Tooth Sensitivity And Tooth Decay

Sensitivity is usually an early symptom of decay, gum recession, over-zealous brushing or hard clenching or grinding habit. Before blindly following what in the television advertisers say, it is mandatory to check the underlying cause and take treatment .

Signs And Symptoms

Sensitivity to hot or cold food and beverages, acidic food like sport drinks, orange juice, tomatoes, fruit and yogurt can cause painful sensitivity in your teeth.
Contact with cold air is another of cause sensitivity.

Desensitizer Per Tooth

Procedure to reduce sensitivity and discomfort to help manage your tooth sensitivity

Dental decay

Tooth colored fillings can be used to treat the decay. This will prevent further damage of teeth and free you from sensitivity with esthetic results.

Dental Filling

DENTAL FILLING : GIC TYPE II
Fillings done with tooth coloured filling material which releases fluoride to prevent secondary decay

DENTAL FILLING : GIC TYPE IX
Fillings done with tooth coloured high strength filling material which releases fluoride. Indicated for posterior teeth.

DENTAL FILLING : LC GIC
Designed primarily as a restorative material for use in Class III, V and deciduous teeth, GC Fuji II LC Improved is a multipurpose material, with secondary indications such as liner, base and core build-up. It has excellent aesthetics as particle size is small.

 

COMPOSITE RESTORATION

COMPOSITE ANTERIOR
Filling done with most aesthetic and natural colour looking material for anterior teeth

COMPOSITE POSTERIOR
Filling done with most aesthetic and natural colour looking material for posterior (back) teeth.

GIC + COMPOSITE
Sandwich technique that used 2 layers of filling material (used for deep caries management)

COMPOSITE + GIC + BASE

Filling technique that has 3 layers of filling material (used for deep caries management)

AMALGAM FILLING

High strength mercury containing filling material with metallic colour
Amalgam fillings are very rarely used nowadays because of mercury toxicity and low esthetic looks.

DENTAL FILLING : IRM / TEMPORARY
Intermediate restorations intended to remain in place for up to one year as well as during multiple sitting RCT. The material has sedative like qualities on hypersensitive tooth pulp and is a good thermal insulator as well.

 

 

INCISION AND DRAINAGE

Unattended dental decay can progress to infection of pulp, root apex and can even spread to the adjacent bone and soft tissue leading to swelling. This can be treated by placing an incision on the soft tissue swelling and draining pus which is done by Specialists once infection subsides further treatment is advocated.

GUM RECESSION

Symptoms:
Bad breath, swollen and bleeding gums, bad taste in your mouth,
loose teeth and sensitivity.
Causes:
Old age, poor oral hygiene, medical conditions such as diabetes, injury’s , smoking , poor-fitting partial dentures, teeth not in right alignment, teeth grinding while sleeping.

Treatment

Technological advancement like LASER Desensitization, Dental Microscope assisted root coverage procedures can cure sensitivity can save the teeth.
Mild cases can be treated using scaling and root planning ,dental varnishes can be used to seal the exposed dentine, serious cases will require gum grafting.

Grinding Habits

Symptoms
Headache, earache and even jaw pain.
Causes
Anxiety, sleep disorders, missing or abnormally positioned teeth.

Mouth guards and splints
They can be constructed of hard acrylic or soft materials and fit over your upper or lower teeth.

Dental correction
Reshaping dental surfaces or by using crowns.
Stress or anxiety management
Behavior change
Biofeedback
Muscle relaxants
Medication for anxiety or stress

Bad breath and bleeding gums

This indicate gum disease, which will soon lead to tooth loss. It may be due to poor oral hygiene, ageing, diabetes, pregnancy or genetics.

Causes

Gum disease is usually due to plaque and calculus accumulation around the teeth. If addressed early, your tooth can be saved. Delay in treatment will result in loss of teeth.

Scaling

Even when we brush/ floss regularly, plaque build up occurs in a few nooks and corners that are not reachable to the cleaning aids. This plaque collection hoards bacteria that is the very cause of decay and gum disease. Studies show that this bacteria also spreads to the heart, reproductive organs etc. In diabetics, it may even cause tooth loss. It is advisable to go for an ultrasonic tooth cleaning once in six months.

Scaling
Even when we brush/ floss regularly, plaque build up occurs in a few nooks and corners that are not reachable to the cleaning aids. This plaque collection hoards bacteria that is the very cause of decay and gum disease. Studies show that this bacteria also spreads to the heart, reproductive organs etc. In diabetics, it may even cause tooth loss. It is advisable to go for an ultrasonic tooth cleaning once in six months

Deep scaling
When plaque build up has affected the gum health, causing pockets, then the cleaning has to be deep, often done in multiple sittings

Root planning
Cleaning and smoothening the root surface of the tooth to prevent further accumulation of plaque on the root surface – that can cause more bone support loss for the tooth

Curettage
Cleaning and sterilizing the infected gums that may be bleeding or causing bad breath using special instruments

Laser Curettage
Using LASERS to sterilize the pockets to rid them of the recalcitrant infections that repeatedly infect the gums

Flap Surgery
Reaching within the gums to remove the disease causing germs and infection. This can be performed with and without lasers

Flap surgery with Bone Grafting
Gum infection almost always progresses to the bones, which being delicate, almost always dissolves resulting in a loss of tooth support – this is the reason for shaky tooth and migration of the teeth causing spaces in between the teeth. When the gum disease has progressed to this level, it may also have puss build up in the gums and pockets causing bad breath. In such a situation, it may be necessary to augment the bone support that is lost by adding calcium particles to the tooth surroundings. This will strengthen the tooth further and prolong the life of the natural tooth.

Flap surgery with Biogenic Material (PRF)
When bone loss cannot be just compensated with calcium particles, we use special bone growth inducing growth factors to enhance and ensure healing. These special proteins are sometimes derived from the individuals own body (platelets) .

 

 

Depigmentation
Removal of the black pigmentation of the gums to make the gums pink is called gingival depigmentation.

Root coverage / Recession Coverage
When the bone around the tooth is lost, the gum sags and gradually recedes exposing the roots of the teeth. This causes sensitivity . This cannot be cured by desensitizing tooth pastes, it has to be “covered” by stretching the gums and placing them back in their original position.

Splinting
This is a procedure to stabilize shaky teeth till the bone healing occurs.

PERIODONTAL FLAP SURGERY

Gum Diseases Management
Periodontal plastic surgery is designed to restore form and function to the gum tissue, periodontal ligament, and the bone that supports your teeth or an individual tooth. The real long-term goal of any periodontal surgery is to increase the life expectancy of the teeth and their usefulness. Basically, periodontal surgery removes UNHEALTHY tissue that has been transformed by the disease and then reconstructs the gums and surrounding tissues to better support the teeth and to recreate a normal appearance.

Periodontal Disease
Periodontal disease is diagnosed when gingival or gum tissue attachment to the teeth is abnormal and bone changes may be evident through x-rays. A PERIODONTIST will determine the degree of periodontal disease by examining “pockets” between the gum and tooth to see how much ATTACHMENT LOSS exists and then will thoroughly examine the x-rays.

When periodontal disease is detected, first recommendation are a few behavioral changes including an enhanced oral hygiene program, quitting smoking, and possibly some additional lifestyle changes.
A regular and thorough professional tartar or calcified plaque removal program will become an essential part of your oral hygiene routine. Typically this is a painless procedure but, in some extreme cases, pain medication may be required for a few days.

LASER- Crown Lengthening /Frenectomy/Frenotomy/Operculetomy/ polyp excision

All the above mentioned procedures can be performed using LASERS. The advantages being, less bleeding, faster healing, pain free.

Gingivectomy/Gingivoplasty/Depigmentation per arch per sitting

GINGIVECTOMY is the surgical removal of gingiva (i.e., gum tissue). A gingivectomy is necessary when the gums have pulled away from the teeth creating deep pockets. The pockets make it hard to clean away plaque and calculus. Gingivectomy is usually done before gum disease has damaged the bone supporting the teeth. Removal of the black pigmentation of the gums to make the gums pink is called gingival depigmentation

Root Planning and LBR (per quad)

The procedure includes cleaning and smoothening the root surface of the tooth to prevent further accumulation of plaque on the root surface – that can cause more bone support loss for the tooth.

Root Coverage – per Quadrant

When the bone around the tooth is lost, the gum sags and gradually recedes exposing the roots of the teeth. This causes sensitivity . This cannot be cured by desensitising tooth pastes, it has to be “covered” by stretching the gums and placing them back in their original position.

 

Splinting

A procedure to stabilise shaky teeth till the bone healing occurs

Bone graft -Autograft

Gum infection almost always progresses to the bones, which being delicate, almost always dissolves resulting in a loss of tooth support – this is the reason for shaky tooth and migration of the teeth causing spaces in between the teeth. When the gum disease has progressed to this level, it may also have pus build up in the gums and pockets causing bad breath. In such a situation, it may be necessary to augment the bone support that is lost by using graft from patient’s own body.

 

 

 

Local drug delivery

Injection of medications into the infected gum pockets

Periodontal Pack/ Antibiotic Fibers

Medications that are applied over the gums following gum surgery to promote healing and prevent infection.

Surgical Therapy /Regenerative Procedures
In cases of severe periodontal disease, surgery will be necessary to repair and regenerate the soft and hard tissues and replace any missing teeth. The goal of surgery is to eliminate pockets between the gum and tooth and attempt to encourage reattachment and normal function and esthetics to the patient.
Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease

Preventing Periodontal Disease
While steps can be taken to alleviate the ravages of periodontal disease, the best step is prevention. Remove plaque and bacteria through daily brushing, flossing, and regular oral hygiene. Routine visits to a dental professional for cleanings are also essential. Quitting smoking has proven to be very helpful in preventing the onset of periodontal disease.

Periodontal Plastic Surgery Procedures
Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.

Gummy Smile or Uneven Gum Line
Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gum line is sculpted to give your new smile just the right look.

Exposed Roots
Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.

Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.
Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.