Hello!
Crown, Veneer Lumineer, those are strange terms that one can come across, or hear at the dental office. What are they?

They are actually methods of preserving / restoring a tooth.

A crown is a prosthetic restoration used to entirely cover or cap a damaged tooth. Besides strengthening a damaged tooth , a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth like shape and structure for function.

Your dentist may recommend a crown to

  • replace a large filling when there isnt enough tooth remaining.
  • protect a weak tooth from fracturing
  • restore a fractured tooth
  • attach a bridge
  • cover a dental implant
  • cover a tooth that has had a root canal treatment.

How a crown is fit

Visit 1. On your first visit to the dentist, the tooth is prepared and an impression is taken.

  1. step1 : After numbing the area the dentist trims some tooth structure ,just enough to provide space for the crown to fit in. This is also done to provide adequate strength and give room for proper shape.
  2. Step2: After the tooth is reshaped and impression is taken by the dentist.
  3. Step 3: Shade selection with your dentist, to make sure that it looks as natural as possible , similar to remaining teeth
  4. Step 4: A temporary tooth is made on the chair to replace the tooth while the impression is being sent to the laboratory.

Visit 2.

  1. On your second visit, the temporary tooth is removed.
  2. The permanent crown is fitted, and occlusion is tested using an articulation paper.
  3. Once both doctor and patient is satisfied, the crown is cemented tp the tooth.

Crowns can be of different materials such as metal , ceramic or ceramic over metal.

Veneers

Dental Veneer are tiny shells of porcelain that are custom made to fit over teeth providing a natural attractive look. they can be used to fix chipped stained misaligned worn down uneven or abnormally spaced teeth. Veneers are difficult to stain , making them popular for people seeking a perfect smile while keeping as much sound tooth structure as possible.

Procedure for getting a veneer

Getting a veneer usually takes 3 sittings with the dentist.

The first one is consultative where a dentist examines the teeth to make sure if it is appropriate and discuss the procedure and planning .

If a different shape is desired like the case I am working on at the moment, then at first appointment an impression is taken for study model and sent to the laboratory and a wax up is made.

At second appointment, if the patient validates the projected result, the dentist will shave a little bit of enamel from the tooth surface. This will be equal to the thickness of the veneer that will be added on the tooth.  Next an impression will be taken and sent to the dental laboratory where a the prosthesist will fabricate the veneer. The dentist will put a temporary veneer on your tooth. And you will be recalled in about a week time.

After a week, the temporary veneer is removed and the permanent veneer is cemented. The dentist will tell you a list of precautions to be taken.

Lumineers on the other hand are very very thin shell like structures placed on the teeth without the need of shaving the tooth. This is done in very specific cases. And very few laboratories do it in the Indian Ocean do it.

Personally the laboratory I send my works to do Emax Veneers.

IPS e.max Lithium Disilicate

Lithium disilicate (LS2) glass-ceramic is ideally suitable for the fabrication of monolithic restorations or veneered restorations in the anterior and posterior region. Due to its natural-looking tooth colouring and excellent light-optical properties, this material produces impressive results.

Years of clinical experience
The material is used in the dental laboratory in conjunction with either press or CAD/CAM technology. Years of clinical experience confirm the high strength of 500 MPa* for IPS e.max lithium disilicate. The outstanding performance of the material is based on a combination of excellent flexural strength and high fracture toughness adjusted to the given dental requirements. The clinical success of the material attests to its quality. Furthermore, these properties allow you to work according to the requirements of conservative dentistry. Depending on the patient situation, the restorations may be veneered in a highly esthetic manner or, if fabricated as monolithic restorations, they will be stained.

Patients with devitalized teeth
Even if the preparations demonstrate a dark shade (e.g. as a result of discolouration or titanium abutments), all-ceramic restorations may be used. In this case, it is important for you to inform your laboratory about the die shade, and the dental technicians then selects the IPS e.max lithium disilicate material in the required opacity in order to design the true-to-nature esthetic appearance.

Indications

  • Veneers (≥ 0.3 mm)
  • Inlays and onlays
  • Occlusal veneers, partial crowns
  • Minimally invasive crowns (≥ 1 mm)
  • Implant superstructures
  • Hybrid abutment solutions
  • Three-unit bridges up to the second premolar as the terminal abutment

Advantages

  • Excellent esthetics and high strength (500 MPa*)
  • Versatile applications and extensive indication range
  • Minimally invasive preparation and adhesive cementation of crowns with a layer thickness of 1 mm
  • Clinical long-term success and scientifically documented results
  • Natural-looking esthetics irrespective of the preparation shade
  • Adhesive, self-adhesive or conventional cementation depending on the indication

* Mean biaxial flexural strength (IPS e.max CAD 530 MPa, IPS e.max Press 470 MPa). Source: R&D Ivoclar Vivadent, Schaan, Liechtenstein

Below are more information about the materials used. Please do not hesitate to contact me if you have more questions.
Links:

Brochure for patient information.

Brochure for dentist 

Lab to dentist

Video of Crown fabrication at the lab

 

Like all things dentist-related, dental anesthesia probably seems a little scary at first. We understand that gut reaction. If your dentist gives you a drug for a procedure, it probably means that procedure is really serious, right? You might even think that dentists only use anesthesia for risky or especially complicated procedures.

We’d like to show you why your fears are unfounded. Truthfully, dental anesthesia is safe, effective, helpful, and totally routine. Dentists use it every day, for all kinds of different procedures. Just because you have to have anesthesia for a dental procedure doesn’t mean there’s something seriously wrong with your teeth.

WHAT WE USE

Dentists use a variety of different anesthetics for different purposes. The type they use depends on what they need the specific anesthetic to do. Here are three pain control items we commonly use at dental offices, how they work, and what they’re for:

TOPICAL ANESTHETIC

Topical anesthesiaTopical anesthetic is applied to a specific area of soft tissue to numb it. It’s commonly referred to as numbing gel or jelly and even spray. Dentists usually apply it with a simple cotton swab or cotton roll. In order to work effectively, dentists let the gel sit on the surface it’s numbing for a few minutes.

Generally, dentists use topical anesthetic to numb the cheek or gums before an injection of local anesthetic in order to make the injection more comfortable. It works great on the surface of the mucosa or gums, but it can’t reach the nerves deep under the gums or within the teeth. Whenever dentists need to drill into teeth (like they do when placing fillings), they need to use more than just a topical anesthetic. It’s possible that your dentist won’t use topical anesthetic for every procedure. If your dentist doesn’t use numbing gel, don’t panic. If you are concerned about the anesthetics they’re applying, feel free to ask!

My patients love the gel, and mind you they are mostly adults! 🙂

LOCAL (INJECTED) ANESTHETIC

local anesthesticDentists use local anesthetic by injecting it directly into the area they want to numb. A local anesthetic temporarily deactivates the nerves in a specific part of the mouth. After administering it, dentists can perform a variety of procedures in that area without the patient feeling it. Dentists inject local anesthetics through a thin needle, usually after applying a topical anesthetic to the area. The patient seldom, if ever, feels pain from the prick of the needle used for the injection. At worst, they may feel a brief, slight pressure at the point of insertion.

Lidocaine is the most commonly used local anesthetic among dentists, but there are several other common varieties as well. Along with the anesthetic itself, injections often include a small amount of epinephrine (which your body already makes for itself in larger quantities) to constrict the blood vessels around the injection site and help the anesthetic work effectively and last longer. Dentists use local anesthetic for dental procedures that would be painful without it, like root canals, extractions, or fillings. Contemporary local anesthetics effectively numb any area that invasive dental procedures could affect.

NITROUS OXIDE (LAUGHING GAS)

NOT YET ALLOWED IN MAURITIUS- DEMAND HAS BEEN MADE

nitrous oxideNitrous oxide, or “laughing gas,” is a colorless, odorless gas commonly used to reduce anxiety in patients during dental procedures. Although it’s technically not an anesthetic, it does have some pain control properties. It’s called “laughing gas” for the euphoric state it imparts when it’s inhaled. Dentists administer it via a breathing mask that fits over the patient’s nose. The patient breathes in a mixture of the gases that’s usually around 30% nitrous oxide and 70% oxygen. The gas begins working within minutes. Dentists easily reverse the effect after treatment by switching to 100% oxygen.

Nitrous oxide doesn’t put patients to sleep, but it does have an effect on the nervous system. It’s used primarily as a means of relaxing anxious patients, but it also has some analgesic properties that help control pain. Nitrous oxide is considered reliable and safe because the effects are mild and easily reversed. It’s ideal for dental procedures because patients under its effects remain conscious and can respond to questions. Dentists can also easily control the amount of nitrous oxide administered to the patient. Dentists use Nitrous oxide in conjunction with, not instead of, local anesthetics.

WHY WE USE IT (anesthesia) ?

Procedures like fillings, crowns, and root canals involve drilling into a tooth to remove decayed tooth material. In the case of root canals, dentists even have to remove inflamed or diseased pulp tissue and nerves. Fortunately, anesthetics allow dentists to perform these procedures safely and effectively in the controlled environment of the dental office while your body doesn’t know that’s what’s happening.

Without anesthetics, many dental procedures would be quite painful, even though they’re being performed perfectly correctly. Anesthetics numb your mouth’s nerves to keep them from transmitting pain signals to your brain. You don’t interpret the procedure as painful. After the dentist finishes the procedure, your mouth won’t either! Many dental procedures may cause minor aches and pains for a couple days after they’re completed, and sometimes injection sites can be sore as well. This discomfort is also natural, and is usually the result of the needle penetrating through gums or mouth muscles during the injection.

 

Still feel a little scared of dental procedures? That’s ok! You can always ask me about any and all concerns you have. We’re always happy to walk you through our process and put your mind at ease.

Happy  Divali Friends

I hope you had a great one!! We can have a good Divali and healthy teeth if we follow the following tips :

  • Sweets and chocolates are an integral part of our celebrations. Enjoy your Divali cakes, but just ensure to brush twice a day, in the morning and at bedtime. Make it a habit to floss as well.
  • Use fluoridated toothpaste as they prevent bacteria buildup in your mouth and help prevent cavities.
  • During the day, if you cannot brush, have a glass of water after eating sweets. Having a glass of water helps wash away the sticky sweets. Not to forget, drinking water even helps you control weight.
  • You may chew upon Sugar free gums after eating sweets as the sugar free gum helps in cleaning the mouth and increase saliva flow. Increased saliva flow increases our ability to fight bacteria and avoid cavities.
  • Avoid fizzy drinks; they are  bad for our health.
  • Avoid sweets just before bedtime.
  • Take special care of your kids as they tend to skip brushing during festivities. Remind them to brush and floss at morning and bedtime. Ask them to rinse after eating sweets. Get them a tooth brush of their favorite character to motivate them to brush.

Toothache is the worst thing to happen during Diwali time and especially when others are savoring on Diwali sweets.

Have a fun filled, prosperous and safe Diwali!!!!!

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What to expect if you have to have a tooth removed?

You will be administered a certain dose of anesthetic agent in the surrounding tooth area, to numb the region so that you do not feel the pain. One should make the difference between pain and pressure.

Dental extraction forceps and tooth (IMAGE:123RF)

If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.

Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches — usually self-dissolving — to close the gum edges over the extraction site.

Attention!

Do’s and Dont’s After a Tooth Extraction

Can we save a tooth that got knocked out?

If the tooth is handled properly, your dentist can attempt to save your tooth.

  • Remember to quickly get to a dentist.
  • Make sure it is a permanent tooth
  • To hold only the crown of the tooth (the part where you chew)
  • If the tooth got dirt ,wash it quickly less than 10s under water
  • Put it back in the mouth, tooth socket
  • If you cannot place it back in its space, place on buccal area between cheeks and molars. Do not swallow!
  • Or Put it in milk
  • Or put in a container
  • Don’t dry, don’t wipe ,don’t scrub it.

Once at the dentist, we will try to save it by administering local anesthesia, splinting, then you will be called in 7/10days depending on the state of the tooth, root canal treatment will be performed and prescribed antibiotics.

Regular review visits are recommended.

Patient instructions

  • Avoid participation in contact sports.
  • Soft food for up to 2 weeks.
  • Brush teeth with a soft toothbrush after each meal.
  • Use a chlorhexidine (0.1%) mouth rinse twice a day for 1 week.

More information:

Avulsion

At first, take your baby along to your own dental appointments. That way he’ll get to know the sights, sounds, smells and routine of your dental surgery. (Read more what to expect at an appointment)

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If you get anxious about going to the dentist, make a separate appointment for your baby instead. Then he won’t pick up on your fears.

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Do certain foods cause tooth decay in babies?

Sweets (including fruit, dried fruit, juice, and food such as peanut butter and jelly) and starches (such as breads, crackers, pasta, pretzels) can contribute to cavities.

Serve these foods at mealtime rather than as snacks so they’re more likely to get dislodged and won’t sit on the teeth too long. Serving them with water is also helpful.

Don’t put your baby to bed with a bottle of milk, formula, juice, or sweetened liquid. These liquids feed bacteria in the mouth that cause tooth decay.

Do I need to clean my baby’s gums before his teeth come in?

Yes. Even before your baby sports his first tooth, it’s a good idea to get into the habit of wiping his gums with gauze or a soft wet washcloth during bath time.

Continue reading “Caring for your baby’s gums and emerging teeth”