DENTAL RESTORATIONS AND FILLINGS

Dental Fillings Amalgam: Made of : Mercury mixed with silver, tin, zinc and copper. Mercury is nearly 50 percent of the mixture. Types : Traditional (non-bonded), bonded Use for : Fillings in teeth Advantages : 1. Amalgam fillings are strong and can withstand the forces of chewing. 2. They are inexpensive and convenient. 3. The filling can be completed during one dental visit. Disadvantages : 1. Amalgam doesn't match the color of your teeth. 2. Healthy parts of your tooth must often be removed to make a space large enough to hold an amalgam filling. 3. Amalgam fillings can corrode over time, causing discoloration where the filling meets the tooth. 4. A traditional (non-bonded) amalgam filling does not bond to the tooth. It just sits in a pocket created by your dentist. 5. Some people may be allergic to mercury or be concerned about its effects, although research shows the amount of mercury  exposure from fillings is comparable to what people get from other sources in the environment. Composite Resin: Made of : A mixture of plastic and fine glass particles. Types : Direct or indirect Use for : Small and large fillings, especially in front teeth or the visible parts of teeth; inlays Advantages : 1. Your fillings or inlay will be invisible. Your dentist chooses a resin that matches the color of your teeth. 2. A filling can be completed during one dental visit. An inlay may require two visits. 3. Composite fillings can bond directly to the tooth, making the tooth stronger than it would be with an amalgam filling. 4. Less drilling is involved than with amalgam fillings because your dentist does not have to shape the space as much to hold the filling securely. The bonding process holds the composite resin in the tooth. 5. Indirect composite fillings and inlays are heat-cured, increasing their strength. 6. Composite resin can be combined with glass ionomer to provide the benefits of both materials. Disadvantages : 1. Although composite resins have become stronger and more resistant to wear, it's not clear whether they are strong enough to last as long as amalgam fillings under the pressure of chewing. 2. These fillings take 10 to 20 minutes longer, or sometimes more, to place than amalgam fillings because each thin layer of the filling must be cured, or hardened, using a visible blue light. 3. Indirect fillings and inlays take at least two visits to complete. Your dentist takes impressions at the first visit and places the filling or inlay at the second visit. 4. In large cavities, composites may not last as long as amalgam fillings. Glass Ionomer Made of : Acrylic and a component of glass called fluoroaluminosilicate Types : Traditional, resin-modified or hybrid composite, metal-reinforced Use for : Most commonly used as cementation for gold inlays, but is also used for fillings in front teeth. As filling material, glass ionomer is typically used in people with a lot of decay in the part of the tooth that extends below the gum (root caries). It is also used for filling baby teeth and as a liner for other types of fillings. Advantages : 1. Glass ionomer matches the color of the teeth, although it does not always match as precisely as composite resin. Resin-modified glass ionomer is usually a better match than traditional glass ionomer. 2. In some cases, no drilling is required to place a glass ionomer filling. This makes this type of filling useful for small children. 3. Glass ionomers release fluoride, which can help protect the tooth from further decay. 4. Glass ionomer restorations bond to the tooth, helping prevent leakage around the filling and further decay. Disadvantages : 1. Traditional glass ionomer is significantly weaker than composite resin. It is much more susceptible to wear and prone to fracture. 2. Traditional glass ionomer does not match your tooth color as precisely as composite resin. 3. If you are receiving a resin-modified glass ionomer filling, each thin layer needs to be cured, or hardened, with an ultraviolet light before the next layer can be added. This makes the tooth stronger, but can lengthen the time of the dental appointment.

IMPLANT SUPPORTED OVER DENTURE

Introducing a NEW DENTURE STABILIZATION SYSTEM Undoubtedly the lower denture presents the most difficulty for patients adjusting to dentures for the first time … or even for experienced denture wearers. It can be frustrating as you attempt to eat certain foods, or even to speak with confidence without fear that your lower denture will begin to float in your mouth. We have recently introduced a new treatment procedure called aDENTURE STABILIZATION SYSTEM . Essentially it is a mini dental implant system that in most cases can be placed and attached to your lower denture in the same visit. There is no need for any incision or stitches. Within one hour you can be on your way with a secure lower denture, and able to eat and speak much more comfortably. . What are MDI Implants? The MDI system consists of a miniature titanium implant that acts like the root of your tooth and a retaining fixture that is incorporated into the base of your denture. The head of the implant is shaped like a ball, and the retaining fixture acts like a socket that contains a rubber O-ring. The O ring snaps over the ball when the denture is seated and holds the denture at a predetermined level of force. When seated, the denture gently rests on the gum tissue. How are MDI Implants Placed? Placement of the implants is accomplished quickly and easily in a process performed in the dentist's office. The procedure generally takes 1-1 1/2 hours. Using a precise, controlled, minimally invasive surgical technique, MDI Implants are placed into the jawbone. The heads of the implants protrude from the gum tissue and provide a strong, solid foundation for securing dentures. (upper dentures can also be secured). It is a one step procedure that involves minimally invasive surgery, no sutures nor the typical months of healing.

DENTAL IMPLANTS

Implants What is a Dental Implant? A dental implant is typically a small screw shaped attachment usually made from titanium. It is inserted within the jawbone to take the place of a missing tooth root. Once Osseo integration (when the bone attaches firmly to the implant) has occurred, a replacement tooth can be secured to the top of the implant. This new tooth can look, feel and perform just like a natural tooth. It is also possible to use multiple implants to support a denture or bridge.

What are Benefits of Implants?

• Implant secured or stabilised replacement teeth are more comfortable than conventional dentures because there is no slipping movement. This eliminates some of the key worries of dentures and improves self confidence.
• Dental implants are the alternative to bridgework for permanently replacing missing teeth, eliminating the need to grind down healthy teeth.
• When teeth are missing the surrounding bone begins to shrink. Dental Implants can help maintain the shape and structure of the jaw bone.

TOOTH JEWELLERY

TOOTH JEWELLERY Cosmetic procedures; medical expertise  Dentists of today are finding that expertise and more people who consult them are no longer really patients. They are individuals who desire perfectly aligned sparkling white teeth, and who may even ask for tooth jewellery. These cosmetic procedures have to be accomplished by professionals with professional products. Vivadent has developed the Skyce® system of tooth jewellery, which enables dentists to satisfy this cosmetic demand according to dental requirements. Stunning jewellery; healthy teethPatients want a sparkling smile dentists want teeth to be healthy. We are committed to maintaining the health of teeth at all costs. Vivadent has developed Skyce® in such a way that dentists can carry out the procedure responsibly using tried-and-tested products. The dental jewellery does not need to be pre-treated and is bonded onto the tooth in the same way as an orthodontic bracket. Slight etching; strong bond Skyce is easy to apply. First. a retentive pattern is produced on the enamel using 37%. phosphoric acid. Then. Skyce is bonded to the tooth with the transparent, flowable Heliobond. In the process, Heliobond penetrates into the retention niches on the back of Skyce and into the etch pattern on the tooth. Skyce must be encircled by a little Heliobond to ensure macromechanical retention.

FLEXIBLE DENTURES

FLEXIBLE DENTURES 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!

The preparation is relatively simple because your natural teeth don't need to be altered in any way. The Valplast partial is virtually invisible because there are no telltale metal clasps and the material itself blends with the tissue in your mouth so that the only thing that shows is your beautiful smile.

When considering a removable partial, many people find the Valplast Flexible Partial to be the most comfortable option, and the final restoration can be made very quickly! While the cost is often higher than a partial made with visible metal clasps, the results of the flexible partial are beautiful, and patient satisfaction is very high. The Valplast flexible partial involves only non-invasive procedures, and gives you confidence in your restoration while talking, eating, and most importantly: smiling!

COMPLETE DENTURES

COMPLETE DENTURES There are two types of appliances: conventional and immediate. A conventional appliance is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed. It is a process that can take several months. An immediate appliance, on the other hand, is inserted as soon as the remaining teeth are removed. With an immediate appliance, the patient does not have to be without teeth during the healing period. An immediate appliance may require basing or relining to fit properly during the healing period (6-8 weeks) due to bone and gum shrinkage. After the healing period, a conventional appliance is then made.

Fabricating a Complete Denture

There are many factors involved when designing this type of appliance and if one factor is overlooked, it can lead to failure of the case. In many instances, the appliance should fit comfortably soon after being inserted. One of the most critical aspects of the process is that the impression must be perfect and with a flawless technique, used to make a model of the patient's gums. The dentist must use a process called border molding to insure that the denture edges do not hit aggressively into the edges of the mouth. An endless array of never-ending problems with this appliance may occur if the final impression is not properly made. Designing it takes a considerable amount of patience.
The full upper appliance is usually easier to design so that it is stable without slippage. The lower appliance tends to be more difficult because there is no "suction" holding it in place. For this reason, most dentists have come to strongly recommend that a lower denture be supported by 2-4 implants placed in the lower jaw for support. This is a far superior product than a lower appliance without implants that is held in place with weak lower mouth muscles. The ability to bite into an apple or corn-on-the-cob with a lower appliance anchored by implants is possible. The ability to bite into this same apple or corn on the cob with a lower appliance that is not supported with implants, is a difficult, if not impossible task to achieve.
Some patients, believing full denture appliances are in their best interest, extract all of their teeth and have the appliance inserted. Yet, statistics show that the majority of patients who received the appliance in this manner come to regret their decision. They come to find that there is a decrease in their chewing ability (full dentures have only 10% of the chewing power of natural teeth) and they experience difficulty with the appliance sitting properly. They do not realize that while a full upper tends to be very stable, the lower appliance needs as much help from the natural teeth as possible for stability to be successful. If one tooth is retained on the lower area of the mouth, that tooth can contribute to the appliance's stability. It is advised that patients keep their natural teeth as long as possible, especially the lower teeth.
Newly Inserted Dentures
Your new appliance may feel awkward for a few weeks after they are inserted. They may feel loose while the muscles of the cheek and tongue learn to keep them in place. It is also not unusual to experience minor irritation or soreness. You may find that your saliva flow also increases. As the mouth becomes accustomed to the appliance, these problems should diminish. One or more follow-up appointments with the dentist are generally needed after an insertion.
Eating takes practice with a newly inserted appliance. It is advised that patients begin with soft foods cut into small pieces, chewing slowly using both sides of your mouth at the same time to prevent the appliance from tipping. As you become accustomed to chewing, you can add other foods until you return to your normal diet, being very cautious with hot or hard foods and sharp edged bones or shells. Continue to chew food using both sides of the mouth at the same time.
Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your appliance "clicks" while you talk, try to speak more slowly. It may occasionally slip when you laugh, cough or smile. Reposition the by gently biting down and swallowing. If any of these problems persist, consult your dentist for further help.

We will provide instructions about how long the appliances should be kept in place. During the first few days, you may be advised to wear them most of the time, including while you sleep. After the initial adjustment period, you may be instructed to remove them before going to bed. This allows gum tissues to rest and promotes oral health. Generally, the gum tissues should not be constantly covered by the appliance.Problems with Complete Dentures
Some of the problems associated with removable appliances include an overproduction of saliva, sore spots, gagging, gingivitis and movement.

Saliva

The brain senses this appliance as "food" and sends messages to the salivary glands to produce more saliva and to secrete it at a higher rate. Patients must become accustomed to having an appliance inside their mouth that is not food.

Sore Spots
Newly installed appliances may cause sore spots in many individuals as they tend to rub and press on the mucus membranes of the mouth. Subsequent adjustments for the weeks following their insertion should take care of this problem.

Gagging
Gagging is another issue encountered by some patients. The cause of this may be due to a loose fitting or to a appliance that is too thick or not extended far enough back on the palate. Some suggest that at times, the gagging may be attributed to some sort of psychological denial of the appliance. And since the psychosis is difficult to treat by the dentist, as it is beyond the scope of their expertise, both a psychologist referral or an implant supported palate less may be offered as alternative to helping a patient.

Gingivitis
Gingivitis can develop underneath the appliance, a result of accumulating dental plaque. Gingivitis can involve gum inflammation and mouth sores. The condition is generally reversible. Denture wearers are advised to clean the thoroughly. The removal of plaque and calculus is usually not painful, and the inflammation of the gums should be gone between one and two weeks. A dentist or dental hygienist can also perform a thorough cleaning of the teeth and gums areas of the mouth. Following a professional service, patients must be persistent with their oral hygiene care. Oral hygiene including proper brushing and flossing is required to prevent the recurrence of gingivitis. Anti-bacterial rinses or mouthwash may reduce the swelling and local mouth gels which are usually antiseptic and anesthetic can also help with the problems associated with gingivitis.
Movement: Support, Stability and Retention
Some patients experience problems with keeping their appliances in place. There are three rules which dictate the existence of removable oral appliances: support, stability and retention.

Support
Support describes how well the underlying oral tissues keeps the appliance from moving. Recently, dentists have been looking to increase the stability of this appliance by using implants. After many years of wearing dentures, the ridges upon which the appliance rests deteriorates and can easily all but disappear. The insertion of implants into the bone below the appliance can help to keep it from occurring. The implants are strategically placed to bear the brunt of the pressure when the appliance is used for chewing, keeping the bone from melting away. When implants are integrated into treatment, the appliance is now referred to as being an implant supported overdenture and the implants are referred to as overdenture abutments.
Stability
Stability describes how well the appliance base is prevented from  sliding side to side or front and back. The more the base runs in smooth and continuous contact with the ridge area upon which the teeth used to reside, the better the stability.
Retention
Retention describes how well the appliance is prevented from moving in the opposite direction of insertion. The better the inside surface of the base to the surface of the underlying mucus membranes, the better the retention will be. The most critical element in the retentive design of a full upper appliance is a complete and total border seal in order to achieve 'suction'.
Complete Dentures and Implants
There has been an increase in dental practitioners incorporating the use of full dentures with implants. The use of implants when designing a full denture appliance has increasingly shown to improve a patient's denture wearing experience by increasing its stability, as well as saving the patient's bone from wearing away. Implants used with full appliances has also been shown to help with appliance retention.

Conclusion
The fabrication of a complete denture appliance is a challenge for any dentist, including those who are experienced. At least two follow up visits for an adjustment to remove sore spots will also be necessary. The upper appliance is fabricated to work in harmony with the lower appliance. If the only variables in the equation are the patient's ridges and two full appliances, the dentist sets the teeth to help prevent dislodgement during opening, closing and swallowing. But once food enters into the picture, the stability of the appliances can be disrupted. During chewing, the appliance bases will sometimes move. In a perfect world, a patient with a perfect edentulous ridge with a perfectly fitting appliance would require no adhesive, as the actual form of the appliance base should work without moving in any way, shape or form. But alas, this is not a perfect world. Therefore, an adhesive is recommended as a way to provide additional retention for well-fitting appliances.
Denture adhesive products should not be used for old, ill-fitting dentures. A poorly fitting appliance can cause constant irritation over a long period of time, and contribute to the development of sores. The appliance may need to be relined or replaced. If, at any point, your dentures begin to feel loose, or cause pronounced discomfort, contact your dentist for a consultation.
Over time, dentures will need to be relined, rebased, or remade due to normal wear. To reline or rebase the appliance, the dentist uses the existing teeth on the denture and refits or makes a new base. The appliances may need to be replaced if they become loose and the teeth show signs of significant wear. This usually occurs as a natural progression of aging. Bone and gum ridges can recede or shrink, causing jaws to align differently. Shrinking ridges causes dentures to fit less securely, making chewing more difficult and changing facial features. Loose appliances can also contribute to sores and infections. Therefore, it is important to replace worn or poorly-fitting appliances before they cause serious health problems.

HOME TEETH WHITENING

 Steps that we as dentists  and yourself will perform on your teeth:

1.An impression of your teeth is taken by the dentist. 2. A perfectly formed mouthguard tray is made for you to take home with your own kit of pola night. 3. Brush and floss teeth. Take a syringe out of the kit. Remove the cap and insert an application tip by twisting it securely onto the syringe. 4. Place a small drop of gel into every compartment of the tray for the teeth undergoing treatment. 5. Make sure the tray is seated in the mouth.

6. Wipe away excess gel in mouth with finger, tissue or dry soft tooth brush.

Depending on the level of staining on your teeth, and the health of your teeth, we  would have supplied you with Pola Day in either 10%, 16% or 22% carbamide peroxide gel concentrations. This percentage will be marked on the box. Wear the trays in your mouth for the below corresponding times to the percentage of carbamide peroxide in your kit: