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PATIENT EDUCATION
What is a cavity (dental caries)?
Dental caries or a cavity
is an infectious disease that causes damage to tooth
structure. Such
damage can lead to pain, bone abscess and tooth loss.
Initially, dental caries appears as a small chalky area but
eventually develop
into a large, brown cavitation. Depending on the
location of the dental caries,
they can be seen either directly or
through a radiograph (x-ray) in order to
inspect less visible areas
of teeth and to judge the extent of destruction.
Dental caries is caused by acid producing bacteria that are present in the
mouth. These bacteria produce acid by breaking down food remnants stuck on
or between teeth. Dental caries may or may not be associated with symptoms.
The risk of dental caries can be reduced via proper and thorough oral hygiene,
and regular visits to your dentist.
What is root canal therapy?
Root canal therapy is a procedure that involves the removal of the soft tissue
within the tooth. To understand the procedure better, we need to know a bit
about the anatomy of the tooth.
A tooth is like an onion, consisting of several layers. The outermost layer is
called Enamel- it is the shell of the tooth. The middle layer is called dentin.
The innermost layer is called the pulp- this is the center of the tooth where the
blood vessels and nerves lie.
Root canal therapy is required when the pulp of the tooth becomes inflamed or
infected. This can be due to several causes: deep decay, repeated dental
procedures on the tooth or a crack in the tooth.
Root canal therapy involves several steps. First your dentist will administer
anesthetic to numb the tooth. Then the tooth will be isolated using a protective
sheet, called a rubber dam. Then the dentist will make an opening through the
top of the crown. Through this opening your dentist will clean out the pulp of
the tooth using very small instruments. At the end of the process, your dentist
with fill and seal the root canals with a biocompatible material.
With modern anesthetics, most patients are comfortable during the root canal
procedure. For the first few days after treatment, the tooth may feel sensitive, but
any discomfort can be relieved with over the counter pain medications.
Teeth that have had root canal will require a crown to prevent them from
fracturing.
- First image: tooth
with a cavity that has caused an abscess
- Second image: opening
made thru top of the tooth
- Third image: canals
of tooth cleaned out, removing all the infected and inflamed pulp
- Fourth image: canals
are filled with a biocompatible material and a crown is placed
What is a
crown?
A crown (sometimes called
a cap) is a covering that goes on top of a tooth to
strengthen it
and improve its appearance. A crown is made for teeth that have
been
heavily damaged, that have undergone root canal therapy, or teeth
that are
discolored or badly shaped.
Making a crown involves two appointments. In the first appointment, your
dentist will make an impression of your tooth, and then anesthetic may be
administered to make the tooth numb. Your dentist will prepare the tooth, a
process that involves removing the outer layer of the tooth, along with any
decay or crack lines. Then a second impression is made of the prepared tooth. At
this point a temporary crown is made and temporarily cemented onto the tooth.
The impression is sent to
the laboratory, where a custom permanent crown is
made. A crown can
be made of porcelain, porcelain fused to metal, or metal.
Then you
will be scheduled for your second appointment, where your dentist
will remove the temporary crown and cement the permanent crown. With
proper oral hygiene and care, a crown can last 10 or more years.
What is a bridge?
When a tooth is lost, the neighboring teeth may shift, there is loss of function
and the smile is affected.
There are several options to rectify this problem, including a bridge. A bridge is
a prosthesis that replaces missing teeth with artificial teeth that are attached to
natural teeth.
Fabrication of a bridge involves two or three appointments. The
neighboring
teeth are first prepared, and an impression is taken.
The impression is sent to
the laboratory, where a custom bridge is
made. Once the bridge is returned to
your dentist, an appointment is
setup where the bridge is fitted in your mouth,
and then cemented in
place.
A bridge requires extra care during cleaning, but with proper oral hygiene can
last 10 or more years.
What is a dental implant?
When a tooth
is lost, the neighboring teeth may shift, there is loss of function
and the smile is affected.
There are several options to rectify this problem, including a dental implant. A
dental implant is a post, made of titanium, which is placed in the jawbone and
fuses to the bone. This acts as an artificial root on top of which a crown is
cemented.
Implants offer long-term stability because they fuse to bone. They are much
more stable than other options, such as partial dentures, have a very high
degree of esthetics, and with proper care can outlast a bridge.
What is a porcelain veneer?
A porcelain veneer is a very thin custom-made porcelain shells that is
& designed to cover the front surface of a tooth, similar to the way that artificial
fingernails are attached to the natural fingernails. Veneers improve the
appearance of teeth that are stained, chipped, oddly shaped or unevenly
spaced.
Making veneers involves two appointments. In the first appointment, your
dentist will make an impression of your teeth, and then anesthetic is
administered to make the teeth numb. Your dentist will prepare the teeth,
removing a small amount of enamel from your teeth to accommodate the
porcelain shell. Then a second impression is made of the prepared teeth. At
this point temporary veneers are made and temporarily cemented onto your
teeth.
The impression is sent to the laboratory, where custom porcelain veneers are
made according to the shape and colour that you choose with your dentist.
Then you will be scheduled for a second appointment, where your dentist will
remove the temporary veneers, and cement the permanent veneers. With
proper oral hygiene and care, veneers last 7-10 years.
What is an onlay?
An onlay is a method of tooth restoration, which covers, protects or
reinforces
one or more cusps (pointy corners of tooth). Onlays are
often used when teeth
present extensive cavities, extensive tissue
loss due to trauma or caries, as well
as when direct restorations
lack retention.
Fabrication of an onlay involves two appointments. In the first
appointment,
your dentist will make an impression of your tooth, and
then anesthetic may
be administered to make the tooth numb. Your
dentist will prepare the tooth
and remove any decay or crack lines.
Then a second impression is made of the
prepared tooth. At this
point a temporary onlay is made and temporarily
cemented onto the
tooth.
The impression is sent to the laboratory, where a custom onlay is made. An
onlay can be made of porcelain or a high noble metal alloy. Then you will be
scheduled for your second appointment, where your dentist will remove the
temporary onlay and cement the permanent onlay. With proper oral hygiene
and care, an onlay can last 10 or more years.
What is tooth whitening?
Tooth whitening has been available for over 15 years, and has become more
and more popular. Whitening treatments are used to improve the appearance
of teeth, by removing stains. It should be noted that the natural colour of teeth
will vary from person to person, and teeth will naturally darken with age.
There are two types of stains that cause teeth to discolour; external stains and
internal stains. External stains are a result of the accumulation of surface
stains caused by certain foods or drinks such as soy sauce, coffee, tea, red
wine, as well as tobacco products. Internal stains can result from certain
antibiotics, excessive fluoride in the water and dental trauma.
Tooth whiteners are of two different classes, surface whiteners and bleaching
agents. Surface whiteners employ mild abrasives to remove surface stains.
They are often found in products such as toothpastes or chewing gums. They
will produce a mild effect on the appearance of the tooth.
Bleaching agents employ peroxide products to bleach the tooth. They
work
well on natural teeth, and results depend on the concentration
and type of
bleaching agent used.
Certain discolourations however, will not respond to bleaching
agents. Your
dentist will help determine if this treatment approach
is appropriate for r
your teeth. It is important to note existing
fillings and crowns will not change
colour during whitening
treatment. Sometimes such restorations need to be
changed after
teeth whitening to match the new lighter colour of the teeth.
Bleaching products are available over the counter or through your
dentist. The
primary difference is that over the counter products
are much milder in
concentration that those available through your
dentist, hence results tend to
be less noticeable.
Dentists employ primarily two types of bleaching products. The first
involves
fabrication of custom made trays for each jaw. These trays
are filled with
bleaching agents and worn for part of each day for
usually 10-28 days. The
second type of bleaching products give
immediate results; they involve a
single visit to your dentist
during which your teeth are isolated, and a highly
concentrated
bleaching agent as well as light and/or heat is applied to your
teeth. Such products have been featured on makeover shows that are
abound
on TV nowadays.
With any teeth whitening treatment, tooth sensitivity and soft tissue irritation
may occur, but effects are transient.
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Patient Education
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