Dry Socket

After Teeth Extractions

ALVEOLAR OSTEITIS or Dry socket is a complication where wound healing is altered that may occur following extraction of teeth if the initial blood clot is not formed or lost.

dry-socket

An improper wound healing results in exposed bone in the socket which is devoid of normal healing tissues (Clot), hence the name “dry socket.”It occurs three to five days after an extraction and is characterized by an increase in severe and throbbing pain.

Dry socket is treated by temporarily packing the site with eugenol, antibiotics and oral rinses. As the socket forms a new layer of the healing tissue the pain will gradually subside and the socket slowly fills in over the next 2-3 months.

  • In patients the risk for dry socket increases who smoke after extractions, too early vigorous rinses, forceful spitting, or use a straw to drink within the first 24 hour, which can disturb the initial blood clot formation.
  • Another major risk factor for dry socket is traumatic surgical procedures such as tearing the gum tissue, excessive manipulation of the extraction socket and aggressive drilling of the bone which ultimately will result in devitalized tissue with poor blood supply.

While the possible incidence of dry socket is between 1-3% data shows that no dry sockets were recorded after performing more than 150,000 extractions over the past 20 years.

THE SECRETS TO AVOID DRY SOCKET AFTER TEETH EXTRACTIONS:

  • Non-traumatic surgical techniques and procedures: This means no or minimal gum tissue flap, no or minimal removal of bone, use of irrigation, gentle handling of the tissues and atraumatic removal of teeth with ease.
  • Avoid rinsing or brushing: Any forceful rinsing or brushing immediately following a tooth extraction can cause dislodging of the blood clot leading to a dry socket. Do not rinse or brush within 24 hours of extraction then rinse gently for the next 1-2 days and more vigorously in the following days.
  • Do not use a straw: The use of a straw in the first 24 hours can also cause suction and dislodge the blood clot. Use a glass following liquid consumption.
  • Avoid smoking: Smoking creates suction in the mouth that can dislodge the blood clot. It also directly inhibits the normal healing physiology.
  • Do not spit: With blood and saliva accumulating in the mouth following an extraction you may be urging to spit that out. This action can disrupt the formation of blood clot and dislodge it. Instead of spitting let the accumulated blood and saliva drool down and wipe it gently with a gauze or tissue.
  • Keep firm pressure on the extraction site: The gauze should remain in place for at least 30-45 minutes after extraction. Constant and firm pressure helps to slow down the bleeding and stabilizes the formed blood clot.

HOW TO PREVENT DRY SOCKET

Dry socket (alveolar osteitis) is a wound healing complication that can occur following teeth extractions if the initial blood clot is lost. This results in exposed bone in the socket devoid of normal healing tissues, hence the name “dry socket.” It usually occurs three to five days after an extraction and is characterized by a sudden increase in severe and throbbing pain. Dry socket is treated by temporarily packing the site with eugenol, antibiotics, and oral rinses. As the socket forms a new layer of healing tissue the pain gradually subsides and finally the socket slowly fills in over the next 2-3 months.

The risk for dry socket increases in patients who smoke after teeth extractions, vigorously rinsing too early, spitting, or using a straw to drink within the first 24 hours—all of which can disturb the initial blood clot.

While the possible incidence of dry socket is between 1.5-2%, here at   Dr. Sachdeva’s Dental Implant Institute, Delhi, we have experienced no dry sockets after performing more than 6500 extractions over the past 13 years.

Platelet Rich Fibrin (PRF) as healing aid in extraction socket:

Platelet rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane, regulate inflammation and increase the speed of healing process.

It is a simple, natural and inexpensive technique for the production of leukocyte- and PRF (L-PRF) concentrates. It includes collection of whole venous blood (around 5 ml) in each of the two sterile vacutainer tubes (6 ml) without anticoagulant and the vacutainer tubes are then placed in a centrifugal machine at 3,000 rpm for 10 min, after which it settles into the following three layers: Upper straw-colored acellular plasma, red-colored lower fraction containing red blood cells (RBCs), and the middle fraction containing the fibrin clot. The upper straw-colored layer is then removed and middle fraction is collected, 2 mm below to the lower dividing line, which is the PRF. The mechanism involved in this is; the fibrinogen concentrated in upper part of the tube, combines with circulating thrombin due to centrifugation to form fibrin. A fibrin clot is then formed in the middle between the red corpuscles at bottom and acellular plasma at the top. The middle part is platelets trapped massively in fibrin meshes. The success of this technique entirely depends on time gap between the blood collection and its transfer to the centrifuge and it should be done in less time.

Tips: How To Get Your Child To Brush Teeth

Here we present you with few tricks to encourage your children to enjoy brushing:

  1. Let your child pick his toothbrush. They may be attracted by Color, cartoon theme or with those toothbrushes that light up when squeezed, so there are plenty of choices available in the market.
  2. Practice makes them perfect. Let your child enjoy the brushing of teeth of his favorite animated toothbrush. When he’s done with brushing, give him a chance to brush his teeth by himself. Make sure his teeth and gums are thoroughly cleaned.
  3. Show your child the brushing technique. You should show them how you brush your teeth if they refuse to brush. Children enjoy copying what their parents do and they can get engaged in taking care of his oral health.
  4. Add spice to the brushing routine. While they try to brush their teeth, sing and dance along!
  5. Give your kids chewable tablets that turn plaque into pink color, and playfully convince them to brush away the color with their toothbrush.
  6. Make him understand that each tooth of his pearls is important. Let your child give a nickname to each tooth and remind not to leave any tooth alone without brushing.
  7. Don’t forget to praise your child after he learns slowly to brush properly and reward him for a well done job.
  8. Let them choose the flavor of the toothpaste that appeal to their taste and be sure to use toothpaste that is specially made for kids.

 For more information, you can book an appointment at Dr Sachdeva’s Dental Aesthetic & Implant  Center I 101 Ashok Vihar Phase 1, Delhi- 110052

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CHECKED BRUXISM

ARE YOU GRINDING TEETH?

Bruxism is involuntary habitual grinding of the teeth, typically during sleep.

Several commonly associated symptoms with bruxism are hypersensitivity of teeth, jaw muscles soreness, headaches, wearing off teeth, damage to dental fillings and crown and overall damage to teeth.

Teeth grinding or bruxism is very common in children as well as adults and people may not realize it initially until their dentist spots out the symptoms in their mouth.

There are two main types of bruxism: during sleep (sleep bruxism) and during wakefulness (awake bruxism). Bruxism may be mild or aggressive.

 

SIGNS

  • Attrition means flattening of the occlusal surface, and Abfraction is where notches/grooves are formed at the neck of the teeth near the gum-line.
  • Fracture of teeth and repetitive failure of dental restorations including crowns.
  • Teeth Hypersensitivity due to wearing away of the protective layer of dentin and enamel.
  • Loosening of the teeth due to inflammation of periodontium due to excessive pressure.
  • Cheek biting/linea alba, or lip biting.
  • Indentations on the tongue.
  • Tenderness, fatigue or pain of the muscles of mastication, mainly masseter.
  • Trismus(restricted mouth opening).
  • Pain and clicking of TMJ

SYMPTOMS

  • Tooth wear
  • Tooth mobility
  • Pain

TREATMENTS

  • First of all the patient needs reassurance that the condition is not that serious that may lead to anxiety.
  • Specially made night guard to wear while sleeping to avoid clenching.
  • Orthodontic correction of teeth if the misaligned teeth are the cause for clenching.
  • Avoiding smoking and alcohol and having a healthy lifestyle.
  • Other interventions include relaxation techniques, stress management, behavioural modification and habit reversal.

 

 

For more information, you can book an appointment at Dr Sachdeva’s  Dental Aesthetic & Implant Center I 101 Ashok Vihar Phase 1, Delhi- 110052

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What Are Dental Emergencies? How To Deal With Them

 

  • Are you suffering from severe pain?
  • Does your mouth bleed while brushing?
  • Are your teeth mobile/loose?
  • Do you have any swelling in your mouth inside or outside?

Dental emergencies are very common, but one should have the knowledge to handle the situation in case of stress or emergency. Proper maintenance of oral hygiene and regular visit to dentist can help to reduce the chances of experiencing a dental emergency.

The most common dental emergencies may include teeth that are –

Forced out of position causing loosening of tooth

  • Facial trauma
  • Fractured facial bones.
  • Chipped, Broken or fractured tooth
  • Infection indicating an abscess

Treatment will depend on the severity of the damage. For example a chipped tooth is slightly damaged; it can be corrected by smoothening, of maybe restoring the tooth by bond and composite filling material. If the damage is beyond dentin and pulp involvement with severe pain, then the tooth should be treated (RCT).

Here are few scenarios where you may prevent the symptoms before they get worse, or even you get an idea that the time is right to see a dentist now:

  1. Chipped Tooth Or Broken Tooth

If it fairly visible and you are afraid about your looks then call your dentist and explain the situation.

Try to find and retain the chipped particle or any pieces and place it in a moist cloth with a few drops of water or saliva (If kept in good condition, it may be possible to reattach it).

  1. What To Do When Tooth Is Knocked Out Of Socket?

If your tooth is knocked out due to a blunt force trauma causing severe facial injury, try first to find the lost tooth. If the appropriate emergency steps are followed immediately after the tooth has been knocked out, the chances are very good that the tooth can be reinserted and preserved by a dentist.

  • Handle the tooth only by the crown not by the root. If you try to touch the root, u may damage the fragile cells on the root necessary for its reattachment back into the bone.
  • If the tooth is dirty, very gently rinse it in water to ensure that the tooth is clean but do not scrub the tooth or remove any tissue attachment.
  • If you want to then try placing the clean tooth gently back in the socket without touching the root and make sure that the tooth is facing the right direction. Do not force it into the socket. If it is not possible to put the tooth back in position then wrap it in a clean cloth or gauze. Soak it in a container of cold milk or if milk is not available, put the tooth in water that contains a pinch of table salt.
  • It is important to see the dentist for an emergency appointment for the best chances of retaining the tooth.

 

  1. What To Do When Tooth Is Fractured Or Cracked?


  • Rinse your mouth immediately to clean the area with warm water.
  • Take medication prescribed by your physician or dentist.
  • Do not attempt to put any painkiller directly on the site of injury to avoid any burning sensation, it may worsen the situation.
  • Avoid chewing with the injured site and always avoid extreme temperatures that may affect the already traumatized area.
  • Immediately contact your dentist as only he can tell how bad the condition is. The dentist might need to do an X-ray for evaluation of the severity of the situation.
  • See your dentist as soon as possible. Not receiving the proper treatment may result in progression of infection or further decay or damage.

IN CASE OF:

 

Lost Filling

As a temporary measure, you stick a piece of softened sugarless chewing gum at the place where filling is missing.  You should be sure that the gum is truly sugarless, as sugar can cause pain when in contact with the tooth and can lead to bacterial infections in the area.
See your dentist as soon as possible for the proper treatment and care.

Lost Crown

If you dropped out a crown of the mouth, make sure to visit your dentist as soon as possible without waiting for extra days. The tooth portion now exposed that has lost its support could easily be damaged or break off or crumble.

Keep the crown in a cool, safe place because if the crown is not damaged your dentist can reinsert it.

If the crown is out of the mouth for a long period of time, the teeth may shift causing further damage and the old crown will not fit at this stage.

Broken or Loose Brackets, Wires Or Bands

If a wire breaks or sticks out of a bracket it may cause discomfort by poke in cheeks, tongue, or gum.

Try to cover the pointed end with something soft substance like orthodontic wax, sugarless gum, or piece of gauze to avoid discomfort until you visit your orthodontist.

You should never try to cut the wire as you could swallow it or breathe it into your lungs.

Abscess

 

Dental abscess or tooth abscess is an accumulation of pus inside the teeth or gums. It should not be ignored as the infection may spread into nearby spaces affecting other teeth as well.

You may try to gargle with pinch of table salt in lukewarm water for a brief time for some relief.

Contact your dentist for proper care and treatment for the dental abscess before the infection spreads.

Possible Broken Jaw

To control the swelling in the traumatized area apply cold compressions. Stabilize the jaw with bandage wrapped beneath the jaw and tied on top of the head.
A broken or dislocated jaw may cause breathing problems or significant bleeding. If it is not treated properly, a broken jaw can leave you with devastating effects on a person’s ability to eat and breathe.

Sip on ice water and hold for sometime in your mouth until you see your dentist.

 

For more information, you can book an appointment at Dr. Sachdeva’s Dental Aesthetic & Implant Center  I 101 Ashok Vihar Phase 1, Delhi- 110052

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Why Did My Dentist Recommend a Root Canal?

Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.

A root canal is a procedure that is recommended by your dentist in order to repair & save a badly damaged or infected tooth. This procedure involves removal of inflamed or infected pulp, careful cleaning & disinfecting it & then filling & sealing it with a material called gutta percha. The causes that affect pulp are a deep cavity approaching pulp, repetitive trauma to the tooth, a cracked tooth, faulty restoration.

Root canal is essentially a term that refers to the natural cavity that occurs within the core of a tooth. The nerve i.e. the pulp which is removed in the root canal treatment has no role in health & function of a tooth. Its only core function is to provide sensitivity towards hot & cold.

Why root canal treatment is recommended?

Pain: A toothache is the most common symptom of needing a root canal. The tooth may start to hurt spontaneously, in the middle of the night, or sometimes when the patient isn’t even using the affected tooth to eat or drink. The pain can progress to a very severe generalized headache that may cause the person to even forget what initially caused the pain. If the tooth is dead and has become abscessed, the patient will feel pain when he or she chews food or puts pressure on the tooth.

An Abscess:  may or may not produce swelling or bleeding around the tooth, and sometimes it causes significant swelling of the cheek, jaw, or throat. If this swelling is noticed, treatment needs are urgent.

It is very important, when feeling some pain around a tooth, to get a thorough examination with pulp vitality testing by a licensed dentist for a proper diagnosis.

What to expect during a root canal procedure?

  1. X-ray: If a dentist suspects you may need a root canal, he will first take x-rays to be certain of decay location.
  2. Anesthesia: Procedure is initiated with the administration of local anesthesia to the affected tooth.
  3. Pulpectomy: an opening is made & the diseased tooth pulp is removed.
  4. Filling: The roots that have been opened to get rid of the diseased pulp are filled with gutta-percha material & sealed off with cement.

 

Why Root Canal??

Saving the natural tooth with root canal treatment has many advantages:

  1. Efficient chewing
  2. Normal biting force and sensation
  3. Natural appearance
  4. Protects other teeth from excessive wear or strain

Modern endodontic treatment is very similar to having a routine filling and usually can be completed in one or two appointments, depending on the condition of your tooth and your personal circumstances.

You can expect a comfortable experience during and after your appointment at Dr. Sachdeva’s Dental Institute.

Post-Operative Complications of Implant Placement

With the increasing acceptance of dental implants as a viable tooth replacement therapy, complications & failure rates have also increased proportionately.

A range of possible post-operative complications & their prevention are described below:

  1. Infection: Implants are made of titanium, which is strong & biocompatible, which means that is not rejected by the body. So the chances of developing post-operative infection are extremely rare. At times when dentist do not follow effective & strict protocol of sterilization, patient might be vulnerable to post operative infection.

Post-operative infection causes pain & discomfort to the patient, reason being- bacterial contamination of implant or surgical site during the procedure.

If the infection is limited to the soft tissue, a small gum boil will be noticed over the implant site. It can be punctured using a sharp probe & irrigated with chlorhexidine solution or citric acid. It heals & the pain subsides within 24hrs.                                                                                        In case of continuous pus discharge & severe pain which is not relieved by analgesics, this depicts that the infection has reached to the bone-implant body interface.

Prevention: one should follow strict protocol of sterilization in the operatory in order to avoid any bacterial contamination. Also, in such cases, the implant should be removed immediately & prescribe good antibiotic like tab Augmentin 1000mg twice a day for 5-7 days. A new implant can be inserted when the site gets healed in 6 weeks.

  1. Post-operative Edema: Post-operative edema develops in cases of traumatic implant placement. High speed drilling & no constant stream of chilled saline causes bone to overheat & this leads to accumulation of fluids in tissue spaces i.e. edema.

 

Prevention: Unnecessary trauma to the bone must be avoided during osteotomy preparation. Drilling speed must be set according to the density of bone along with a pumping motion of the drill should be employed during drilling to allow the saline to cool down the bone. This prevents overheating & necrosis of the bone.

Patient must be advised to apply an ice pack over the facial   skin of the surgical site intermittently for 45 min to cool down the bone in order to suppress heat generation & inflammatory oedema.

        prevention

  1. Pressure necrosis: results in cases where implant has been inserted & screwed at a very high torque, it may lead to pressure necrosis of the surrounding bone & the patient will complain of continuous pain not relieved by analgesics, for weeks after the surgery.

 

Prevention: Drilling at higher speed with maximum amount of chilled saline irrigation flow to cool down the bone. Use of final drill with the diameter only 0.2mm less than the implant diameter along with the use of bone tap to prepare threads in the bone to accommodate implant threads. Following these instructions help in reduction of post-operative pressure necrosis.

  1. Suture line opening: leads to exposure of implant threads in the oral environment & may cause the collection of plaque over the exposed rough surface of the implant, which may further cause peri-implantitis & loss of hard & soft tissue around the implant.

 

Causes of implant thread exposure

  • Suture line opening & loss of graft in cases where simultaneous bone grafting has been performed with implant placement also leads to implant exposure.
  • More superficial implant placement.
  • Thin mobile soft tissue recedes with muscle pull.

        Management:

  • Tension free sutures should be used to avoid the suture line opening because of the tension in the flap.
  • The open suture line should not be re-sutured but the patient should be instructed to keep it clean, as it heals by secondary intention in 2-3 weeks.
  • If soft tissue healing has not covered the exposed threads, either cover the threads using soft tissue grafting with or without simultaneous bone grafting, or adequate grinding & polishing should be done to make the surface smooth & prevent accumulation of plaque.

  1. Bone resorption: one of the most common complication in dental implantology. When occlusal forces are not distributed equally i.e. is off-axis to the implant prosthesis leads to resorption. Also, when implant with a wider platform is placed into the narrow crestal bone causes crestal bone resorption.

 

Prevention: Implant must be placed along the axis of the future prosthesis. For large mesio-distal diameter two implants should be placed with narrow occlusal table of prosthesis. Along with the maintenance of oral hygiene, soft tissue grafting for compromised soft tissue around the implant must be addressed.

  1. Peri-implantitis: is an inflammatory reaction with the loss of supporting bone in the tissues surrounding a functioning implant. Peri-implantitis is characterized by bleeding/suppuration on probing, together with loss of supporting bone.

The peri-implantitis lesion exhibits histopathological features that similar, but not identical, to those in periodontitis. Similar to periodontitis, the treatment of peri-implantitis must be based on infection control. Under these conditions, progression of the disease may be arrested & subsequent, lost peri-implant tissues may be generated by bone augmentation & soft tissue grafting procedures.

peri-implantitis

With this increasing trend of replacing the lost tooth with an implant, at Dr. Sachdeva’s Dental Institute, we incorporate several associated procedures like bone augmentation to provide this therapy to the maximum number of patients. We follow strict protocol for sterilization & restore implants to minimize postoperative or post loading complications.

Root canal , Apicoectomy and Cancer

What Is Apicoectomy And Why It Is Done?

root canal procedure is a treatment to save a damaged, infected or badly decayed tooth.

Although root canal infections can be treated by conventional root canal therapy, but in some cases when the infection persists after root canal treatment or re-treatment, an APICOECTOMY is considered to be important to solve the infection and treat the problem.

  1. What Does Apicoectomy Mean?
  • Apicoectomy is a microsurgical treatment procedure where the very end of the tooth’s root (Apex) is removed along with the infection attached to the root tip. The apex is sealed with a filling to prevent micro leakage.

  1. What About Apicoectomy Procedure I Need To Know?
  • The endodontist gives local anesthetic to the already RCT treated tooth to numb the surgical site of the patient.
  • The gum and bone is cut and lifted to access and visualize the root tip/apex.
  • The root tip is resected and the infected tissue is curetted. The end part of root canal is cleaned and sealed with biocompatible sealer material. The endodontist then sutures the tissue back in the original place.

  1. Does The Procedure Hurt?
  • The endodontist will give local anesthesia to make sure that the treatment is painless and more comfortable.
  • Other than that, patients are prescribed with appropriate pain medications to help ease the discomfort.

  1. How Long Does The Apicoectomy Treatment Take?
  • The treatment is generally done in single sitting appointment.
  • The procedure takes about 1-2 hours depending upon the tooth location and complexity of the roots.

  1. If The Patient Doesn’t Want The Treatment?
  • If the patient is not willing for the treatment, then the tooth needs to be extracted and an implant can be surgically placed to replace the missing tooth.

Root Canal and Cancer

  • In new studies, Researchers found that patients had a 45% reduced risk of cancer with multiple endodontic treatments.

Till date, there is no valid, scientific evidence that proves any link between root canal-treated teeth and disease elsewhere in the body.

 A 2013 study published in a journal found that a patient’s risk of cancer doesn’t alter after a root canal therapy. Researchers also found that patients with multiple endodontic treatments had a 45% reduced risk of cancer.

There are also few myths about Root Canal Treatment shared by a large section of people onto which we would like to shed some light.

  1. MYTH –The Root canal treatment is painful.
  • TRUTH – In fact Root canal treatment doesn’t cause pain, it actually relieves it.
  1. MYTH – Root canal treatment makes you ill/sick.
  • TRUTH – There is no substantial, scientific valid proof which links root canal-treated teeth and disease elsewhere in the body.
  1. MYTH – An excellent substitute to root canal treatment is extraction of the tooth.
  • TRUTH – Saving your natural teeth, is always the ultimate best option if the tooth is not damaged beyond repair.
  1. MYTH – Root canal therapies often requires many visits, wasting your precious time.
  • TRUTH – Now due to introduction of advanced technologies, Root canal therapies can be completed in one or maybe two appointments.
  1. MYTH – If you’re not feeling any pain in your tooth, you do not need a root canal treatment.
  • TRUTH – Teeth are not always painful that require root canal therapy.

We at Dr. Sachdeva Dental Institute And Implant Center try to leave no question unanswered.

We practice endodontics with dental microscope which provides enhanced visualization and access to the most difficult angles of the teeth, mouth and jaws, and allows for a better and more accurate diagnosis and treatment.

It significantly improves quality of treatment and improved after treatment results.

For more information, contact us at: Contact us at
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10 Frequently Asked Questions about Caries

The world has almost 60–90% of teenagers and about 100% of adults suffering from dental cavities.

People often get confused about what to follow for their dental health and hygiene so here we present you some answers for the most often asked queries.

  1. None of my teeth hurt; does that mean I don’t have cavities?

There is no such evidence that proves relation between pain and cavity, which means that even though you might not experience any pain but cavities still are present. Smaller cavities are generally associated with sensitivity to cold or sweet as similarly with the wrong brushing techniques, teeth grinding, abrasive food or beverages etc. these conditions are present without any painful symptom but already in queue for dental care attention.

These conditions are treated with minimally invasive restorations at an early stage but if ignored, it is always going to deteriorate into a much painful and worse condition. It is always preferred to ask help from a dentist when a person suspects anything unusual and better get it treated earlier before you get more problems.

.

  1. What happens inside cavity?

A cavity always starts with the enamel damage that gradually grows deeper into dentin. It takes a long time for an enamel damage to develop into a cavity. There is always time to prevent decay at initial stage.

When the decay reaches the deeper layers, it will form a cavity which needs to be cleaned and filled before it reaches pulp. If the pulp is affected, a person is going to have every symptom from sensitivity to cold, sweet, hot food to severe pain on biting.

  1. Does a decayed tooth ever heal by itself?

A cavity is a permanent destruction to the tooth surface caused by bacteria which will never heal by it-self. There’s one and only one thing a person can do is to visit your dentist and get it cleaned and filled to stop the further decay of the tooth. If a person wishes to wait to decide for the treatment, the caries would be progressing towards the pulp therefore creating more damage to the tooth.

In case if decay reaches the pulp, only one treatment is left which is root canal treatment in which the dentist removes the infected pulp and filling is done. If the damage is even more, then it goes for extraction.

  1. How a dentist treats a cavity?

Firstly the dentist cleans the decayed portion on the surface of tooth, after the surface is cleaned, the dentist fills the cavity with the filling material which are either self-hardening or cures (hardens) by light. Then the surface is shaped, finished and adjusted to a height which doesn’t hinder in biting.

  1. What does a dentist do to relive the pain?

A dentist always tries to num the pain using topical gel and sprays, followed by injections if needed. It is always advisable to tell your dentist about your discomforts and anxiety so that he could address them properly.

  1. What if a person has more than one cavity? How many appointment a person generally needs?

A filling normally takes about 20-30 minutes depending upon their size. It also depends on how a person is comfortable with opening their mouth for the time required for filling. The longer a person is comfortable with their mouth open, the less time it will take to fill the cavity

Also it depends on the number of cavities. A dentist always evaluates about the damage teeth has and the most damaged tooth is given the priority in such cases.

When crowns are concerned, they always take more than one appointment. In first appointment the tooth is shaped and prepared for the crown, and the impression is taken in that sitting and a temporary crown is given. One week later the new customized crown is ready to e bonded over the prepared tooth. Adjustments are done and patient is called for a follow-up and the patients if have any discomfort is corrected.

  1. Who needs a filling?

When a tooth has small fractures, it usually doesn’t require filling. May be polishing and minor shape adjustments are enough for that. Bigger fractures may require fillings and in some cases, crowns.

  1. Is the filling is as strong as natural tooth?

Small and mediums fillings are generally strong enough to withstand some amount of force. Bigger damaged tooth may require crown if adequate strength is needed. A big filling may also provide some strength but may not work well under tremendous pressure and might end up breaking and is some cases it breaks along with tooth. In such cases, the tooth is even more damaged than before. Therefore dentists generally prefer crown in such cases.

  1. Fillings last for how long?

Researches show that amalgam filling has survived over 12 years and composite fillings up to 9-10 years. Crowns and veneers can survive for at least 10-20 years and even longer depending upon the care taken. Studies have shown that a filling is safe after 8-12 years and crowns lasting for 30-40 years depending on the situation and the precautions taken.

  1. Should one expect soreness or pain after the treatment?

A person may feel slight discomfort for a few days after your tooth has gone under drilling and filling. The symptoms only last for few days or less.

The tooth may feel more sensitive if the cavity was large than usual. The symptoms will gradually fade away after certain time. In such cases monitoring the cavity is recommended for the symptoms and the healing.

Therefore it is important to visit your dentist regularly for dental check-ups and when you feel any discomfort and pain so that you can control the situation at the earliest to avoid the risk in future.

Intraoral welding of implants-known since decades- conveyed to practice

In cases of complete oral rehabilitation there are multitudes of complications which may occur with either the surgical or prosthetic phase of implant dentistry. In order to mend this, intraoral welding technique has been introduced as a rescue.

In cases of deficient bone or atrophic ridges, higher chances of implant failure occur due to micromotion of implants during healing phase.

This is one phase procedure to attain the goal of primary stabilization of implants while fabricating immediate prosthesis to the patient on the same day of the surgery or within a few days.

 Discussing about the advantages of welding, it rigidly splints the implants, helps in healing, distributes the force to all implants, and increases the success through Osseo integration of implants. In cases of implant overdenture, absolute stabilization of implants can lead to immediate loading and oral rehabilitation on the same day of surgery.

The welding of the implant abutments with titanium bars is done directly in the mouth. It also has an advantage of eliminating the possible errors or distortions due to the impression.

 The rigid splinting of the implant abutments done before the immediate loading provides retention to the implants & decreases the stress exerted on the implants. The method incorporates either welding a titanium bar or a wire to the abutments of these implants. Once the implants have achieved the stability and retention, they can be loaded with crowns/ bridges or over dentures.

weldone

This has been reported leading to lesser degree of implant fractures. This means ensuring success for the longevity of the implants, in a short period of time. For example in a case of complete rehabilitation of a patient required extractions are done followed by insertion of implants (either 6 or more if required) into the jaw bones.

 During the surgical stage the curettage of the gums is done simultaneously. The bite of the jaws is recorded at first before commencing any procedure.post implant insertion the intra oral welding of the abutments is done. Afterwards the fabrication of the hybrid denture prosthesis is done and fixed in the mouth.

 The stabilized prosthesis helps in chewing & speech of the patients along with the natural aesthetic look. The discomfort due to the movement and clicking of the dentures is avoided in such cases. The aim of this new technique is to find the optimal conditions for the success of the implants through continuous joint without alterations in the intraoral welding of titanium by electric resistance technique.

The proposed technique allows intraoral welding of titanium for solidarization of dental implants to improving their primary stability. Commercially pure titanium (c.p. Ti) wires and dental screws were welded by electric resistance technique. Worldwide, clinical cases have demonstrated the effectiveness of this technique in the improvement of dental implants primary stability practically.

“Start-Up” Program in Implant Dentistry Mentoring

Mentoring by Surgical Master Dr.Rajat Sachdeva

If you are looking for a Mentor to help you with your dental implant career then we may be able to help.

Dr Rajat Sachdeva has mentored and trained many Dentists over the years through formal courses and individually on a one-to-one basis.

If you have no experience of dental implants then it may be helpful to take a look at the section http://www.sachdevadentalcare.com/implanto-dontia.html

where details of our courses can be found. These courses are a great way to get started with dental implants.

Alternatively if you already have experience with dental implants but want to increase your confidence in certain areas then individual mentoring with Dr.Sachdeva may be more appropriate. For example, if you have already completed a few cases but want help with overall treatment planning then one-to-one Interaction with Dr Rajat could be very beneficial. Or, if you place implants confidently but want help with bone grafting techniques, Dr Rajat will be pleased to assist you.

Basically we can tailor individual mentoring to whatever level or area you require.

If you want to consider being mentored by Dr Rajat Sachdeva contact him directly on 01142464041 for an informal chat.