Anti-Microbial Periodontal Therapy

Periodontal disease, also known as gum disease, is the infection of the soft and hard tissue around one or more tooth, caused by specific bacteria, resulting in the breakdown and disappearance of gum and underlying alveolar bone, which is responsible for holding and supporting the teeth.

The most common bacteria associated with periodontal disease are Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P. G), Tannerella forsythia (T.F) and Treponema denticola (T.D). A high level of these bacteria infiltrates the periodontal tissue and cause a localized infection. If left untreated and uncontrolled, they can spread to distant organ and tissue made possible via the blood stream and lymphatic system or nerve

Recent studies have supported the association of periodontal disease with a number of systemic and degenerative disease like, Alzheimer’s Disease, Inflammatory Arthritis, Stroke, Heart Attack, Pneumonia, Osteoporosis, Pregnancy Diabetes Melitus, and Diabetes.

The conventional gum treatment is now inadequate to diagnose and treat rapidly developing severe periodontal disease effectively. The periodontal therapy provided has to be customized to target specific bacterial infection to treat the periodontal infections, and to prevent the development of systemic and degenerative diseases as a result of untreated periodontal disease

The use of oral bacteria DNA and gene testing will allow accurate diagnosis and then appropriate anti-microbial periodontal treatment can be rendered. This treatment will only be successful with the co-operation of the patient in order to treat and prevent the progression of periodontal disease. Home care is essential to the complete the anti-microbial periodontal therapy.

Gum Treatment (Root Planing)

Gum disease is a very common disease where the gums become infected and red with occasional swelling. There are 2 stages of gum disease. The earlier stage of gum disease is gingivitis. Symptoms of gingivitis is tender gums and bleeding gums during toothbrushing.

If gingivitis is left untreated, it will then progress to periodontitis. The gum infection and damage become permanent. Symptoms of periodontitis is bleeding gums, swelling gums, receding gum and bad breath. Periodontitis can eventually cause deep periodontal pockets and bone loss around roots of teeth. Small spaces can open up between the gum and teeth. Teeth can become loose and fall out eventually due to loss of support.

Deep periodontal pockets happen due to bacteria invasion into the gum and towards root of the tooth. For patients who has gum disease, scaling itself is not sufficient. Thus, gum treatment (root planing) will be necessary to control general gum disease.

Fillings

Dental filling is indicated if the tooth structure is damaged either by tooth decay or tooth wear so as to restore aesthetic and function of teeth.

The affected tooth is prepared by removing decayed and damaged tooth structure. Then, the prepared cavity is cleaned in order to remove bacteria and debris. Lastly, the clean cavity is filled with a dental filling material.

Choice of filling material will be decided by the dentist based on the extension and location of the cavity.

Topical Fluoride

After scaling and polishing, professionally applied topical fluoride is normally indicated to provide additional protection to teeth surfaces. Topical Fluoride can prevent tooth decay as the fluoride is incorporated into the enamel matrix of teeth and make the structure harder and more resistant to caries and acid erosion.

Scaling and Polishing

Scaling and Polishing is the most common dental treatment which should be done periodically along with a dental examination in order to prevent dental disease.

Scaling is a process that removes deposits of plaque, calculus and stains on the teeth by using an ultrasonic scaler or manually. Polishing is a process that remove stains and smooth down rough patches on the teeth to protect against further build up of plaque.

Everyone is advised to brush their teeth at least twice a day with fluoride toothpaste to prevent decay and gum disease. However, there will always be some areas that are difficult to clean. Plaque will build up and eventually calcified to form tartar around these areas, which can only be removed by scaling. If dental tartar is allowed to build up over a period of time, gingivitis and more severe form of gum disease develops.

Therefore, it is important that regular twice daily brushing should be complemented by professional dental cleaning. Dentist will usually advise patients on how often they should have a scale and polish. This varies according to patient’s oral health.

Dental Implants

Dental Implants are used to replace missing teeth, preventing movement of the remaining teeth and restoring function and aesthetic. This is made possible by replacing the root of a missing tooth/teeth with a small Titanium screw in the jaw bone. After the surgical insertion of the dental implant, a replacement tooth/teeth in the form of a crown, bridge or denture, is placed over the implant. This completes the whole dental implant process. Visiting a dental clinic in Singapore for Dental Implants, these eliminate inconveniences and hassles of using a removable denture. Missing teeth replaced by the implants will work together with the remaining teeth to maintain facial appearance, better smile and improve functional when eating and talking.

Wisdom Teeth Removal

Impacted tooth/teeth arise when a small jaw cannot accommodate the full set of teeth, especially common to wisdom tooth, or when the tooth erupts into the wrong position. The wisdom tooth may not have enough space in the jaw to fully erupt. This can cause tooth decay or gum disease to the adjacent teeth as well, damage to the adjacent nerves; and causes unwanted shifting of teeth.

X-ray is used to check and locate the position of your wisdom tooth inside the jaw for diseases and identify potential risk if surgical removal is required. Some wisdom teeth are completely buried but sometimes, they can cause formation of dental cyst. By removing the impacted or buried wisdom tooth, we can prevent the followings —- Tooth Decay, Crowding and unwanted movement of Teeth, Gum Pain & Swelling and formation of dental cysts. Routine regular dental checkup is advised.

Root Canal Treatment

A root canal is the space at the centre of the tooth, where the pulp (containing nerve tissues and blood vessels) is found. Root canal treatment involves the removal of the pulp tissues to save the tooth if the pulp gets infected or inflamed due to either deep decay or fractured tooth due to fall.

Using small files, the root canals are cleaned and shaped to a form that can be sealed. The canals are then flushed with an anti-bacterial solution to disinfect and to flush out debris. Finally, the canals are sealed with an inert material called gutta-percha. The tooth should be restored to full shape and function with either a permanent filling or a crown, depending on the amount of the tooth left. This should be done as soon as possible to prevent the risk of tooth fracture due to biting forces. Often, X-rays are taken to determine the length of the roots and to monitor the various treatment stages. Root canal treatment procedures can be less uncomfortable and painless as the tooth is anaesthetized during treatment. After treatment, it is important to avoid chewing on the tooth as it may fracture and the tooth will be sensitive for a few days due to inflammation of the surrounding tissues. To relieve you from pain a general dentist in Singapore will persuade you to take painkillers. However, if the pain persists, gets worsen or swelling developed you should consult your dentist as soon as possible.

Crowns and Bridges

A crown is a tooth-shaped cap that is placed over a tooth. It is used to strengthen and protect the inner tooth structure. Most crowns are made of ceramic to help to them look natural. Sometimes, metal crowns are advised if you have teeth clenching or grinding habits. A dental bridge covers or “bridges” the gap between missing teeth, like a series of dental crowns joined together. A bridge can keep your other teeth from moving out of place. Once a bridge is placed, it works just like your natural teeth.

Removable Dentures

Dentures are plastic teeth and gums molded to replace missing teeth and gums and to restore the shape of your face and mouth. Dentures can be used to replace a single tooth, a row of teeth and even the entire mouth! While dentures do require proper home care maintenance, it will restore your natural smile, allow you to eat better and even help with speech issues.

Veneers

Veneers are usually made out of porcelain or composite resin and are used to change the length, shade and even the feel of your teeth whilst removing minimal tooth structure. This is done by bonding with the front of the tooth which results in minimal removal of the tooth structure. It can change the color of teeth, worn down, broken and uneven teeth and help restore the visual appearance of your teeth and smile. Porcelain are stronger and preferred over composite resin usually.

Teeth Whitening

Teeth can be discolored naturally or by the various food we consume. Teeth Whitening is a conservative fast and easy way to give you a natural smile with white teeth in a short period of time. Teeth Whitening is a quick procedure, it carries very little risk aside from occasional gum irritation and transient tooth sensitivity, which will disappear after treatment has ended.

Braces

Braces are used to move teeth and straighten teeth to help to improve function, oral hygiene the appearance of teeth and face. The teeth in the jaw are crowded due to the larger teeth size to jaw size and thus dental extraction is necessary before the teeth can be straightened. Usually, the premolars are the preferred choice for removal as they have the least importance for aesthetics and function.

Braces can be fixed using brackets (ceramic or metal) and wire, or removable using customized clear plastic trays. The treatment duration can vary from 1.5 to 3 years approximately, depending on individual need and requirement.