- May 16, 2013
Pedodontics or pediatric dentistry specializes in preserving the health of deciduous and permanent teeth, and treatment of dental diseases seen in children aging from 0 to 14.
All the required dental treatments are applied to children by pedodontists. Excellent dental health of children can be accomplished by regular dental follow-ups in every 6 months. Every potential dental problem can be detected during these follow-ups. Early diagnosis and treatment are of great importance since they play a positive role in both the physical and emotional development of the infant patient.
Examination begins with communicating both with the child and the parents. After introduction, medical and dental history is taken and it is followed by a clinical and radiographic examination. Once these are completed, the infant patient and the parents are informed about diagnosis and treatment planning. Pedodontists use many methods to preserve permanent and deciduous teeth from foremost dental problems such as caries and periodontal diseases.
Education of the oral hygiene concept, acquirement of tooth brushing habits and brushing techniques, systemic or topical fluoride applications and fissure sealing can be counted among these methods.
Fluoride treatment is recognized as the most efficient treatment method in preventive dentistry. Fluoride can be used for treating sensitivity, tooth erosions and it can be applied to healthy individuals, patients with high caries risk, and also to patients with systemic diseases who need special care. Regularity and the amount of fluoride applications are determined depending on the patient age and dental caries risk.
Anatomical fissures and bulges existing on occlusal surfaces of molar teeth create areas in which food can accumulate easily.
Dental caries initiate from these areas that are difficult to clean. With fissure sealants, these deep fissures are changed into shallow areas where food accumulation is less, thus these surfaces can be easily brushed. Subsequent to clinical applications of fissure sealing, it is known that caries formation is reduced by 70 to 80%.
Nutrition is our life long basic necessity and we fulfill this need through a proper diet and mastication. Our teeth are essential for the mastication process. Aging affects our teeth and gums just like any part of our body and eventually tooth loss can occur. Tooth loss can be treated with various types of prosthetics, depending on the severity.
1. Fixed Prosthetics
2. Removable Prosthetics
3. Implant supported prosthetics
1. Fixed Prosthetics
The existent loss of tooth tissue is restored by fixing a prosthetic on the remaining tooth structure. Patients perceive their fixed prosthesis as their own natural teeth. Crowns that restore a single damaged tooth or the bridges that restore several missing teeth are called fixed prosthetics.
Damage resulting from caries or trauma, causes considerable amount of loss in tooth tissues and evidently weakens its structure. In such cases, fillings are not adequate and the tooth needs to be capped with a metal-ceramic or an all-ceramic restoration to reinforce its strength. This restoration which gives color, shape and function to the damaged tooth is called a crown.
Bridge prosthetics is another way of restoring missing teeth. Missing tooth/teeth are restored by fabricating a bridge using the support of the adjacent teeth. For this reason, the abutment teeth are reduced in size. Bridges are usually composed of an esthetic porcelain material that is supported with a metal substructure to resist mastication forces. However, with today’s technology, it is also possible to make all ceramic dental bridges on some conditions.
2. Removable prosthetics
Removable prosthetics are frequently used to restore teeth loss. In situations which fixed prosthetics are not adequate, a removable prosthetic can replace the missing teeth. When the prosthetic replaces one or more teeth in an arch, it is called a removable partial denture; when it replaces all the teeth in an arch, it is called a removable full denture. Some patients worry that their dentures are apparent and noticed easily. However with today’s technology, it is possible to provide a natural look with dentures and satisfy patients’ expectations and concerns about aesthetics.
If you lost several or all of your teeth, dentures improve your appearance, mastication, biting and phonation. If the missing teeth are not replaced, the remaining teeth are prone to incline towards the edentulous area which at the end results in the failure to masticate or bite properly. Prosthetics can be applied right after tooth extraction; such prosthetics are called immediate dental prosthetics. Dentures are never the same as the patient’s own teeth and it takes time to get used to them. If you are going to use a denture for the first time, your doctor will explain the difficulties of using a denture as well as the advantages and your new appearance due to your denture. Motivation of the patient is crucial for the ability to use a denture.
Removable full dentures are successfully fabricated from acrylic. Removable partial dentures can also be fabricated from acrylic but using an alloy for a part of a removable partial denture reduces its mass. Therefore, a smaller denture is used and a more resistant structure is obtained. This denture is a little bit more expensive.
If you have a removable denture, it is important to keep it clean. Cleaning dentures is easier than cleaning natural teeth since they are removable. Some suggestions:
Clean your denture in a pot filled with water so that if it drops, it doesn’t fracture.
Use a brush with bristles of medium hardness to brush the denture everyday. You can use toothpaste or soap but wash it sufficiently before placing in mouth.
3. Implant supported prosthetics
Implants are used to replace missing teeth. A component of an implant is placed into the bone with a surgery; therefore the patient perceives and uses the implant as his own tooth.
Although implants have lots of advantages, they are not suitable for every patient. Patient should have healthy gums and no severe systemic diseases. Also, adequate volume of bone is needed to place the implant. Some chronic diseases such as diabetes, osteoporosis, and chronic sinusitis affect healing, and cause the failure of the implant.
If you plan on getting implants, you are going to have a surgical operation and the treatment is going to take a few months. Also it should be noted that implant therapy is expensive compared to other alternatives.
Your doctor will inform you about treatment process and in certain conditions, he might direct you to a specialist.
During the operation, doctor exposes the bone in the edentulous area and drills a hole in which the implant is going to be placed. This procedure is usually performed under local anesthesia but sedation or general anesthesia can be used if the patient can be hospitalized. Then the tissue is sutured and a few months of healing period is required for the bone to form over the implant to obtain stabilization.
Cosmetic dentistry aims to design natural looking and aesthetically pleasing teeth that are consistent with an individual’s face and restore the health and vitality of their smile.
Artificial teeth with exaggerated form and color can be recognized easily even by an amateur eye. Therefore, a comprehensive preparation and planning phase is necessary in cosmetic dentistry.
Clinic and radiographic examination:
Before moving to cosmetic solutions, a general examination of mouth and dental health is performed. A complete radiographic examination of the patient’s mouth is performed to decide on the following procedures.
Impressions of lower and upper jaws are taken to produce casts of the teeth and surrounding tissues.
By taking photographs of the patient’s face, smile, profile and intraoral tissues, every feature is recorded for a better evaluation.
With the aid of casts and photographs of the patient, problematic areas of teeth and gums in are evaluated in cosmetic aspects considering the whole facial appearance. During these evaluations, problematic areas are shown to the patient on casts and photographs; solutions on how to fix these problems are explained and the cosmetic treatment of the patient is planned.
When an extensive treatment is necessary to overcome aesthetic problems, specialists on orthodontics and periodontics are consulted. Considering the patient’s expectations, a new smile that is consistent with the lips and facial features of the patient is designed. The smile makeover can be shown to the patient before the beginning of the treatment through impressions and casts that are prepared at the laboratory. Photographs of previous smile makeovers can be shared so that the patient can see clearly the difference between the previous appearance and the achieved results.
Gingivectomy (Reshaping of gum lines)
It is common that when a person smiles, the gums can be extremely apparent due to insufficient height of teeth or the gums can look asymmetrical. A specialist in periodontics can solve this problem with a minor procedure called gingivectomy, in which the gums can be reshaped symmetrically and the height of teeth can be increased. After achieving harmonious gums, with the contributions of prosthodontists in necessary conditions, various aesthetic designs can be accomplished.
Natural dark teeth or discolored teeth due to various reasons can be improved by bleaching. Two main methods at present are:
An impression is taken from the patient and a mouth tray is prepared. Then the patient applies tooth whitening gel provided by the dentist via the mouth tray on a periodic basis.
In office bleaching
The gums are isolated and the bleaching agent is applied to teeth. A special curing light is used to activate the agent.
Porcelain Dental Veneers
Unlike a conventional dental prosthetics, preparation of only the front surface of a tooth is sufficient for a porcelain dental veneer. 0.3 to 0.7 mm of tooth tissue is removed and the impression is taken. A thin porcelain layer is fabricated and then cemented on the tooth. Dental veneers are the most conservative prosthetic procedures due to minimum tissue removal during preparation.
All Ceramic Crowns and Bridges
Although fabricated as esthetically as they can be, metal supported ceramic crowns and bridges reflect natural light at the surface of the restoration and therefore prevent the transmission of light from the teeth to gums. This can cause an unnatural look compared to natural teeth. All-ceramic restorations with a ceramic substructure can be used in patients allergic to metals or in restoring anterior teeth that are essential for an aesthetic look.
Porcelain is the most compatible material with gums and teeth. As porcelain inlays do not discolor in time like composite fillings and they maintain an aesthetic look along with protective features for many years.