At TLC dentists, we believe that it is really important that you understand the types of treatment in dentistry.
This makes discussion, understanding and decisions much easier.
This provides more information on the choices for you.
This solves your problems more easily.
The first part is a quick 3 point summary, then for more information, keep reading the deeper explanations.
1. Reduces an infection but may not fix the cause of the problem.
2. Usually combined with other treatments.
3. If used too often, may become ineffective as germs can build up resistance to it.
Antibiotics are a medication capable of destroying or preventing the growth of bacteria. They are specifically used when an infection has been diagnosed. Signs of infection include swelling, redness and soreness.
The instructions for the use of antibiotics should be followed precisely, as there is a growing trend that bacteria have become increasingly resistant to certain antibiotics due to incorrect use and overuse. Antibiotics may also be prescribed before treatment as a prophylaxis to control potentially problematic bacteria prior to certain treatments.
Some people may be allergic to certain types of antibiotics and this could affect treatment. Common antibiotics used in dentistry include: Penicillin, Amoxycillin, Metronidazole, Cephalexin and Erythromycin. Each antibiotic works in a specific way and can target certain bacteria. Many pharmaceutical companies have different brand names for these antibiotics.
Bad Breath Treatment = Halitosis Treatment
1. Bad Breath can originate from teeth, gums, tongue, throat or other infections.
2. A dental clean and check-up can usually identify and fix the problem.
3. Sometimes, the cause of bad breath can be systemic from the body.
Bad breath can be caused by teeth, gums, other intraoral areas. 15% of the other causes of bad breath come from the rest of the body including the nose, sinus, throat or stomach. Sometimes the occasional bad breath comes from a drying of the inside of the mouth.
More serious causes of bad breath include gum disease and infection. Treatments should begin with good oral hygiene such as thorough toothbrushing with the correct technique, flossing and mouthwash. Tongue cleaning can also help. Mouthwashes that contain chlorhexidine or cetylpyridinium chloride can also help.
Braces = Orthodontics, Clear Aligners
1. Straightening front teeth often involves improving the bite and position of the back teeth.
2. Wearing retainers after orthodontic treatment is very important to keep the teeth straight as the bone and the bite may take years to grow in to the new position of the teeth.
3.Straight teeth can improve muscle and breathing problems, decrease gum disease and the premature wearing down of teeth.
Braces correct crooked misaligned teeth. Teeth that are in the wrong position or in the incorrect alignment can lead to functional problems such as excessive wear or chipping, jaw joint soreness and gum disease. This misalignment may also lead to a cosmetic dental and facial concern.
The position of teeth is important because of the interaction of all teeth with their adjacent and opposing (biting) neighbours. A single misaligned tooth can eventually affect other teeth.
Orthodontics includes all aspects of aligning and positioning of teeth, and uses metal and ceramic fixed braces attached to teeth, a series of removable clear plastic aligners, and a variety of removable plates to move teeth and influence jaw growth to align teeth into a better position.
Bridge = Fixed Prosthodontic Bridge
1. Two crowns attached to teeth on either side of a missing tooth/teeth gap, are then joined together to fill the gap space with an artificial tooth.
2. Relies on the strength of the teeth either side of the gap remaining strong and healthy.
3. Strong load bearing if the support teeth are strong.
A dental bridge is used to replace teeth where one or several teeth are missing. It joins the remaining adjacent (abutment) teeth or implants together permanently and is not removable. The bridge then spans over the area of the missing teeth with a set of replacement artificial teeth.
The bridge span of artificial teeth is called the pontic. It relies on the health and load bearing ability of the abutment teeth on either side of the teeth gap. The abutment teeth supporting the bridge can be thought of as crowns which link the artificial pontic teeth together. If one of the abutment teeth fails, the bridge may also fail. In many of these cases, dental implants are another treatment option.
Crown = Cap or Onlay
1. Covers all weakened structural areas of a tooth and acts as a protective helmet.
2. Very strong to chew on and very long lasting.
3. The only way to save a severely broken down tooth and often combined with root canal treatments.
A crown or onlay restores a very badly broken down tooth by wrapping around the remaining tooth structure in addition to restoring all the lost areas of tooth structure. Crowns are very strong and in some cases, equal to or stronger than natural teeth, however, they rely on the foundation or core of the weakened tooth underneath.
Some teeth that are root canal treated can utilize the root canal space as an anchorage for the core to improve the strength of the foundation of the crown. Crowns can be made of different types of porcelain, resin and alloy combinations for varying physical properties and different functional requirements.
Denture = False Teeth, Removable Prosthodontic Plate
1. Dentures are very durable, but clips used to hold the false teeth in place may wear down the holding teeth.
2. The fitting surface of a denture may become loose over time as gums and jawbones age or change shape.
3. Loose dentures can sometimes be stabilised with implants to hold them in place or can be replaced with implants.
A denture is a removable set of artificial teeth to replace missing teeth. The usually clip onto adjacent teeth or sit above the gum over the jawbone.
Dentures may be more difficult to function with, and may also alter speech as they tend to have more movement than permanently fixed replacement teeth options. Dentures can be made of hard acrylic, flexible acrylic or metal, or a combination of these materials.
Extraction = Tooth Removal
1. This is the removal of a tooth for the treatment of a severe infection or the removal of a deeply fractured tooth to prevent spread of infection and further loss of teeth and jawbone.
2. The jawbone shrinks soon after the removal of a tooth so a bone filler must be used to maintain the bone if any future replacement of the tooth is planned.
3. Taking care of the area after the removal of the tooth is very important for quicker healing.
When a tooth or surrounding structure is extremely broken down and is a factor to problems in the surrounding area, it will need to be removed to prevent further problems in the future. A tooth may be extracted whole or in sections. If the infection has spread to the jawbone or surrounding areas, these areas may require treatment.
After the extraction, soreness and swelling will accompany any healing over the next few days or weeks. Analgesic painkillers and antibiotics may be taken on advice of the dentist. After extraction (post-operative) care instructions from the dentist should be followed closely to avoid a re-infection or dry socket of the healing area.
If the tooth is to be replaced with an artificial tooth implant, bridge or denture at any time in the future, it is recommended that the dentist be notified prior to the extraction. This is so that strategies can be put in place to slow down the jaw bone shrinkage that occurs after a tooth is extracted. The remaining teeth opposite and adjacent to the extraction area have been shown to tilt and move after a tooth has been removed, and this might affect chewing and other functions in the future.
Filling = Dental Restoration
1. Repair of a broken part of a tooth.
2. White fillings use bonding to stick to tooth structure.
3. Deep fillings which may be near the nerve may need a medication lining or root canal treatment.
After the preparation and cleaning of tooth structure to ensure that it is free from tooth decay, weakened structure or contamination, a dental material is used to restore the missing portion of the tooth. Filling materials are usually either metal or resin based. Modern fillings use biological adhesives to bond to any remaining stable tooth structure.
Some short or medium term filling materials may contain preventive fluoride as part of their structure. If there is inadequate stable tooth structure, an onlay or crowning restoration may be required. This type of filling restores the tooth by surrounding and protecting it from the outside rather than relying mainly on adhesion to hold it together from the inside.
Fluoride Treatment = Fluoride or Calcium Remineralisation
1. Molecules which harden the surface of a tooth that has been weakened.
2. Strengthens tooth structure and improves tooth shape if used when the tooth is still forming.
3. First treatment of choice for the prevention of tooth decay when combined with good cleaning and good diet.
Remineralisation of a tooth involves the hardening of the calcium based enamel and dentine structure of a tooth usually after it has been weakened due to acid attack. The hard enamel structure of a tooth consists of hydroxyapatite which relies on calcium for strength. Acid, usually from the diet or from oral bacteria, removes some of the calcium from this structure, and is the first step in tooth decay.
Fluoride from toothpastes, mouthwashes and in some tap water, combines with tooth structure to harden the tooth. Fluoride can be found naturally in some mountain streams. Fluoride also appears to change the shape of any developing teeth to improve their long term resistance to decay. A casein milk based protein (CPP-ACPF) when used as a topically applied tooth crème has been shown to quickly increase the strength of tooth structure through remineralisation.
Gum Disease Treatment = Periodontics
1. Long term gum disease may be painless but can lead to teeth loosening and falling out suddenly. Some short term gum disease can be very painful.
2. Bleeding, swelling and plaque is usually present and is associated with gum disease.
3. Once the gum shrinks due to gum disease, it is almost impossible to grow back.
4. Treatment is deep periodontal scaling to allow the gum to become healthier and tighten its grip on the teeth.
Gum disease is the inflammation and infection of the gum and the loss of supporting jaw bone around teeth. Gum disease is caused by the build-up of bacteria and toxins around the teeth near and under the gums.
The build up (plaque) eventually calcifies and hardens (calculus or tartar) and needs to be removed by a dentist before it harbours more bacteria. Gum disease may be painless but still lead to shrinkage and permanent loss of height of the supporting jaw bone. Early gum disease is reversible, medium and long term gum disease leads to irreversible gum and bone loss. The teeth affected by gum disease can become infected or may loosen and fall out. Gum disease is a factor to bad breath and gum bleeding.
The gum disease bacteria has been linked to heart disease. The proven treatments for gum disease are: flossing and toothbrushing thoroughly, Chlorhexidine based mouthwashes and professional dental clean and scaling.
1. When a dental treatment is perfomed or an area in the mouth undergoes change, it takes time to heal and adapt.
2. In most cases it takes a few days to a few weeks to adapt. During this time there may be associated soreness
3. If there are any concerns or a worsening of the symptoms, please see your dentist immediately.
After a dental treatment is performed, the part of the body needs to heal. This may take several days to several weeks. Soft tissue such as gums heal faster than hard tissues such as bone. Medications such as antibiotics, anti-inflammatories and analgesics might help in the healing process.
Implants = Dental Implants
1. Biocompatible titanium root grown into the jawbone to replace a missing tooth.
2. Very strong and stable.
3. Requires good bone density and volume.
When a tooth has been removed, the best self-supporting tooth replacement is a dental implant. This is a biocompatible screw in anchorage which is placed into the jawbone of the missing tooth. After an initial healing period where the bone grows into the implant, an artificial tooth is placed onto the implant. This is becoming the most common type of tooth replacement.
The dental implant is very strong, but it relies on the underlying health of the jawbone to support it. The denser the jawbone and the more volume of bone, the better the longevity of the dental implant. Dental implants can be used to replace a single missing tooth or whole sets of teeth can be supported on several implants. Dental implants can fail due to trauma, gum disease, excessive force and immune system responses where the body can reject the implant.
1. Dental lasers can cut and/or sterilise and dry an area of gum and tooth.
2. Using dental lasers in surgery results in less soreness.
Laser treatments use high intensity light waves to cut, heal or sterilise an area. Sometimes, all three effects are used. In some treatments, lasers have replaced the need for a dental drill, a scalpel or a cauterizing instrument. There is often less soreness during and after the procedure. There are still some procedures where the laser is unable to be used.
Occlusal Splint = Bite Guard, Bruxism Splint
1. An Acrylic plate worn when excessive subconscious grinding and clenching of teeth is present.
2. Spreads the biting pressure load over many more teeth to prevent natural teeth from chipping or wearing down excessively.
3. The TMD or Jaw Joint version of the splint can help relieve the load and realign a strained or clicking jaw joint.
An occlusal splint is for those who clench or grind their teeth persistently (bruxism), leading to chipping or worn teeth and fillings, or jaw joint (TMJ) or jaw muscle aches. Most often this bruxism occurs at night or during times of stress.
Certain medications may exacerbate the bruxism. An occlusal splint is a clear thin acrylic plate that fits onto the biting surface of the teeth and spreads the biting load over all the teeth rather in specific areas; changes the chewing muscle power and relieves the pressure on the jaw joint. Types of occlusal splint include: night guards, bite splints, hard/soft splints and front teeth only anterior splints.
Painkillers = Analgesics
1. Decreases soreness but may not fix the cause of the problem.
2. Certain types of painkillers will increase bleeding as they thin the blood.
3. Some types of painkillers will decrease swelling.
Analgesics commonly known as painkillers, are a medication which provides relief of pain. There are two main over-the counter analgesics. The ibuprofen type is described as an NSAID (non-steroidal anti-inflammatory) and is able to relieve any swelling and pain and decrease the inflammation associated with it.
The paracetamol type of analgesics relieves pain through a different method and is not anti-inflammatory. Excessive long term use may damage to the kidneys and the liver. Alternating between the types of analgesics has been shown to provide a higher degree of pain relief in some cases of dental pain. Aspirin type analgesics may increase bleeding.
Root Canal Treatment= Endodontics
1. The only method to save an extremely sore tooth caused by nerve pain.
2. Due to the nerve inside a tooth being infected or the nerve dying.
3. A weakened tooth that has been root canal treated can require structural reinforcement anchorage and reconstruction such as a post and crown.
The root canal of a tooth is usually in the middle of the tooth surrounded by the strong hard tooth structure. The root canal contains nerves and blood vessel providing nutrients and sensation to the tooth. If the tooth structure is severely damaged due to decay, fracture or trauma, the nerve in the root canal may become injured, die and become infected. If the nerve is injured, it may be sore but can recover.
If the nerve is dies, it may not be sore, but the subsequent stage always leads to infection, and at this stage it may become very sore and swollen and affect the jawbone and endanger the surrounding teeth. Root canal treatment aims to remove the dead or dying nerve, medicate and cleanse the area, and then seal the root canal to minimize the chance of reinfection.
Root canal treatment is usually a multiple step procedure, and the patient should proceed with each step in order for it to be successful. The first step can usually provide pain relief, but if subsequent steps are not followed, the infection will return with increased severity and the tooth may become unsaveable.
If the tooth structure lost is a large portion of the tooth, then after the root canal treatment is complete, an rebuilt anchorage core and a full coverage crown is required to reconstruct the tooth.
Snoreguard = Mandibular Advancement Splint
1. Works for certain types of snorers.
2. Repositions the bottom jaw forwards during sleep to open up the breathing space.
3. If suitable, is less costly and a simpler option than other anti-snoring solutions such as CPAP.
A mandibular advancement splint remedies certain forms of snoring by positioning the lower jaw forwards to open up the airway during sleep. The sound from snoring is due to the vibrating of the upper airway as air passes through it.
This is exacerbated by the narrowing or loosening of the tissues around the airway. Other causes of snoring may not be remedied by the mandibular advancement splint.
Teeth Cleaning = Scaling and Prophylaxis
1. Gums and Teeth can have stains and the build-up of bacteria and food debris.
2. Brushing, flossing and mouthwashes combined with a low sugar and low acid diet are the best ways to keep your teeth healthy.
3. Hardened or calcified plaque known as tartar can stick on your teeth and if not cleaned off regularly, can lead to gum disease and teeth problems.
Teeth and gum cleaning includes the scale and cleaning of the tooth and gum and related areas. Plaque is bacteria and food debris and the hardened calcified version is known as calculus or tartar.
The removal of plaque and calculus removes one of the factors that leads to tooth decay and gum disease.
Fermentable carbohydrates in the diet, acid attack, specific bacteria such as Streptococcus Mutans, duration of contact with the tooth and weakened tooth structure are other interrelated factors leading to tooth decay and gum disease. Professional dental cleaning uses a rotating brush and paste or a spray to remove the plaque. It involves the use of hand instruments or ultra high speed vibration sound wave instruments to remove the hardened calculus.
Within a few days, the now clean teeth and gums start to heal – with the tooth structure strengthening and the gums tightening. In between dental cleans, flossing, thorough brushing with the correct technique, a mouthwash and a careful diet will minimize the build-up of plaque and calculus.
Teeth Whitening = Teeth Bleaching
1. Chemicals penetrate deeply into the tooth structure to whiten it.
2. Abrasive particles contained in Whitening toothpastes may remove the surface layer of stains but also remove tooth structure.
3. May cause sensitivity and weaken the teeth for a period of time.
4. In some cases, the darkness of teeth can be associated with decay, dying nerves or gum disease and the use of Whitening may worsen these conditions.
Teeth Whitening is the cosmetic process using bleach or abrasives to make teeth look whiter. The whitening material either removes stains from the surface of the tooth or soaks into the tooth to whiten the deeper tooth structure.
Weak, damaged or thin teeth may be more sensitive and weaken when during the whitening procedure. Abrasive whitening can remove a layer of the hardest but thinnest layer of tooth structure known as the enamel. Bleach chemical whitening can penetrate too deeply into the tooth structure and irritate or injure the nerve.
Both methods of whitening should be done under supervision after a dental examination. Types of whitening available include : whitening toothpastes, take home whitening kits and in-clinic rapid whitening.
Temporary Sealant Fillings or Desensitisers
1. When the filled area is healing – it might require desensitising agents or sealants to insulate the area.
2. The insulation or desensitiser only needs to be temporary until the tooth adapts or heals
A temporary sealant filling or desensitizing agent allows the tooth or area to heal with decreased soreness. Once the tooth is healed, the temporary sealant is no longer required.
Veneers = Porcelain Veneers
1. Can be used to change the Shape and Colour of front teeth.
2. Limited by the position of the front teeth and by the strength of the bite and health of the back teeth.
3. Material can be brittle.
A dental veneer is a layer of material bonded to the front surface of a tooth to improve aesthetics or to protect it. Veneers can allow a tooth to be reshaped and recoloured. Most people request straighter and whiter teeth.
It is rare to see a natural set of teeth of uniform bright intense whiteness and of perfectly straight alignment. Dental veneers are usually made of a resin or porcelain based material. The strength of the veneer relies on the strength and health of the underlying tooth as well as relying on the back teeth to take the biting load away from the front teeth.
Wisdom Teeth Removals
1. Wisdom teeth are at the very back of the mouth closest to the throat up at the top jaw or closest to the back of the tongue down on the lower jaw.
2. When they are stuck and cause a problem, they need to be removed and are known as impacted wisdom teeth.
3. Lower wisdom teeth removals can be more difficult than upper wisdom teeth removals.
4. Difficult impacted wisdom teeth may be removed by an Oral Surgeon in hospital under General Anaesthetic.
Wisdom teeth are the most furthest back molars in the upper and lower jaw. They are technically known as the third molars. Jaws often lack sufficient space for them to erupt correctly into line with the other teeth.
When they have no space to erupt, wisdom teeth are more likely to grow crooked or become infected. The removal of wisdom teeth requires access to the back of the mouth and has a risk of prolonged nerve compression or damage.
After wisdom teeth are removed, post operative care instructions need to be followed to allow healing. This might include the use of saltwater mouthwash and antibiotics.
Wound Dressing or Remedication
1. Medications are placed to assist in healing wounds.
2. Root canals and extraction sockets heal well by themselves but may respond well to healing medications.
Wound dressing and remedications may be required if the body is not healing well after treatment or if the body has used up all the medicament while the healing process is incomplete.
In extraction sockets where a tooth has been removed, there might be a need for a dressing which helps the gum and bone grow into and over the socket. In root canal treatments, the root canal medication may be used up by a severe infection and need to be replaced in order to clean the root canals thoroughly enough for the body to heal around it.