Your teeth and gums are a lifetime gift of nature. They give you your smile, permit you to chew, and help you speak. If lost, they will not regrow. Strict oral hygiene especially brushing and flossing regularly at home will protect them against any decay. Your teeth and gums are valuable to us as they are to you. Here at our office, we will help you perfect your dental hygiene in order to ensure that you keep smiling.
The flowing types of periodontal services are offered.
- Scaling and Root planning (SRP)- Your teeth tend to accumulate plaque (soft deposit) and calculus (hard deposit) despite best personal oral hygiene. If left unattended they can result in tooth decay, gum disease, bone loss, and even loss of tooth. We provide professional scaling and root planning to protect you against such possibilities. Scaling is the professional cleaning of your teeth above the gum line, and the in between spaces to rid them of plaque and calculus. Scaling may be followed by polishing which gives your teeth extra shine, and makes them less likely to accumulate plaque and calculus. Root planning is scaling under the gum line. The gum flesh is carefully lifted and calculus in the sulcus is removed. This is followed by planning of the tooth surface so bared. The flesh is then repositioned after applying antibiotics.
- Arestin- Arestine is an antibiotic (minocycline HCl) available in the form of 1mg micro granules used with SPR. Arestin can be placed in the sulcus at the end of SRP and also during follow up visits. Patient sensitivity to Arestin is possible in the form of skin reaction or breathing difficulty. People who are sensitive to tetracycline will also be sensitive to Arestin.
- Periodontal Splinting– It is a technique for stabilizing teeth loosened either due to gum conditions, or loss of bone due to periodontal disease (secondary occlusal trauma). Splinting is done by bonding teeth together with the help of a bonding device such as wire, fiber-reinforced tape, etc. Splinting is extra-coronal when vertical surfaces of the teeth are bonded and intra-coronal when the thin splinting wire pierces radially through holes in the teeth. The latter is less visible. Normal sized teeth will benefit from splinting when the bone loss is 40 percent or more. Before going for splinting it is better to control the periodontal disease and see if the teeth still require splinting. Splinting is likely cause difficulty in cleaning but can save them from extraction. Splinting is an in-office procedure and does not normally require any anesthesia.
- Gingivectomy– Gingivectomy is surgical removal of excessive gingival tissue. Overgrowth of the gum tissues can occur due to many reasons such as inflammation, dental infections, pregnancy or due to certain drugs. Gingivectomy can also provide visibility to subgingival calculus for effective cleaning.
- Crown Lengthening– It is a surgical procedure that is carried out when overgrowth of the gum tissue reduces the visible length of the crown portion of the tooth. Necessary amount of gum flesh has to be removed to expose more of the tooth. Exposing part of the tooth root has its demerits, and must be considered seriously before going for crown lengthening.
- Occlusal Adjustment– Occlusal adjustment is required to correct the bite which may have been disturbed due to loose, shifting, or crowded teeth; or due to habit of teeth grinding. It is done by grinding, and realigning teeth in incremental steps, and adjustment of the TMJ. In the older method impressions were taken to make stone casts which would be used to determine what corrections were necessary, and in what order. Newer techniques use a computer scan to make a model of the mouth and predict the sequence and extent of operations.
- Crowns- Crowns are placed over teeth both for restorative and decorative purposes. Teeth that need to be protected- weak, likely to crack, or recently restored- are given crowns to protect them from further damage. Crowns may be used simply for decorative reasons, but most often aesthetic materials are used to make crowns for restorations. Gold has been used for ages (the Pharaohs are said to have also used gold). Currently, zirconia, porcelain (ceramic), porcelain fused to metal (PFM), where metal could be gold or zirconium, are popular materials for applying crowns.
The latest porcelain crown technologies such as Emax are being used for fabrication of very high quality and dimensionally accurate crowns by utilizing the CAD CAM technology. Fabrication and placement of a dental crown can take up to 2 to 3 visits. In the first visit your tooth will be trimmed to make space for the crown. A mold of the trimmed tooth along with the surrounding teeth is taken and sent to the lab for crown preparation. The color shade is also specified at this stage with the consolation of the patient. You will be given a temporary crown to protect your tooth in the meantime. Conventional crown preparation takes 2 to 3 weeks, but modern methods can expedite the process. After the crown is made you will be given another appointment. Your crown will be cemented to the pre-trimmed tooth using special adhesives. If you have been dealing with a good dentist, your crowned tooth will not look different from the adjacent normal teeth. The crown can easily last 10 to 15 years if give it the normal care of brushing and flossing as you do to your natural teeth.
- Bridges- Dental bridges are called so because they bridge a gap due to one or more missing teeth. In the first visit one healthy tooth on either side of the gap is trimmed for receiving a crown. These teeth are to act as the anchors for the bridge. A mold of the trimmed teeth along with the gap area and surrounding teeth is sent to the lab for preparation of the bridge while you are given a temporary bridge. The lab prepares the bridge having the necessary number of pontics (replacement teeth) with crowns on either side to fit onto the anchor teeth. In the next visit your bridge will be placed. You may take some time to get used to having a bridge in your mouth. Avoid eating hard foods initially for a while and later you will be able to eat anything you like. Of course, the bridge will need good oral hygiene maintainance if you want them to last for a long time.
- Bondings – Bonding is used for two purposes. It can be used to repair cracked or chipped teeth. Or, more popularly it can be used to hide discolored and stained teeth. The material used is a composite resin which is available in various colors, including white. Composite can also be used for making fillings. Composite bonding is a rather simple operation. The surface to be bonded is cleaned and applied with a liquid adhesive. Composite is then applied and shaped (sculpted) to the proper dimensions and shape. The material is then hardened by ultraviolet light and again trimmed if necessary, and polished to give. Composite fillings are superior to amalgam fillings in terms of aesthetics when used on front teeth.
- White Fillings- White fillings are resin fillings. They are superior to amalgam fillings as far as aesthetics are concerned. Consequently, composites are preferred for visible fillings on front teeth. With good oral hygiene they can last for over a decade.
- Dentures- Dentures are replacements for missing teeth and surrounding tissue that can be removed from your mouth and put back again at will. The teeth are made over a gum colored acrylic base which fits over your gums. Dentures are convenient and useful, but not like real teeth. You will take time to get used to them. They may also need to be adjusted and relined after some time as the gums shrink. Some jawbone loss may be witnessed over a few years. It is possible that shape of your faces changes as a result. Like all dental appliances dentures will need care. Basic dental hygiene must continue. Dentures need to be removed and cleaned regularly. At sleep time those are removed and must be stored in a soaking solution or clean water to avoid warping. They must be handled carefully to avoid damage. Damaged dentures will not only be uncomfortable to wear but they can also severely damage your oral soft tissues. Dentures can be complete or partial:
Full dentures- are applied when all of the natural teeth are missing or have been removed. Full dentures are of two types:
- Conventional Complete Dentures – Complete dentures are provided to those patients who have lost all of their natural teeth. Your dentist will make an impression of your existing teeth, which will then be sent to the dental laboratory for the fabrication of denture. Fabrication of complete dentures requires multiple dental appointments and visits.
- Immediate Full Dentures – sometimes patients do not want to live without their teeth while their dentures are being prepared. In these cases, they are provided with immediate dentures, which are placed immediately after extraction of their remaining teeth.
Partial dentures- are used when only a few teeth need to be removed. These are like bridges but are removable at will. Partial dentures gain their support and retention from the oral soft tissues as well with the help of metallic extensions known as clasps, that engage around the adjacent natural teeth. Valplast is a recently introduced denture base material. It has the advantage of flexibility and hence, less chance of breaking. Being nylon based it is suitable for those who have sensitivity to acrylics. It is very good for partial dentures, but due to its flexibility, not used for full dentures except in cases like acrylic sensitivity, or implant supported dentures.
- Veneers- Veneers are very thin ceramic shells that cover your teeth. They can very significantly improve your smile. In the process of attaching veneers many issues with your teeth like cracks, stains, chip-offs, spaces, misalignment, and length adjustments can also be taken care off. During your first visit we will discuss and plan what is to be done in terms of aesthetic improvements of your teeth and smile. To prepare your veneers, your dentist will prepare your teeth by slightly removing a thin surface of your teeth and then take an impression of teeth. This will be sent to the laboratory for fabrications of the veneers using processes and materials of the best quality. As this process can take nearly two weeks, your dentist may give you temporary but very good looking veneers for the interim period. After your veneers have been fabricated you will be asked to pay another visit. Your dentist will bond the veneers to your teeth which have already been prepared. You are sure to acquire a smile which you will enjoy in the coming years.
- Whitening- Despite your best efforts at maintain dental hygiene it is possible for your teeth to get discolored due to various reasons. In such a situation we can perform whitening of teeth at our office to restore the white color of your beautiful teeth. We can make them even whiter than natural. That is defined as bleaching. Three possible systems are available for teeth whitening or bleaching.
- Zoom Bleaching- At the office we will first check and discuss your oral health and advise you if zoom bleaching is the best option for you. Any dental health problems will be resolved first. If you decide to go ahead with bleaching the dentist will first protect your lips and gums from effects of chemical gel to be used. The gel will be applied to your teeth and illuminated with a special light. This light accelerates the release of hydrogen peroxide which enters the enamel and dentin of your teeth to bleach them. This process is allowed to continue for about 15 minutes, and repeated normally twice. After the whitening special gel will be applied to your teeth to reduce any possible sensitivity. The overall chair time is normally of the order of one hour. The results will vary case to case but you can expect teeth whiter than normal.
- Tray system- The tray whitening system also uses chemicals releasing hydrogen peroxide. We clean your teeth and take care of any immediate dental problems. Impressions of your teeth are then taken which will be used to prepare custom trays to fit your set of teeth. You collect these trays, place the given chemical in them, and wear them on your teeth for two to four hours a day for about two weeks. These trays are made of clear plastic and hence not noticeable when worn. At the end of the procedure you may note pleasantly surprising results.
DIY trays are also available and cheaper, but may not fit your teeth well, and may leak the chemical. Custom trays are worth the extra cost.
- Opalescence- Opalescence offers a ready-to-go bleaching system only available from a licensed dental professional. There is no need to wait for tooth impressions and fabrication of custom trays. It is a patient friendly gel. The gel contains water to prevent any dehydration. Potassium nitrate and fluoride are part of the formula to reduce any consequent sensitivity. A choice of flavors is also available.
We have excellent facilities meeting any oral surgery needs. Oral surgery will be needed in many situations. The important ones are:
- Extraction– lack of proper oral hygiene can lead to tooth cavities. If not treated properly and in time these can lead to a very serious situation where the tooth may ultimately have to be removed. Most teeth can be pulled out under anesthesia. But some teeth which may be so strongly rooted in the jawbone that surgery may be needed to extract them. We have all the necessary facilities for such surgical extractions.
- Impacted Wisdom Teeth– Wisdom teeth are the last to come out. In some people they never come out but remain trapped between the jawbone and the gum flesh. This is a very painful. If not treated it can lead to an abscess and damage to neighboring teeth also. Impacted teeth are surgically removed after splitting the gum above.
- Bone Grafting– Bone grafting may be required when a person needs an implant or in a full mouth reconstruction if some jawbone has been lost. It is required in cases where there is insufficient quality or quantity of jaw bone available to support a dental prosthesis. It is a very delicate and involved procedure which takes time to succeed. Bone can be ‘harvested’ from another suitable part of your body and grafted into the location where the deficiency exists, or bone from an artificial source can also be used. We can help you in getting a high quality bone graft as we have cooperation with top experts in this area.
Implants are the latest, and currently the ultimate, in replacements of lost or extracted teeth. Implants provide tooth replacements which are just like natural and free from the inconvenience, possible embarrassment, and other problems associated with conventional dentures. A titanium dioxide post with threads on it is screwed into the jawbone to act as the root. That is the implant. An abutment is made or screwed onto the implant and is the structure over which is placed whatever restoration is needed to be placed. We have a team of implant experts working with us. When you visit us these experts will examine your oral health, after discussion with you make out detailed plan of operation. Three types of restorations are normally placed:
- Implant retained crown– A single crown (visible part of a tooth) is constructed or attached over an implant. This is like a stand-alone arrangement.
- Implant retained Bridges- If two or more adjacent teeth need replacement they will be made into a bridge structure, and supported on two implants. This structure is called a bridge because it ‘bridges’ a gap between existing teeth.
- Implant Supported Full Dentures– All teeth of a jaw can be supported on just four implants. This is usually termed as ‘All-on-four’ denture.
We take very good care of your children also. Pediatric services offered include among others:
- Sealants– Children tend to bring out their first molars (back teeth) around the ages of 5-7 years, and another set of molars between 11 to 14 years of age. Biting surfaces of molars are uneven to facilitate chewing food. However, uneven surfaces of rear teeth are difficult to clean. Remnants of food lodged in there can cause tooth decay and cavities. As it is molars are the most important for chewing process and must be especially protected. Sealants are a very good means of protecting against tooth decay of the molars. Sealants are best placed when the molars comes in. To start with the teeth are cleaned an adhesive liquid applied to them. Then the sealant is painted over it. The sealant liquid hardens and forms a solid barrier between the tooth and any, food particles, plaque, and bacteria. Sealants can last for about a decade and if necessary, can be reapplied.
- Mouth Guards– Mouth guards are an essential protective equipment to be used by sportsmen engaged in contact sports like football, hockey, wrestling, and many other sports. Their use is not limited to children. All sportsmen of contact games should use them. Mouth guards protect against physical damage to teeth and jaws, tongue, lips, and cheeks, and could decrease risk of .concussions. They are freely available at sports stores, but readymade mouth guards may not fit perfectly. Hence they may not afford as good protection. We can produce mouth guards custom made for your mouth using very thin plastic sheets which are then hardened. Thinness permits easy breathing and communication.