CONSERVATIVE TREATMENTS

Fillings – for small to large cavities

Dental cavities are caused by acid-forming bacteria which breakdown certain carbohydrates such as sugar, fructose, glucose, etc. From these substances bacteria form acid as a by-product which damages the tooth surface which is sensitive to the low pH. This is initially a reversible process but over an extended period of time can cause irreversible damage to the tooth. Depending on the degree of tooth decay, there are different procedures for the functional, aesthetic and morphological restoration of the tooth.

In fact, the tooth filling will actually restore the gum loss caused by cavities. After removing the damaged areas, the anatomical form of the crown of the tooth is restored using a filler material. The filling material can be a porcelain or resin-based material, which can be used to create aesthetic, long-term fillings that harmonize with the patients teeth color. However, in the case of too many defects the structure of the tooth can not be repaired by filling. In this case we have to resort to so-called teeth making, inlays or onlays, which are made by our dental laboratory out of plastic, ceramic, or precious metal.

What is an inlay?

An inlay is a very durable and aesthetic filling that replaces the missing tooth structure, restoring its anatomical shape, chewing ability and function. With regard to the available types of inlays, there are many ways of looking at the functional and aesthetic needs as well as the patients’ financial considerations. A great advantage of inlays is that it is possible to save and retain the remaining amount of teeth. Additionally, its color is like the patients existing teeth, so that the patients smile becomes natural and harmonious. The quality of the aesthetic inserts used by us is outstanding and their chewing stability offers a long-term solution.

Two steps are required to make the insert;

• For the first visit, the preparation and imprinting is done by the dental technician. It will usually be completed within a week; during this time a temporary filling will be placed in the tooth.
• Once the lab work is completed the inlays are ready to be glued to the cavity with a special adhesive.

When are inlays called for?

• When dental cavities extend to two or more parts of the tooth surface.
• Fillings at the cavity to be removed will affect the surface of one or two teeth adjacent to the tooth.
• Replacing old, large amalgam fillings or replacing the peaks.
• To cover root canal treated teeth.
• For aesthetic reasons (molars are discolored, the tooth structure is innately faulty) if the tooth is not properly matched or the chewing function is unsatisfactory.

When is root treatment necessary?

When the tooth pulp, that is, the soft tissue containing nerves, becomes damaged or infected, it may be necessary to remove it from the root. In the case of large cavities, the gum may become inflamed, spread to the bone near the tooth root  which can cause intense pain and bite sensitivity. If the inflammation is not suppressed by the dentist, pain and inflammation may continue to spread. In extreme case it can even spread along whole jawbone. Root canal treatment may be required due to accidents, heat or chemical sensitivity or pain reduction.

When is it indicated?

If root canal is needed due to inflammation, it is almost certain that there are bacteria in the root canals and the root has begun to rot. Due to this particular anatomical situation, bacteria can not be destroyed by taking antibiotics because they can not accumulate a therapeutic concentration of the drug in the cavity or bone inside the body. The removal of damaging bacteria is absolutely necessary otherwise inflammation is flares up again and again. The mechanical cleaning of root canals during root management is one of the most important tasks along with chemical cleaning, guarantees that the roots are truly germ free.

The root canal process:

• The first step is an X-ray taken of the root of the tooth to assess the problem.
• Subsequently, anesthesia, followed by exploration of the root cavity, results in drilling.
• If the bottom of the tooth cavity is visible, the root canal inputs are detected.
• Once all channels have been found, we must make them interoperable. For this task we use special, small-scale instruments that are both suitable for spreading and widening.
• Once the channels are interoperable, we can move to the length determination.
• When using the appropriate disinfectant flushing solution, the root canals are formed in a slightly funnel shape.
• Root sealing usually takes place during several sessions. At the first session, a Ca (OH) 2- (calcium hydroxide) medicated paste is placed in the canals and a temporary filling in the tooth.
• The medicine may remain in the tooth for 1-4 weeks, if necessary 1-2 additions may be made.
• When the dentist declares the channels clear, the root canal may occur, followed by a verification x-ray

Possible difficulties with roots management

In rare cases root canal treatments are not successful. In some instances it may not be possible to properly clean the channels because they are too narrow. Another reason could be that the capsule or the crown did not properly close the small holes drilled in the tooth allowing bacteria that caused the inflammation to enter into the root canal again. In this case, further root work is required if you want to avoid surgical intervention or remove the tooth.