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Adhesive dentistry is a branch of dentistry that is concerned with adhesion or bonding of the adhesive material to the natural substance of teeth such as the enamel and the dentin. Adhesive dentistry is a science that studies the strength and the nature of the adhesion to the hard tissues of the mouth. It also deals with the properties of adhesive materials, causes and mechanisms of failure of the bonds, clinical techniques for bonding and new applications for bonding for instance, bonding to the soft tissue.

Adhesive techniques have penetrated almost all fields of dentistry but a gap still remains between the accepted treatment modes and what is carried out in daily practice. New methods are beneficial for the dentition but dental practitioners hesitate to this change as they need more data, more information and argument.

The new applications and materials that are used in adhesion have transformed the delivery of dentistry. The techniques used in bonding have been restricted to the tooth hard tissue, the enamel and also the dentin. These have obvious applications in operative and preventive dentistry and also in esthetic and pediatric dentistry, prosthodontics and orthodontics. Recent developments of adhesive techniques for soft tissues and slow – releasing agents expand applications to periodontics as well as oral surgery. Adhesive dentistry allows dentists to treat teeth in the most conservative fashion.  Bonded restorative materials do not only replace missing tooth structures due to tooth injuries or decay but they also strengthen and support the remaining tooth structure without removing the healthy tissues.

Over the years, dental adhesives have evolved and improved their systems. The development of products has improved not only the physical properties but also the convenience. The universal adhesives bond to all dental substrates, which include the enamel, dentin, metal, porcelain, ceramic and zirconia, with a single application. Dental adhesives can be used with light cure self cure and dual- cure materials.

Most of the research conducted in adhesive dentistry is aimed at simplifying clinical protocol. Developments are still progressing to eliminate the ambiguity that is associated with the wet bonding technique. The adhesive technology provides an expanded treatment option that can create confidence in the techniques used in restorations. Refinements will still be conducted to improve techniques and materials used in adhesive dentistry.

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Dental bonding has its own limitations due to which it is considered suitable only for small cosmetic changes, for temporary correction of cosmetic problems as well as for teeth correction in low bite pressure areas.

The Good

  • Dental bonding is the most common and easy procedure in cosmetic dentistry.
  • The procedure can be performed in the dental clinic.
  • Usually anesthesia is not required unless the teeth are decayed.
  • The procedure can be completed in a single visit to the dental clinic unless several teeth are involved.
  • During the procedure, very little or no dental enamel is removed.
  • The duration of the procedure is between 30 to 40 minutes.
  • It is not an expensive procedure.

 

Some Considerations

  • The dental bonding material is not very strong as compared to other procedures.
  • As compared to crowns, veneers etc. dental bonding can easily chip off or break.
  • Dental bonding is not a long lasting procedure and may need replacement in a few years.
  • The material used in dental bonding is somewhat stain resistant but when compared with crowns, the stain resisting property is inferior.
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Dental bonding is a procedure in which a tooth-colored resin material is applied on the tooth with the help of adhesives and a high intensity curing light.  This material bonds with the tooth and gives a natural appearance. It is a painless procedure which can be done in minutes.

 The uses of dental bonding:

  • For improving the look of discolored teeth.
  • For repairing decayed or rotten teeth.
  • For repairing broken, chipped or cracked teeth.
  • For filling gaps between teeth.
  • For altering the shape or color of teeth.
  • For making the teeth last longer.
  • For replacing amalgam fillings.
  • For providing protection to the exposed dental root due to gum receding.

 

Procedure of dental bonding:

 

  • Painless procedure usually performed without anesthesia.
  • Anesthesia may be needed if used for decayed teeth.
  • The dentist selects the matching color of composite resin with the help of a shade guide.
  • Then the dentist roughens the tooth surface and applies conditioning liquid.
  • Next the tooth colored resin is pasted, molded in the desired shape, and is smoothed out.
  • Now the material is made to harden by using ultraviolet light or laser.
  • Finally the tooth is trimmed and polished to make it resemble closely with the adjoining teeth.
  • The whole procedure takes about 30 to 60 minutes for each tooth.

 

 

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Malocclusion is defined as improper positioned teeth in the upper and lower jaws with inability to bite properly. Abnormal growth and development are believed to affect the bite, health of gum tissue, growth of jaw as well as appearance. Almost every person has a little bit of malocclusion of the teeth but most of the times, no treatment is needed.

It is generally believed that the development of malocclusion is associated with hereditary along with environmental factors. A recent research paper suggested that since the humans changed their dietary habits some 10,000 years ago and started eating soft and processed foods, it resulted in a reduction in their bite force to chew foods which eventually contributed in the development of misalignment and malocclusion of teeth.

The causes of malocclusion are as follows:

 

  • Childhood habits
  • Thumb sucking.
  •  Prolonged use of pacifier.
  • Prolonged bottle feeding.
  • Cramped or extra space in the jaw for teeth.
  •  Abnormalities of the teeth
  •   Impacted teeth.
  • Extra teeth.
  • Crooked or distorted teeth.
  • Lost teeth.
  • Acquired causes like ill fitting dental fillings, crowns, braces, etc.
  •  After injury or fractures of the jaw.
  •  Tumors of the mouth or jaw.

 

 

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People’s dental health care has improved over the years but there are still cases of tooth loss among individuals. This may be as a result of a gum disease, such as gingivitis, trauma or dental decay. Though dental plates and bridges have improved, many people opt for dental implants. These are usually a successful solution and enable the person to almost forget that they have ever had a tooth loss. This is because the implants look and feel natural. However, having dental implants is a complex procedure which does have some disadvantages.

One of the main disadvantages of dental implants is the cost. As compared to other alternatives for replacing a missing tooth or teeth, cost can be quite high. Included in the price of a dental implant is the price of the surgical placement and its restoration with a crown.

Another disadvantage is the length of time required from initial dental implant placement to implant restoration. The treatment time varies from approximately three to six months. This depends on the location of placement of the implant, the necessity for adjacent procedures like bone grafting, the quality and quantity of healthy bone and overall health of the dental implant recipient.

The need for a minimally invasive surgical procedure could also fit in as a disadvantage. With apprehension to dental treatment being quite common, many potential dental implant patients choose less invasive treatment to replace their missing teeth.

The implant could also fail to integrate with the surrounding bone. This is indicated by a loose implant a few weeks after the surgery. The integration of the implant can be affected by factors, some of which include an infection in the dental implant recipient site, over heating of the surrounding bone, compromised blood supply, limited bone available to stabilize the dental implant.

Prolonged pain can be encountered. After a dental implant is surgically placed in the bone, the surrounding area can be tender for a few days. This is mainly due to post surgical inflammation of the surrounding tissue. Sometimes, the pain persists for a longer period of time or even indefinitely. The pain can be caused by chronic localized inflammation, close proximity of the dental implant to a major or even a minor nerve branch or a more severe foreign body reaction. Thus, they are not a good solution to people who do not recover quickly or are unable to deal with varying degrees of pain.

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Cosmetic dentistry refers to any dental procedure that is aimed at improving the appearance of a person’s teeth, gums and/ or bite. These procedures correct the simplest dental problems to severe ones. The procedures also improve the functions of the teeth which include chewing food properly, as well as speaking properly. Medical practitioners who perform these dental procedures are known as cosmetic dentists.

Cosmetic dentistry has been classified into two categories: orthodontics and prosthodontics. The field of orthodontics deals with studying and treating ‘bad bites’ or malocclusions. Bad bites may be due to tooth irregularity, jaw misalignment or both. Prosthetic dentistry has been popularly known as prosthodontics. This field deals with the diagnosis, treatment and rehabilitation of oral appearance and function.

Cosmetic dentistry may involve:

  1. Addition of a dental material to the teeth or gums. For example: bonding, porcelain veneers, crowns, gum grafts.
  2. The removal of tooth structure or gums- examples: enameloplasty, gingivectomy.
  3.  Neither adding nor removing dental materials, tooth structure or gums- examples: teeth whitening.
  4. Straightening of teeth accompanied by improvement in appearance of the face, orthodontics.

Common cosmetic dentistry options include:

  • Whitening- this is the most common cosmetic dental procedure. It is also known as tooth bleaching. Whitening options include over the counter products and dentist supervised treatments which remain the recommended procedures for lightening discolored teeth.
  • Tooth reshaping entails the removal of the enamel to enhance the appearance of the tooth. It may be used to correct a small chip, or to alter the length, shape or position of teeth. It can be used to correct crooked more excessively long teeth. The removed enamel is irreplaceable, and may sometimes expose the dentin.
  • Bonding is a process in which enamel like dental composite material is applied to a tooth’s surface, sculptured into shape, hardened then polished.
  • Dental bridges. These are false teeth that are fused between two porcelain crowns to fill in the area left by a missing tooth. Bridges reduce the risk of gum disease, help correct some bite issues and even improve speech. They require proper oral hygiene and they last as many as ten years or more.
  • Veneers. They are ultra thin, custom made porcelain laminates that are bonded directly to the teeth. They close gaps and disguise discolored teeth that do not respond to whitening.

Having dental structures that are natural looking is what has always been preferred by both dentists and patients of cosmetic dentistry.

 

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Gum Lifts

by on March 30, 2012 | Posted in Cosmetic Dentistry

Gum lifts involve the removal of gum to make the teeth appear longer and the gum line even. It is also known as gingivectomy. This procedure involves working with the underlying tissues and bones and aims at rendering symmetrical teeth to make the individual’s smiles look aesthetically appealing and attractive. This process, also called crown lengthening, aims at covering up the ‘gummy’ smile of an individual.

People who have excess gum covering the front teeth and the upper lip that come up high when they smile are often self conscious of their smiles. An uneven gum line can make the teeth to appear to have different lengths. People with tainted or infected teeth where the damage has gone past the gum line are the ideal candidates for a gum lift. Removal of gingival tissue/ gum lift can be undertaken when:

ü  There is abnormal wear and tear of the teeth which in turn makes the normal gum line to look abnormal.

ü  There is irritation due to the presence of braces

ü  The gums do not move back naturally when a new tooth emerges.

ü  The lip is unusually high such that the gum line becomes clearly visible.

ü  There are problems: periodontis, dryness and tooth decay beyond a certain extent can necessitate the procedure.

ü  The gums do not move back naturally when a new tooth emerges.

A gum lift procedure starts with the numbing of the gums. This is usually followed by the creation of incision on the gums. These incisions further help in relocating the gums from their natural position. Following this, the dentist reshapes the tissues surrounding the gum and the underlying bones so as to make it look aesthetically pleasing. Placement of stitches to cover up the incision follows and this is deemed to be the last step of the procedure. This procedure is not painful, but some mild discomfort can be expected a day or two after the procedure. The gum is not damaged due to the procedure as long as the dentist has experience, and removes the proper amount. It a procedure that can be completed in 30 minutes.

Healthy, well contoured gum tissues compliment and frame the teeth. A gum lift cannot only give someone a beautiful smile, but it also enhances confidence and boosts self esteem.

 

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Tooth polishing is the smoothening of all exposed tooth surfaces with a rubber cup, a brush or by an air polisher driven by a slow speed hand piece or water unit. It is frequently the final stage of dental cleaning and scaling, along with certain other processes. This method removes stains, smoothens and polishes the surface of the tooth. As a result of these procedures, the teeth are smooth clean at the end of the treatment. Dental polishing was considered important for the removal of plague and stain prior to a fluoride treatment to ensure that the fluoride is adequately taken into the enamel.

As a final touch, the dental hygienist polishes the patient’s teeth after the routine cleaning, scaling and planning procedure. Dentists may polish any additional restoration installed, such as a crown or composite. The dentist utilizes either a prophy jet polisher or a rubber cup polisher. Polishing paste is contained in this cup, which is positioned against the surface of the tooth on a rotating hand piece. The prophy jet uses baking soda and a jet of water. It acts as a power washer to smooth and polish teeth.

Although polishing is not unusual and can help some cases, it isn’t required with customary cleaning. Polishing takes out fluoride- rich outer layers of the enamel to avoid occurrence of tooth decay. Structures that do not have stains do not need polishing. The teeth’s coronal surfaces is polished using rubber cups, abrasive, brushes, dental tape, and Porte polishers. This dental prophylaxis procedure removes supragingival deposits. The polishing paste used by pro dentists has smaller particles sizes than the composite area.

Dental polishing, or commonly called coronal polishing, is performed when scaling has removed the hardened tartar buildup. The patient is assessed by the dentist and hygienist to determine where coronal polishing is necessary. If it is deemed necessary, a coronal polishing will remove any stain build up not removed by the scaling procedure. The duration of a polishing appointment can vary, depending on the amount of plaque and tartar build up. Commonly, prophylaxis is scheduled for 45 minutes of the hygienist’s time and 10 minutes of the dentist’s time.

When an unpolished surface is magnified thousands of times, it usually looks like mountains and valleys. Through the process involving repeated abrasions, those ‘mountains’ are worn down until they become flat. The process of polishing with abrasives starts with coarse ones and graduates to fine ones.

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Sedation Dentistry

by on March 29, 2012 | Posted in Cosmetic Dentistry

Sedation dentistry refers to the use of pharmacological agents to calm and relax a patient prior to a dental procedure. It can vary from drugs such as tranquillizers, depressants, and anti- anxiety medications to nitrous oxide. Sedation dentistry is a way of keeping the patient calm and relaxed through the use of sedatives. In the past, it was common to administer sedatives through the intravenous method, which is injecting it to the blood vessels of either the arm or hand.

Medical advancements in dental technology helped create alternatives for taking in sedatives without using injections which may cause anxiety to the patient. Nowadays, patients can choose oral administration or taking in anti- anxiety medication through the mouth.

The decision to use sedation is best arrived at through a conversation between the dentist and the patient. Depending on the procedure, the patient’s anxiety levels and other health factors (including age and pre- existing conditions), the dentist will decide the kind of sedation to be used and how much of it. During sedation dentistry, a patient can go through a dental procedure without being fully aware of what is happening. Through pre-treatment consultation, the dentist checks the dental history, the anxiety levels and other health factors of the patient. Taking sedatives may pose risks, thus it is very important for the dentist to know about medical conditions if there are any to take note of. Since some sedatives may react a certain way to vitamins, food supplements, smoking or taking alcohol.

Sometimes during the treatment, the patient might require assistance of a close friend or relative to stay with them for a few hours. The effect of sedation dentistry may vary from patient to patient. Some may feel sedated an hour or two after the procedure, requiring assistance at home until the effects wear off.

Sedation dentistry has become very popular because it offers several benefits for both the patient and the dentist. Lengthy procedures such as cosmetic dentistry or dental surgeries that can take more than an hour to perform may seem to last only a few minutes for the patient under sedation. It can also cut down the number of appointments in which these complex procedures can be performed.

It also allows the patient to regain confidence because anxieties are kept at bay through the painless treatment. This would encourage further visits to the dentist and eventually, promote a routine of proper oral health practices for the patient.

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