DENTAL CONCERNS

TEETH CAVITIES

Cavities in teeth happen because of decay or wearing away of teeth. The hard structure of the tooth gets damaged leading to a hole on the tooth structure. They are very common dental problems caused by food, poor teeth cleaning methods, excess sugar in diet and excessive grinding of teeth.

Initially, they can cause tooth sensitivity, black discolouration on teeth, food lodgement and when not treated, root infection and tooth pain.

There are many treatment options which depend on how deep the cavity is, such as:

Simple teeth fillings
Complex teeth fillings
Root canal treatment

For cavities involving enamel and dentin, fillings can be done with silver amalgam or tooth coloured filling materials. When cavity is shallow but wide, complex fillings like inlays and onlays can be considered. When tooth cavity is deep, root canal treatment is the option advised.

CROOKED TEETH

Crooked or malaligned teeth can make your smile unattractive and confidence low. There are many problems that can be seen when teeth are not aligned properly like crowding, space between teeth, protruding teeth, improper fit of upper and lower jaws. This can make your smile look bad, can lead to food lodgement between teeth and increased chances of tooth decay.

Correction of crooked teeth can be done by orthodontic treatment. A number of options exist such as:

Braces – Metal, Ceramic or Self-ligating
Clear (Invisible) Aligners
Orthognathic Jaw surgery

Minor corrections can also be accomplished with:

Dental Veneers
Dental Crowns

STAINED TEETH

Tooth discolouration or tooth staining can be due to extrinsic or intrinsic reasons. Extrinsic stains happen because of our food, acidic beverages, habits like smoking, chronic use of some mouthwashes, prolonged use of some medicines, dry mouth etc. Intrinsic stains, discolour the tooth from within and can be due to dental fluorosis, developmental reasons from birth, loss of vitality of tooth after accidents/trauma.

These stains can be yellow, brown or black and can make smile look unesthetic. They are a very common dental complaint of many patients and can be treated with very simple methods.

Along with stoppage of habits, removal of causative factors from diet and lifestyle, some dental treatment options are there such as:

Scaling for extrinsic stains
Teeth whitening/ Bleaching for intrinsic stains
Dental laminates or veneers for intense intrinsic stains

BAD BREATH

Bad breath, also known as halitosis, is a common dental issue faced by many patients. it can lead to lot of social embarrassment and may often be bought to notice by friends/relatives around.

Most commonly it happens due to poor oral hygiene, gum infections, dry mouth, food lodgement due to tooth cavities, habits like smoking, tobacco chewing and sometimes due to nose throat or gastrointestinal infections.

Treatment of bad breath is generally easy and first needs main contributing factor to be identified. In case of other infections, referral to physician is required. For oral causes, treatments include:

Scaling
Treatment of gum infections
Treatment of decayed teeth with fillings or Root canal treatment
Extraction /Removal of grossly decayed teeth
Habit stoppage

MISSING TEETH

Accidents, tooth decay, gum infections can cause tooth loss. This leads to missing tooth which can cause difficulties to chew in case of back teeth and poor aesthetics in case of front teeth. Missing tooth can also be due developmental defects and in that case, will be missing from birth/childhood.

Modern dental treatments include many options for replacement of missing teeth, both fixed and removable options.

Dental implants for fixed replacement of missing teeth are the best option and mimics natural teeth as best as possible.
Crowns and bridges are another fixed replacement option which takes support from nearby teeth, can be metal ceramic or all ceramic in material.
Removable dentures, are a third/ last option when fixed is not possible. They can be complete for full mouth or partial for few teeth.

BLEEDING, SWOLLEN GUMS & LOOSE TEETH

After tooth decay, gum infections are 2 nd most common dental problem faced by majority of the population. Poor oral hygiene leads to bacterial deposits accumulating on teeth and between gums & teeth. This starts gum infections which goes on to spread deeper till the bone, weakening tooth support.

Gum infections will lead to symptoms like:

Bleeding of gums
Bad breath
Swelling and enlargement of gums with food lodgement between teeth
Pus discharge from gums
Loose teeth

A visit to gum specialist (periodontist) is required for such problems and treatment can vary from non-surgical to surgical depending on severity of gum infection.

Scaling & Root planning
Laser deep cleaning (LANAP)
Flap surgery and regeneration like bone grafting (when required)
Removal of severely affected teeth

TOOTH PAIN

Toothache or tooth pain is the most common issue for patients visiting dental clinic. Tooth pain can be continuous or intermittent, can be localised to a particular tooth or radiating to head neck area.

There are many reasons for toothache like tooth cavities, fractured tooth, cracked tooth, infection with an impacted wisdom tooth, referred pain from the jaws, acute swelling of the gums and gum infections.

Severe tooth pain can be very troublesome and requires emergency treatment to relieve pain. The treatment options for toothache depend on the cause of the pain:

Root canal treatment for deep cavities, fractured teeth and cracked teeth
Removal of infected wisdom teeth
TMD clinic visit for relief of pain from the temporomandibular joint
Periodontal treatment for gum infections like abscess drainage, scaling and further necessary treatments.

RECEDING GUMS

Gum recession is the movement of gums away from teeth, leading to long tooth appearance.

This occurs due to gum infections, wrong brushing technique, vigorous brushing force and some factitious habits. Problems due to gum recession include teeth sensitivity, exposed roots, higher chance of root decay and poor appearance.

To treat receding gums, many types of gum grafting procedures have been developed. These include free gingival graft, connective tissue graft, pedicle grafts, use of additive like membranes with grafting surgery and advanced techniques like VISTA, Pinhole method.

JAW PAIN

Jaw pain generally refers to pain from the temporomandibular joint (TMJ) and muscles & ligaments attached to this joint. This can start due to injury, excessive grinding of teeth, genetic malalignment of upper and lower jaws, injury to jaws.

This pain will not be localised to specific teeth, but rather spread on side of face, neck, head areas. There can be pain on mouth opening, locking of jaws when opening mouth, clicking sound from the jaws, restricted jaw movements.

Treatment of this condition requires visit to TMD clinic and consultation with TMD specialist. There are a range of treatment options from medications, to non-surgical managements, occlusal splints and surgical treatment in severe cases.

WISDOM TEETH PROBLEMS

Wisdom teeth or third molars are the last teeth to come out in the mouth, by which time the jaws have grown and there may be no space left for them. In such cases, they get stuck within the bones, known as impacted teeth. This can cause pain in the jaws, swelling and infection of the gums around that area, ulcers/ cheek bite in back regions of mouth, food lodgement with neighbouring teeth, decay of wisdom teeth.

Treatment options depend on level of difficult position of wisdom teeth and severity of infection around.

Tooth contouring – For some mild cases, coronoplasty of sharp tooth edges can be done to relieve from neighbouring skin.
Wisdom tooth removal – For more severe cases, teeth become difficult to access to clean and to treat, hence the most suitable option in such cases is extraction of wisdom teeth.

FACIAL BONE FRACTURES

Facial fractures mean broken bones of the face and jaw. This is a result of some injury, accident, fall or fights.

The complexity of the issue will depend on number of bones broken. It may be restricted to localised bones like socket of the eye or cheek bones, broken nose or jaw or can involve combination of many bones like mid face and pan-facial fractures.

Symptoms shown by patients will follow the bone which is broken. There can be swelling of face, bruising, nose bleeds, problems with vision, injuries to teeth, pain with jaws, some nerve damage. Treatment is more complex, requiring Oral & Maxillofacial surgeons, general surgeons, anaesthesiologist and a hospital setting.

UNPLEASANT SMILE

Smile is an important part of your face, of your appearance and affects your social confidence. There are many components that affect your smile like shape & alignment of teeth, position of lips, colour of the gums, colour of the teeth and symmetry on both sides. Problems like crooked teeth, spaced teeth, chipped off teeth edges, small sized teeth, dark gums, discoloured/stained teeth, poor tooth fillings, all can create an unpleasant smile.

For treatment, a detailed examination is done first by an entire team of specialist including prosthodontist, cosmetic dentist, orthodontist and periodontist. All contributing factors present, related to gums, lips and teeth need to be corrected. Some of the treatment options are:

Smile designing
Veneers and laminates
Clear aligners
Metal free crowns

KIDS TEETH PROBLEMS

Children dental care is a very specialised and exclusive care as kids require different techniques to perform treatment, to reduce their fear and make them co-operative.

Dental problems in kids can include tooth cavities, tooth pain, loose milk teeth, nursing bottle (childhood caries), habits like thumb sucking, tongue thrusting, malaligned teeth etc.

It is important to treat dental problems in kids at early stage to avoid them from infecting permanent adult teeth, to keep teeth and mouth free of problems from young age and educate them about importance of oral hygiene from early on.

Treatment requires a visit to exclusive pediatric dental clinic and can include:

Preventive treatments – like cleaning, fluoride application, pit & fissure sealants
Interceptive treatments – minor orthodontic treatments, habit breaking appliances, space maintainers, serial extractions
Restorative treatments – like fillings, pulpectomy, crowns