Pediatric Dentistry

Stainless Steel Crown

The stainless steel crown provides an effective and practical way for restoring badly broken down baby and permanent teeth. While dentists in general would prefer to do small, traditional fillings, on occasion these fillings may not be expected to withstand the forces of chewing for a long enough period of time. Alternatively, the stainless steel crown is very durable and can be expected to provide good functional service for many years or until that time when the tooth is ready to fall out. On young permanent teeth the stainless steel crown can act as an excellent temporary filling and is often replaced with a porcelain crown once the child has reached adulthood.

There are a few common reasons for placing a stainless steel crown:
Repairing baby and/or adult teeth that are significantly decayed.
Repairing baby and/or adult tooth following a nerve treatment
Repairing baby and/or adult teeth that are structurally deficient due to a genetic or other unknown condition
On occasion a tooth may be too damaged to be repaired with a stainless steel crown. If this is the case the dentist may discuss other treatment options including extraction of the broken tooth.

Space Maintainer

Space maintainers also can be placed on the mandibular or maxillary arch. Consequently, we could have a maxillary removable bilateral space maintainer, or a mandibular fixed unilateral right side space maintainer, and so forth. There are numerous variations on these basic themes. For example, some space maintainers are used for missing anterior teeth and some are used to preserve space for posterior unerupted teeth.

Space regainer

A fixed or removable appliance capable of moving a displaced permanent tooth into its proper position in the dental arch.

Palatal crib/ Oral Crib

The appliance's technical name is a "fixed palatal crib," and is a type of brace that sits full-time on the upper teeth and the roof of the mouth. The crib consists of semicircular stainless steel wires connected to supporting steel bands or rings. The half-circle of wires fits behind the child's upper front teeth, barely visible in normal view. The bands are fastened to the baby upper second molars. There are a number of different crib designs used by orthodontists, all variations on the same theme. Treatment for thumb sucking patient

Palatal Expander

A palatal expander, also known as a rapid palatal expander, rapid maxillary expansion appliance, palate expander or orthodontic expander, is used to widen the upper jaw so that the bottom and upper teeth will fit together better. It is thought this can only be done when the patient is still growing, unless surgery is used to separate the two halves of the palate, however there is evidence to the contrary. It is most often followed by braces to straighten out all the teeth now that room has been created.

Crown and Bridge

Fixed Partial Denture

A tooth-borne partial denture that is intended to be permanently attached to the teeth or roots that furnish support to the restoration.

All Porcelain/ All Ceramic Crown

Advantage: good esthetically

Disadvantage: not as strong as porcelain fused to metal crown, require more tooth reduction

Porcelain Fused to Metal Crown

A porcelain-fused-to-metal crown (PFM) could be considered to be a hybrid of the other types of crowns, in the sense that it is composed of two different types of materials. One is a metal alloy that is used to create that portion of the crown that fits directly on the tooth. The other is porcelain. The porcelain forms the tooth-shaped aspect of the crown and gives the crown a white tooth-like coloration.

All Metal Crown

A metal dental crown is stronger than a porcelain restoration and even stronger than the original tooth enamel coating. The area of the mouth with the highest chewing force is in the second molar area. The masseter muscle ( beaver muscle ) attaches right over the second and third molar area so that there's a great deal of force applied to these teeth. The second molar area is also very hard to see so having metal is not a big esthetic problem.
The surface of a metal dental crown can be highly polished so that the gum tissues will grow up onto the restoration. There are several choices for the type of metal used. Gold is the most popular dental casting alloy but many dentists also use a silver palladium alloy. Besides color, the only other disadvantage is that it conducts hot and cold temperatures. This is not important if the tooth has had a root canal but can be bothersome for several months with a living tooth.
Since gold or silver alloys are strong, the dentist can take less tooth structure off to make room for a metal dental crown. Whenever possible, it is always a good thing to conserve natural tooth material. This type of restoration is particularly good in patients that suffer with tooth grinding problems. The metal surfaces help prevent excessive wear and help support the adjacent teeth.

Dentures

Complete Denture

Complete dentures are the restoration of last resort. They are indicated as a treatment procedure only when the prognosis for the remaining teeth is hopeless, when any remaining teeth will not adequately support a prosthesis or when all upper or lower teeth
have been removed.

Removable Partial Denture

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and they are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps. Consult with your dentist to find out which type is right for you.

Flexible Denture

Flexible partial dentures are the comfortable, beautiful, and affordable choice. It was long thought that removable partial dentures had to be rigid to be effective. The innovation of the Valplast Flexible Partial allows the restoration to adapt to the constant movement and flexibility in your mouth.
This is the underlying thinking behind Valplast's innovative flexible, removable partial denture. The flexibility, combined with strength and light weight, provides total comfort and great looks!

TMD Splint and Mouth Guards

TMJ SPLINT

Splints and night guards are plastic mouthpieces that fit over the upper and lower teeth. They prevent the upper and lower teeth from coming together, lessening the effects of clenching or grinding the teeth. They also correct the bite by positioning the teeth in their most correct and least traumatic position. The main difference between splints and night guards is that night guards are only worn at night and splints are worn full time (24 hours a day for 7 days).

Myofunctional Appliance

Myofunctional Appliance

Removable or fixed orthodontic appliance which use forces generated by the streching of muscle,facia or periodontium to alter Skeletal of dental relationship

Types of Myofunctional Appliance

1. Bionator: The double retainer ("bionator") covers the surface of both the upper and lower teeth and is held in place when the patient moves their lower jaw forward to bite into it. For maximum benefit, it needs to be worn for 14 hours/day for several months until the overbite is reduced. After that, it is worn only while sleeping, just like a regular retainer, in order to maintain the improvement that was achieved.

The goal is to encourage the lower jaw to grow in a more forward direction. If the upper teeth are leaning forward, it can help with this, too.

2. Frankel Appliance: Soft Tissu Borne appliance. Good in mixed dentition. Good when soft tissues significantly contribute to the malocclusion

3. Twin Block Appliance: most commonly used, consist of two separate removable appliance. It is recommended for some patients where the upper jaw is larger than the lower jaw. As a result, the upper teeth protrude ahead lower teeth.

4. Herbst Appliance: This appliance encourage the lower jaw to grow in forward direction by positioning forward and holding it there. It is also has the ability to push the upper molar backward. It is normally worn for 12 months

Dental Braces

Dental Braces

Also known as orthodontic braces are device use in orthodontics to align teeth and their position with regard to a person's bite. They are often used to correct malocclusion such as underbite, overbite, cross bite and open bite, or crooked teeth and with various flaws of their teeth and jaws. They are mainly used for children however adult can also use them.

Types of Braces

1. Traditional Braces -made of metal stainless steel

2. Clear braces - made of ceramic or plastic alloy

3. Gold Plated braces- are for people allergic to nickel titanium braces

4. Lingual braces - braces behind the teeth

5. Self ligating Braces - Damon Braces

6. Invisalign

Cosmetic Dentistry

Distema Closure


Distema are spaces between teeth and usually the gap closes by composite filling





Laminates




These wafer-thin shells of porcelain which are bonded onto the front side of teeth can be an excellent cosmetic solution for teeth that are stained, chipped, or slightly misaligned.





Advantages

1. It create very life-like tooth appearance
2. It resist staining

Disadvantage

1. Expensive

Tooth Bleaching

Also known as tooth whitening.

Types of Tooth Bleaching

1. Bleaching Gel (Take Home Bleaching): applies in teeth using guard trays. Advantage: cheaper, Disadvantage: Result depends on patient following instruction
2. Laser Bleaching ( Chairside Tooth Bleaching): usually done in an hour using laser. Advantage: you can see the result in an hour, 4-6 shades lighter. Disadvantage: more expensive

Sealant

Sealant

Sealant are consisting of applying plastic material to one or more teeth, for the intended purpose of preventing dental caries or other form of tooth decay.

Fluoride Treatment

Fluoride Treatment

Fluoride is a naturally occurring element that can help to prevent tooth decay by strengthening teeth. Experts say the best way to prevent tooth decay is to use several sources of fluoride.

Fluoride is found naturally in water sources in small but traceable amounts, and in certain foods such as meat, fish, eggs and tea. Fluoride also is added to water in some areas and to toothpastes, rinses and professional treatments. Prescription fluoride tablets are available for children who do not drink fluoridated water.

Uses of Fluoride

1. Fluoride help streghtens teeth


2. Protect tooth againts Tooth Decay

How It's Done

The fluoride treatments you receive in a dental office have a higher concentration of fluoride than over-the-counter fluoride mouthwash or toothpaste. They are used for both children and adults. Dental-office treatments also are different chemically and stay on the teeth longer

Composite Filling

Composite Filling

Also known as white fillin gor Tooth Colored is a tooth-colored plastic mixture filled with glass (silicon dioxide) and is a composite quartz resin that usually contains some sort of light sensitive agent.

Advantage of Composite Filling
- non toxic ( because no mercury)
- prevent tooth from fracture because it doesnt require severe undercut

Disadvantage
- more expensive than amalgam restoration
- the material shrink and it usually last 5 years and you have to refill the tooth to prevent leakage

Odontectomy

Odontectomy

Surgical removal of impacted tooth or tooth that fails to erupt into the dental arch within the expected time. Teeth most become impacted because of inadequate dental arch lenght and space in which to erupt; that is the total alveolar bone arch lenght is smaller than the total arch lenght. The most frequently impacted teeth are upper and lower 3rd molar or wisdom tooth, followed by upper canine and lower premolar. As general rule all impacted tooth should be removed unless it is contraindicated.

Indication for removal of impacted tooth

1. Prevention of Periodontal Disease
2. Prevention of Dental Caries
3. Prevention of Pericoronitis
4. Prevention of Root Resorption
5. Impacted tooth under Dental Prosthesis
6. Prevention of Odontogenic Cyst or Tumors
7. Prevention of pain of unexpected origin
8. Prevention of fracture of the jaw
9. Facilitation of orthodontic treatment
10. Optimal Periodontal healing

Contraindications for Removal of Impacted Teeth
1. Extreme of age
2. Compromise Medical Status
3. Probable excessive damage to adjacent structures

Root Canal Theraphy

Root canal therapy is designed to correct disorders of the dental pulp-- the soft tissue inside the tooth that contains nerves, blood vessels, and connective tissue.

Symptoms of Pulpal damage

• long standing pain
• facial swelling

Post-Operative Care

1. Brittleness pulp less tooth is more brittle than non treated tooth and great care should be used to avoid fracture and chipping

2. Discoloration - a non vital tooth ( dead tooth) may become discolored over time, which can be treated with bleaching. In most cases, the discoloration poses no threath to the health of the tooth.

Tooth Extraction

Tooth Extraction is the removal of the tooth from it's socket to the bone,


Indication:

- severe caries
- for orthodontic purpose
- impacted tooth


Two type of extraction

1. Simple Extraction is performed on a tooth that can be seen in the mouth

2. Surgical Extraction involves teeth that cannot be seen easily in the mouth. They may have broken off at the gum line or they may not have come in yet.

Gingivitis and Periodontitis

Gingivitis

Gingivitis refers to gingival inflammation induced by bacterial biofilms (also called plaque) adherent to tooth surfaces. This inflammation can, over the years, cause deep pockets between the teeth and gums and loss of bone around teeth—an effect otherwise known as periodontitis

Symptoms:

1. Swollen Gum
2. Sores
3. Bright Red Purple Gums
4. Swollen Gums with pus
5. Gums that bleeds easily, even with gentle brushing
6. Gums that itch with varying degrees of severity
   

Prevention

1. Regular Oral Hygiene that includes Brushing and Flossing.
2. Mouthwash is optional

Treatment

Oral Prophylaxis

• Scaling and Polishing
• Helps keep teeth and gums healthy
• It removes hard tartar or calculus that cannot be removed by brushing

Periodontitis

Inflammatory disease affecting periodontium-(the tissue that surround and support the teeth). It involves progressive loss of alveolar bone . If untreated can lead to the loosening and subsequent loss of teeth


Sign and Symptoms

• Redness or Bleeding Gums while brushing teeth or flossing
• Recurrent gingival swelling
• Halitosis or Bad Breathe
• Gingival recession, resulting lenghtening of teeth
• Deep Pockets between teeth and gums
• Loosening of tooth or tooth mobility
  

Prevention

• Regular Dental check-up and professional teeth cleening is required
• Using antiseptic mouthwash
• Regular Brushing and Flossing
  

Treatment

Periodontal Scaling and Root Planing

• Periodontal Scaling and Root Planing also known as scaling and curretage is a conservative cleaning procedure
• The purpose is to remove hard deposits and infection from beneath the gum and cleanse and clean the root surfaces