Endodontics

Root canal treatment (RCT)

Root canal procedure involves removal of infected pulp tissue from the tooth and filling it with an inert material in order to help the tooth heal.

Steps involve removal of the infected pulp tissue, cleaning and irrigating the canal with medications followed with shaping the canal to facilitate the final filling material.

FAQ’s:

1. When root canal is required?
   RCT or Root Canal Treatment is required in conditions where the decay of tooth has reached its pulp and it’s irreversibly infected due to trauma i.e., damage to tooth either by a fall, sports injury, accidents, trauma from occlusion, attrition of teeth, etc.
   Intentional RCT before placing crowns may be required in certain conditions such as:
• Severe periodontal disease
• Non-vital tooth
2. Does root canal hurt?
   Root canal treatment is usually done under local anaesthesia. And with the help of automated instruments pain is very minimal or nil.
3. How many steps are involved in RCT?
   Usually it requires 2 or 3 sittings, but in some conditions single sitting RCT can also be performed after assessing the X- ray.
4. When do we come to know whether a tooth requires RCT?
   Teeth having severe pain and the decay extending up to pulp as seen in radiograph usually requires RCT. But it’s best if the dentist examines and detects which tooth needs to undergo RCT. However, pain is not the only criteria to indicating that you need an RCT.
5. Does a root canal treated tooth require a crown?
   Crown is placed to strengthen the tooth structure after RCT. It is required in most of the cases with tooth showing extensive damage. It’s always the dentist who decides whether a crown is required or not.

Periodontics

Periodontal therapy

Periodontal therapy involves the treatment of gums and bone i.e., gingiva, alveolar bone. Deposition of plaque and calculus which contains bacteria leads to deterioration of gums and bone. Too much of bone destruction leads to loosening of teeth and loss of teeth due to periodontitis.

Treatment includes:

• Oral prophylaxis and counselling
• Scaling and root planning
• Local drug delivery like tetracycline fibres
• Periodontal flap surgeries
• Root coverage procedures
• LASER assisted surgeries
• Bone regeneration (bone graft)
• Gingival depigmentation
• Splinting
• Frenectomy
• Depigmentation

FAQ’s:

1. Who needs to get periodontal therapy done?
   Periodontal therapy is commonly required in cases of swollen, bleeding gums, bad breath, loose teeth, and pus drainage from gums.
2. How can I know if I have periodontal disease?
   Bleeding gums while brushing or without any stimulation, bad breath, loosening of teeth, exposure of tooth root surface indicates periodontal disease. In dental clinics doctors will advise for a full mouth X- ray (OPG)to check the bone status.
3. Why did I get gum disease?
   It’s a common problem which is seen in most of the population. It is mainly because of the deposit (calculus) which is present. Other factors are hereditary, diabetes, systemic conditions and other illnesses.
4. Do periodontal surgeries hurt?
   Surgeries will be done under local anaesthesia , so pain will be minimal. Newer techniques like LASER flap therapy are involved which are painless and less invasive.
5. How will the loose tooth be strengthened?
   For treating the loose tooth, the doctor examines the extent of bone loss and other factors. If the factors are favourable, bone grafts can be used to help increase the bone height. In case of unfavourable cases minimal treatment may be carried out to retain the tooth along with periodontal and other interdisciplinary approach.
6. What complications can be anticipated?
   Procedures involve minimal complications, but few minor complications like sensitivity, swelling may be observed which are for short duration.

Orthodontics

This branch of dentistry deals with diagnosis, prevention and correction of malposed tooth.

Different types of treatment includes:

• Fixed orthodontics
• Removable orthodontics
• Invisible orthodontics

FAQ’s:

1. What complications can be expected?
   Toothache, occasional discomfort or pressure on the teeth
   Scratches and bruises in buccal mucosa
   White spots on tooth
   Gum infection
2. Is it necessary to remove a tooth for the treatment?
   Removal of a teeth helps in getting more space for the correction of malposed tooth. But it is not necessary to extract a tooth in every case. Extraction depends on the amount of space required and severity of case.
3. For how long do the braces have to be worn?
   It varies from case to case. Different factors influence the timing like severity of cases, force applied, other adjunctive treatment if required, age of the patient, etc.

Clear aligners

It is a form of orthodontic tooth movement using sets of transparent aligners for upper and lower arch.

Advantages include:

1. Approximating the treatment duration a little more precisely than braces
2. Avoiding extractions of premolars by creating interdental space via interproximal
3. Less frequent trips to the dental chair by allowing the patients to replace their aligners on their own every few weeks
4. Healthier periodontal tissue and less risk of enamel decalcification by avoiding brackets
5. Aesthetics: Clear aligners are often not visible, allowing patients to smile with greater confidence

FAQ’s:

1. Can all cases be treated with aligners?
   Severe form of malocclusion requires regular bracket therapy. Before selection of cases for aligners your doctor conducts some regular clinical examinations to decide whether aligners are suitable.
2. How long does the treatment go?
   It depends on the severity of cases. May extend from 12 months to 36 months.
3. I am a frequent traveller, but I want orthodontic treatment. Is aligner suitable for me?
   Definitely yes! But the severity of malocclusion has to be assessed.
4. If I don’t wear my aligners occasionally whether the treatment gets delayed?
   Movement of tooth with clear aligners are completely dependent on how diligent you are in wearing the aligners. Its always recommended that you wear your aligners regularly as scheduled. If missed, then the treatment may get delayed.

Oral surgery

Wisdom tooth removal

The third molar removal usually referred to as wisdom tooth removal involves removing impacted third molar by an oral and maxillofacial surgeon. Procedure differs from regular extraction as it may involve removal of bone and also the position of tooth.

FAQ’s:

1. When do I get my wisdom tooth removed?
   Wisdom tooth removal is done only if there are any complications involving the same such as pain, decay or if the impacted tooth is exerting force on the neighbouring tooth. It is not necessary that every wisdom tooth has to be removed.
2. How long does the procedure take?
   Procedural time depends on the severity of the case.
3. Is wisdom tooth removed under general anaesthesia ?
   In some cases, yes. But otherwise its done under local anaesthesia.
4. Will there be complications?
   Pain, swelling, difficulty in opening mouth, prolonged bleeding, temporary paraesthesia. All of these are treatable.

Geriatric dentistry

Geriatric dentistry or gerodontics may refer to attending to dental care of older individuals involving diagnosis and management of age related changes with an interdisciplinary approach.

Treatment includes:

• Replacement of missing tooth
  1. Complete dentures
  2. Removable partial dentures
  3. Implant supported dentures
  4. Full mouth rehabilitation
• Treatment of dry mouth and associated problems
• Treatment in case of systemic diseases that show up in oral cavity due to chronic long-term diseases.

Prosthodontics:

1. What are dental crowns and bridges?
   They are prosthetic devices which protects the broken tooth and helps in replacement of missing tooth. These are fixed form of prosthesis which can be removed only by dentist.
2. When are crowns recommended?
   Your dentist may recommend a crown to:
   • Replace a large filling when there isn't enough tooth remaining
   • Protect a weak tooth from fracturing
   • Restore a fractured tooth
   • Attach a bridge
   • Cover a dental implant
   • Cover a discoloured or poorly shaped tooth
   • Cover a tooth that has had root canal treatment
3. What are bridges?
   They are a fixed form of replacement for missing tooth. It involves taking support from the adjacent teeth which acts as anchor for the tooth that is being replaced. Once the dentist prepares the tooth the impression of it is sent to lab for fabrication of bridge which is later cemented on to tooth surface.
4. What materials are used for the crowns and bridges?
   There are different types of material which are available for the crowns. Selection of materials are based on aesthetic appearance, functionality and cost. Not all material can beused in every condition.

Material used range from acrylic, metal, metal ceramic, ceramic etc.

Aesthetic dentistry

Aesthetic dentistry

Aesthetic dentistry or cosmetic dentistry refers to any dental treatment that enhances the appearance of a person. It is the combination of various dental specialities leading to a final result.

Treatment modalities include :

• Addition of tooth material – composite teeth build up, veneers, crowns
• Removal of tooth or gums- enameloplasty, gingivoplasty
• Teeth whitening, bleaching, gum depigmentation
• Straightening of tooth or aligning of teeth using orthodontic therapy
• Closing the gaps between teeth
• Tooth jewellery

FAQ’s:

1. Is aesthetic treatment permanent?
   Aesthetic treatments are permanent provided the maintenance is good and regular checkups are done.
2. Is tooth jewellery safe?
   Any dental material used inside the mouth is safe. So even a tooth jewel is safe.
3. Does digital smile designing come under aesthetic dentistry?
   Digital smile designing is a part of aesthetic dentistry. It helps the patient to visualise the final outcome of the treatment digitally even before the final treatment.
4. What are the precautions to be taken after placing aesthetic filling?
   As aesthetic dentistry involves many procedures, it is extremely important for the patient to maintain it like avoiding any coloured substance (food material) in order to prevent the change in shade of restoration done. Be careful with the type of force applied on the restoration to prevent any breakage. Regular checkups are important.
5. What are the different types of filling materials?
   Based on the strength and appearance, restorative material are available in different types. Most commonly used materials include the tooth coloured filling materials like glass ionomer material or resin based material also called composite.

Digital smile designing

Digital Smile Designing (DSD):

DSD is a new technological advancement in dentistry that helps doctors and their clients to design, adjust and visualize the treatment digitally before the treatment.

It involves recording the client's smile pattern using photographs and models altering it using digital software to modify and design the perfect smile which is then transferred to a cast to get the final design. By this the clients will get an idea of the final outcome.

The whole concept is based on the analysis of the patient’s facial and dental proportions, utilising a predetermined series of high quality digital photographs and videos, understanding the relationship between teeth, gums, lips, smile with the facial features in motion and with emotion.

FAQ’s:

1. Is it done for cosmetic reason?
   Digital smile designing is a part of aesthetic procedure
2. Can functionality be assessed?
   Yes. Functionality is also assessed.
3. What is mock up?
   Once the patient intra-oral and extra-oral details are recorded digitally the final outcome of the treatment is designed using smile designing software. This is shifted to a model which replicates the final outcome. Using a temporisation material the final outcome is prepared which is placed within patients mouth to asses fit and functionality.

Dental implants

Dental implants

Dental implants are the most popular form of tooth replacement option due to:

• Longevity of the replacement i.e., if maintained well it will sustain for a lifetime
• It is almost tooth-like
• No damage to adjacent tooth
• Can help to provide tight and secure denture in completely edentulous patient

What are dental implants?

Dental implants are a tooth replacement therapy where a titanium screw-like material is placed into the bone which on healing helps in replacement of tooth.

It can be used for replacement of

• single tooth
• multiple tooth
• complete set of teeth

FAQ’s:

1. Can implants be placed on everyone?
   Implant dentistry has advanced so much that it can be used in almost all patients and in all situations. But there are few conditions where it may not be possible like:
   • Uncontrolled diabetes, any bone related diseases
   • Areas with improper bone support and less height of bone
   • Anatomical considerations like nerve very close to implant
2. How do the doctors select who is eligible for the implant?
   There are certain examinations that are carried out by the doctors which will help them to assess whether patient is eligible for treatment or not. Doctors conduct clinical examination and plaster models which replicate the patient teeth arrangement. Along with those CBCT image is required for the assessment of bone quality, height of the bone, anatomical structure. A complete blood picture is necessary to go ahead with the procedure.
3. How long is the procedure?
   Implant placement can take around 30 minutes to an hour depending on the complexity of the procedure and the number of implants.
4. Can I get a tooth in single day?
   There are options of placing the tooth on single day but it depends on the situation and complexity of treatment required.
5. Are regular checkups and maintenance important?
   Regular checkups and maintenance is the key to success of any treatment. So it is very important for you to schedule regular checkups and maintenance.
6. Are implants very costly?
   While considering the long-term benefit of the treatment it is a cost effective treatment. However, it may be more expensive than regular removable dentures.
7. What is the advantage of implant over a fixed partial denture or bridge?
   In a fixed partial denture or bridge the neighbouring tooth has to be trimmed in order to connect the missing tooth. This in long term may affect the health of neighbouring tooth. Also the crowns have to be replaced periodically.
8. Which implants are recommended?
   There are many companies which provide implants. The common implants used in our clinic are Nobel biocare, Osstem, Dentium implants. You can discuss with your dentist for more options.

Paediatric dentistry (child dentistry)

Paediatric dentistry deals with the dentition of child from birth to adolescence. It is recommended that a dental visit should occur within six months after the presence of the first tooth or by a child's first birthday. This is to aid in detection of early tooth decays and pattern of tooth eruption.

Treatment includes:

• Tooth eruption pattern assessment
• Space maintenance for erupting permanent tooth
• Habit breaking appliances (tongue thrusting, thumb sucking)
• Parental guidelines and counselling
• Fluoride therapy and pit and fissure sealents

FAQ’s:

1. Why do we have to care for milk teeth that will eventually exfoliate?
   Milk tooth acts as a guideline for the erupting permanent tooth. There is a sequence in which the deciduous tooth exfoliates and the permanent tooth erupts. If there is any disturbance in the above sequence like early loss of deciduous tooth will lead to abnormal eruption pattern of permanent tooth leading to malocclusion and other pathologies.

Fillings - Tooth Coloured / Silver

Dental cavities are not a new problem. These blackish brown cavities (caries) cause sensitivity, pain and discomfort affecting the quality of life. It is important to get cavities filled in its initial stage before they cost you your good night sleep or your best friend’s wedding! However, in the modern world of aesthetics and look good factor, dental technology has bought tooth colored materials to restore dental cavities. This will give you total confidence due to the aesthetic streak that will make your fillings look like your natural teeth. But, if you feel that it is okay for your friends and colleagues to see your shimmering silver fillings while you yawn or talk, then silver is another option. At Toothpix Dental Healthcare, we offer a range of filling materials which would suffice the dental needs, and of course, your confident smile.

FAQ’s:

1. How long will the filling last?
   Many factors affect the longevity of restoration like the severity of decay, maintenance, area of the restoration, biting force etc.
2. Why filling is necessary?
   Restoration is done when there is decay on tooth. If it is left behind the decay progresses to reach pulp which leads to pain ending in root canal treatment.