain procedures, such as
wisdom teeth extraction.

LOCAL ANESTHESIA Procedure:

1. Preparation – If you need local anesthesia, your dentist will dry part of your mouth with air or use cotton rolls. Then your dentist will swab the area with a gel to numb the skin.
   
2. Injection – Next, your dentist will slowly inject the local anesthetic into the gum tissue. Most people don't feel the needle. Instead, the sting they feel is caused by the anesthetic moving into the tissue.
   
3. After effects – An injection of local anesthesia can last up to several hours. After you leave the dentist's office, you may find it difficult to speak clearly and eat or drink. Be careful not to bite down on the area that is numbed. You could cause damage to yourself without realizing it.

TOOTH BRUSHING & FLOSSING TECHNIQUES

TOOTH BRUSHING TECHNIQUE:

 


What Is the Right Way to Brush?
 
Proper brushing takes at least two minutes — that's right, 120 seconds! 

Most adults do not come close to brushing that long. 

To get a feel for the time involved, try using a stopwatch. 

To properly brush your teeth, use short, gentle strokes, paying extra attention to the gumline, hard-to-reach back teeth and areas around fillings, crowns or other restoration. 

Concentrate on thoroughly cleaning each section as follows:

• Clean the outer surfaces of your upper teeth, then your lower teeth
• Clean the inner surfaces of your upper teeth, then your lower teeth
• Clean the chewing surfaces
• For fresher breath, be sure to brush your tongue, too

TECHNIQUE

Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline. Gently brush the outside, inside and chewing surface of each tooth using short   back-and-forth strokes.

Gently brush your tongue to remove bacteria and freshen breath.

 
What Type of Toothbrush Should I Use?
 
Most dental professionals agree that a soft-bristled brush is best for 

Removing plaque and debris from your teeth. 

Small-headed brushes are also preferable, since they can better reach all areas of the mouth, including hard-to-reach back teeth. 

For many, a powered toothbrush is a good alternative. 

It can do a better job of cleaning teeth, particularly for those who have difficulty brushing or who have limited manual dexterity. 

To find the right Colgate toothbrush for you, click here.

How Important is the Toothpaste I Use?
 
It is important that you use a toothpaste that's right for you. 

Today there is a wide variety of toothpaste designed for many conditions, including cavities, gingivitis, tartar, stained teeth and sensitivity. 

Ask your dentist or dental hygienist which toothpaste is right for you. 

To find the right Colgate toothpaste for you, click here.

How Often Should I Replace My Toothbrush?
 
You should replace your toothbrush when it begins to show wear, or every three months, whichever comes first. 

It is also very important to change toothbrushes after you've had a cold, since the bristles can collect germs that can lead to reinfection.

FLOSSING :

                                                                                  
 


What is the Right Way to Floss?

 
Proper flossing removes  plaque  and food particles in places where a toothbrush cannot easily reach — under the gumline and between your teeth. 

Because plaque build-up can lead to tooth decay and gum disease, daily flossing is highly recommended.
 

To receive maximum benefits from flossing, use the following proper technique:

• Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with
• Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
• Gently curve the floss around the base of each tooth, making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue
• Use clean sections of floss as you move from tooth to tooth
• To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth.

What Type of Floss Should I Use?

  
















There are two types of floss from which to choose:

• Nylon (or multifilament) floss
• PTFE (monofilament) floss

Nylon floss is available waxed and unwaxed, and in a variety of flavors. 

Because this type of floss is composed of many strands of nylon, it may sometimes tear or shred, especially between teeth with tight contact points. 

While more expensive, single filament (PTFE) floss slides easily between teeth, even those with tight spaces between teeth, and is virtually shred-resistant. 

When used properly, both types of floss are excellent at removing plaque and debris.
                                                                                

SIGNS AND SYMPTOMS WHEN TO VISIT A DENTIST

SIGNS AND SYMPTOMS TO VISIT A DENTIST:



Signs For Which You Should See a Dentist:

1. Your teeth are sensitive to hot or cold.
2. Your gums are puffy and/or they bleed when you brush or floss.
3. You have fillings, crowns, dental implants, dentures, bridgework etc.
4. You don’t like the way your smile or teeth look.
5. You have persistent bad breath or bad taste in your mouth.
6. You are pregnant.
7. You have pain or swelling in your mouth, face or neck.
8. You have difficulty chewing or swallowing.
9. You have a family history of gum disease or tooth decay.
10. You have a medical condition such as diabetes, cardiovascular disease, eating disorders, or are HIV positive.
11. Your mouth is often dry.
12. You smoke or use other tobacco products or drink alcohol.
13. You are undergoing medical treatment such as radiation, chemotherapy or hormone replacement therapy.
14. Your jaw sometimes pops or is painful when opening and closing, chewing or when you first wake up; you have an uneven bite.
15. You have a spot or sore that doesn’t look or feel right in your mouth and it isn’t going away.

TREATMENT PROCEDURES IN DENTISTRY

ROOT CANAL TREATMENT:

Overview

A root canal is a treatment to repair and save a badly damaged or infected tooth. 

The procedure involves removing the damaged area of the tooth (the pulp), cleaning and disinfecting it and then filling and sealing it. 

The common causes affecting the pulp are a cracked tooth, a deep cavity, repeated dental treatment to the tooth or trauma. 

 The term "root canal" comes from cleaning of the canals inside the tooth's root.

What to Expect During a ROOT CANAL:

If you think you need a root canal, consult your dentist. There are a number of steps that occur over a few office visits.

1. X-ray – if a dentist suspects you may need a root canal, he will first take X-rays or examine existing X-rays to show where the decay is located. 
2. Anesthesia – local anesthesia is administered to the affected tooth. Contrary to popular belief, a root canal is no more painful than a filling.
3. Pulpectomy – an opening is made and the diseased tooth pulp is removed.
4. Filling – the roots that have been opened (to get rid of the disease pulp) are filled with gutta-percha material and sealed off with cement and covered with a Crown when needed.
   
   
   TOOTH REMOVAL/EXTRACTION PROCEDURE:
   
   
   Overview  If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other dental treatment. But when there's too much damage for the tooth to be repaired, the tooth may need to be extracted — or removed — from its socket in the bone.
   
   Beyond damage and decay, here are some other common reasons for tooth removal:
   Some people have extra teeth that block other teeth from coming in.

• Sometimes baby teeth don't fall out in time to allow the permanent teeth to come in.
• People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
• People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
• People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
• Wisdom teeth, also called third molars, are often extracted either before or after they erupt in the mouth. They commonly come in during the late teens or early 20’s. They need to be removed if they are decayed, infected, or if there is not enough room in the mouth
  
  

  Understanding:

  
  

  There are two types of extractions:
  
  
  

  • A simple extraction
     
  • This is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called forceps to remove the tooth.
    
  • A surgical extraction 
     
  • This is a more complex procedure, which is used if a tooth may have broken off at the gum line or has not erupted in the mouth. 
  • Oral maxillofacial surgeons typically perform this procedure, though general dentists can also perform them. 
  • The doctor makes a small incision (cut) into your gum to surgically remove the broken tooth or impacted wisdom tooth. 
  • It may be necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it.
   

  Most simple extractions can be done using just an injection (a local anesthetic); you may or may not receive drugs to help you relax. 

   

  For a surgical extraction, you will receive a local anesthetic, and you may also have anesthesia through a vein (intravenous). Some people — such as patients with specific medical or behavioral conditions and young children — may need general anesthesia.
   

  If you are receiving conscious sedation, you may be given steroids, as well as other medicines in your intravenous sedation line. 

   

  The steroids help to reduce pain and swelling after the procedure.
   

   

  During a tooth extraction, you can expect to feel pressure, but no pain. 

   

  If you feel any pain or pinching, tell your dentist.

   

  Planning:

  
  

  Having a tooth taken out is a surgical procedure. You can expect some mild discomfort even after simple extractions. 
• Research has shown that taking drugs that include ibuprofen, such as Advil^®, Motrin^® and others, can greatly decrease pain after a tooth extraction. 
•  Take the dose your doctor recommends, 3 to 4 times a day.
• Take the first pills before the local anesthesia wears off, and continue taking the mediations for 3-4 days following or as your dentist has recommended.  
• Surgical extractions generally cause more pain after the procedure than simple extractions. 
• The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth. 
• Your dentist may prescribe pain medicine for a few days. Most pain disappears after a couple of days.  
• Here are a few tips to help minimize your discomfort and speed recovery:
• You can put ice packs on your face to reduce swelling. Typically, they are left on for 20 minutes at a time and removed for 20 minutes. 
• If your jaw is sore and stiff after the swelling goes away, try warm compresses.
• Eat soft and cool foods for a few days.
• A gentle rinse with warm salt water, started 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. 
• Most swelling and bleeding ends within a day or two after the surgery. Complete healing takes at least two weeks.
• You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was.

 
If you need stitches, your doctor may use the kind that dissolves on their own. 

This usually takes one to two weeks. Rinsing with warm salt water will help the stitches to dissolve. 

Some stitches need to be removed by the dentist or surgeon.
Call your dentist or oral surgeon if,

• The swelling gets worse, instead of better.
• You have fever, chills or redness.
• You have trouble swallowing.
• You have uncontrolled bleeding in the area.
• The area continues to ooze or bleed after the first 24 hours.
• Your tongue, chin or lip feels numb more than 3 to 4 hours after the procedure.
• The extraction site becomes very painful -- This may be a sign that you have developed a dry socket.
  FILLING/RESTORATIONS  :
  
  
  Overview 
  
  
  

  A filling helps to restore a tooth damaged by decay back to its normal function and shape, and helps prevent further decay by eliminating areas where bacteria can enter the tooth. 
  
  Your dentist will consider a number of factors when choosing which type of filling material is best for you; this includes the extent of the repair, whether you have allergies to certain dental materials, where in your mouth the filling is needed and the cost.
  
  
  There are various types of fillings available including.
  
  
  Composite Fillings 
  
  A composite resin filling is made from a mixture of plastic and fine glass particles and matches the color of the tooth. 
  
  Thus, composite fillings are used most often on front teeth or the visible parts of the tooth. 
  
  Composite fillings bond directly to the tooth, reducing the drilling needed (like for a amalgam filling) and they are stronger than amalgam fillings.
  

  
  Amalgam Fillings 
  
  Amalgam fillings are made from a mixture of metals including mercury and silver, and thus doesn’t match the color of your teeth. 
  
  This type of filling is used most often for fillings in the back teeth. 
  
  These fillings are very strong and usually last at least ten years if not longer.
  
  
  Gold Fillings 
  
  Gold fillings are made from gold allow which is extremely durable. 
  
  
  This type of filling lasts longer than any other type.
  
  
  Gold fillings do not match the natural color of your teeth and are expensive, they usually cost six to ten times more than amalgam.
  
  
  Ceramic Fillings 
  
  Ceramic fillings are made of porcelain and are tooth colored, so they look natural. 
  
  Ceramic fillings are more brittle than composite resin and can break but they are also more resistant to staining. 
  
  Ceramic fillings are expensive, and can cost as much or more than gold fillings.
  
  
  Glass Ionomer
  
  Glass Ionomer fillings are made from acrylic and fluoroaluminosilicate, a component of glass. 
  
  This type of filling is very strong and most often used in people with a lot of decay in the part of the tooth that extends below the gum. 
  
  It is also used for filling baby teeth.
  

  Understanding

  To help minimize the pain associated with getting a filling, your dentist may choose to administer a local anesthetic, like Lidocaine. 
  
  Next, your dentist will remove decay from the tooth, using a drill or laser.
  
  Once all the decay is removed, your dentist will shape the space to prepare it for the filling. 
  
  Different types of fillings require different shaping procedures to make sure they will stay in place. 
  
  Your dentist may put in a base or a liner inside the tooth to protect the tooth's pulp (where the nerves are).
  
  Certain types of fillings get hardened by a special light. With these fillings, your dentist will layer the material, stopping several times to shine a bright light on the resin.
  
  This cures (hardens) the material and makes it strong.
  Finally, after the filling is placed, your dentist will use burs to finish and polish the tooth surface.
  

  Planning:

  
  

   
• After a filling procedure, there are a variety of side effects that can occur after the anesthesia wears off.  
• The tooth may be sensitive to pressure, cold air or liquids or sweet foods. 
• Some people many experience numbness, tingling, and some minor pain around the injection site. 
• These side effects often subside within a few hours of the procedure.   
• Sensitivity should decrease in one to two weeks. Until then, try to avoid anything that causes it. 
•  If your tooth is extremely sensitive or your sensitivity does not decrease after two weeks, contact your dentist's office for an appointment.
   
• The most common reason for pain right after a filling is that the filling is too high; your dentist can adjust the filling by checking the occlusion (bite) of your teeth and removing sufficient of the excess filling material to decrease the pain.
   
• Another less common type of discomfort after a filling is a very sharp shock that appears only when your teeth touch. 
• This is called galvanic shock, and happens when two metals (one in the newly filled tooth and one in the occluding tooth) touch, producing an electric current in your mouth. 
• This would happen, for example, if you had a new amalgam filling in a bottom tooth and had a gold crown in the tooth above it.
  
  
  
  
  
  DENTAL SEALANTS:
  
  

   

  Overview

  Sealants, also referred to as dental sealants, consist of a plastic material that is placed on the chewing (occlusal) surface of the permanent back teeth — the molars and premolars — to help protect them from bacteria and acids that contribute to tooth decay. 
  
  The plastic resin in sealants is placed by a dental hygienist into the depressions and grooves of the chewing surfaces of back teeth and a light is utilized to cure it to the enamel which acts as a barrier, protecting the enamel surface of the teeth from plaque and acids.
  
  
  Thorough brushing and flossing helps remove food particles and plaque from the smooth surfaces of teeth, but toothbrushes can't reach all the way into the depressions and grooves to extract all food and plaque. 
  
  
  Plaque accumulates in these areas, and the acid from bacteria in the plaque attacks the enamel, causing cavities to develop. 
  
  While fluoride helps prevent decay and helps protect all the surfaces of the teeth, dental sealants add extra protection for the grooved and pitted areas. 
  
  Sealants can help protect these vulnerable areas by "sealing out" plaque and food debris from the occlusal surfaces of the teeth.
  

  Understanding

   

  Placing dental sealants is usually painless and doesn't require drilling or numbing medications.
  
• First, the dental hygienist will polish the surface of the tooth with a pumice material to remove plaque and food debris from the pit and fissure surfaces of the teeth selected for sealant placement.
• Next, the hygienist will isolate and dry the tooth so that saliva doesn't cover the pit and fissure surfaces. Then the hygienist will etch the surface of the tooth in the pit and fissure areas, rinse off the etching material and dry the tooth.
• The hygienist will apply the dental sealant material to the surface of the tooth with a brush; a self-curing light will be used for about 30 seconds to bond the sealant to the tooth surface.
• Finally, the dental hygienist and dentist will evaluate the dental sealant and check its occlusion. Once the dental sealant has hardened it becomes a hard plastic coating, and you can chew on the tooth again.