Dr. Vivek Patni

Dental implants are titanium posts, which resemble the root of the tooth. These posts are embedded on the jawbone below the gums. This makes it easy to place missing bridge or teeth of the area where inserted. Implants are different from dentures and benefit the oral health as they are not fastened to other teeth like the bridges. Titanium is considered to have an affinity with bones and also when the new cells grow they attach to the post, thereby, making a strong bond.

Factors to consider for oral implants:

For consideration of implants, it is a must that one should have healthy gums and sufficient bone support. In case the bone is soft and thin, a bone graft might be required to support the implant. Also, if in the upper jaw the bone height is not much or the sinuses are near the jaw then a sinus lift might be required.

One has to undergo a surgery to get replacements through dental implants and this fact is enough to give jitters to people. The fact is that implant surgery is just a routine procedure and is very successful if done in the correct manner and by trained hands.

Reasons not to worry about implant surgery:

The procedure is planned: This surgery is a minor operation as all the details are usually plotted prior to the procedure. In a case of complex conditions, Ct imaging or x-rays are used to locate the positions for the implants. Surgical guides can also be used to generate passages and incisions for the placement of the implants.

Surgery can be done under local anesthesia: If a person has a healthy mouth then there is no problem for an implant surgery as it is much easier as compared to an extraction. When performed under local anesthesia then only the implant site and the tissues close to it are numb. Some people who suffer from anxiety can request their dentist anti-anxiety medication or a sedative to make them calmer.

Minimal post surgery discomfort: A pre-planned procedure and advanced technique lead to less tissue disruption. Also, the tissues, which are incised are stitched together with absorbable sutures. Post surgery a NSAID (non-steroidal anti-inflammatory drug), such as aspirin is enough to relieve discomfort. In some cases, strong pain relievers might be required.

The implant heals very quickly and success rate of dental implants is almost 90 to 97%. After some days of the bone integration, dentist fixes a permanent crown which provides the same functions as that offered by the natural tooth. A successful implant is sure to give a confident smile and functions for a long time.

Tooth decay is treated removing the damaged portion of your tooth and substituting it with ‘fillings’. Fillings can be made up of different materials such as silver amalgam, porcelain, gold or even plastic. Hence these plastic, tooth-colored, glass mixtures that are used to restore decayed teeth are known as composite fillings. Composites are also used for changing the color of or reshaping disfigured teeth. 

How are they placed? 
The dentist sets the composite in layers employing a specialized UV Laser light to harden each of the layers. After this, the dentist moulds the composite to fit in your tooth. The composite is then polished to prevent premature staining or wearing out of the composite. Good shaping and polishing of the tooth to produces a virtually invisible restoration.

When are composite fillings used? 
White fillings can be used for cosmetic options as well. 

Esthetic dentistry

1. Short or spaced out teeth: Composites are able to reshape any deformed teeth or add length to a tooth. 
2. Cracked or chipped teeth: It can fill in any chips or worn down teeth to appear healthy yet again. 
3. Smile Makeover: It does not require for healthy tooth structure to be removed unlike a veneer

Preventive dentistry: The molars in the back have deep groves on the sides that food particles can get trapped in causing infection. The composite can be filled in those areas as a preventative.

Advantages of Composites:

1. The shade of the composite filling is well suited to match the color of your existing teeth.
2. They can chemically bond to your tooth structure, rendering additional support.
3. Composite fillings are also used to mend broken or cracked teeth.
4. With composite filling, not much of your tooth structure needs to be taken off as compared to amalgam fillings.

Precautions with Tooth coloured fillings 

1. Composite fillings wear faster as compared to silver fillings should be replaced within 3-7 years.
2. Need regular follow up care or maintenance as they are subject to microleakage. 

   If you wish to discuss about any specific problem, you can consult a dentist.

Dental problems can be very painful and take the smile off your face completely. Those who have experienced sensitivity would vouch for it. It just will not allow you to enjoy the hot coffee or a favourite sweet or a cold smoothie.  The pain that shoots down the tooth after any of these would leave the person shuddering.

The tooth has 3 layers, from the outside in these are the enamel, the dentin and the pulp.  The outermost enamel is mineralized and the hardest structure in the body. The next layer, dentin, has fine tubules and when the enamel is worn off exposing the dentin, sensitivity sets in. The enamel is thinner in some portions of the tooth like the neck and the roots, therefore sensitivity onset is quicker in these areas.

Some of the common reasons for sensitivity are listed below:

1. Tooth decay:  As caries progresses from enamel to dentin, sensitivity sets in, especially to hot and cold foods.
2. Wear and tear:  Excessive brushing of teeth can lead to wearing of teeth, especially near the neck areas, leading to loss of enamel and resulting in sensitivity.
3. Dental damage:  Chipped or broken tooth can lead to sensitivity.
4. Gingival disease: This leads to loss of gum cover over the tooth, leading to exposure of dentin and therefore sensitivity.
5. Bruxism: Clenching of teeth, common in people with high levels of stress, can lead to enamel wearing and subsequent sensitivity.
6. Dental treatment: Some dental procedures like scaling, crowns, root planing, and some fillings can cause transient sensitivity.
7. Highly acidic food items: Citrus fruits, tomatoes, tea, etc. can lead to tooth sensitivity.
8. Bleaching agents:  Most tooth whitening agents result in sensitive teeth.
9. Excessive use of mouthwash: The mouth rinses contain high amount of alcohol which can also lead to tooth sensitivity.

Management: As with all health conditions, the first step in management is to identify the problem.  Whether it is dental decay or recent dental treatment, food habits or tooth whitening agents, the cause needs to be identified and then treatment begun accordingly.

1. For lost enamel, be it decay or damage, the tooth again needs to be restored to its original form to cover the dentinal tubules and reduce sensitivity.
2. For habits, be it food related or bruxism, in addition to treating the tooth, the habit per se needs to be addressed to prevent recurrence.
3. For associated dental products like whitening agents or mouth rinses, talk to a dentist to switch to a less harmful product.
4. De-sensitizing pastes are also available that can be used on a regular basis to reduce the problem.

Tooth sensitivity is annoying but there are ways to manage it effectively.