Asking questions and getting answers is a part of good oral health care. To help you find those answers, we have prepared responses to frequently asked questions (FAQs) posed by the public. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.


Endodontics

WHAT IS IT?
  • An Endodontist, is a dentist who specializes in endodontic (root canal) therapy. Endodontics is a highly specialized type of dental care developed to save teeth. We, at Sigal Dental Clinics, are dedicated to providing you the highest quality of endodontic care. The latest proven clinical techniques are used with skill and precision. We understand that you may be apprehensive about your endodontic treatment. We will make every effort to ensure that your visit is as comfortable as possible and becomes a good dental experience. We seek to create an atmosphere of understanding, open communications and mutual respect. Please do not hesitate to ask questions or offer suggestions.

    WHAT IS ROOT CANAL THERAPY?


    Endodontics, sometimes referred to as root canal therapy, is the removal of the soft center or nerve tissue from the inside of the tooth. This tissue, called the pulp, can become diseased, thereby causing pain and/or infection. The cure for such a pulp problem follows three basic steps.

    1. First, the pulp is entered through a small opening made in the chewing surface of the tooth.



    2. Then, the pulp is removed and the entire root canal space is cleaned, shaped and sterilized.



    3. Finally, the root canal is sealed with a rubber-like material called gutta-percha.

FAQ IN ENDODONTICS:
  • ARE ADDITIONAL X-RAYS NEEDED?

    Usually at least four or six x-rays are required during treatment to insure that every step is performed correctly. We are concerned about reducing the radiation exposure to our patients. Our office takes computer dental radiographs. This new x-ray technique reduces your radiation exposure by 90%. Since the x-ray image is viewed on a computer screen, you can more easily see and understand the problem associated with your tooth, and the steps in providing therapy. This technology also saves time because the x-ray image is seen immediately without having to wait for it to be manually or machine developed.

    HOW LONG DOES IT TAKE?

    Root canal therapy is usually done in one to two visits depending on the complexity of the case. Each visit generally lasts between 1 1/2 to 2 hours. Being prepared to begin treatment at your first scheduled appointment will help eliminate delays.

    RETURNING TO YOUR DENTIST

    When root canal therapy is complete, you must return to your dentist for the permanent restoration of your tooth. Your dentist will decide what type of restoration is required. Usually a cap or crown is required to protect the remaining tooth structure. At times, all that is needed after root canal therapy is a small filling. We can place the permanent access filling if requested by your regular dentist.

    ARE MY TEETH WORTH SAVING?

    YES! The only real alternative to having root canal therapy, is to have the tooth extracted. To have a tooth extracted without replacement can result in a loss of chewing ability, speech may be affected, and other teeth adjacent to the missing tooth might drift changing your "bite". A false tooth to replace the missing tooth is weaker than a natural tooth. Adjacent teeth may be affected if a bridge is constructed, and a bridge is more difficult to keep clean than natural teeth. In addition, a replacement bridge would probably cost more than endodontic treatment and a permanent restoration.

    ARE ROOT CANALS SUCCESSFUL?

    We will recommend treatment only when we believe it will be successful. More than 95% of routine cases respond to the treatment methods used in this office. Due to complications, some teeth pose a greater than normal chance of not responding to treatment, even though endodontic therapy is still required. These cases may require more than one procedure. In a few cases, no amount of treatment will produce satisfactory results. We can usually inform you before treatment if your tooth is of the high risk type.

    HOW ARE APPOINTMENTS SCHEDULED?

    IF YOU ARE IN ACUTE PAIN: Patients who are in acute pain will be worked into our schedule as an emergency patient and will be seen as soon as possible.

    IF YOU ARE NOT IN PAIN: All you need to do is call and arrange a convenient appointment time. For your convenience, we see patients by appointment only. Call 01-4628661. We encourage that your initial appointment be made by your referring dentist who best knows your dental needs. He can usually provide information as well as an x-ray that can benefit us in providing your treatment. Due to the unforeseen need to manage emergency situations and our commitment to quality care, we may at times fall behind schedule. Should this occur, we ask that you be patient. We assure you that complete care will be extended to you during your treatment. Please note, that should you be seen for emergency care, we may require additional visits to complete treatment.

    WHAT DOES ROOT CANAL THERAPY COST?

    Fees for root canal therapy are generally determined by the number of canals involved and the complexity of the situation. Pre-existing dental conditions which increase treatment complexity and cost can often be predicted. You will be informed of the fee range before treatment is started..

    One Appointment Root Canal Therapy

    We strive to perform root canal therapy in one appointment as often as possible. We, and our best referrers, have found that this is only possible when patients have been well informed prior to the treatment appointment. We therefore request;

    1. That the doctor's office assists the patient with the referral by calling our office and provides the pertinent information necessary for treatment.
    2. That an x-ray be provided to assist our treatment planning.
    3. If a long treatment appointment has been scheduled, the patient understands the need for the recommended RCT and is financially prepared to proceed.



Orthodontics

WHAT IS IT?
  • Orthodontic is the specialty of dentistry that involves the treatment of malocclusion (correction of dental crowding and mal-alignment). Malocclusion is when the upper and lower teeth or jay do not meet correctly. Individuals may need to be treated by an orthodontist if they have problem with their bite (such as an over or under bite), crooked teeth or overcrowding in the mouth. An orthodontist may move the teeth into position or correct the bite using braces, which are appliances bonded to the teeth and use brackets, wires, rubber bands or other ways of moving the teeth. An orthodontist may also use removable appliances of reposition the teeth. In more serious cases, a patient may need jay surgery to align the bite. Children and adults can be treated for malocclusion.

    In Sigal Dental Clinics, we understand the importance of having Consultants in Orthodontics to provide proper orthodontic care for our patients. Patients usually make an appointment with Orthodontic Consultant who usually explains the whole procedure to the patients. In addition, he will answer any question that they may have.
TREATMENT METHODS
  • When should the orthodontic treatment begin?

    Orthodontic treatment can be done at any time but the earlier the treatment starts, the better the prognosis will be. In children, interceptive orthodontic treatment can be done. The dentist and or orthodontist should evaluate children by the age of six years. Then, the problem, if present, will be analyzed to determine when the treatment should be done. Orthodontic problems are not similar, i.e. every case is different from another.

    How long will treatment take?

    It is difficult to estimate the time needed for orthodontic treatment. In most orthodontic cases, the treatment will range from 18 months (for simple problems) to 36 months (for severe problems). If a patient does not follow the orthodontist instructions, the treatment time may take longer.
PAYMENT PLANS
  • How much will the orthodontic treatment cost?

    As the orthodontic problems vary, the treatment fees also vary. Treatment fees depend on the type of appliances, existing problems, as well as those anticipated after completion. In general, the orthodontic treatment fees in Sigal range between 15,000 Saudi Riyal and 25,000 Saudi Riyals.



Pediatric Dentistry

WHAT IS IT?
  • Pediatric Dentistry:

    In 1995, the American Dental Association has defined Pediatric Dentistry as an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

    Sigal Dental Clinics have recognized the importance of providing dental care for young generation. For this purpose, all dental treatments needed fro children is provided by Pediatric Dentist Consultants.
STARTING AGE
  • When should I bring my child to the dentist?

    It is important for parents to know that prevention is better than treatment. Early dental visit for children should be done after the eruption of first tooth (at the age of six months) and should not be later than one year.


    In Sigal Dental Clinics, Pediatric Dentistry Consultants will examine the child and provides important information to the parents such as: proper feeding practice, proper method of brushing child's teeth, important signs of dental caries?etc.


PRIMARY TEETH
  • What is Primary (Baby) Teeth?

    Children have 20 primary teeth (baby or milk teeth). These bay teeth start to erupt at the age of six months. The eruption age vary from one child to another. It shouldn't be of a concern, but if the teeth do not erupt by the age of eight months, we recommend seeing a pediatric dentist for consultation.

    These baby teeth play important functions for the children. These functions are not limited only to chew the food, but these teeth help in speech development, reserving the space for permanent teeth, and improve the child's psychology by providing better smile.



Micro-Endodontics

WHAT IS IT?
  • COMING SOON...



Dental Implant

WHAT IS IT?
  • A dental implant is an artificial tooth root that a periodontist places in the jaw to hold a replacement tooth or bridge. Dental implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. Dental implants are teeth that can look and feel just like natural.

    Types of Implants in Use Today

    Endosteal (in the bone): This is the most commonly used type of implant. This type of implant is generally used as an alternative for patients with bridges or removable dentures.

    Subperiosteal (on the bone): These are placed on top of the jaw with the metal framework's posts protruding through the gum to hold the prosthesis. These types of implants are used for patients who are unable to wear conventional dentures and who have minimal bone height.
IMPLANT SYSTEM
  • Dental implant therapy is rapidly becoming the most ideal and conservative method of "permanently" replacing one or more missing teeth. This remarkable advancement in dental treatment will significantly enhance the quality of life by restoring health, function and appearance.

    WHAT IS A DENTAL IMPLANT?

    A dental implant is a biocompatible screw-like titanium "fixture" that is surgically placed into the jawbone. After healing is complete and the implant is anchored in the bone, an implant post or abutment and permanent tooth can be attached in a variety of designs.

    HISTORY

    The scientifically-based method of implant therapy was first developed over 30 years ago in Sweden. A Swedish orthopedic surgeon and researcher, Dr. Per Ingvar Branemark, observed that a titanium implant could naturally and predictably bond with bone. This phenomenon was termed "OSSEOINTEGRATION". Since the original implant was placed three decades ago, several hundred thousand patients have enjoyed the benefits of successful "permanent" tooth replacement with dental implants.

    PHILOSOPHY OF TREATMENT

    We strongly believe in the "team concept" of providing patient-centered care. As a highly trained surgeon, the periodontist is responsible for all surgical aspects of implant therapy. The surgeon works closely with the general dentist or prosthodontist and laboratory technician. The end result of this collaborative process is a beautiful and functional "permanent" tooth replacement that leads to an enhanced quality of life for our patients.

    EXAMINATION AND TREATMENT PLAN

    During the examination process, the overall condition of the mouth will be evaluated. Information is gathered regarding the health of the gums, quality and quantity of underlying bone, position of teeth, occlusion and cosmetic desires. Routine x-rays will be necessary to help visualize the teeth and jawbone. In many cases, more sophisticated imaging such as a CAT SCAN will be required to precisely determine bone contours and the position of vital anatomical structures. Impressions and study casts of the teeth and gums contribute to the careful analysis process.

    Once all of the information is recorded, the periodontist, dentist and lab technician will determine which type of dental implant restoration best suits the patients needs. Some examples of "fixed" and "removable" treatment options can be seen below:

    REPLACEMENT OF A SINGLE TOOTH

    REPLACEMENT OF A SEVERAL TEETH

    "FIXED" REPLACEMENT OF A LOWER OR UPPER ARCH

    "REMOVABLE" REPLACEMENT OF A LOWER OR UPPER ARCH

    SEQUENCE OF EVENTS DURING IMPLANT TREATMENT

    STEP 1: IMPLANT PLACEMENT

    Using regular dental anesthetic, the surgeon lifts the gum tissue away and performs a precise and gentle technique to place the dental implant fixture into the jawbone. The gum is repositioned and sutured. Most patients experience no major discomfort after the procedure.

    STEP 2: OSSEOINTEGRATION PERIOD

    The dental implant fixture will be left undisturbed in the jawbone for a period of four to six months. During this time, the bone attaches to the implant and OSSEOINTEGRATION takes place. Depending on the case type, a temporary removable denture may be worn to preserve cosmetics, as shown at right.

    STEP 3: ABUTMENT CONNECTION

    Once osseointegration of the implant is complete, the surgeon exposes the top of the implant and attaches a post or abutment. This abutment passes through the gum and ultimately supports the new tooth.

    STEP 4: FINAL PROSTHETIC RESTORATION

    Your dentist will take an impression of the implant and will work with the lab technician to make the new implant-supported tooth, as per the original treatment plan. The final prosthetic tooth can be screwed to place or cemented. The new tooth is firmly anchored into the bone and gums, and will look and feel just like a natural tooth.

    This information was adapted from the Nobel Biocare brochure "Dental Implants, Bringing Quality Back to Life"? Periodontal Associates, Inc., 1996. All rights reserved.



Periodontics

WHAT IS IT?
  • Periodontics:

    Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth..

    Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

    In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

    Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

    Causes of Periodontal Disease

    The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums.

    Smoking/Tobacco Use

    As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

    Genetics

    Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interceptive treatment may help them keep their teeth for a lifetime.

    Pregnancy and Puberty

    As a woman, you know that your health needs are unique. You know that brushing and flossing daily, a healthy diet, and regular exercise are all important to help you stay in shape. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.

    Stress

    As you probably already know, stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

    Medications

    Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

    Clenching or Grinding Your Teeth

    Has anyone ever told you that you grind your teeth at night? Is your jaw sore from clenching your teeth when you're taking a test or solving a problem at work? Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

    Diabetes

    Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body's ability to use blood sugars) or the body's inability to use insulin correctly. According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.

    Poor Nutrition

    As you may already know, a diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums.

    Other Systemic Diseases

    Diseases that interfere with the body's immune system may worsen the condition of the gums.

    Types of Periodontal Disease

    There are many forms of periodontal disease. The most common ones include the following.

    Gingivitis

    Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.

    Aggressive Periodontitis

    This is a form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

    Chronic Periodontitis

    A form of periodontal disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gingiva. It is recognized as the most frequently occurring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

    Periodontitis as a Manifestation of Systemic Diseases

    Periodontitis, often with onset at a young age, associated with one of several systemic diseases, such as diabetes.

    Necrotizing Periodontal Diseases

    The infection is characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions including, but not limited to, HIV infection, malnutrition and immuno-suppression.

    Treatment of Periodontal Disease

    If you're diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

    - Pocket Reduction Procedures
    - Regenerative Procedures
    - Crown Lengthening Procedures
    - Soft Tissue Grafts
TREATMENT TYPES
  • Treatment of Periodontal Disease

    If you're diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

    - Pocket Reduction Procedures
    - Regenerative Procedures
    - Crown Lengthening Procedures
    - Soft Tissue Grafts

    Pocket Depth Reduction Procedure

    Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.

    Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

    Your periodontist has measured the depth of your pocket(s). A pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine. During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone. What are the benefits of this procedure? Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth ? and decrease the chance of serious health problems associated with periodontal disease.

    Periodontal Tissue Regeneration

    Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed and pockets develop. Eventually, if too much bone is lost, the teeth will need to be extracted. Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed. These procedures can reverse some of the damage by regenerating lost bone and tissue. During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue- stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue. There are many options to enhance support for your teeth and to restore your bone to a healthy level. Your periodontist will discuss your best options with you.

    Case # 1


    Case #2: Class II furcation involvement


    Case #2: Placement of Guided Tissue Material (membrane)


    Case #2: Resolution of the defect 6 months following the GTR procedure


    Case # 3: Pretreatment x-ray view: notice the bony defect distal to # 47

    Case #3: One year following GTR application: Resolution of the bony defect is appreciated

    Soft Tissue Graft procedures:

    Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line.

    Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you're not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

    Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment your periodontist can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.

    Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

    What are the benefits of this procedure?

    A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health ? your keys to smiling, eating and speaking with comfort and confidence.

    Before soft tissue graft


    After soft tissue graft
TYPES OF DISEASES


  • Types of Periodontal Diseases


    There are many forms of periodontal disease. The most common ones include the following.

    Gingivitis

    Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.

    Aggressive Periodontitis

    A form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

    Chronic Periodontitis

    A form of periodontal disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gingiva. It is recognized as the most frequently occurring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

    Periodontitis as a Manifestation of Systemic Diseases

    Periodontititis, often with onset at a young age, associated with one of several systemic diseases, such as diabetes.

    Necrotizing Periodontal Diseases

    An infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions including, but not limited to, HIV infection, malnutrition and immunosuppression.



Oral & Maxillofacial Surgery

WHAT IS IT?
  • In Sigal, Oral Surgery specialists perform most of the dental surgeries. Examples include removal of wisdom teeth, ridge augmentation, removal of impacted teeth and place implants. All the above procedures are done in the dental clinics.

    In addition, Oral Surgeon specialists do maxillofacial surgeries.



Dental Hygiene

WHAT IS IT?
  • In Sigal, hygiene specialists provide the ultimate services to patients attending Sigal. These services include, and not limited to, dental cleaning, removal of calculus, and application of different preventive treatments. Hygienists teach our patients the proper way of cleaning their teeth. They use hands-on training and jay models to explain the brushing and flossing the teeth.

    Dental cleaning is done using hands instruments in comfortable way. In addition, dental prophylaxis is done as part of the cleaning treatment. To keep patients' teeth in good condition, recall system has been established. In this system, recall cards are sent to patients reminding them about their recall time.



Prosthodontics

WHAT IS IT?
  • COMING SOON...



Restorative Dentistry

WHAT IS IT?
  • What is Operative Dentistry?

    It is simply the restoring of decayed, broken, discolored or slightly mal-positioned teeth.

    Dental restorative choices

    Advances in modern dental materials and techniques increasingly offer new ways to create more pleasing, natural-looking smiles. Researchers are continuing their often work developing esthetic materials, such as ceramic and plastic compounds that mimic the appearance of natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials used to repair missing, worn, damaged or decayed teeth.

    The advent of these new materials has not eliminated the usefulness of more traditional dental restoratives, which include gold, base metal alloys and dental amalgam. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.
RESTORATION TYPES
  • Types of Dental Restorations

    There are two types of dental restorations: direct and indirect.

    Direct restorations are placed immediately into a prepared cavity in a single visit. The dentist prepares the tooth, places the filling and adjusts it during one appointment.

    Indirect restorations generally require two or more visits. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The impression is sent to a dental laboratory, where the dental technician fabricates the restoration. At the next appointment, the dentist cements this restoration into the prepared cavity and adjusts it as needed.

    Materials used as direct restorations

    Dental amalgam

    Dental amalgam has been used for well over a century. It is the most thoroughly researched and tested restorative material among all those in use. It is safe, durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.

    Dental amalgam is a compound of mercury and other metals (mainly silver, tin and copper). It is often called a silver filling or metal filling because of its appearance.

    While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies?including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others?have been satisfied that dental amalgam is a safe, reliable and effective restorative material.

    Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest.

    Amalgam fillings, like other filling materials, are considered biocompatible?they are well tolerated by patients with only rare occurrences of allergic response.

    Disadvantages of amalgam include possible short-term sensitivity to hot and cold temperatures after the filling is placed. The silver-colored filling is not as esthetically pleasing as one that is tooth-colored, especially when the restored tooth is near the front of the mouth, visible when the patients laughs or speaks. And lastly, to prepare the tooth, the dentist may need to remove more tooth structure to accommodate an amalgam filling than for other types of direct fillings.

    Dental resin composite

    Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be ?bonded? or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.

    In teeth where chewing loads are high, composite fillings are moderately resistant to wear, but less so than amalgam fillings. The cost is moderate and depends on the size of the filling and the technique used by the dentist to place it in the prepared tooth. The time required to place a composite filling is usually longer than what is required for an amalgam filling. Composite fillings require a cavity that can be kept clean and dry during filling and they are subject to stain and discoloration over time.

    Ionomers

    Glass ionomers are tooth-colored materials (not as good as composite) made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a minute amount of fluoride that may be beneficial for patients who are at high risk for decay. When the dentist prepares the tooth for a glass ionomer, less tooth structure is removed; this may result in a smaller filling than that of an amalgam.

    Because they have a low resistance to wear and fracture (weaker than composite), glass ionomers are primarily used as small fillings in areas that need not withstand heavy chewing pressure.

    Resin ionomers also are made from glass filler with acrylic acids and acrylic resin. They also are used for non-load bearing fillings (smooth surfaces) and they have low to moderate resistance to fracture. Resin ionomers fit in between glass ionomers and resin composites regarding their physical properties and cosmetic properties.

    Ionomers experience high wear when placed on chewing surfaces. Both glass and resin ionomers mimic natural tooth color but lack the natural translucency of enamel. Both types are well tolerated by patients with only rare occurrences of allergic response.

    Indirect restorations (Two visits or more)

    Sometimes the best dental treatment for a tooth is to use a restoration that is made in a laboratory from a mold. These custom-made restorations require two or more visits. The cost of indirect restorations is generally higher due to the number and length of visits required, and the additional cost of having the restoration made in a dental laboratory.

    Materials used as indirect restorations:

    These include all- porcelain (ceramic), porcelain fused to metal, gold alloys, base metal alloys and resin composite.

    All-Porcelain (Ceramic) Dental Materials

    All-porcelain (ceramic) restorations are particularly desirable because they are highly aesthetic and their color and translucency mimic natural tooth enamel. Their strength depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth. They are highly resistant to wear but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough.

    Porcelain-fused-to-Metal

    The combination of porcelain and metal creates a stronger restoration than porcelain used alone. This kind of restorations is indicated more for bridges and crowns for posterior teeth. Although they are highly resistant to wear, porcelain restorations can wear opposing natural teeth if the porcelain becomes rough. There may be some initial discomfort to hot and cold.

    Gold Alloys

    Gold alloys contain gold, copper and other metals that result in a strong, effective restoration. They are highly resistant to corrosion and tarnishing.

    Gold alloys exhibit high strength and toughness that resists fracture and wear. This allows the dentist to remove the least amount of healthy tooth structure when preparing the tooth for the restoration. Gold alloys are also gentle to opposing teeth and are well tolerated by patients. However, their metal colors do not mimic natural teeth.

    Base metal alloys

    Base metal alloys are non-noble metals with a silver appearance. They are used in crowns, fixed bridges and partial dentures. They are highly resistant to corrosion and tarnishing. They also have high strength and toughness and are very resistant to fracture and wear.

    Some patients may show allergic sensitivity to base metals and there may be some initial discomfort from hot and cold. The metal color does not mimic natural teeth.

    Indirect Composites

    These materials are similar to those used in direct fillings and are tooth colored but their physical properties are higher than those of the direct composites because they are cured more efficiently out side the patient?s mouth. One advantage to indirect composites is that they do not excessively wear opposing teeth. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discoloration.

    Types of indirect restorations

    Inlay

    An inlay is small restoration that fits within the contours of the tooth. It is fabricated using gold, porcelain or composite.

    Onlay

    An onlay is similar to an inlay, but it is larger and covers some or all chewing surfaces of the tooth.

    Crown

    A crown covers the entire chewing surface and sides of the tooth. It can be gold, porcelain, porcelain fused to metal, composite or base metal.

    Veneers

    Veneers are thin, custom-made shells crafted of tooth-colored materials (porcelain or composite) designed to cover the front side of teeth to change the shape and the color of the teeth. They can totally change your look and help you have a beautiful smile. They're made by a dental technician in a dental lab, working from a model provided by your dentist.

    You should know that this is usually an irreversible process, because it's necessary to remove a small amount of enamel from your teeth to accommodate the shell.

    BLEACHING

    Everybody loves a bright white smile, and there are a variety of products and procedures available to help you improve the look of yours.

    Not every case is suitable for bleaching, your dentist. can tell you whether whitening procedures would be effective for you or not. Whiteners may not correct all types of discoloration. For example, yellowish hued teeth will probably bleach well, brownish-colored teeth may bleach less well, and grayish-hued teeth may not bleach well at all. Also bleaching may not enhance your smile if you have had bonding or tooth-colored fillings placed in your front teeth. The whitener will not affect the color of these materials, and they will stand out in your newly whitened smile. In these cases, you may want to investigate other options, like porcelain or composite veneers or dental bonding.

    There are three different approaches available for bleaching:

    - In-office bleaching;
    - At-home bleaching;
    - Over-the-counter (OTC) home-use products and whitening toothpastes

    In-Office Bleaching

    If you are a candidate for bleaching, your dentist may suggest a procedure that can be done in his or her office. This procedure is called chair-side bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour.

    During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent (35 percent hydrogen peroxide) is then applied to the teeth, and a special light may be used to enhance the action of the agent.

    Lasers have been used during tooth whitening procedures to enhance the action of the whitening agent. No whitening products using lasers currently are on the ADA list of Accepted products.

    At-home Bleaching

    Your dentist will make a custom-fitted mouthguard for you that will fit your teeth precisely. Peroxide-containing whiteners typically come in a gel and are placed in this custom mouthguard. Usage regimens vary according to the product you are using, some products are used for about twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks.

    You also may want to speak with your dentist about possible side effects. For example, teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation?either from a tray that doesn?t fit properly or from solution that may come in contact with the tissues.

    Over-the-counter (OTC) home-use products

    Although bleaching agents are available OTC, it is not recommended and only those dispensed through the dental office are considered for the Seal because professional consultation and supervision are important to the procedure's safety and effectiveness.

    Whitening toothpastes (dentifrices) do not do internal bleaching. They contain polishing or chemical agents to improve tooth appearance by removing surface stains through gentle polishing, chemical chelation, or some other non-bleaching action.