Examination
The purpose of a dental examination is to find out if you have any problems or diseases of the mouth or teeth. The most common dental diseases are cavities, or holes, in the teeth (dental cavities) and tooth loss (periodontitis). The sooner these diseases are detected, the easier they are to treat. There are also other diseases of the mouth and teeth that can be detected during an examination. Therefore, it is recommended that you go for regular checkups. Depending on your treatment needs, we can create an individual treatment plan for you as well as decide how often you need to go for checkups.
Periodontal Disease (gum disease)
Gum disease is a serious infection that affects and breaks down the tissue surrounding the teeth. An early sign of gum disease is that your gums bleed when brushing your teeth.
Inflammation of the gums is caused by thin layers of bacteria and food residue that constantly form in the mouth. If these are not thoroughly and regularly cleaned at home they, in conjunction with saliva, form tartar (or plaque). Tartar can accumulate along the gum line, and will spread down along the root of the tooth, creating deep pockets in the gums. This leads to an irreversible loss of the jawbone which causes poorer stability and, eventually, loss of the tooth.
Gum disease is often such a slow and painless illness that you do not detect the disease yourself until one or more teeth begin to feel loose. Therefore, it is important to be regularly examined by a dentist or dental hygienist.
Treatment of Cavities
There are several hundred different types of bacteria in the mouth. Most of these fulfill an important function, but some may cause harm. When oral bacteria are fed with carbohydrates, especially sugar, they begin to produce acids that corrode the enamel. The attack of these acids is usually interrupted after a while when saliva in the mouth neutralizes the balance and the dissolved enamel is repaired. If the teeth are often exposed to the harmful acid attacks, the saliva is unable to keep up with the damage and the risk of cavities increases.
Cavities should be prevented as much as possible. With the help of fluoride, the development of cavities can be slowed down. Given the right conditions, a small cavity can even heal on its own. Fluoride does not, however, have much of an impact on cavities caused by disease. In such cases more specific treatments are required. Locally applied fluoride gel, improved cleaning between the teeth, and a change in diet are examples of such measures. An early sign of cavities can be seen as a white spot or stripe on the tooth. However, not all injuries are not visible with the naked eye. If the damage is on the surfaces of teeth that are not visible, such as between the teeth or under a previous repair, the dentist must rely in help from an X-ray. Untreated cavities will eventually spread to the softer dentition under the enamel. Then the damage is done and must be repaired.
Filling Treatment
A tooth with ongoing damage from cavities must be repaired. This involves removing the diseased tissue well before it spreads to the deeper tissues causing greater damage. The more extensive the damage, the more costly the treatment to repair it will be. If most of the tooth is intact, we can do a filling treatment with good results.
The most common filling material is composite. Composite consists of a plastic pulp with small particles of quartz or glass. It is hardened, or cured, using light. Composite is a tooth-colored plastic filling giving it good aesthetic properties, and it requires minimal tooth removal as it can adhere directly to the tooth. It has good mechanical properties and a good long-term prognosis.
Glass ionomer cement is another tooth-colored filling material that can be used when composite is not suitable. The main benefit of glass ionomer cement is its ability to absorb and release fluoride, which can prevent cavities. In addition, it is less moisture sensitive and can be used on hard to reach surfaces. However, glass ionomer cement has its limitations and is used primarily for long-term temporary fillings. It is also used as dental filling material on milk teeth (baby teeth) as well as in adults with high risk of cavities.
Root Canal Treatment
Deep cavities or leaking fillings can damage the interior of the tooth. If you are bothered by dull pain, sensitivity to cold and heat, swelling and soreness, it can be a sign that bacteria have reached the dental nerve. The bacterial infection spreads through the root canal and causes the jawbone to degenerate and break down at the root tip. If you do not do a root canal in such cases, the tooth may need to be removed. There may also be other reasons why a tooth needs a root canal treatment, for example, during heavy clenching of the jaw.
A root canal is time consuming and is usually performed on two treatment occasions. Initially, the root canal is cleaned and filled with an antibacterial agent for a couple of weeks. Then the root canal is filled with a dense rubber material and sealed so that no bacteria can reach it. A tooth that has had a root canal is usually weakened. Therefore, the tooth must be ground down a bit to avoid force and stress from chewing otherwise there is a risk that the tooth may crack. Then the tooth is built up again with a filling or a crown.
Prosthetic Treatment
In cases of extensive dental damage caused by cavities or trauma, normal repair of the tooth, such as a large composite filling, does not lead to a good prognosis. A better alternative is to reconstruct the tooth with a laboratory-made crown. After the damaged tooth has been sanded and adjusted, we make a cast of the tooth with an impression which is then sent to a dental technician for the production of the crown. A week later, the crown is ready.
In the case of the loss of one or more teeth caused by cavities, damage, or trauma, a dental gap can occur. It can also occur at birth.
If one or more teeth are missing, and the neighboring teeth are partially repaired, we can replace the gap with a bridge anchored to the neighboring teeth. The adjoining teeth are ground down in a similar manner to when installing a crown. With the help of an impression, we make a cast of the teeth that will be included in the bridge. After about a week, the dental technician has produced the bridge which can then be cemented in.
If, on the other hand, the neighboring teeth are intact and lack repairs, a single implant should be considered. This means cementing a crown on a titanium screw that is screwed down into the jaw bone. This makes it possible to avoid having to grind down the healthy neighboring teeth.
Tooth Removal
Sometimes a tooth becomes so severely damaged or infected that it cannot be saved. In such cases the tooth must be removed. A deep cavity injury that has spread into the root under the bone can be difficult to repair and then the tooth should be removed. Even a tooth that has had a root canal on two different occasions, but shows no improvement has poor prognosis in the event of a new treatment. Therefore, it be removed. A vertical fracture through the root has the worst prognosis and cannot be saved. Severe periodontal disease, where significant bones have been broken down, has very poor prognosis for recovery and the tooth must also be removed.
Reasons for removing one or more teeth can also be found in connection with corrective orthodontics. Usually this is necessary because the teeth are too crowded and there is no space. Therefore, some teeth must be removed to make it possible to move the other teeth with the help 0f braces. You may also need to remove teeth that are stuck in the jawbone, as there is a risk of injury to the adjacent teeth. If you get repetitive pain and swelling in a wisdom tooth, it can be gum inflammation caused by bacteria in a gum pocket. It can also lead to difficulties in opening your mouth widely. Wisdom teeth can also grow obliquely into the neighboring tooth. To prevent this, it is recommended that the wisdom tooth be removed if it risks causing problems. If the tooth is deep in the jawbone, a minor operation is a faster and safer alternative than a regular tooth extraction. Such an operation can normally be performed with the same kind of local anesthetic used in common dental repairs.
TMJ and Orofacial Pain
People of all ages can suffer from pain in the head and face as well as parts of the neck. It may be because you grind, squeeze or clench your teeth while sleeping. This is called a tension headache and can be described as pressing, heavy and dull pain, but not pulsating. The pressure is felt over the forehead, the temples, or the neck. The jaws and neck muscles can feel sore and tense. Teeth can also be jagged and have sharp edges.
The most common cause of tension is stress of various kinds. A tension headache can be seen as the body's way of showing you that you need some peace and quiet.
A mouth guard is used to make it easier for tense jaw muscles to relax. This leads to reduced pain as well as improved jaw function. It is a molded plastic mouth guard in soft or hard plastic that you use during the night. It also stabilizes the bite and protects against wear on the teeth and jaw joint. Sometimes irregularities in the bite can lead to tension caused by and during chewing. In such cases it can suffice with a bite adjustment where, for example, an older filling is smoothed out. Even exercise and relaxation exercises can help with tension headaches.