Dentists will usually indicate periodic (i.e. 6 monthly) dental examination to prevent dental problems. Most complex dental problems can be prevented where minor problems are detected and treated during the examination.
Scaling & Polishing
Scaling and Polishing is the most common dental treatment which should be done at least twice a year, 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 or manual scaler. The removal of plaque and calculus allows your dentist to check through your teeth thoroughly for any signs of dental disease. Polishing is a process that removes stains and smooths 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 calcify to form calculus around these areas, and this can only be removed by scaling. If dental calculus is allowed to build up over a period of time, gingivitis and more severe forms 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 scale and polish. This varies according to the patient’s oral health.
After scaling and polishing, professionally applied topical fluoride is normally indicated to provide additional protection to tooth surfaces. Topical Fluoride can prevent tooth decay, acid erosion and reduce tooth sensitivity as the fluoride is incorporated into the outer layer of the teeth to make it stronger and more resistant to caries, acid erosion and sensitivity.
Dental X-ray such as periapical or panoramic radiographs may be indicated during your dental visit as they are useful in diagnosing underlying dental problems such as dental caries or infection. The radiation levels with the use of digital X-rays are very low and pose minimal harm to patients of all ages. Cone-Beam CT (CBCT) Scan is a 3D Scan that is very useful for identifying the distance between teeth and underlying anatomical structures such as the inferior dental nerve or maxillary sinus.
Dental fillings are indicated if the tooth structure is damaged either by tooth decay or tooth wear, in order to restore function and aesthetic of tooth.
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. In today’s dentistry, tooth coloured fillings are preferred as they look more pleasant and do not contain mercury.
Gum Treatment (Periodontal Root Planning):
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 include tender and bleeding gums during tooth brushing.
If gingivitis is left untreated, it will then progress to periodontitis. Symptoms of periodontitis include bleeding, swelling and receding gums and bad breath. Periodontitis can eventually cause deep periodontal pockets and bone loss around the roots of teeth. Small spaces can open up between the gum and teeth, which can then become loose and fall out eventually due to loss of support.
Deep periodontal pockets form due to bacterial invasion into the gum and towards root of the tooth. For patients who have gum disease, scaling alone is not sufficient. Thus, gum treatment (root planing) will be necessary to control the gum disease.
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, Diabetes, and Pregnancy Diabetes Mellitus.
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.
Root Canal Treatment
Root canal is the space at the centre of the dental root, which connects the dental pulp (at the center of a tooth containing nerve tissues and blood vessels) to the underlying dental nerve. Root canal treatment involves disinfection and removal of the pulp tissues to save the tooth if the pulp gets infected or inflamed due to deep decay or fractured tooth.
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.
Once the root canal treatment is completed, the tooth should be restored to its full shape and function with either a permanent filling or a crown, depending on the amount of tooth structure left. This should be done as soon as possible to prevent the risk of tooth fracture, as a non-vital tooth tends to be more brittle and discoloured over time.
Dentures are plastic teeth and gums moulded to replace missing teeth and gums. Dentures are used to restore function and aesthetic, allowing patients to eat and speak better. There are two kinds of dentures, partial denture and complete denture. Partial dentures are used to replace one or more tooth/teeth. Complete dentures are used to replace a whole arch of missing teeth. Flexible dentures can be in the form of partial or complete denture; however, the difference between them is that the base of a flexible denture is made using a softer material to ease the insertion and removal of the denture. Chrome base dentures have a hard and stiff frame to give a stronger support for the acrylic resin denture. Dentures require proper home care maintenance in order to last.
Dental Implants are used to replace missing teeth, restoring function and aesthetic, especially during eating and talking. It can also prevent movement of the remaining teeth. Dental implants replace the root of the missing tooth with a small titanium screw, also known as an implant fixture, in the bone of the jaw. After the surgical insertion of the implant fixture, replacement tooth or teeth in the form of a crown, bridge or denture, is placed over the implant. This completes the whole dental implant process. Dental Implants eliminate the inconvenience and hassle of using a removable denture. Dental implants can be permanent if it is well-maintained.
Tooth that is damaged either by tooth decay, tooth wear or dental trauma can normally be treated with a filling, crown, root canal treatment or other dental treatments. However, sometimes, extractions will be necessary as the damage to the tooth is too severe to repair. In order to ease the extraction procedure, local anaesthesia is normally administered to numb the compromised tooth region before extraction.
Crowns & Bridges
A dental crown is a tooth-shaped cap that is placed over a tooth. It is used to strengthen and protect the inner tooth structure. It is necessary for protection of root canal treated teeth or for teeth that cannot retain filling materials due to the size/position of the cavity. 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.
Wisdom Tooth Removal
A wisdom tooth is the third molar that grows at the back of the jaw. Impacted wisdom teeth arises when a small jaw cannot accommodate the full set of teeth or when the tooth erupts into the wrong position, causing pain due to decay or gum inflammation. Wisdom tooth usually traps food and allows bacteria to accumulate as it is difficult to brush and floss, thus wisdom tooth extraction or surgery will be indicated.
X-rays will usually be taken to locate the position of your wisdom tooth inside the jaw, check for diseases (I.e Dental Decay, Formation of Dental Cyst), and identify potential risks (I.e Maxillary Sinus Perforation, Inferior Dental Nerve Damage). By removing the impacted or buried wisdom tooth, we can prevent and treat the followings — Tooth Decay on Wisdom Tooth or Adjacent Tooth, Crowding and Unwanted Teeth Movement, Gum Pain & Swelling. Inferior Dental Nerve (IDN) Damage and Formation of Dental Cysts.