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What is Tooth Decay?
Tooth Decay describes the conditions wherein
the tooth, under a variety of harsh
conditions, breaks down leading to the
formation of a cavity. It starts with a
hole/opening in the enamel. If this is not
treated, it progressively reaches the deeper
sections of the tooth, where the pulp and
the nerves are causing the tooth to become
sensitive to a variety of stimuli, a variety
of gum problems such as inflammation and
swelling, pain, and ultimately tooth loss.
Is it very common?
Tooth decay is a common dental ailment that
may occur at any time of age. However, since
the onset of tooth decay is strongly related
to the unregulated consumption of sweet
foods and beverages, it tends to affect the
young and adolescents more than any other
age. One form is diagnosed in nursing
infants and is referred to as nursing
caries.
What are the causes of Tooth Decay?
POOR ORAL HYGIENE: Irregular and
improper brushing, not flossing between
teeth, not rinsing with water or mouthwash
after meals speed up the process of tooth
decay.
UNREGULATED DIET OF SWEET FOOD AND
DRINKS: Periodic snacking on aerated
drinks, jam, marmalade, even potato chips
can lead to the formation of acidic by
products which damage the surface of the
tooth enamel. This is the reason why most
young children adolescents suffer from tooth
decay.
BAD OR WORN OUT DENTAL FILLINGS:
Tooth decay might develop again from exposed
tooth surfaces.
What can I do if I have Tooth Decay?
If you have developed black or brown spots
of decay on your teeth either in the
fissures or on the smooth surfaces and it is
associated with discomfort and/or
sensitivity to hot and cold and/or frank
pain, it is likely that you have tooth
decay. Your dentist will evaluate you
comprehensively and based on his clinical
and radiographic findings he will do one of
the following
Make an opening in the crown and remove
decay, shape the cavity and fill it with a
tooth coloured filling or an amalgam
filling. This could also be done under local
anaesthesia.
If the decay is very deep and pulp (nerve,
root canal) is involved in the decay process
he will, under local anaesthesia go deeper
into the pulp chamber, remove the pulp and
the nerve, render it free of infection, do a
root filling and later put an amalgam or a
tooth coloured filling. Subsequently he will
put a veneer or a crown on the tooth as the
case may be.
Prevention is the best cure for Tooth Decay.
Certain preventive measures are known to
reduce the risk of tooth decay. You must
practice these good dental habits.
BRUSHING
Brush your teeth twice a day. Hold a soft
brush at the gum line at a 45° angle. Brush
in a circular motion to massage the gums and
an up-down motion to dislodge plague. Do
this gently on the outer as well as inner
surfaces of teeth.
CHOOSE THE RIGHT TOOTHBRUSH
Dentists recommend using a toothbrush with
soft bristles and a small head. Replace your
toothbrush every 3 months or as soon as it
loses it's original shape. Once a brush
loses its shape, you require more pressure
for the same cleaning action. This extra
pressure is damaging to gums as well as the
protective enamel layer.
FLOSS
Floss daily to remove plaque from between
teeth. Take about 18" of floss and wrap most
of it around your middle finger and the rest
around the middle finger of the other hand,
leaving a 2" length between them. Using your
thumb and forefinger, gently scrape the side
of each tooth away from the gum.
RINSE
Rinse your mouth with water thoroughly after
each meal. Rinse for a minute everyday with
mouthwash.
DIET
Reducing the frequency of in take of sweets
during the day, decreases the number of
'acid attack' by the digestive breakdown of
these foods in the mouth. This prevents
further damage to the tooth.
Expectant mothers must be particularly
careful with their diet and must make sure
that it contains all the necessary nutrients
and vitamins [described below] since the
foundation of a child's teething is laid
early in the second trimester [3 to 6
months]
A balanced diet that includes all food
groups such as fresh fruits, vegetables,
bread, cereals as well as other grain
products, Dairy products such as milk,
cheese, yogurt, meat, poultry, fish provides
the essential nutrients required for dental
growth.
What is root canal treatment (RCT)/
Endodontic treatment?
Root canal treatment, also known as
endodontic treatment, is a dental procedure
in which the diseased or damaged pulp (core)
of a tooth is removed and the inside areas
(the pulp chamber and root canals) are
cleaned, filled and sealed.
When is the root canal treatment needed?
Inside the tooth, the pulp's soft tissue
contains the blood supply, by which the
tooth gets its nutrients, and the nerve, by
which the tooth senses hot and cold. RCT is
necessary when the pulp, the soft tissue
inside the root canal, becomes inflamed or
infected. The inflammation or the infection
can have a variety of causes; deep decay,
repeated dental procedures on the tooth, a
crack or a chip in the tooth, a sudden blow
to the tooth. The microorganisms may spread
inside the tooth from the crown to the tip
of the root in the jawbone, creating a
build-up of pus which may eventually cause
an abscess. This can be very painful and the
teeth may become very sensitive to heat or
cold.
Normally the crown of the tooth will protect
the pulp against infection, but once a tooth
becomes damaged and infection spreads, it
must be treated in order to avoid further
damage, or the tooth must be removed
altogether.
In some instances the tooth may also require
intentional root canal treatment as part of
an adjunctive therapy during prosthetic
rehabilitation in the mouth.
Is there any alternative to root canal
treatment?
The alternative to root canal treatment is
extraction of the infected tooth. However,
in order to keep your oral tissues in a
healthy state and prevent the problems
caused by missing teeth, it is always
recommended to retain natural teeth wherever
possible.
Removal of the tooth is preferable to no
treatment at all, as an infected tooth can
cause further painful complications if left
in the mouth. The pulp will not heal of its
own accord once it has become infected.
What are the signs or symptoms of needing
a root canal treatment?
Severe, constant or throbbing pain in the
tooth, prolonged sensitivity to heat or
cold, tenderness to touch and chewing,
discoloration of the tooth and swelling,
draining pus and tenderness in the lymph
nodes as well as nearby bone and gingival
tissues are the most commonly associated
signs with an infected tooth. However, in
some cases, the pulp may die so gradually
that there is little noticeable pain.
What is the procedure involved during a
root canal treatment?
Root canal treatment is performed under
local anesthesia. A thin sheet of rubber,
called a rubber dam, is placed in the mouth
to isolate the tooth. The dentist removes
any tooth decay and makes an opening through
the natural crown of the tooth into the pulp
chamber. Creating this access also relieves
the pressure inside the tooth and can
dramatically ease pain.
The dentist determines the length of the
root canals, usually with a series of x
rays. Small wire-like files are then used to
clean the entire canal space of diseased
pulp tissue and bacteria. The debris is
flushed out with large amounts of an
irrigant (normal saline or sodium
hypochlorite usually). The canals are also
slightly enlarged and shaped to receive an
inert (non-reactive) filling material called
gutta percha. However, the tooth is not
filled and permanently sealed until it is
completely free of active infection. The
endodontist may place a temporary seal, or
leave the tooth open to drain, and prescribe
an antibiotic to counter any spread of
infection from the tooth. This is why root
canal treatment may require several visits
to the dentist.
Once the canals are completely clean, they
are filled with gutta percha and a sealer
cement to prevent bacteria from entering the
tooth in the future.
Is there any risk associated with root
canal treatment?
There is a possibility that the root canal
treatment will not be successful the first
time. If infection and inflammation recur
and a radiograph of the tooth indicates
retreatment is feasible, the old filling
material is removed and the canals are
thoroughly cleaned out. The dentist will try
to identify and correct problems with the
first root canal treatment before filling
and sealing the tooth a second time.
In cases where a radiograph indicates that
retreatment cannot correct the problem,
endodontic surgery may be performed. In a
procedure called an apicoectomy, or root
resectioning, the root end of the tooth is
accessed in the bone, and a small amount is
removed. The area is cleaned of diseased
tissue and a filling is placed to reseal the
canal.
In some cases, despite root canal treatment
and endodontic surgery, the tooth may have
to be extracted when there is a non healing
lesion or failure of endodontic treatment.
What is a post crown?
In root-filled teeth it may be necessary to
insert a post before placing a crown. A post
provides support and helps the crown stay in
place. The post is placed into the root
canal and cemented in position, ready for
the crown to be attached.
Are there any alternatives to post crowns
for root-filled teeth?
If a root-filled tooth is not completely
broken down, it may be possible to build it
up again using filling material. This core
is then prepared in the same way as a
natural tooth and the impressions are taken.
How long does treatment for crowns take?
You will need to make at least two visits:
the first for the preparation of the tooth,
impression, shade taking and fitting the
temporary crown; and the second to fit the
permanent crown. The second appointment is
scheduled based on the laboratory time
required for fabrication of the crowns.
Does it hurt to have a tooth prepared for
a crown?
No. A local anaesthetic is used, if
necessary and the preparation should feel no
different from a filling. If the tooth does
not have a nerve, and a crown is being
prepared, then a local anaesthetic may not
be needed.
How do I care for my crown?
How long your crown lasts depends on how
well you look after it. The crown itself
cannot decay, but decay can start where the
edge of the crown joins the tooth.
Therefore, it is important to keep this area
just as clean as you would your natural
teeth in order to prevent decay affecting
the crown.
What is a dental implant ?
Dental Implant is a modality of treatment
wherein Roots of missing teeth are replaced
by Implants fixed in the bone. These
Implants can either support Crowns, Bridges
or Removable Dentures in the mouth. Oral
Implantology has become one of the fastest
growing disciplines of dentistry. Most
modern implants are made of titanium.
Titanium and titanium alloy are well
accepted by the jaw bone. The external
surface of the implant may be treated by
different methods to increase the surface
area available for bone cells to grow into.
Dental implants are available in different
sizes and shapes like screws, blades and
cylinders. The implant dentist selects the
most appropriate implant after studying the
case.
At what age can an implant be placed ?
Boys younger than 18 years and girls younger
than 16 are usually not treated with
implants, though there may be exceptions
depending on the individual considerations.
Healthy individuals, however old they may be
can avail of implant treatment, after
consulting with their respective physicians.
Why should I replace missing teeth?
The most important reason is Appearance. The
next important reason is if the lost teeth
are not replaced at the earliest the teeth
adjacent to the teeth lost lean towards each
other and the teeth from the opposing jaw
will get elongated more . This will cause
disturbance in the bite and many a times
pain at the TM Joint. This situation may
also lead to gum diseases
How are missing teeth replaced?
The best way of replacing the missing teeth
is by fixing an Implant. The presence of
Implant in the jaw where teeth missing keeps
the bone and gums very healthy. Anything in
the mouth that do not require removal on and
off gives the Best Quality of Life. If
implants are given no need to grind two good
teeth for fixed dentures.
The next best way is fixed Bridges taking
support from the two or more adjacent teeth.
Good quality Ceramic bridges give near
natural looks and comfort.
The final way is to give removable dentures
which has a lot of its drawbacks and not
very comfortable but cost effective and
sometimes given as an intermediary before
implants or final bridges are provided.
What are the advantages of an implant ?
1) Improved self esteem
Removable Dentures can loosen and dislodge
while speaking. With implants, however the
person can confidently talk, eat, chew and
speak naturally.
2) Improved comfort
Conventional Removable Dentures is seated on
the gum and hence is mobile. Such Dentures
can be clipped on Implants which remain firm
as they take their support from the bone and
the thus the Denture would be stable & more
comfortable.
3) Improved health
Implants greatly enhances chewing efficiency
and hence allows the patient to eat all
types of nutritious food easily.
4) Improved appearance
When teeth are lost the facial appearance
begins to change. The muscle tone is lost
and the person looks older. Dental implants
greatly reduce the bone loss and this in
turn has a beneficial effect on the facial
musculature.
Why are implants costly ?
Implants are cost-effective. Most implants
are imported and their advantages far
outweigh the initial investment in the long
term, as compared to loose removable
dentures. Long term health with natural
esthetics and function are provided with
implants.
Are implants successful ?
Treatment with dental implants is highly
successful and very predictable. However, as
with all dental procedures, adequate hygiene
and maintenance has to be observed to ensure
long term success. |
