Sealants are thin plastic coatings applied in the dental office on the chewing surfaces of back teeth, which are prime spots for cavities. Sealants act as a barrier to prevent bacteria and food from collecting and sitting on the grooves and pits of teeth. Sealants are best suited for permanent first molars which erupt around the age of 6 and second molars that erupt around the age of 12. It is important to have the sealant applied as soon as the tooth has fully come in. They are also indicated on the pre-molars if there are deep pits and fissures present. Sealants are nearly 100% effective in preventing decay in the chewing surfaces of the back teeth. Fluoride helps fight decay on the smooth surfaces of the teeth.
Fillings and Restorations
After diagnosing the problem and devising a treatment plan, the next step to restore a tooth to health is to make you comfortable. We will give you a local anaesthetic so that you do not feel any discomfort. After the decay is removed, the tooth is ready to receive either a direct restoration or an indirect restoration.
A direct restoration means that the tooth can likely be restored in one visit and that there is sufficient tooth structure for the filling to go inside of the tooth. Examples of direct restorations are amalgam, which is silver-colored; and composite, which is tooth-colored. There have been more amalgam fillings placed worldwide than any other kind of filling, but tooth-colored fillings are being placed more frequently in recent years because they match the remaining teeth and look like the natural tooth.
An indirect filling means that the restoration is made outside of your mouth, either by a lab or by a milling machine. An indirect filling also needs to be cemented into place. Examples of indirect restorations are crowns, inlays, and onlays. A crown covers the entire tooth, an inlay fits inside the tooth and can replace a wall of the tooth, and an onlay replaces at least one cusp of the tooth.
Wisdom teeth get their name because they usually appear around age 18. They can erupt straight, crooked or not at all. Even if they come in straight, wisdom teeth might need to be extracted due to a lack of space and the ability to be cleaned and maintained.
Pericoronitis is a common problem that occurs around an erupting wisdom tooth that typically does not have enough room and it most commonly occurs on lower wisdom teeth. It literally means inflammation around the crown. A piece of gum tissue appears over the biting surface of the tooth, which is very difficult to clean. Debris collects under the flap and, when the debris is not removed, the gum becomes inflamed. The gum can also become inflamed if the top tooth catches the flap of tissue during chewing. In most cases Pericoronitis is treated with an antibiotic for a few days and when the infection has decreased, the wisdom tooth is removed.
Gum Disease/Bone Disease
Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless “plaque” on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring “tartar” that brushing doesn’t clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.
The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called “gingivitis.” In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.
When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth.”) In periodontitis, gums pull away from the teeth and form “pockets” that are infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. Additionally, modifying certain behaviours, such as quitting tobacco use, might also be suggested as a way to improve treatment outcome.
Extraction is the painless removal of complete tooth or the tooth root with minimum damage to the adjoining structures. This is done by injecting a local anaesthetic solution around the tooth being extracted. This leads to numbness over the injected region leading to any absence of pain sensation. The numbness may stay for an hour to 2 hours after which it gradually recedes. During this time the extraction is carried out.
Teeth need to be extracted for the following reasons:
- When the tooth becomes too loose (in case of severe gum / bone disease ).
- Tooth with large cavity which cannot be filled.
- Broken teeth.
- Tooth with large periapical infection.
- Over retained deciduous / milk teeth.
- Prophylactic extraction in case of Orthodontic / Pedodontic treatment.
- Impacted teeth.
- Teeth involved in pathologies like cysts / tumors.