Conservative Dentistry  (root canals and fillings)

It is the branch of dentistry which is concerned with the conservation of teeth in the mouth. It embraces the practice of operative dentistry and endodontics(RCT), and includes various kinds of direct and indirect restorations of individual teeth in the mouth. It includes:

  • Inlays, Onlays & Veneers
  • Porcelain Crowns & Fixed Bridges
  • Root Canal Therapy
  • Tooth-Colored Dental Fillings

Composite filling is a tooth-colored  mixture used to restore decayed teeth. Composites are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

Composite resins, or tooth-colored fillings, provide good durability and resistance to fracture in small- to mid-size fillings that need to withstand moderate pressure from the constant stress of chewing. They can be used on either front or back teeth. They are a good choice for people who prefer that their fillings look more natural.

It generally takes longer to place a composite filling than it does for a metal filling. That’s because composite fillings require the tooth be kept clean and dry while the cavity is being filled. Tooth-colored fillings are now used more often than amalgam or gold fillings, probably due to cosmetics. In a society focused on a white, bright smile, people tend to want fillings that blend with the natural color of their teeth.

Ultimately, the best dental filling is no dental filling. Prevention is the best medicine. You can dramatically decrease your risk of cavities and other dental diseases simply by:

  • brushing your teeth twice a day with fluoride toothpaste
  • flossing daily
  • eating a balanced diet
  • visiting the dentist regularly

Composite white fillings have a natural colour which is similar to the colour of your natural teeth and so blends it well with them. Plus there have been issues raised about the safety of silver amalgam fillings due to their mercury content which has prompted some people to switch to composite fillings instead.

In regard to inlays and onlays: these fillings are less extensive than a normal filling, are easy to care for and long lasting.

How is Filling performed?

For both the silver amalgam and composite white fillings the procedure involves the drilling of a small hole within the affected tooth which is then packed with the filling. The only difference is that the dentist will give the composite filling a final polish to ensure that it has that clean, white look and fits in with the rest of your teeth.

Dental Jewels

Tooth gems and jeweller  has no pain, infection, no drilling, and no damage to tooth, easily removable and at the same time add more attractiveness and sparkle to the smile, makes them more user friendly. Forget tattooing and body piercing, to be a really celebrity tantalize your teeth with tooth jewellery or tooth gems, add sparkle to your smile. Proper oral hygiene maintenance and regular checkup visit to dentist are required to avoid debonding and caries.

Inlays and Onlays

Dental inlays and onlays are restorations used to repair rear teeth with mild to moderate decay or cracked and fractured teeth that are not sufficiently damaged to need a crown. Ideal candidates for inlay or onlay work typically have too much damage or decay in the tooth structure to be successfully treated using a filling, but have sufficient healthy tooth remaining to avoid the need for a crown. This allows the dentist to conserve more of the patient’s original tooth structure.

There are other benefits to inlays and onlays in comparison to metal fillings:

  1. Inlays and onlays are durable — they’re made from tough, hard-wearing materials which last up to 30 years.
  2. They help to strengthen teeth by up to 75 percent, unlike traditional metal fillings which can actually reduce the strength of the teeth by up to 50 percent.
  3. Inlays and onlays prolong tooth life and prevent the need for more dental treatment in the future.

Dental inlays and onlays are used when old fillings need to be removed or replaced. A dental inlay is similar to a filling and fits inside the cusp tips (top edges) of the tooth. A dental onlay is more extensive and extends over the cusps of the treated tooth.

During treatment the dentist removes the old fillings under local anesthesia and takes an impression of the tooth, which is sent to the dental laboratory. The new inlay or onlay is made from this mold in porcelain, gold or composite resin material. The inlay or onlay is then cemented into place at the next appointment. The inlay or onlay blends successfully with the treated tooth and the rest of the teeth to achieve a natural, uniform appearance.

Endodontics (RCT)

Endodontics encompasses the study and practice of the basic and clinical sciences of the biology of the normal dental pulp and the etiology, diagnosis, prevention and treatment of diseases and injuries of the dental pulp along with associated periradicular conditions. Endodontics has evolved tremendously in the past decade and its applications have immensely improved the quality of dental treatment.

Endodontists perform a variety of procedures including endodontic therapy (commonly known as “root canal therapy”),endodontic retreatment, surgery, treating cracked teeth, and treating dental trauma. Root canal therapy is one of the most common procedures. If the dental pulp (containing nerves, arterioles, venules, lymphatic tissue, and fibrous tissue) becomes diseased or injured, endodontic treatment is required to save the tooth.

Root Canal

A root canal is a treatment to repair and save a badly damaged or infected tooth. The procedure involves removing the damaged area of the tooth (the pulp), cleaning and disinfecting it and then filling and sealing it. The common causes affecting the pulp are a cracked tooth, a deep cavity, repeated dental treatment to the tooth or trauma. The term “root canal” comes from cleaning of the canals inside the tooth’s root.

What to Expect during a Root Canal?

If you think you need a root canal, consult your dentist. There are a number of steps that occur over a few office visits.

  1. X-ray – if a dentist suspects you may need a root canal, he will first take X-rays or examine existing X-rays to show where the decay is located.
  2. Anesthesia – local anesthesia is administered to the affected tooth. Contrary to popular belief, a root canal is no more painful than a filling.
  3. Pulpectomy – an opening is made and the diseased tooth pulp is removed.
  4. Filling – the roots that have been opened (to get rid of the disease pulp) are filled with gutta-percha material and sealed off with cement.

Tips for Care after a Root Canal:
A treated and restored tooth can last a lifetime with proper care. Root canals have a high success rate. Here are a few ways to take care of your teeth after a root canal:

  • Practice good oral hygiene – brush teeth twice a day, and floss at least once. Taking care of your teeth can help prevent future problems.
  • Visit the dentist regularly – cleanings and examinations by dentists and hygienists.
  • Avoid chewing on hard foods – chewing on hard foods such as ice can cause teeth to break, and can harm root canals

Root Canal Retreatment
A root canal retreatment may be necessary if a previously root canal treated tooth fails to heal or if a recurrent infection is evident.

Root canal treatment has a very high rate of success, but as with other medical or dental procedures, infection or inflammation may persist or recur despite our best efforts. Your Endodontist may be able to provide insight into potential causes and how they may be corrected. A root canal retreatment procedure may be the best option to preserve your tooth.

What are the Signs/ Symptoms?
If you are having infection of the soft tissue, initially you may not experience pain. However, if it is not identified timely, infection will cause swelling and pain. In several cases, abscess may form. Your tooth may require root canal if:

  • It gets sensitive to heat/ cold for lasting moments
  • It aches whenever you bite, push or touch on it
  • Swelling around the tooth
  • Discoloured
  • Broken
  • Long term decay resulting in constant irritation of dental nerve

The root canal retreatment procedure is similar to the root canal treatment procedure described above, but has a few extra steps . The first visit consists of removal of all root canal filling materials and placement of an antibacterial paste called calcium hydroxide. The tooth is then closed with a temporary filling material. This antibiotic medicament is left in the tooth for some time to reduce the number of bacteria and give the tooth the best chances of healing.

On the second visit, the calcium hydroxide paste is removed, the canals are once again thoroughly cleaned and shaped, and a new root canal filling is placed. Finally, a temporary filling is placed to close the opening in your tooth. Your dentist will remove this temporary filling at the time the tooth is restored. Following root canal treatment your tooth is susceptible to fracturing, or to infection due to loss of the temporary filling. Therefore it is imperative that you return to your dentist in a timely manner in order to restore the tooth to its full functionality.

Single Sitting Root Canal Treatment
When there is an acute infection with no pus accumalation in & around the tooth, RCT can be completed in a single sitting. The biggest diagnostic aid in this case is an X-ray. The Xray usually indicates presence of pus accumalation in the form of a change (radiolucency) around the root tip of the involved tooth.

Apisectomy

Generally, a root canal is all that is needed to save a tooth with an injured pulp from extraction. Occasionally, this non-surgical procedure (the root canal) will not be sufficient to heal the tooth and your dentist will recommend endodontic surgery. An apicoectomy implies the surgical removal of the tip of the root of the problem tooth. A draining pimple in the gum above or below the tip of the root of a tooth reveals the infection from the dead nerve inside the tooth has spread beyond the tooth root and into the surrounding bone. This usually happens before root canal therapy is initiated and resolves by removing the dead nerve. In rare situations, it will happen after a root canal and that suggests an apicoectomy is needed. This surgical procedure can be used to locate root fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure.

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