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COSMETIC DENTISTRY

The word cosmetic refers to beneficial changes in appearance

It is all dental work that restores or improves a person’s appearance.

A great smile improves your self confidence, which can have a positive impact on the social and professional aspects of your life. Cosmetic dentistry is not just about having a pretty smile. It is also about making your mouth look great, get healthy and function better at the same time.

Ans. The 1st step to improving your smile, this analysis involves a study of all the elements of your smile- teeth appearance, alignment, gums, jaws- and also your facial features and how they all fit together.

The results of this analysis are then shown to you by a process called Digital Smile Design in the form of a before after picture and also as a peel off version of your ideal smile in your own mouth without damaging your natural teeth.

A chipped tooth can be restored depending on its degree of damage

  • Small chip –can be reshaped
  • Moderate chip can be recreated with a tooth colored filling or attaching a veneer to support the tooth.
  • Large chip involving the nerve-Root canal treatment and a crown

Discolorations can be treated by dental cleanings,bleaching or veneers based on the intensity of discolouration.

There are 2 ways in which tooth position can be altered:

  • Actual physical movement – Orthodontic braces or clear aligners to move teeth into more attractive and functional positions.
  • Apparent change in position – Bonding with composite resin, full ceramic crowns. veneers and cosmetically acquire a new position.

Tooth replacement can be done in 2 ways

  •  Actual replacement of a tooth

A dental implant replaces the root of a missing tooth and a crown is then placed on the root  to become a functioning unit.

  •  A tooth replacement resting on gums by the support of adjacent teeth

A full ceramic bridge or a metal fused to ceramic bridges which replaces only the missing crown (and not the root of the tooth) by slight trimming the front and the back of the missing one.

Yes. Sometimes people have too much gum tissue or there is an asymmetry of the tissue across the smile. The solution is simple. A specialized soft-tissue laser can remove the excessive gum tissue. There is always a margin of tissue that can safely be removed to further enhance a smile. This non-surgical and pain-free procedure is completed in a matter of minutes

Cosmetic treatments can be categorised

 1. PROBLEMS OF COLOUR

WHITENING (For yellow or discoloured teeth)

  • Cleaning
  • Dental bleaching

 REPLACEMENT

  • Discoloured fillings in front teeth
  • Defective or unsightly old crowns
  • Missing teeth with bridges or implants

2. PROBLEMS OF SIZE & SHAPE

RECONTOURING (For mild misalignement or shape and size problems)

  • Enameloplasty/reshaping of teeth

Resin or porcelain veneers

  • For severely discoloured teeth
  • Change the shape and alignment of teeth

FILLINGS

  • Restore chipped teeth
  • Closing spaces between teeth
  • Restoration of worn and short teeth to their proper shape
  • Making teeth shorter or longer
  • Filling in tooth-brush abrasion notches

3. PROBLEMS OF POSITION

INVISIBLE BRACES

  • For straightening crooked teeth
  • Correcting a deep bite

 4. PROBLEMS OF GUMS

COSMETIC SURGERY

  • Gum lightening surgery
  • Gum reshaping procedure

Gum reduction (tooth lengthening)

DENTAL CROWN

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

Crowns are an ideal way to repair teeth that have been broken, or have been weakened by decay or a very large filling. A crown could be used for a number of other reasons, for example:

  • You may have a discoloured filling and would like to improve the appearance of the tooth
  • You may have had a root filling and need a crown to protect what is left of the tooth
  • Replacing the missing tooth or teeth.

Crowns can be made of a variety of different materials. They are listed below:

  • Metal Crowns withstand biting and chewing forces well. Also, metal crowns rarely chip or break. The metallic color and they tend to wear the opposite teeth are the main drawbacks.
  • Porcelain – Fused – To – Metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). These crowns can be a good choice for your back teeth.
  • All – Ceramic or All – Porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies.
  • Zirconia or Milled Crowns which are digitally constructed either in an office that has the software and hardware to produce them in a dental lab.

When you and we are happy with the fit and appearance of the new crown, it will be fixed in place with special dental cement or adhesive. The cement forms a seal to hold the crown in place.

Because the shape of the crown will be slightly different from the shape of your tooth before it was crowned, you may be aware of it at first. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if your bite does not feel comfortable, we will check and adjust it.

In root-filled teeth it may be necessary to insert a post into the tooth root before placing a crown. A post gives support and helps the crown to stay in place. The surface of the tooth may be removed down to the level of the gum.

A post can be made of prefabricated stainless steel which we can fit directly into the root canal. Or a custom-made post can be constructed by a dental technician to accurately fit the shape of the prepared root canal. The post is placed into the root canal and cemented in position, ready for the crown to be attached.

On average, dental crowns last between five and 15 years. The life span of a crown depends on the amount of “wear and tear” the crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting fingernails.

While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the tooth is protected from decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day, flossing daily — especially around the crown area where the gum meets the tooth — and rinsing with an antibacterial mouthwash at least once a day.

DENTAL IMPLANTS

No. It is done under local anaesthesia. Once the anaesthesia takes effect, you shouldn’t feel anything.

If you have missing tooth or a series of teeth, a dental implant may be suggested. Missing teeth can cause a number of problems, including difficulties chewing or eating.

Once you get dental implants, they no longer have to struggle with gaps caused by missing teeth. You feel more confident in their smile and can attend social functions without fear of uncomfortable situations. Dental implants give patients a beautiful smile, more confidence, and the ability to resume eating solid foods without worry.

Generally there are no open wounds with implant surgery so healing is quite quick and uneventful.

You can expect minor discomfort, but can be managed by antibiotics and painkillers.

A good rule of thumb is to eat soft, nutrition foods and keep well hydrated.

It depends on the number and location of the dental implant, usually it takes less than an hour.

The entire process usually takes about 4 to 6 months.

There are 2 phases:

  • First the implants have to heal by fusing to the bone. (Takes around 3 months to fuse)
  • And then the tooth replacement restoration have to be fabricated and attached.

Very rarely does a person’s body reject a dental implant. The jawbone readily accepts the implant, and the few rejections that do occur are caused by rare allergies to the titanium alloy that makes up the implant. Another reason for implant failure comes from the patient’s care after surgery. Without great oral hygiene, regular teeth fail and eventually fall out. A dental implant is no different. Taking care of your teeth, even the implants, prevents gum decay and structure failure in the long run. And then a bridge is placed instead of implant.

Make an appointment with us as soon as you lose the tooth. The implant’s success depends on the strength of the jawbone. Over time, the bone wears down and decays, leaving a weaker structure on which to affix the implant. Eventually, patients may require bone grafts before they can undergo placement of a dental implant. Avoid this painful and lengthy procedure by consulting with us as soon as the tooth falls out.

Dental implants in smokers are four times as likely to fail when compared to implants in non-smokers. Smoking leads to gum recession and disease, making the implant structure weaken over time. Dentists recommend that patients with dental implants avoid smoking or chewing tobacco.

EXTRACTION

Our first attempt is always to save a natural tooth for as long as possible.The following are signs that your tooth may be a candidate for removal after all attempts have failed

  • Severe pain for a prolonged time
  • Severely decayed and broken down
  • Toothhas severe bone loss
  • Recurrent swelling
  • Broken far below the gum level
  • Tooth is fractured from within

After an extraction, it is normal to have some minor pain which will subside with pain medication.

The extraction area can be tender for upto 10 days and if you have had stitches these are removed then.

Also if the site was that of a wisdom tooth then it may take a month to fill up entirely.

After a tooth extraction, do not brush the teeth next to the healing tooth socket for the rest of the day. You should brush, floss thoroughly, and brush teeth normal in all other regions of the mouth. This will eliminate the bad breath and unpleasant taste that are common after an extraction.

The day after the extraction, gently rinse your mouth with warm salt water(half a teaspoon salt in a glass of water) after meals to keep particles out of extraction site and also helps in healing of the socket. Do not rinse with mouthwash during this early healing period, untill we advise you to do.

When a tooth is removed, the bone that supported this tooth is also lost in time . The only chance we have to save this supporting bone for later use, is to place a bone graft at the time of extraction. After healing, you will typically have more suitable bone in which to place an implant and restore your tooth.

Wisdom tooth are typically extracted when there is not enough room in the mouth. The crowding can create discomfort or pain and result in other teeth becoming crooked. Wisdom teeth are also removed when they are infected, coming in wrong position and damaging other teeth orlodging in the gums or adjacent teeth leading to decay or gum infections.

For these reasons, removal of wisdom teeth is highly effective in preventing later dental problems.

1st 24 hours are very important in term of fast healing. You should,

  • Avoid hot drinks and take in sips.
  • Do not use a straw (the resultant suction pressure can dislodge a clot)
  • Eat soft foods in small mouthfuls.
  • Do not rinse your mouth and avoid spitting or rinsing ( that can dislodge blood clot and will start bleeding).
  • Do not smoke, drink alcohol or any form of tobacco.

Usage of  ice packs from the time tooth is removed and continue to apply for atleast 48 hours. Avoid hot packs,spicy food or even anything crunchy which may get lodged in the wound area.

These precautions and timely medication schedules prevent the appearance of any swelling and minimise discomfort in the healing period.

FILLINGS

Tooth decay happens when the enamel and dentine of a tooth become softened by acid attack after you have eaten or drunk anything containing sugars. Over time, the acid makes a cavity (hole) in the tooth.

Bacteria and food can cause tooth decay. A clear, sticky substance called plaque is always forming on your teeth and gums. Plaque contains bacteria that feed on the sugars in the food you eat. As the bacteria feed, they make acids which leads to tooth decay.

The best way to prevent dental decay is by brushing your teeth thoroughly last thing at night and at least one other time during the day, with a fluoride toothpaste. Make sure that you brush the inner, outer and biting surfaces of your teeth. Using ‘interdental’ brushes, or dental floss, also helps to remove plaque and food from between your teeth and where they meet the gums. These are areas an ordinary toothbrush can’t reach.

Yes there are.

  • A pit and fissure sealant’ is be used to protect permanent tooth from decay.
  • Fluoride varnishes painted onto their teeth twice a year which will help to reduce the chances of decay.

Sealants are a thin, plastic coating that is painted on the chewing surfaces of teeth usually the back teeth (molars and premolars) to prevent decay. It quickly bonds into the depression and grooves of teeth forming protective shields over the enamel of each tooth,preventing any food from lodging there.

Typically, children are more prone from ages 6 to 14 years, so are recommended to get the sealants on the permanent premolar and molars. Dental sealants can protect their teeth from decay for up to 10 years.

Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth colored filling. They provide good durability and resistance to fracture in small-to-mild size restorations that need to withstand chewing pressure.

Our bodies have the amazing ability to repair injured structures. For example, when we break a bone, our body is able to heal the bone by creating new cells that glue the bone back together. Unfortunately, this isn’t true when it comes to our teeth. Once a hole forms in a tooth, the body cannot repair it. Hundreds of years ago (before fillings existed), cavities eventually caused people so much pain that they would have the tooth removed.

Amazingly, modern dentistry has found a way to let you keep your decayed teeth. All that needs to be done is to have the bacteria professionally removed and then to replace the hole in the tooth with a hard, tooth-like material known as a dental filling.

Dental fillings last for 3 to 7 years. It can last you longer depending on your diet and oral hygiene.

Fillings require annual checkups to ensure they are not leaking,chipped or discoloured,ensuring there is no secondary decay below the filling.

An inlay is a filling made in a dental laboratory. It represents a better solution then one made directly in the mouth. it is done in major tooth defect. Inlays are made using composite/ceramic materials.

LASER DENTISTRY

The laser is the miracle technology in dentistry which teplaces the surgical blade as well as the dreaded drill.

A laser is an instrument that produces a narrow, intense beam of light energy which is visible to the human eye as a red light beam. When laser light comes in contact with tissues, it causes a reaction.

The beam of light produced by laser has the ability to remove, vaporize or shape soft tissues (gums, cheeks, tongue) or hard tissues (removal of decay).

Tooth structure contains water, and laser is absorbed by that water. The laser energy causes the water to boil and resulting steam pressure vapourizes the decay.

Other uses in dental procedures are:

  • Removal of swollen tissues.
  • Can reduce inflamed/infected gum tissues and reduce the bacteria.
  • For reshaping/remove the excess gum tissue to provide adequate tooth shape.
  • For crown lengthening procedures.
  • Gum lightening procedures

Biopsy procedures.

The aspect of laser surgery that most people appreciate is its COMFORT. It is painless, and the laser minimizes after procedures welling, bleeding and even the need for after procedure pain medication.

You will experience symptoms of an ulcer in the healing phase of a laser treated area.

No swelling and very minimal bleeding is expected at the time and even after surgery.

The discomfort of the ulcer like pain or burning can be easily controlled by an anesthetic gel given to you after the procedure to be applied 15 minutes prior to meals.The only precautions to follow are to avoid hot spicy or crunchy foods which may injure the area and prolong healing. Most symptoms subside within 48 hours as even the healing of these areas is accelerated.

There are several advantages. We may not need to use a drill or administer anesthesia in some procedures, allowing the patient to enjoy a more relaxed dental experience. Laser procedures can be more precise. Also, lasers can reduce symptoms and healing times associated with traditional therapies; reduce the amount of bacteria in both diseased gum tissue and in tooth cavities; and control bleeding during surgery.

ROOT CANAL TREATMENTS

Root canal is necessary when when the inside or the pulp (3rd layer of the tooth) becomes infected or inflamed. The pulp contains nerves- essentially they keep the tooth alive. The inflammation or infection can have many causes but mostly are result of deep decay or trauma.

The procedure begins by administering local anaesthesia to relieve pain. This will numb the tooth and surrounding area. So that you don’t feel anything. We then dissolve the nerve or infected tissue with the series of solutions. After that a sterile filling is done in the space earlier occupied by the nerve tissue.

A root canal makes you feel better not worse’’. Usually the symptoms are relieved on the 1st appointment. Local anesthesia during the procedure keeps you blissfully unaware while we carry out our procedures. Mild pain or discomfort after the procedure can be controlled with medication.

If you have pain that keeps you awake at night or starts up when you take cold and hots liquids, can’t chew on the tooth; those are all indications that the nerve is possibly dying. You may or may not have a swelling.

  • Pulling the tooth may sound like a quick fix, but keeping your natural tooth is hands down the best option.
  • Removal of tooth can lead to other dental problems like drifting of teeth, bite problems, TMJ discomfort. No matter how effective modern tooth replacements are and can be very effective.
  • Nothing is as good as your natural tooth.
  • RCT is more cheaper than extracting your tooth and getting an implant or a bridge.

Once a tooth has had a root canal, it becomes very dry and brittle, making it more susceptible to fracture. Covering the tooth with the crown helps to protect it.

I most cases the tooth will be tender for few days but as long as you prevent chewing hard things like popcorn, nuts, bones, candy etc. which cancause tooth to fracture.

SCALING

Dental cleaning involves removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time.

  • All dental problems start with the bacteria in the mouth. Food particles that stick to teeth becomeshavens for bacteria.
  • As food debris hardens and gets infected with bacteria it is called plaque,then tartar and finally calculus.
  • It can lead to cavities by the constant bacterial attack.
  • It can cause tooth loss by infecting and weakening the gums till teeth start shaking.
  • It can also cause diseases in the rest of the body like heart diseases, complications of diabetes if the bacteria travel in the bloodstream.

It is done with a water jet which selectively dispels food and bacteria from the teeth without damaging them.

In every 6 months to a year depending on various factors like your diet, your brushing techniques.

A tooth cleaning is never meant to be painful, by using topical anesthesia we ensure complete comfort. If you have a lot of bacteria build up in your mouth, it can irritate your gums so that they become more sensitive and bleed more easily. This gum sensitivity may lasts for a day or two after a cleaning.

Yes, it can be cured if it is at an initial stage it just needs stringent home care follow up.

For more progressive diseases there are various laser treatments and gum surgeries which can not only control but also reverse the damage to a certain extent.

The prognosis of the gum disease always depends on early detection and a dental cleaning or scaling is always the first line of treatment for any gum infection and must be done regularly.

TEETH/WHITENING

Teeth whitening lightens teeth and helps to remove discolouration which cannot be removed by a regular cleanup procedure.

This may vary among individuals. Typically, you can expect whitening to last from 6 months to 1 year. Avoid colored beverages and staining substances like red wine, coffee, green tea, smoking – all which can cause staining, helps preserve the results.

Teeth whitening/bleaching is harmless when done under supervision with the right concentration, duration and frequency of bleach based on your individual tooth type. It can be harmful or have side effects in case when done with over the counter products or with self unsupervised use.

Teeth whiteners do not damage existing intact dental restorations such as tooth coloured fillings, crowns, bonding, veneers, bridges. But they do not alter their colour. This means that any pre existing dental work may need to be replaced to match the new tooth shade achieved in the natural teeth.

To get and maintain good results you have maintain good oral hygiene and regular 6 monthly clean up. Avoid stained food, beverages, and tobacco. You can also opt for customized bleaching trays to do a mild teeth whitening maintenance procedure at home to maintain the shade.

Yes. You can protect your tooth enamel by using calcium sulphate and fluoride in your bleaching product.

Sensitivity from teeth whitening is always transient. It goes away within one or two days after the treatment.

If you already know that you have sensitive teeth, start using desensitizing tooth paste 2 weeks prior to bleaching. And 1 week after the bleaching procedure is done.

There are two kinds of stain on teeth — superficial and inherent. Superficial stain comes from the things we eat, drink and expose to our teeth. This kind of stain is usually yellowish in nature and yields the best results with teeth whitening systems.

Inherent stain comes from things we absorb into our bodies such as minerals, fluoride and various antibiotics such as tetracycline. Ingested especially at key developmental phases in life these substances can permanently discolour teeth. People with inherent stain will often choose to whiten their teeth with veneers, which addresses the teeth colour as well as length and shape