HAVE A HAPPY SMILE

GENERAL DENTISTRY

Teeth also help us say certain sounds. The shape of the arch inside the mouth helps you talk. Many letters of the alphabet cannot be sounded without the help of teeth.

Primary Teeth: Most babies are born with no teeth showing (the teeth are forming inside the gums). The 20 primary teeth (also called baby teeth or first teeth) erupt (poke through the gums) over the time from when a baby is from about 6 months to a year old.

Permanent Teeth: Primary teeth fall out and are replaced by 32 permanent teeth (also called the adult teeth). This happens over the time from when a child is from about 6 to 14 years old.

As a permanent tooth forms under the gums and in the jawbone, the roots of the primary tooth it is replacing dissolve. Then the primary tooth becomes loose and falls out. The permanent tooth will fill the space.

Wisdom Teeth: Wisdom teeth (also called the third molars) are molars that usually erupt from the ages of 17 to 21.

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 primary (baby) teeth, which often erupt as early as six months of age. They are then shed at various times throughout childhood. By age 21, all 32 of the permanent teeth have usually erupted.
  

                               
                               Primary Teeth Eruption Chart                                Permanent Teeth Eruption Chart
 

Parts of your tooth:

The human tooth has two primary components: the crown and root. The crown is the portion of the tooth that projects above the gums while the root is that portion that anchors the tooth to the bone.

The teeth are composed of 4 tissues. The enamel covers the crown of the teeth and is the hardest known substance in the human body. This extreme hardness is necessary to survive the powerful forces exerted on the tooth surface during chewing.

Inner to the enamel is the dentin forming the bulk of the tooth. Cementum covers the root portion of the tooth and gives attachment to certain fibers called periodontal ligament that help the tooth attach to the jaws.

The Pulp is the innermost part of the tooth containing the nerves, blood vessels and other cells. The pulp is the vital area of the tooth. Gums are soft tissues that cover the tooth like a collar.

Teeth have different shapes for different jobs. For example, when you eat, the upper teeth work together with the lower teeth of the same shape to bite, chew, and tear food. The names of these teeth are

Ø   Incisors (Central & Lateral) - There are eight incisors located in the front of the mouth (four on the top and four on the bottom). They have sharp, chisel-shaped crowns that cut food.

Ø   Cuspids / Canines -  The four cuspids are next to each incisor. Cuspids have a pointed edge to tear food.

Ø   Premolars - Also called bicuspids, the four pairs of premolars are located next to the cuspids. They crush and tear food.

Ø   Molars - There are twelve molars, in sets of three, at the back of the mouth. They have wide surfaces that help to grind food.

Adults have 32 teeth. Depending on their age, children may have fewer because they lose baby teeth as adult teeth grow. In addition to chewing, teeth help you to speak clearly.

“Teeth also give your face its shape and add to the way you look. Not only do clean, healthy teeth help you look good, they contribute to total body health and well-being. And a smile always helps you look your best.”

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2)   How to Brush Your Teeth?

Regular, thorough brushing is a very important step in preventing tooth decay and gum disease. Brushing removes the bacteria that promote tooth decay and the plaque that can cause gum disease.

Ideally, you should brush after every meal, because the bacterial attack on teeth begins minutes after eating. At the very least, brush once a day and always before you go to bed. Brushing your teeth isn't complicated, but there is a right and a wrong way. We do it every day without thinking too much, but there are some important points to remember when brushing your teeth

Here are a few tips to help your brush better:

1.        Squeeze some toothpaste onto a soft-bristled toothbrush. Your toothpaste should contain fluoride

2.        Use short, back-and-forth brushing motions to clean the outside and inside surfaces of the teeth, as
     well as the chewing surfaces. Follow with up-and-down motions to clean the inside surfaces of the
     front teeth.

3.        Clean every surface of every tooth.The chewing surface, the cheek side, and the tongue side.

4.        Don't rush your brush. A thorough brushing should take at least two to three minutes. Try timing
     yourself.

5.        Brush along the gum line. This is extremely important, as gum disease starts here. Brush gently to
     avoid damaging your gums.

6.        Make sure to brush your back molars, where bacteria like to hide.

7.        Brush your tongue to remove bacteria that cause bad breath.

8.        Spit out the toothpaste and rinse your mouth with water or mouthwash.

9.        Use a soft brush with rounded bristles. The right toothbrush cleans better. Choose a size and shape
     that allow you to reach all the way to your back teeth. There are many different types of brushes, so
     ask your dentist to suggest the best one for you. It is recommended you replace your toothbrush
     every three months.

10.     Try to floss at least once a day, since most adult cavities occur between teeth. The most important
    time to floss is before going to bed. Floss before or after you brush'either is fine. Guide the floss
    between the teeth and use it to gently rub the side of each tooth.

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3)   How to Floss your teeth?

Flossing removes plaque and bacteria that you cannot reach with your toothbrush. If you don't floss, you are missing more than one-third of your tooth surface. Plaque is the main cause of gum disease. It is an invisible bacterial film that develops on your teeth every day.

Within 24 to 36 hours, plaque hardens into tartar (also called calculus) which can only be removed by professional cleaning. Floss at least once a day, and plaque never gets the chance to harden into tartar. Getting into the habit of daily flossing is easier when you floss while doing something else like watching TV or listening to music, for example.

Here is the suggested way to floss right:

Step 1  -  Take a length of floss equal to the distance from your hand to your  shoulder. Wrap it around your index and middle fingers, leaving about two inches between your hands.

Step 2 -  Slide the floss between your teeth and wrap it into a "C" shape around   the base of the tooth and gently under the gumline. Wipe the tooth from base to tip two or three times.

Step 3 -  Be sure to floss both sides of every tooth. Don't forget the backs of your last molars. Go to a new section of the floss as it wears and picks up particles.

Step 4 -  Brush your teeth after you floss — it is a more effective method of preventing tooth decay and gum disease.

Note: Gums sometimes bleed when you first begin to floss. Bleeding usually stops after a few days. If bleeding does not stop, see your dentist. Floss can shred if you snag it on an old filling or on the ragged edge of a tooth. Try another type of floss or dental tape. Ask your dentist for advice. If your floss still shreds, see your dentist.

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4) Orthodontics (Correcting Irregular Teeth with Braces)

Orthodontics is the science of straightening and correcting teeth and any impaired (mismatched) growth of the jaws.

    Pre Treatment               During treatment             Post Treatment

Who needs orthodontic treatment?

·         Children as well as adults, are choosing to have orthodontic treatment for several reasons:

      -          Malocclusion
-          Tooth Mal-alignment
-          Unhappy with appearance of teeth

·         During the preteen and teenage years, the jaws are growing and maturing; therefore it is easier to shift 
  teeth at this stage rather than later on in adulthood.

·         More adults are choosing to have orthodontic treatment in order to improve the appearance of their teeth.
  Since their jaws are no longer growing. Treatment may take a little longer.

What is Malocclusion?

Malocclusion is the improper positioning of the teeth and jaws. It is a variation of normal growth and development, which can affect the bite, the ability to clean teeth properly, gum tissue health, jaw growth, speech development and appearance.

Some Types of Malocclusion:

There are three basic categories of malocclusions.

ü   The first category consists of dental problems, in which the teeth (for various reasons) don’t have the correct position on their osseous base (dentoalveolus), and as a result they appear crowded, spaced or rotated. Usually these problems are not visible when the mouth is closed. 

ü    The second category consists of skeletal problems, where the jaws have not grown harmoniously and that in turn has a negative effect on the function of the mouth and the esthetics of the face. In this category the goal of orthodontic treatment is to correct the position of the teeth and restore the balance of the face. 

ü    Finally, in the third category the patient has a combination of dental and skeletal problems, which not only affect the oral cavity but also the esthetics of the face.

Why treat Malocclusion?

     Orthodontics is not only used to improve your appearance. The main purpose of treatment is to get teeth into proper occlusion so as to improve the overall stability of your oral cavity.

·    Malocclusion or malaligned teeth can have long term effects, such as:

-          Interference with normal growth and development of the jaws.
-          Abnormal swallowing patterns
-          Abnormal Facial Muscle function
-          Impairment of chewing
-          Speech defects
-          Susceptibility to cavities due to the difficulty of removing plaque from crooked teeth.
-          Vulnerability to accidents or fractured teeth (if your front teeth stick out, they may be more easily 
           injured)

What are the goals of any orthodontic procedure?
To create:

What do the braces do to the teeth?

Teeth can slowly be moved and shifted into proper position by applying pressure in certain directions.

Bands, Wires and elastics are placed on the teeth to move them in the right direction. This takes place slowly and carefully over an extended period of time. Shifting teeth back into a functional position can take months to years, but eventually you will have a new and improved mouth and a longer lasting smile. Retainers are often used after the braces, to hold the teeth in their new position until they are stable.
It is important to wear the braces or an appliance for however long the dentist suggests. If you quit at any point during the treatment, the teeth can shift back into their old position.

Tips & Suggestions for maintaining your Braces

Braces collect food and dental plaque very easily. If proper oral hygiene is neglected during orthodontic treatment both tooth decay and periodontal disease can occur easily.

It is very important to maintain a daily plaque control program. Such a program may be as follows:

-     A soft toothbrush should be used. A special orthodontic toothbrush can also be used to brush your teeth.
-     Flossing with braces on takes more time than usual. Superfloss or floss threaders can aid in flossing, and make
      it more time efficient.
-     An interdental brush can be used to fit between the wire and the tooth to remove hard-to-reach plaque and
      food debris.
-     Oral irrigators can be used along with brushing and flossing. This helps remove food debris and plaque.
-     A mouthwash containing fluoride can be used to help prevent cavities from occurring.
-     Hard foods should be avoided since they can bend the wires, loosen the bands, or break the brackets
      (braces). Fruits and raw vegetables should be cut up into smaller pieces and chewed on the back teeth.
-     Sticky foods such as chewing gum, hard candies, & toffees should be avoided as they can bend and break the
      wires and brackets.
-     Foods high in sugar should also be avoided, since this will increase the chances of tooth decay.

Regular dental appointments are important to monitor the health of teeth and gums during orthodontic treatment.

·    Orthodontics is lot of work and taking care of the braces is not easy, but in the end, the results will be worthwhile when you have your new and improved smile.…and remember, be proud to give a silver smile!

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5) Root Canal Treatment

What is root canal treatment?

Root canal treatment, also known as endodontic treatment, is a dental procedure in which the diseased or damaged pulp (core) of a tooth is removed and the inside areas (the pulp chamber and root canals) are filled and sealed.

Why do I need it?
The pulp, or soft inner tissue of your tooth, is normally surrounded and protected by a layer of dentin. Above the gumline, a layer of enamel protects the dentin; below the gumline, the dentin is covered by cementum. When a deep cavity, decay or crack destroys these protective layers, the pulp is exposed to the bacteria in your mouth. This can result in inflammation, infection and, eventually, necrosis (pulp death). A severe blow to the tooth can also damage the pulp. Irritants may then escape from the end of the root and cause a diseased area (apical lesion) in the bone. Pus accumulates at the ends of the roots, forming a painful abscess (Pus filled cavity usually seen in this condition in side the mouth), which can damage the bone supporting the teeth. Such an infection may produce pain that is severe, constant, or throbbing, as well as prolonged sensitivity to heat or cold, swelling and tenderness in the surrounding gums, facial swelling, and discoloration of the tooth. However, in some cases, the pulp may die so gradually that there is little noticeable pain.

Root canal treatment removes the damaged pulp and irritants. This allows the bone surrounding the root end to repair and heal.

Common signs of pulp problems include:

• Pain when biting down on a tooth

• Sensitivity to hot or cold food or beverages

• Tooth discoloration

• Swollen gums around the infected tooth

Couldn’t I just have the tooth removed?
You could get it removed, but then adjoining teeth may shift and interfere with biting and chewing. You can have a replacement tooth implanted or attached to adjacent healthy teeth, but this can be expensive and require even more dental treatment. There is no real substitute for your own natural tooth, which is more efficient in chewing and biting than an artificial one.

What happens during root canal treatment?
An examination, including X-rays, will be performed. A local anesthetic will be given, if necessary. A sheet of rubber latex, called a “rubber dam,” will/may be placed around the tooth to isolate it and keep it clean and dry during treatment.

Complete root canal treatment usually consists of the following five basic steps:

Step 1. An opening is made in the crown of the tooth. Creating this access also relieves the pressure inside the tooth and can dramatically ease pain.
 

Step 2. The pulp is removed from the pulp chamber and root canals. The dentist determines the length of the root canals, usually with a series of X-rays. Tiny instruments (“files”) are used to clean the root canals and shape them to a form that will ensure they will be well sealed. A temporary filling is placed in the opening to seal the opening and protect the tooth between appointments.

Step 3. The root canals are filled and sealed with a material that prevents bacteria from re-entering. The opening in the crown of the tooth is sealed with a temporary filling. Radiographs (X-rays) are made before, during and after treatment.

Step 4. At the next appointment, the temporary filling will be replaced with a permanent filling and then with a ceramic / porcelain crown.
Root canal treatment is not complete without the placement of a crown/cap.

Step 5. The root canal, permanent filling, and/or crown are evaluated for healing at periodic intervals called recall appointments.

 

Is this procedure going to hurt?
With modern techniques and anesthetics people report that having a root canal treatment is about as painless as having a cavity filled. Should you experience any discomfort, call your dentist, who will do everything possible to make you comfortable.

What care should be taken after the root canal treatment?
The tooth may be sore or you may experience pain/discomfort for several days after the filling. Pain relievers, may be taken to ease the soreness as prescribed by the dentist. The tissues around the tooth may also be irritated. Rinsing the mouth with warm salt water several times a day will help. Chewing on that side of the mouth may need to be avoided for the first few days following treatment. A follow-up appointment should be scheduled with the dentist for six months after treatment to make sure the tooth and surrounding structures are healthy.

How long will my teeth last after this treatment?
Although the pulp is removed, your tooth remains alive, nourished by surrounding bone and gum tissues. With a permanent restoration (crown), regular brushing and flossing, proper diet and periodic dental checkups, your tooth has an excellent chance for success.

What you need to know after a Root Canal treatment:

• Soreness
  Most patients experience a little soreness after the appointment. This may be due to the injection, the necessity of keeping the mouth open for a long time, or the treatment. Your temporary filling will be hard enough to bite on within approximately a half-hour, but avoid biting or chewing on the treated tooth if it hurts.
   

• Pain
  Over-the-counter pain relievers usually relieve the discomfort. Should pain last more than a few days, or if severe pain or swelling occur, call your dentist. Remember, if your tooth hurt before you came in for treatment, it may take a while to heal.
   

• Permanent Filling
  When your root canal treatment is complete, a temporary filling is placed. The tooth needs to be permanently restored to prevent contamination or fracture, so you will need to return for a permanent restoration. It is important to return promptly because the temporary filling can loosen and leak, possibly causing the root canal treatment to fail, which would necessitate re-treatment.

Myths About Root Canal Treatment
There are many misconceptions surrounding root canal (endodontic) treatment. As always, when considering any medical procedure, you should get as much information as you can about all of your options. Your dentist or endodontist can answer many of your questions.

Myth #1: Root Canal treatment is Painful
Truth—Root canal treatment doesn't cause pain, it relieves it. Most patients see their dentist or endodontist when they have a severe toothache. Damaged tissues in the tooth can cause the toothache. Root canal treatment removes this damaged tissue from the tooth, thereby relieving the pain you that you feel.

The perception of root canals being painful began decades ago when root canal treatment was painful. But with the latest technologies and anesthetics, root canal treatment today is as easy / comfortable like having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as "painless" than patients who have not had root canal treatment.

Myth #2 : Root canal Treatment Causes Illness (Fever)
Truth—Root canal treatment is a safe and effective procedure.
Research conducted over the years showed no relationship between root canal treated teeth and the presence of illness(Fever). Instead, researchers found that people with root canal fillings were no more likely to be ill than people without them.

The presence of bacteria in teeth and mouth has been an accepted fact for many years. But presence of bacteria does not necessarily mean there should be "infection" and is not necessarily a threat to a person's health. Bacteria are present in the mouth and teeth at all times, even in teeth that have never had a cavity or other trauma.
One of the causes for illness in earlier days may be due to improper sterilization procedures. But in modern day dentistry today sterilization if all instruments is of utmost priority which has almost totally eradicated the event of causing illness.

It is now well known that teeth that receive proper root canal treatment do not cause illness.

Myth #3—A good alternative to root canal treatment is extraction (pulling out the tooth).
Truth—Saving your natural teeth, if possible, is the very best option.
Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet.

Root Canal treatment, along with appropriate permanent restoration (cap or crown), is a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant.

Root Canal treatment also has a very high success rate. Many root canal treated teeth last a lifetime.

Placement of a bridge or an implant will require significantly more time in treatment and may result in further procedures to adjacent teeth and supporting tissues.

Millions of properly root canal treated teeth serve patients all over the world, for years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through root canal treatment, Endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.

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6) Gum Disease

Stages Of Gingivitis And Periodontal Disease

Did you know?

Gum disease is a common dental problem that may result in tooth loss. Gingivitis and Periodontitis are the most common types of adult gum disease.

 Healthy Gums

Healthy teeth and gums are maintained by daily plaque removal from all surfaces of the tooth (through tooth brushing and interdental cleaning)

The following features characterize healthy gums:

• Pink or coral pink color, (normal variations in color depend on race and complexion)

• Firm, resilient tissues

• 'Orange-peel' texture (known as stippling)

• Shape that follows the contour of the teeth and forms a scalloped edge

• No areas of redness, swelling or inflammation

• No bleeding during daily plaque removal

What Is Gingivitis?

Gingivitis is inflammation of the gum tissue. The gums are irritated and swollen due to a plaque or calculus (tartar) buildup along the gumline. The gums may be sore, bleed easily and appear puffy, soft and swollen. No bone structure is lost around the teeth at this stage of gum disease. Blood on the toothbrush or dental floss is one of the earliest and most common signs of gingivitis. Your gums should never bleed while brushing or flossing. The good news about gingivitis is that it is preventable and reversible through good brushing and flossing techniques (or other interdental tooth cleansing). On the other hand, if oral hygiene habits are poor, gingivitis may progress to Periodontitis.

What Is Periodontal Disease?

Periodontal disease is destruction of bone and the structures supporting the teeth. Unfortunately Periodontitis is irreversible, but you can stop its progression through good oral hygiene and visiting your dental professional. 

Eight Warning Signs of Periodontal Disease:

• Gums that bleed when you brush or floss your teeth

• Gums that are red, swollen or tender

• Gums that have pulled away from teeth

• Infection including purulence (pus) between the teeth and gums when the gums are pressed

• Permanent teeth that are loose or separating

• Any changes in the way your teeth fit together when you bite

• Any changes in the fit of your partial denture

•  Bad breath

• Itchy sensation
   

 Early And Moderate Periodontitis: 

• Periodontitis occurs when the inflammation of the gums progresses into the deeper underlying structures and bone.

• In the most common form of Periodontitis, plaque (and sometimes calculus) is found below the gumline.

• The gums may feel irritated, appear bright red, and bleed easily.

• The ligaments holding the tooth in its socket break down and the gums pull away from the teeth, resulting in a periodontal pocket or space between the tooth and gum.

• The periodontal pocket deepens and fills with more bacteria. Supportive ligaments and bone start to show damage.

    Calculus and plaque do not have to be evident to the naked eye for periodontal
    disease to be present. You need regular examinations performed by your oral health
    professional to assess your periodontal health and determine if periodontal disease
    is active in your mouth.

   After non-surgical periodontal therapy (i.e. scaling). The gums have been restored to health. Notice the gums have receded, exposing the root of the tooth. This is due to the irreversible bone loss as a result of previous periodontal disease. This can lead to tooth sensitivity.

   Advanced Periodontitis:

• When Periodontitis progresses to the advanced stage, the gums severely recede (pull away from the tooth); pockets deepen and may be filled with pus.

• There may be swelling around the root and you may experience sensitivity to hot or cold or feel pain when brushing your teeth. This is due to the severely receding gums exposing the root surface.

• As bone loss increases, your teeth may lose so much support that they need to be removed to preserve the overall health of your mouth.

Advanced periodontal disease: further progression of Periodontitis with major loss of bone support. The teeth may lose so much support that they may be loose

Adult gum disease is usually not painful. It can progress slowly. You may not even be aware of it until the advanced stages, when the tooth is in danger of being lost. Check your gums thoroughly and regularly. It is also important to go for regular checkups (at an interval schedule determined through collaboration with your oral health professional, based on your own personal needs). Your dental hygienist can detect the early stages of gum disease, when it is the easiest to treat.

Protecting your periodontal health brings many benefits. You can chew with more comfort. You can smile and speak with greater confidence. You can keep dental costs down by preventing further problems. A commitment to maintenance therapy is a commitment to better health.

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7) Dental Implants

The modern method of replacing missing teeth. Research shows that 85% of people who wear full or partial dentures experience some related discomfort and difficulty. Dental implants can eliminate those problems, restore self-confidence and improve the quality of life. From a single missing tooth to an entire set of teeth, dental implants can provide a permanent alternative to problem dentures, and help prevent the premature loss of remaining teeth. Dental implants can last a lifetime and are an excellent investment in oral health

Q: What are dental implants?

A: Dental implants are made of biocompatible materials that become directly attached to your jawbone. In dental terms, this is called “osseointegration.” Once anchored in place, your implants can be used to replace a missing tooth, support an entire set of teeth or retain an overdenture. The result is a natural type of tooth replacement that can restore the biting and chewing ability you once enjoyed, improve your appearance and renew your self-confidence.

Two-Stage Surgical Procedure           One-Stage Surgical Procedure
 

Q: What procedures are used to insert dental implants?

A: Placement of dental implants is a minor surgical procedure performed in one or two office visits. If you have one-stage implants, their metal tops will extend through the gums while your tissues heal, and you will not need a second surgery. If you have two-stage implants, they will be placed under the gums while the bone heals. You will need a second, simple surgery to uncover them and attach a post to support your replacement teeth. Your dentist’s decision to do a one- or two-stage surgical procedure depends on a number of clinical factors, such as the amount of available bone and location of the implants. After the implants are placed, the bone attaches to them and permanently anchors them within your jaw. In the meantime, your dentist may adjust your full denture or partial prosthesis for temporary use.

Restoration

Q: What restorations can dental implants provide?

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8) Wisdom Teeth: To Keep or Not

What are wisdom teeth?

These are not extra teeth like most of us think. They are part of our normal set of teeth. Each one of us has 32 teeth. 28 would have erupted into the mouth by the time we are 13 years of age. The last four, one in each end of the upper and lower jaws are the wisdom teeth. There is a sequence of eruption and it just so happens that the wisdom teeth are the last ones to erupt at the age of 18 to 24 years of age. By then there is usually a lack of space for them to erupt properly and so most are always stuck(IMPACTED). So we always have this idea that they are extras!

Do we need to remove them?

There criteria most Dental Surgeons will have to determine whether that wisdom tooth of yours need to be removed.

These are:

• They have given you gum pains before. These pains will usually subside after some medications and then will recur at a later date. No one can predict the frequency and severity of these recurring pains. They may or may not be accompanied by swelling and pustulent products.

• They have caused cavities in the teeth in front of them due to food trapping or they themselves have cavities from food trappings. These are usually determined by the dental surgeons after a check up or through x-rays results.

• They interfere with the treatment you are having. Usually this will happen in those who seek braces treatment.

• They are constant causes of food trapping and irritation.

What is an Impacted Wisdom Tooth ?
A tooth becomes impacted due to lack of space in the dental arch and its eruption is therefore prevented by gum, bone, another tooth or all three. Lack of space occurs because our jaws have become smaller (through evolution), we do not loose teeth through decay as frequently as in the past, and our diet is such that our teeth do not wear down as much.

 How are they removed?

There are two methods of removing wisdom teeth. They can be by simple extraction or they are removed by simple minor surgical procedures. These are determined by their degree of impaction. Removing wisdom teeth either by extraction or surgery can be performed under local anaesthesia or under general anaesthesia.

Local anaesthesia means that they can be done in the clinic when you are fully awake or sedated.

General anaesthesia will mean removing them while you are asleep and is usually done in a hospital environment under Day Surgery. i.e, you go home about four hours after the procedure is performed. These can be carried out either in the private hospitals or restructured hospitals. The surgeons can be private practitioners or from government service.

The healing process begins immediately after surgery as your body sends blood to nourish the tooth socket. Simple pressure from a piece of gause is usually all that is needed to control the bleeding and to help a blood clot to form in the socket, which promotes healing. Within a day or two, soft tissue begins to fill in the socket, aided by the blood clot. Eventually, the bone surrounding the socket begins to grow, eventually filling in the socket completely, as illustrated here:

(note that there is a possibility of a swelling developing in the area which is normal and will reduce within a short time)

The Pro's and Con's of Wisdom Tooth Removal

Some Pro's of Removing a Wisdom Tooth:

• Wisdom teeth may be hard to access with your toothbrush or floss. Over time, the accumulation of bacteria, sugars and acids may cause a cavity to form in the tooth. If it is not restored with a filling, the cavity may spread and destroy more tooth structure causing severe consequences to the tooth and surrounding supportive structures.

• Due to the difficulty of keeping these teeth clean with your daily home care (brushing and flossing), bacteria and food debris remaining on the wisdom teeth may produce a foul smell-causing bad breath.

• A wisdom tooth that is still under the gums in a horizontal position (rather than a vertical position) may exert pressure to the surrounding teeth, causing crowding and crooked teeth. This also may occur if there is not enough space in the mouth for the wisdom tooth. This may warrant braces to repair the damage.

• A wisdom tooth that is still under the gums may become irritated. The gum tissue that lays over the tooth may harbor food debris and bacteria that gets trapped under the gum, resulting in an infection in the gums.

Some Con's of Removing the Wisdom Teeth:

• Depending on the size shape and position of the tooth, removal can vary from a simple extraction to a more complex extraction. With a simple extraction, there is usually little swelling, bruising and/or bleeding. More complex extraction will require special treatment, which may result in more bruising, swelling and bleeding. However, your dental professional will provide you with post treatment instructions to minimize these side effects.

• Following an extraction, a condition called "dry socket" may occur. If the blood clot that formed in the extraction area becomes dislodged, it exposes the underlying bone. This condition is very painful, but resolves after a few days. It is preventable by following the post treatment instructions provided by your dental professional.

• The longer you wait and the older you get, there is the potential for more problems to occur. This is because as you get older, the bone surrounding the tooth becomes more dense, making the tooth more difficult to remove. The healing process may also be slower.

Post Operative Care

• Do Not Disturb the Wound - In doing so you may invite irritation, infection and/or bleeding. Chew on the opposite side for the first 24 hours.

• Do Not Smoke for 12 Hours - Smoking will promote bleeding and interfere with healing.

• Do Not Spit or Suck Through a Straw - This will promote bleeding and may dislodge the blood clot, which could result in a dry socket.

• Control of Bleeding - If the area is not closed with stitches, a pressure pack made of folded sterile gauze pads will be placed over the socket. It is important that this pack stay in place to control bleeding and to encourage clot formation. The gauze is usually kept in place for 30 minutes. If the bleeding has not stopped once the original pack is removed, place a new gauze pad over the extraction site.

• Control of Swelling
  After surgery, some swelling usually expected mainly due to the reason that in some cases some bone covering that particular tooth may need to be removedwhich leads to swelling. This can be controlled through the use of cold packs (ice cube wrapped in a hand towel or kerchief.A cold pack is usually placed at the site of swelling during the first 24 hours in a cycle of 20 minutes on and 20 minutes off.
   
  After the first 24 hours, it is advisable to rinse with warm saltwater every two hours to promote healing. (one teaspoon of salt to eight ounces of warm water).

• Medication for Pain Control - Anti-inflammatory medication such as Ibuprofen is used to control minor discomfort following oral surgery. The dentist may prescribe stronger analgesics if the patient is in extreme discomfort.

• Diet and Nutrition - A soft diet may be prescribed for the patient for a few days following surgery.

Following the removal of your wisdom teeth it is important that you call your dentist if any unusual bleeding, swelling or pain occurs. The first 6-8 hours after the extraction are typically the worst, but are manageable with ice packs and pain medication. You should also plan to see your dentist approximately one week later to ensure everything is healing well.

It is very important to talk to your dentist about extraction procedure, risks, possible complications and outcomes of the removal of these teeth. A dentist may do the actual extraction or it may be referred to an oral surgeon, who is a specialist in the field. This decision is based on the dentist’s preference and the unique features severity of each individual case.

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9) Tooth Whitening

Want Whiter, Brighter Teeth?

The best way to keep your teeth white is to brush twice a day, floss daily, see your dentist for regular checkups and professional cleanings, and limit stain-causing foods and habits. These include: tobacco, certain foods and beverages (such as coffee, tea and berries), some drugs (such as tetracycline), or trauma to a tooth. As well, your teeth may become stained or discoloured naturally as you age. Your dentist can give you the best advice about whitening your teeth.

HERE'S HOW IT'S DONE: Chairside bleaching - usually takes about 30 to 60 minutes and one to three visits to the dental office. A shield (or rubber dam) protects your gums from the bleaching agent (usually a form of hydrogen peroxide), which is "painted" onto your discolored teeth and activated with heat or high-intensity light.

Mouthguard Bleaching - is done by you at home. You wear a custom-made mouthguard with special bleaching gel (provided by your dentist) for a period of time each day, or overnight, over a number of weeks.

It's important to know that not everyone's teeth will "whiten" the same. It depends on the number of teeth involved and the severity of discoloration. Over-the-counter, at-home whiteners are not recommended because they may cause problems associated with over exposing gum tissues to the active whitening agent. Any bleaching treatment should be done under your dentist's supervision.

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10) Veneers

BEFORE                                        AFTER 

Can I Improve My Smile?

Are you too self conscious to smile because your teeth are chipped, discolored, or poorly spaced? Cheer up, your dentist may be able to apply a porcelain laminate veneer to your teeth and give them a whole new appearance. Veneers are strong, thin pieces of porcelain that are bonded to the teeth. They are used to repair chipped, decayed or stained teeth and for closing gaps between teeth. With a bit of contouring, veneers can also rectify crowded or overlapping teeth. If your teeth have discolored with age, a veneer may improve their appearance. Veneers can also be used for cosmetic reasons instead of crowns, which are more often used for badly damaged or decayed teeth.

HERE'S HOW IT'S DONE: The tooth needs to be ground down and the veneer replaces the ground off surface. Veneer preparations frequently require the use of local anaesthetic and, depending on color and shade, may take two or more appointments t