FAQs

FAQs

IMPLANTS

01.What is a dental implant?

02.What is the osseointegration?

03.Are there contraindications for dental implants?

04.Is surgical intervention long and complex?

05.How is the postoperative period?

06.How long does the whole treatment, from fixing implant until placement of the tooth?

07.Is there any problem for the implant colocation depending on the age of the patient?


08.What prosthesis or teeth can be placed on implants?

09.How are the results? Are they aesthetic?

10.Is there any kind of warranty for this treatment?

11.What conditions are needed for the success of the treatment?

12.Is there any risk to the patient?

13.What happens when the patient has low bone mass to rehabilitate?

14.A patient with pyorrhea: How solve it the implants?

15.Are the implants a lasting solution?


16.Are there implants without surgery?

17.Do you can place implants and teeth on the same day?

18.What are the immediately loading implants?

19.Zirconium implants. What are the advantages over the titanium?

01.What is a dental implant?

It is an artificial root of titanium (biocompatible material) that is placed in the jaw allowing replace with much beauty and naturalness to the lost tooth.

You can place one or more dental implants in maxillary bone, providing us with the construction of fixed prostheses. When total lack of parts are made of two to eight fixations (implants) to have greater stability and put the fixed prostheses over dental implants allowing to rehabilitate all the mouth with new teeth.

The use of this modern surgical technique allows the patient that has suffered a dental loss, a full recovery of masticatory function and oral aesthetics.


Back to top

02.What is the osseointegration?

The process of osseointegration is defined as the firm, direct, stable and lasting mechanical joint between the maxillary bone and the body of a titanium dental implant, that happens without interposition of connective tissue.

Osseointegration occurs, must be made a correct surgical technique, depending on the success of the presence or absence of inflammatory processes, the design of the implant and the time in which the implant is maintained free of charge, which should be around 4 to 6 months.

Today, the most advanced techniques as immediate loading implants allow provide a prosthesis with fixed teeth on implants osseointegrated implants within days or even hours of placement.


Back to top

03.Are there contraindications for dental implants?

There are very few absolute contraindications, among which we can highlight serious diseases that affect the metabolism of the bone, specific infections, malignant tumors that affect the bone, or radiotherapy in large doses.

It is important to tell dental implants do not cause rejection in the organism, commonly when speaking of rejection it refers to a non-osseointegration of the dental implant (a level of failures of the 2% to 5% is estimated to be normal of implants placed).

When an implant dental is not osseointegrated can be replaced another to replace it.



Back to top

04.Is surgical intervention long and complex?

It is an outpatient intervention, this means that the patient is in our dental clinic. The intervention takes place in the majority of cases by local anesthesia.

Interventions of long duration (complete rehabilitations, elevations of maxillary sinus, bone regeneration) may be carried out with intravenous sedation by a anesthesiologist in the dental clinic.


Back to top

05.How is the postoperative period?

Contrary to what may seem, in many cases postoperative means less discomfort and inconvenience to other minor dental interventions in odontology.

Sometimes an implant can cause discomfort in the gum during the wound healing process by which prescribed pain relievers or anti-inflammatory according to the type of intervention.

It is essential to have good hygiene during this period to prevent secondary infections of the gums.

Antibiotics are usually prescribed for safety.

In some cases it appears frequently swelling during the first days which often remit spontaneously within 72 hours, while it is not painful and allows to make normal life.


Back to top

06.How long does the whole treatment, from fixing implant until placement of the tooth?

The prostheses can be placed after three to six months of waiting once the surgery


Back to top

07.Is there any problem for the implant colocation depending on the age of the patient?

The implants can be placed in the young once completed the development, normally from the sixteen years in women and eighteen in men. In adults there is no contraindication due to age.


Back to top

08.What prosthesis or teeth can be placed on implants?

There are basically two forms of prosthetic rehabilitation on implants:

The fixed prostheses in zirconium or porcelain, that provides the highest level of aesthetics, comfort and function, and the removable prosthesis (remove and put), made in resin and that assumes a more economical option to be a treatment less sophisticated. (without teeth) and need more maintenance.

To do so, in clinic, the dentist takes impressions and bite registrations that subsequently sent to the laboratory where technicians empties, or positive, prints in plaster, and make on the resulting models the structures of the fixed prosthesis fixed with wax.

These waxed will be included in special high temperature resistant coatings, and it is casting in metal with different alloys. The last step could be to mount the ceramic on metal structures, depending on the type of fixed prosthesis to perform, since there is also the possibility of crowns and bridges in pure porcelain (without metal) or on a basis of a white material called alumina or zirconia, which in this last case the Cad Cam technology is used.

Back to top

09.How are the results? Are they aesthetic?

The implants correctly placed ensure a few aesthetic results in the majority of cases far superior to the original teeth of the patient. The patient must be clear that he will not only get a healthy mouth but also an aesthetic smile. Those should be his demands.

Volver Arriba

10.Is there any kind of warranty for this treatment?

The implants well placed and size proportional to the load that must support are for a lifetime.

Volver Arriba

11.What conditions are needed for the success of the treatment?

The basic conditions for the success are:

  1. The correct planning of the case
  2. Hands and the experience of the surgeon (the size of the implant and its correct placement)
  3. The preparation of the prosteshis taking into account loads that have to bear and the correct setting to avoid anomalous forces involving a overstrain of implants.

Back to top

12.Is there any risk to the patient?

Perhaps the most significant risk is the loss of sensitivity in the area of the lower lip when during the intervention is touched the nerve of the chin, the loss of sensitivity may be temporary or permanent. For that reason must be especially careful when operating in that area because it is not worth touching the nerve with an implant too long but neither serves us an implant too short that does not hold the load that will be submitted.

On the other hand it is essential that implants are correctly placed from the beginning, since a time that these are osseintegrated are “welded” to the bone, and if necessary to pull them we would lose much maxillary bone, which would greatly complicate rehabilitation and of course the results would never be the same.

Back to top

13.What happens when the patient has low bone mass to rehabilitate?

Today we have advanced techniques to perform surgery in extreme cases. You can use maxillary sinus lifts and implants which may be autologous (patient’s own) or other types, with a very high percentage of success. Fortunately there are very rare cases in which a patient who wishes to be rehabilitated can not be. The field of bone regeneration is undoubtedly one of the major advances in implantology in recent years.


Back to top

14.A patient with pyorrhea: How solve it the implants?

For patients with pyorrhea implants are “the solution”. Traditionally this type of patients were inevitably doomed to lose their teeth. The only treatment that we could offer was a scrupulous hygiene and regular visits to the dentist to perform periodontal treatments. The final perspective was always the same: the complete denture remove and replace.

Now the implants have revolutionized the way of treating these patients. It is very important to know that the long periodontal treatments are not only useless but they are harmful because while an effort is made to preserve the natural part, we cannot prevent the disease take its course and go losing bone.

You have to know to cut this process until it is too late. The bone is fundamental for a good rehabilitation and for an aesthetic result. In extreme cases, it is very difficult to achieve aesthetic.

Back to top
15.Are the implants a lasting solution?

This is perhaps the only case in medicine in which the artificial substitute has better functionality than the original organ. An implant that it works properly in the mouth (because it is placed in the ideal position and support a load axial and proportional to its size), has a very superior durability to the natural life of a tooth.

Back to top

16.Are there implants without surgery?

Speaking of implants without surgery are talking about procedures of surgery blindly guided by computer. All these systems use a template made previously which must be adapted implants and allows us to place them without having to open the gum or give stitches. Logically the intervention is less invasive, but a minimal variation in the position in the mouth of the template may give problems.

Back to top

17.Do you can place implants and teeth on the same day?

It is only recommended in favorable and very specific cases. Even so, the quality of the prosthesis that can be offered in such cases is highly conditioned by the factor time. In these cases we offer provisional teeth in resin that then will be replaced by the definitive maximum aesthetic ceramic. Ceramic treatment cannot be done on the day, only it is possible to make resin prosthesis predesigned, therefore not personalized.

Back to top

18.What are the immediately loading implants?

Those mentioned in the previous question, in which the prosthesis is placed the same day of the surgery.

Back to top

19.Zirconium implants. What are the advantages over the titanium?

Zirconium is an excellent material in the dental field. It has a maximum biocompatibility (the same as titanium) and allows making an insuperable aesthetic prosthesis. However, its use in the surgical field in dentistry is recent and very minority. We can say that as an implant, that is to say, within the bone, does not provide any added advantage with respect to the titanium. It is a choice of the professional.

Back to top

TOOTH WHITENING

20.How does tooth whitening work?

21.What types of whitener exist?

22.How long is the treatment?

23.It works? It is valid for everyone?

24.Has it any risk?

25.How long is it? Do I have to do some kind of maintenance?

20.How does tooth whitening work?

This technique does not consist in a “whitening” of the tooth itself, but in a clearance, since own tooth color is not altered.
The color of a tooth is determined, since we are born, by the tonality of the core of the tooth (dentin) and transparency and capacity of refraction of light by the enamel.

The colour of the core is not altered, however,with the time the enamel is dying based on substances such as tobacco, the lipstick, coffee, tea, tomato, chemical pigments, coke drinks, use of certain medications, etc. As a result, tooth whitening consists of removing enamel, by means of chemical substances, all those particles that alter its original color.


Back to top

21.What types of whitener exist?

The used whiteners are basically 2: hydrogen peroxide and carbamide peroxide, both in variable concentration.
Hydrogen peroxide is more powerful and effective, but sometimes results in an excess of tooth sensitivity after treatment.

The first of these is usually used at concentrations between 35 and 38% to make 1 or 2 sessions whitening in the dental clinic. To be an agent so potent, the treatment must be performed in the clinic to check its effect and avoid risks; the second is used at concentrations between 2 and 10% for a outpatient treatment (at home).

The treatment in the clinic is effectively a priori, but its effect is little lasting, since the first feeling of clearance occurs due to dehydration of the tooth. A few days later, the tooth becomes to hydrate and almost recovers completely its original state. On the contrary, outpatient treatment achieve the effect more gradually, however its action can be extended in time for years.

The most effective is to combine both treatments and apply booster dose every 2 or 3 years to maintain the result.


Back to top

22.How long is the treatment?

In a first visit, we make some replicas of the patient’s mouth, from which draw up transparent plastic moulds, which will adapt to the teeth and will host the whitener gel. Once made moulds, whitening is carried out in 2 stages, a stage in the clinic and another one at home:

1st stage: 
In this first session a polishing of the surface of the teeth is done to remove impurities. A hydrogen peroxide gel to 35% is then applied to 35% for 30 minutes. This produces an important initial clearance.

2nd stage: The same day the patient recives the plastic mould and a syringe of Carbamide Peroxide gel (3-10%). From this moment the treatment continues at home. The patient should apply the gel on the mold and placed it in the teeth. It is recommended to take it 2 hours a day for 7-10 days. At the end of treatment, we check the status and the color of the teeth, comparing through photographs and a shade guide, the result obtained. The treatment concludes with a polishing of the teeth and an application of fluoride to strengthen enamel.

 


Back to top

23.It works? It is valid for everyone?

The efficacy of the treatment is proportional to the degree of staining of the teeth that have been obscured over the years by dye substances. Treatment is less effective, and even useless, in teeth darkened by intrinsic alterations, such as intake of tetracyclines during childhood, congenital hypoplasias of enamel, etc.


Back to top

24.Has it any risk?

The American Dental Association (ADA), after a rigorous follow-up of several years, pointed out that there are no harmful effects for the teeth or for health, by the use, even prolonged, of these whitening gels.

According to experts, the only disadvantage that can occur is tenderness in the gums during the first days.


Back to top

25.How long is it? Do I have to do some kind of maintenance?

The duration of the whitening effect, depends largely on the type of feed that the patient follow after treatment. Thus, in a person who smokes, who drinks wine and drinks coffee regularly, whitening effect will be lost with more quickly. According to the Dental American Association (ADA), after 5 years, only 20 percent of the cases studied had slightly lost got tonality.

However, the first days after the treatment, you have to follow a “white diet”, which consists of taking food without dyes, as milk, natural yoghurt, rice, pasta, fish… and radically eliminate all those who “stained” (coffee, coke drinks, beets, chocolate, tomato, carrot…). Once a year you should make a treatment of memory to keep the result, i.e., return to apply the gel in the mould for 2 or 3 days.


Back to top

VENEERS

26.What is a veneer? What is used for?

27.What types of veneers exist?

28.How are they made?

29.Who is suitable to carry veneers?

30.Is there any risk?

31.How long does it last?

26.What is a veneer? What is used for?

They are thin slices of porcelain, about 0, 3-1 mm. thickness, which are placed to covering all of the anterior surface of the teeth. Bind strongly to the tooth using a special adhesive. The union is so strong that settled once they can not be removed unless the veneer to crack. They are used mainly to cover anomalies of the color of teeth that cannot be treated through conventional whitening. They are also used to hide alterations in size or shape dental, giving the tooth a most ideal appearance.

Their main advantages are the power of adhesion, resistance to abrasion and great aesthetic sense. Practically we must not reduce the tooth to place them. Once cemented, the patient can eat normally. Many personalities of the public life and the media make use of this technique to achieve a sexy smile.


Back to top

27.What types of veneers exist?

1. Porcelain: The main advantages are its power of adhesion, resistance to abrasion and great aesthetic sense. Not worn with time, not lose brightness and maintain intact their color. Once cemented, the patient can eat normally. Many personalities of the public life and the media make use of this technique to achieve a sexy smile. The main problem is that sometimes we need to slightly reduce the enamel. They are also more expensive and require at least 2 sessions.

2. Composite: Realized with material with which fillings are made. Over the years they deteriorate, lose brightness and darken.The advantage is that they are more economical and preserved intact enamel. They are also made in a single session.


Back to top

28.How are they made?

It is simple. The tooth or teeth that are to receive a veneer are slightly lowered in the front, about 0,3-0,5 mm. After preparation, we take a very precise measurement with silicone, which will be sent to the laboratory, where technicians will make the veneer with a modern system of injection or cast porcelain.

When the veneer is ready, the adaptation test is made, and if this is valid, we proceed to place the veneer with a special adhesive. The whole process lasts a few days.



Back to top
29.Who is suitable to carry veneers?

Not all patients are suitable for treatment with porcelain veneers. Cases of severe crowding and defects in the relationship of the dental arches may contraindicate this treatment.

It is not recommended for bruxers patients (grind the teeth).

In any case, your dentist is always to make through a clinical examination to determine if the patient may or not make use of veneers. However, there is the alternative of full porcelain crowns.


Back to top

30.Is there any risk?

Treatment has not almost disadvantages, except those relating to the preparation and placement technique, which relate to the dentist. If the veneer fits wrong, simply we make another.

Once placed, the patient forgets that it takes them and he can eat and speak normally, trying to avoid always biting things too hard with the treated teeth.


Back to top

31.How long does it last?

Depends on the habits of the patient, its duration average is about 12 years. Occasionally, when the patient suffers from a strong impact on the mouth or biting something hard, any veneer can fracture or lift away.

In that case, if the veneer is intact, returns to adhere it. If it’s broken, simply turns to do another within a few days. While drawing up the new veneer, another provisional composite veneer is placed.


Back to top

BRUXISM

32.What is the bruxism?

33.How to detect if you have bruxism?

34.What are the causes?

35.What problem does the bruxism have?

36.How can I treat or alleviate the bruxism?

32.What is the bruxism?

Bruxism is a habit that incites clenching or grinding the teeth to download tension by unconsciously, even while we sleep. If waking up you note certain pain on facial muscles or slight discomfort in the head and neck you can suffer bruxism.

It is an unconscious habit, which is difficult to manage without help. It can cause major damage in our teeth: wear, dental pain, bone destruction, problems of the temporomandibular joint (arthrosis), enamel fractures, vertical fissures and loss of dental pieces. The temporomandibular joint is the joint that connects the jaw with the skull.

The problem manifests itself with the emergence of clicks, pain and, sometimes, the locking of the jaw.


Back to top

33.How to detect if you have bruxism?

Going to the dentist who will examine your temporomandibular joint, the state of your facial muscles and dental pieces.


Back to top

34.What are the causes?

Bruxism is almost always linked to situations of stress, anxiety, nerves or small everyday frustrations. This functional alteration has some consequences, as the wear and tear of the anterior teeth and molars.

Due to this wear, there are patients who tell that waking up in the morning feel a sensation of sand in his mouth; they are their own worn teeth.

Back to top

35.What problem does the bruxism have?

Associated problems

  1. All alterations in the structure of the tooth, as the loos of enamel make the dental elements are more sensitive to temperature changes, acids, etc.
  2. It makes our teeth are more likely to have caries.
  3. Create undercuts where food scraps are left.
  4. Possible loss of nerve by wear of the dental surface.
  5. Contractures and muscular pain in head and neck, alterations in the temporomandibular joint (which is responsible for uniting our jaw with the skull).
  6. It favors the appearance of the pyorrhea or periodontitis.


Back to top

36.How can I treat or alleviate it?

Avoid the habit of chewing gum, as it worsens the situation.

It can be relieved with the use of a relaxing splint for sleep, which is a removable acrylic appliance, which your dentist designs tailored to the upper teeth and conforms to a position articulated physiological.

The opposing teeth hit the plastic creating a very comfortable bite.

In this way the teeth are fixed and protected from touching against each other.

Back to top

PERIODONTITIS

37.What are periodontal diseases?

38.What are the signs and stages of periodontal disease?

39.What happens if the periodontal disease is not treated?

40.What are the causes of periodontal diseases?

41.Are periodontal diseases very common?

42.Since the signs appear until the tooth is lost, you spend much time?

43.Does periodontal disease can affect the patient’s general condition if a long time passes?

44.Is there a solution?

45.How I can prevent pyorrhea?

37.What are periodontal diseases?

Periodontal diseases are a group of diseases affecting the tissues (periodontal) that surround and hold to the teeth in the jaws.

They are diseases of inflammatory nature and infectious cause (caused by bacterias) which, depending on their degree of affectation, we call them gingivitis, when the inflammatory process only affects the superficial periodonto (gum) and the tissues that hold the teeth are not affected.

When inflammation affects deep periodontal tissues, there is destruction of the bone and periodontal ligament, which are the tissues that support and hold the teeth. This degree of affectation we call it periodontitis.

There are several phases of periodontitis from the initial stages to the most advanced. If untreated periodontitis evolves destroying all tooth and thereby support the accommodation and loss of the same.

For this reason, it is important to detect and treat periodontitis in its earliest stages..


Back to top

38.What are the signs and stages of periodontal disease?

There are a number of symptoms that allow to recognize this condition in any of its stages:

  1. Gingivitis: Any periodontal involvement begins in the gum. This goes from pink to deep red, increases slightly in size, slightly hurt and bleeding when brushing teeth.
  2. Initial periodontitis: gum retracts, i.e., the teeth appear longer. Large plaque deposits can be seen in the teeth, primarily on the lower front.
  3. Moderate periodontitis: There is a light mobility of teeth. Sometimes the teeth move and create spaces between them. Gums appear reddened and bleed easily. Halitosis (bad breath) and bad taste are characteristic. Sometimes, very hot or very cold food or drinks produce pain.
  4. Advanced periodontitis: All of the above symptoms are increased. The teeth move too much until they end up falling. Gum bleeding abundantly and pain, which prevents the patient brush correctly, which further exacerbates the problem.


Back to top

39.What happens if the periodontal disease is not treated?

>

Gingivitis also produce inflammation of the gums and bleeding, especially when brushing, in some individuals evolves into periodontitis. Periodontitis by the destruction of the bone that supports the teeth in the jaws causes mobility and separation of the teeth.

Over time teeth end up losing, either by the need to remove them because of their instability or by falling practically alone.

Back to top

40.What are the causes of periodontal diseases?

It is due to a bacteria that everyone has in the mouth, around the teeth, and that if we don’t eliminate properly, they gain access to the space between the tooth and the gums and can colonize this space growing in number and causing the reaction inflammatory and destructive that defines these diseases.

The bacteria are not able to cause the consequences of these diseases, they need a susceptible individual (genetic predisposition) and a suitable environment (factors such as tobacco and stress factors are very important risk factors in the colonization of these bacteria).


Back to top

41.Are periodontal diseases very common?

Gingivitis is one of the most common diseases of the human being, being very common in all ages (in young 75% from 20 to 25 years).

A part of the gingivitis, even in the absence of treatment, do not progress to the destruction of the periodontal tissues of tooth support (periodontitis).

Periodontitis is very rare in young people and teenagers (approximately 1 case/10,000). However, their frequency increases with age. Periodontitis affects approximately 80% of the adult population with more than 35 years.

Therefore, it is a relatively common disease in adults and its frequency clearly increases with age.

Back to top

42.Since the signs appear until the tooth is lost, you spend much time?

It depends on the case, some patients are evolving fast and others slowly. People that evolves fast tends to be young and may lose its teeth in 5 years.

In other cases, the evolution can be slower, but if patients not treated properly they can also lose their teeth.

Back to top

43.Does periodontal disease can affect the patient’s general condition if a long time passes?

If the patient is in good health, usually is not affected general state for being an infection located exclusively in the mouth. However, it may affect negatively in cases of patients with chronic systemic diseases such as diabetes, cardiac, circulatory diseases, etc.

Also, this demonstrated a clear association between periodontitis and risk of heart attack and risk of premature children and low-weight in pregnant women.

These infections can also represent a serious risk to patients who are immunosuppressed (patients with low defenses, such as in treatment of cancer patients, patients with AIDS, etc.).

Back to top

44.Is there a solution?

In the initial stages can be corrected, but it tends to be a chronic picture. This means that when the state of the disease is advanced and much bone support has been lost, the only thing we can do is stop the progression of the disease so that it not to be beyond. The lost bone is difficult to recover. There are regenerative techniques that sometimes give very good results.

The dentist is who has to assess whether the patient is susceptible to this type of treatment. The basic treatment consists of removing existing infection cleaning the whole mouth, with local anesthesia. If the state is very advanced or requires regeneration, requires a minor surgical procedure with local anesthesia.

The treatment can be complemented with the use of antibiotics. The patient should be aware of the problem and assume that after initial treatment, at least once a year he should be going to the dentist to do maintenance cleanings, for the rest of his life. Oral hygiene is essential to treat such problems. Only in this way the patient will get an effective therapy.

The basic treatment consists of the thorough cleaning of gums with a ultrasound device, curettes (scanning instruments) and polishers. All this is aimed at eliminating all bacterial plaque causing the problem. The patient is able to clean the part of teeth exposed in the mouth, but he can not access the part of the tooth that is below the gum. This task is going to be made by your dentist, so after cleaning, the inflammation decreases and the gum again to adhere to the tooth, forming a barrier so that the bacteria do not pass.
The basic treatment is done by parts. The mouth is divided into 4 quadrants, each of which is treated in different sessions. Each cleaning session is performed under local anesthesia, in a way that does not hurt. Its duration is about 45-60 min. At the end of the session and finish the anesthetic effect, patient has very little discomfort, and in 3 or 4 days, the state of gums improved surprisingly. From this moment, will be the patient who must maintain the health of your gums and attend periodic revisions every 4 to 6 months.

Regenerative treatment is performed in severe cases, when involvement is very pronounced and it is extended in time, the patient has experienced a significant loss of bone. In these cases, before any restorative treatment, it is necessary to replace the lost structures as far as possible. So it makes use of different biomaterials: membranes, amelogenin, bone, etc. All is combined effectively to restore lost anatomy.

Back to top

45.How can I prevent the pyorrhea?

Fighting dental plaque and preventing diseases of the teeth and gums.

  1. Floss:
    Use dental floss to remove germs and particles of food between the teeth. Mouth rinse.

Way to hold the dental floss:
To remove the plaque between the upper teeth use the floss by moving it from top to down.
To remove the plaque between the lower teeth use the floss by moving it up and down.

* Attention! Insert the floss between the teeth gently. Not to force it, this might hurt your gums.

  • Tooth brush: Use any method of brushing the teeth that it is more comfortable, but don’t rub them with force from one side to another. Small circular movements and short movements is best. Rinse. To prevent dental caries, it is important that is put on the brush. Use a fluoride toothpaste. Fluoride protects teeth against caries.

Back to top

HALITOSIS

46.What is the halitosis?

47.How can I notice if I have halitosis?

48.How do I fix it?
linia

46.What is the halitosis?

Bad breath or halitosis is a common problem that has affected mankind since ancient times. In the majority of cases these bad smells are caused by bacteria from the oral cavity.

It typically affects people who suffer some form of periodontal disease, caries, defective dental restorations, food packaging or other pathologies.

In healthy persons, these smells come from the dorsal part of the tongue where it is difficult to access with the brush to renew the lingual surface in its bacterial composition.


Back to top

47.How can I notice if I have halitosis?

As we are not able to notice our own bad breath, many people are not aware of your problem.

If someone suffers from halitosis, it is recommended that any close person comment you your problem so that you receive treatment as soon as possible.


Back to top

48.How do I fix it?

Rinses of different kinds have been used to combat it, but while the cause cannot be controlled, these are only temporary palliative actions, such as the use of chewing gum or candy.

The only effective treatment for bad breath is to eliminate the bacteria responsible for. You must treat periodontal disease and caries present, and establish proper hygienic measures.


Back to top

ENDODONTICS

49.What is the endodontics (root canal)?

50.Why is a root canal carried out?

51.How do I detect the necessity of making me a root canal?

52.How a endodontics is done?

49.What is the endodontics?

Endodontics is a treatment consisting of removing the pulp tissue of the tooth and replace it with an inorganic filling to ensure the internal tightness of the piece.


Back to top

50.Why is a root canal carried out?

  1. Clean the root canal system: bacteria, necrotic tissue, etc. in order to let the duct as aseptic as possible. You will never get that the duct is completely sterile since we treat only the main duct of each root and not numerous ducts accessories.
  2. A complete filling with suitable shape and size: Conical shape is given from the crown to the apex of the tooth. A limit occlusal is created so it is fair to the working length, this is that the fill is set to the length of the root and, finally, will have to respect the original morphology of the duct.
  3. Get the apical seal and the rest of the duct: Isolating it from the rest of the body.
  4. Get a biological close: the cementoblasts of the periodontal stump will produce cement that closes the apex, achieving the success of endodontic treatment.


Back to top

51.How do I detect the necessity ok making me a root canal?

The dental pulp contains blood vessels and nerves and can become infected by a deep caries or periodontal disease.

You must be alert when a tooth starts to change color or there is pain to eat. Experience discomfort when taking a cold drink or a hot infusion also can be a sign of alarm.

Your dentist will can at most of the time, save the damaged tooth.


Back to top

52.How a endodontics is done?

Phases:

  1. Diagnosis
  2. Anesthesia
  3. Opening
  4. Isolation
  5. Conductometry
  6. Instrumentation
  7. Filling
  8. Control

After anesthetizing the diseased tooth, is made a small opening to expose the root canal and the diseased pulp. Removed the tissue and widens the root canal with appropriate instruments. colonics are performed to eliminate the infection. Irrigations are made to remove the infection. Finally, it is sealed and rides around the root canal.

Here the endodontic treatment is completed, but the tooth needs to be restored in terms of their function and appearance; It may require an aesthetic filling, reconstruction or crown (mostly in molars).


Back to top

ORAL CANCER

53.Is oral cancer very common?

54.How to detect it in time?

55.What is the treatment?

53.Is oral cancer very common?

Oral cancer is a general term in medicine for any malignant growth located in the mouth. It can appear as a primary lesion of the same tissue of the oral cavity, by metastasis from a distant source site, or by extension of neighboring anatomical structures, such as the nasal cavity or the maxillary sinus. The cancer that appears in the oral cavity can have different varieties. The most common form of oral cancer is squamous cell carcinoma, originating in the tissues that line the mouth and lips.

Oral cancer is usually located in the tissue of the lips or tongue, although it can appear in the floor of the mouth, the lining of the cheeks, the gums or palate or roof of the mouth. Under a microscope, the majority of cancers that are developed in the mouth, have similar characteristics and are called together as squamous cell carcinoma. They are malignant in nature and tend to spread very quickly.


Back to top

54.How to detect it in time?

Some forms of cancer in the mouth begin as a leukoplakia, whitish lesions, or reddened lesions (eritroplaquia) which is not alleviated and that have been present for more than 14 days.
Lesions or ulcers may appear:

  1. In the tongue, lip, or any other area of the mouth
    Usually of small size of pale color, though they may be dark or discolored, initially no pain, with a burning or painful feeling in advanced stages.
  2. Other symptoms that may be associated with this disease:
    – Unsual problems in the tongue
    – Difficulty swallowing
    – Pain and paresthesia, characteristically late signs.


Back to top

55.What is the treatment?

Excision of the tumor is usually recommended if it is small and if the surgery will have a satisfactory functional result. Radiation therapy is often used in conjunction with surgery, or as a radical definitive treatment, especially if the tumor is inoperable.

Because of the vital nature of the structures of the head and neck, the operations of larger tumors may be technically exhaustive. The reconstructive surgery may be required to complete the functional results and cosmetics committed by reason of an invasive therapy. They usually include transplants of bone, and skin, usually from the forearm, to help rebuild the structures eliminated during the removal of the cancer.

The survival rates for oral cancer depend on accurate place and the stage of the cancer in the diagnosis. Survival is usually located near 5 years when the early stages of diagnosis are considered.

The survival of stage 1 is approaching 90%, so it deserves an emphasis on early detection to improve prognosis of the patient’s life.


Back to top

CARIES

56.What is the dental caries?

57.Why is it produced?

58.At what age is most common?

59.How is it diagnosed?

60.What is the treatment?

61.How can I prevent it?

56.What is the dental caries?

Caries is a destructive disease of the structures of the tooth and it is also one of the most common diseases of humanity.


Back to top

57.Why is it produced?

The development of caries is affected by three risk factors:

  1. The sugars in the diet.
  2. Bacteria from the mouth.
  3. The existence of teeth predisposed or susceptible.

In addition, needs the collaboration of a fourth factor, time, which is essential to ensure that the other factors act.


Back to top

58.At what age is most common?

As we said, for the development of the caries, is necessary the time factor, so much older a child, better your chances of dental caries.
However, the temporary teething or milk, it can develop a type of particularly extensive caries, affecting virtually all of the incisors and that usually occurs in children fed for a long time by bottle or by the use of pacifier wet in honey or sugar.


Back to top

59.How is it diagnosed?

Initially, the lesion manifests as a change of color (dark or white) in the enamel of the tooth. When the lesion progresses, there is loss of substance and scour enamel, which gives a look of stain grayish. Finally, enamel is broken and the lesion is easily detectable.

When caries affects only the enamel, it does not produce pain. If lesion progresses and reaches the inner tooth tissue, it is when there is pain, which is sometimes intense and triggers to drinking hot or cold beverages.

As the infection progresses, occurs the passage to the soft tissues surrounding the tooth, appearing phlegmon seeking exit to the outside through the gum.


Back to top

60.What is the treatment?

Treatment should be applied by the dentist and it is based on three basic points:

  1. The control of the infection.
  2. The remineralization of the tissues.
  3. The treatment of complications.


Back to top

61.How can I prevent it?

We have seen how the development of caries is affected by several factors. Some of them cannot be changed (such as individual susceptibility), but above others we can act. There are various preventive measures that we are going to try to expose. In any case, it is advisable to bear in mind that the best treatment is prevention, and that it should begin to apply from the first months of life of the children.

  1. Dietary measures: They have the mission of reducing raw material (sugars) on which bacteria cct. Measures to apply include:
    -Reducing the frequency of exposure to sugars, instead of reducing the total amount of the same.
    -Avoid foods that stick to the teeth (gum, soft candies, etc.), for their permanence in the chewing surfaces.
    -Avoid the use of sucrose. Instead, use xylitol and sorbitol that develop a bacterial flora with less capacity to produce caries.
    -In infants, avoid prolonged contact of teeth with the teat of the bottles (no more than 15-20 minutes by feed). Avoid bottles night or at naptime.
    -Not sweetened pacifiers with honey or sugar and not offer fruit juices on bottles.
    – Promote the intake of foods rich in fiber (Apple, carrots, etc.).
  2. Dental hygiene. Parents should assume the responsibility for oral hygiene until the child get sufficient skill. Two techniques will be used:
    -Toothbrushing. It should start as soon as the first teeth to appear. Use a toothbrush for children and follow a proper technique. It is not recommended to use toothpaste fluoride in children younger than 5-6 years, by the tendency to swallow it.
    -Dental floss. It is useful to eliminate the interdental plaque.
  3. Fluoridation: It is the most effective measure in the fight against caries. Fluoride is stored in the teeth before their eruption and increases the resistance of the enamel, remineralizes the incipient lesions and counteracts the action of microorganisms responsible for caries. Fluoride is administered in two ways:-Via general:
    o Fluoridation of drinking water. It is the most effective, cheap and safe method. It produces a decrease in the incidence of caries up to 50%. It is what recommends the WHO.
    o Inndividual supplementation. It is the second best option. The doses to be used depend on fluoride of drinking water and the age of each child. Supplements are recommended from 0-6 months of age until the age of 13-16.
    – Via local: local or topical fluoride is compatible with supplements fluorinated from 5-6 years of age. In addition to the fluorinated toothpastes, mouthwashes for daily or weekly use is available. Since there are multiple ways to administer fluoride to children, it is advisable to consult with your pediatrician what should be the best option for each child.
  4. Resins and seals: Applied by professionals, they are the most effective measure to prevent caries in pits and fissures of the occlusal surfaces. Here we can also include the fluoridation applied by dentists and stomatologists.


Back to top

PEDIATRIC DENTISTRY

62.What is the pediatric dentistry?

63.What is the difference with general dentistry?

64.What materials are used in the pediatric dentistry?
linia

62.What is the pediatric dentistry?

The Pediatric Dentistry is the branch of dentistry responsible for treating children. The dentist will therefore be responsible for exploring and treating the patient. He is also responsible for detecting possible anomalies in the position of the jaw or teeth to send to the orthodontist, specialist in orthodontics, and restorative treatment in case of need it.

The restorative treatment mainly consists of treating injuries, use sealants, which consists of slightly seal grooves and fissures of the dental pieces without just removing dental material to avoid possible caries, and in treating caries produced and its consequences.



Back to top

63.What is the difference with general orthodontics?

The main difference between general dentistry and the Pediatric dentistry in the treatment of caries is the presence of temporary teeth or milk in children which makes treatment change, so that temporary teeth injury treated in a way less conservative and more aggressive than the occurred in permanent teeth to avoid that, in the worst cases, insufficient treatment could be given to a temporary tooth which then would rebound in its successor the permanent tooth.



Back to top

64.What materials are usen in the pediatric dentistry?

  1. Sealants to stop caries: They are resins applied to the chewing surfaces of the teeth. Decrease the probability of caries in teeth which are placed. They act as protection barriers, avoid that food particles from staying in the reliefs of the teeth. Make surfaces smooth and easy to clean chewing surfaces of the teeth. They are usually applied in children 6 to 7 years, when the permanent teeth begin to leave.
 Although the sealer makes cleaning easier, brushing should not be neglected, if proper hygiene is not performed it can arise a caries near the sealant. Placement of sealants will not damage the enamel, does not require anesthesia, the dentist brushes the piece and brushes it with a cream, hardening applied a light special. The sealants last quite some time, but the periodic inspection of the dentist is necessary to check its status.
  2. Cavity liners and bases: For base or the bottom of the cavity using calcium hydroxide, zinc oxide eugenol which is an antibacterial substance that forms secondary dentin, ionomer glass that fluoride releasing and, before it was used, polycarboxylate cement and zinc phosphate that are no longer used by being very toxic. The cavity liner will take tenths of millimeters of the realized total cavity.
  3. Temporary materials: They are materials used for a limited time until the permanent material is available. They are ionomer, amalgam of silver, eugenol zinc oxide and zinc phosphate cement.
  4. Definitive materials: They are the materiales that we used on on definitive seals.
  5. Silver amalgam: The only that we can use in inadequate conditions as it may be a difficult tooth or difficulty to isolate it.
  6. Fluoride: Take care of our enamel



Back to top

ORTHODONTICS

65.What is the orthodontics?

66.What is it used for?

67.Are the orthodontic treatment painful?

68.Can I have normal life?

69.Are the results estable?

70.What are the causes that motivate these alterations?

71.In whom it is used? Is it possible in adults?

72.At what age can you start treatment?

73.What would be the consequences if not treated?

74.What means are used?

65.What is the orthodontics?

Orthodontics is a branch of dentistry, specializing in the diagnosis, prevention, and treatment of dentofacial irregularities or malocclusion (bad bite). It pursues the perfect positioning of the teeth, with its aesthetic benefits and health, as well as the normal coordination of the jaws, achieving facial harmony.

Healthy teeth that work well, and a balanced face that pleases contemplates it that, affect the self-esteem of the patient, and in its social acceptance.



Back to top

66.What is it used for?

To correct a poor correspondence between the lower dental arch with the upper and/or an abnormal alignment of the teeth. The cases more frequent that they need orthodontic treatment are:

Los casos mas frecuentes que necesitan de tratamiento de Ortodoncia son:

  1. Crowded teeth or overlapping
  2. Overbites
  3. Open bite (close posterior teeth but not the previous)
  4. More or less space between teeth
  5. More or missing teeth

It is a technique used increasingly more, given the current interest in promoting the health of our children. Each time it is requested at an earlier age.



Back to top

67.Are the orthodontic treatment painful?

The forces applied to move the teeth are very soft, so after the first few days you will not notice anything special.



Back to top

68.Can I have normal life?

Yes, of course. Orthodontic appliances will not interfere in their usual activities. You should follow some recommendations for eating or brushing your teeth.


Back to top

69.Are the results stable?

All treatments require proper maintenance. With the help of removable or fixed lingual retainers, the results may be stable, being an investment for a lifetime.



Back to top

70.What are the causes that motivate these alterations?

They may be caused by::

  1. Bad habits (thumb sucking, swallowing with interposition of the language, etc.).
  2. Mouth breathing (by hypertrophy of adenoids – vegetations-, etc.).
  3. Ectopic dental Eruption (A tooth located in a different place in his native).
  4. Tooth Agenesis (is the lack of one or more teeth).
  5. Supernumerary tooth (greater number of teeth than usual).
  6. Cranio-facial Skeletal Dysplasias (are congenital disorders of the bones of the face and head).
  7. Space problems (occurs when the jawbone is still infant and teeth are definitive, that are larger and more).



Volver Arriba

71.In whom it is used? Is it possible in adults?

Used in children and adolescents because they are in full growth of the skeleton and tooth replacement, can therefore act on both structures. Once finished growth, only can be acted on the teeth. In women is considered the end of craniofacial growth at the age of fifteen and in males at the age of nineteen.

Although it can be used at any age, orthodontics is capable of correcting the bad position of the teeth to get a mouth healthy. A smile lights up his face and makes them more attractive.

The bone of the jaw, although it is very hard, it is also very flexible. The biological process involved in tooth movement is the same at any age, so the teeth can move both the 20 and 60 years.

It is not only a matter of charm, is also a matter of health. A bad position of the teeth may favour the emergence of other problems such as caries, periodontal disease (gum) or problems joint.

The spectacular aesthetic improvement of fixed appliances orthodontics allows today, adults of any age, unhappy with the appearance and/or performance of their mouth (crowded teeth, gaps between teeth, protruding teeth, etc. .) stop feeling limited and normally accept orthodontics. Ceramic brackets, similar to tooth enamel without visible metal, go almost unnoticed to others, and satisfy most adults.



Back to top

72.At what age can you start treatment?

It is difficult to establish at what age a child needs orthodontic treatment. If we consider that children between 7 and 12 years are in period change teeth (exfoliate temporary or tooth milk for the arrival of the permanent or definitive), a clinical and radiographic evaluation around age 7 is recommended to begin to observe and control the correct dentofacial growth during this period.

Occasionally, when there are apparent problems may be recommended visit children before age 7 for early treatment. Thus, in some patients we will intervene soon – early treatment – with results often unattainable only with orthodontics once finished skeletal growth, while in others, although the problem is manifest, we recommend to wait for periodically checking children while erupt teeth and the bones of the face are developed.

In adults, you can start the treatment at any age.



Back to top

73.What would be the consequences if not treated?

It is difficult to assess exactly the problems in the future, but normally the alterations that you have will be intensified with the passage of time surely, especially in a child or adolescent, we must not forget that they are in development and the dento-facial problems will also grow.

It is convenient to deal with two fundamental aspects:

  1. If the anomaly is detected and treated in time, it will be treated more easily, reducing discomfort, time and cost.
  2. We could avoid more complex bone treatment (maxillofacial), avoiding possible anomalies in the bones, which would be reflected in the appearance of the face.



Back to top

74.What means are used?

  1. Orthopaedic: they are elements that act by modifying the pattern of bone growth. Among them we have face masks and the chinrest.
  2. Functional: These devices alter the forces that act on the teeth from peridental tissues (tongue, lips, etc.) Expanders palate and lingual grid are useful for this purpose.
  3. Orthodontic: They are means that modify the position of the teeth in dental arches. “Brackets” are used (are small quadrangular supports coordinated by an arch of wire), to which can add any other gadget (spring, elastic ligature, etc.).

    In this category we have 3 types of Orthodontics:
    – Conventional
    – Aesthetic
    – Invisible



Back to top

AESTHETIC

75.What is the dental aesthetic?

76.Do benefit me about dental aesthetics?

77.What is a crown or veneer?

78.What are its indications/contraindications?

79.What kind of crowns are there? What are their advantages and disadvantages?

80.What is the duration?

75.What is the dental aesthetic?

Dental aesthetics, as its name suggests, covers everything that has to do with beauty, aesthetics, or beautification of your teeth, in its different forms and possibilities.



Back to top

76.Do benefit me about dental aesthetics?

The smile is one of the aesthetic factors more important, inherent to the person.

A beautiful and attractive smile offers a positive image and encourages the individual to smile with tranquility and naturalness.

A ranked mouth, healthy and harmonica gives security in oneself.



Back to top

77.What is a crown or veneer?

Crowns or porcelain covers are, as their name indicates, a total covering of the tooth which simulates all of the coronary anatomy. Its thickness ranges between 1-1, 8 mm.

They can make only with porcelain, or with a core of other material to give more consistency, as metal or more recently the zirconium.



Back to top

78.¿Cuáles son sus indicaciones / contraindicaciones?

Indications:

They are used when a large number of dental tissue has been lost for example after a large caries or trauma, since the retention of a venner or a filling would be very difficult due to the great loss of dental tissue. Also they used in cases of teeth with endodontics treatment, to give consistency to the entire tooth and avoid possible fractures, since teeth with endodontics treatment are weakened with the passage of time.

Contraindications:

Practically any patient can wear crowns, with the exception of those who:

– Submit advanced gum disease
– That the tooth has a problem that limits their conservation in the mouth
– Have excessive tooth mobility



Back to top

79.What kind of crowns are there? What are their advantages or disadvantages?

  1. PORCELAIN VENEERS OR CROWNS: Porcelain veneers, also called facets of porcelain, are a few slices of variable thickness ceramic covering the front face of the tooth, usually employed in the anterior, whose purpose is almost always aesthetic. Veneers are attached with an adhesive on the carved surface. They require laboratory phase. With them we can modify the shape of the tooth, light bad positions, and color. It is an irreversible treatment.
    The great development of porcelain veneers is due to two major advances:
    – The ability to record the internal face of the veneer with acid and the possibility of using resin cements that adhere to the tooth through the etched enamel. With the combination of both factors veneers suffer a boost which puts them today as the treatment of choice in compromised aesthetic situations. Advantages of porcelain veneers:- Aesthetics
    – Durability
    – Gingival tolerance
    – Hardness similar to the enamel
    – Color stabilityDisadvantages of porcelain veneers:

    – Greater reduction in tooth
    – Fragility
    – Cost

  2. COMPOSITE VENEERS: This technique is conservative because the preparation is minimal, is used for clinical cases that present alterations in the vestibular surface of the dental element, resolving with a system of composite resins cured in a direct way, in a single session and directly in clinic. does not require any laboratory phase so the cost is lower. Does not require laboratory phase so the cost is lower. It is also necessary to have the scientific and artistic knowledge to achieve success in this type of restorations. The main question facing us, is its duration, since the composite resin is susceptible to discoloration, which reduces the aesthetic result in the long run.

Clinics-radiographics periodic inspections should be performed and recommended an annual maintenance polishing.

Indications of the composite veneers:

– Split tooth, adjacent composite
– Alteration of color, which does not respond to bleaching techniques
– Alterations in the way: conoids sides, hypoplasias…
– Teeth with multiple restorations.
-Transformations of sides in Central
– Alignment
-Large abrasions, erosion…
– Closure of diastema (space between teeth)
– Provisional
– Young patients
– Mock-up (without recording)

Contraindications of the composite veneers:

– Very dark teeth
– Parafunctional habits
– Excessively rotated teeth
– Teeth with little enamel

Advantages of composite veneers:

– Treatment usually rapid, safe and effective
– Modify color, size and position in a single appointment
– Reversible treatment
– You do not need laboratory, less cost
– More conservative technique, minimal or non-existent preparation
– Non-necessary impressions

Disadvantages of composite veneers:

– Less resistance than the enamel
– They are vulnerable to degradation and color change
– Requires technical skill and artistic ability to reproduce the outline, shape and surface texture
– Porosity and irregularidades
– Little capacity to hide the dark surface of the prepared tooth
– They require sometimes a polishing

  • CASES OF ZIRCONIUM: The main benefit is purely aesthetic, since the absence of alloys of metal on pieces allows to obtain a more natural on the traditional prosthesis. Zirconium, as basis for ceramic structures, meets perfectly all requirements, bio-compatible material, high-strength and admirable aesthetic results, has become in the technique of choice for the realization of fixed prostheses of ceramic. The colour of teeth is marked by genetic factors, but the passage of time and other factors both intrinsic as extrinsic, can vary your tonality. Currently we have technical cosmetic that allow us to change the color of teeth giving them brightness and whiteness to have a pleasant and beautiful smile.

 



Back to top

80.What is the duration?

Crowns are made of a material so strong that sometimes can last even more than 50 years. However, due to the wear and tear that produces chewing, sometimes lose the shape or the brightness.

In these cases and if the patient wants it, the crown is removed and is returned to a new.



Back to top

CONSCIOUS SEDATION AND LOCAL ANESTHESIA

81.What is conscious sedation?

82.Why and how is it used?

83.What patients is indicated?

84.What is local anesthesia and what is its use?

81.What is conscious sedation?

Conscious sedation

We understand by conscious sedation the state while remaining still depressed level of consciousness in, protective reflexes are preserved, breathing control is maintained and response to verbal or tactile stimuli.

It is a medical controlled state of depressed consciousness that allows to keep all defense of airway reflexes, the patient retains its ability to have its free independently and continuous airway, allows an adequate response to physical or verbal stimulation, there is response to verbal commands. I.e., the patient is calm, not slept.



Back to top

82.Why and how is it used?

Using conscious sedation we eliminate the anxiety or the fear generated by the visit to the dentist.
In addition, the patient enters in a relaxation and drowsiness state, but without losing the power to respond to the commands of the dentist, since it is not a general anesthesia. In short, the presence of an anesthesiologist who make a conscious sedation is the most comfortable and secure way receive your dental treatment, both for the patient and for the dentist. It is given through a vein in the hand that is channeled to the start of the session.

Once finished the session, using other drugs removed quickly the effects of sedation so that the patient can go home in perfect condition, accompanied by a family member or friend.



Back to top

83.What patients is indicated?

It is indicated for people with fear or phobia to dental procedures, in anxious people or for anyone who wants to a degree of extra comfort during your visit to the dentist. Another important indication are long-lasting treatments in one single session of several hours, because with this method can be with excellent tolerance by the patient.

Especially suitable for:

– Patients with FEAR, PHOBIA or ANXIETY
– Patients with VERY SENSITIVE TEETH PAIN
– Patients with LIMITED AVAILABILITY OF TIME
– Patients with COMPLEX PROBLEMS



Back to top

84.What is local anesthesia and what is its use?

Local anaesthesia

It is used to cancel or decrease nerve transmission, for thick nerve trunks a higher concentration of anesthetic is used, it will be anesthetized by diffusion, never in thick nerve trunks, bone, for example in the upper jaw. Anesthesia usually is linked to a vasoconstrictor to increase its effect and decrease the bleeding.

Types of local anesthesia:

    1. Ester Type: benzocaine, a topical anesthetic.
    2. Amide type: lidocaine, prilocaine, mepivacaine, bupivacaine vs Articaine are most commonly used. They metabolized in the liver and eliminated by the kidneys.

Duration:

Pulpal anesthesia lasts 30-40 minutes and 2 hours anesthesia soft tissues.

Key features and benefits:

  1. Reversible
  2. Low systemic and local toxicity
  3. Quick Launch, from 2 to 10 minutes
  4. Long Duration
  5. Powerful
  6. No adverse actions
  7. Easily sterilizable
  8. Stable: metabolism and rapid elimination



Back to top

EXTRACTIONS

85.Why should I extract a tooth?

86.What are the risk factors for extraction?

87.How extraction is done?

88.Is the treatment painful?

89.And after the extraction?

85.Why should I extract a tooth?

When there is no possibility of conservative treatment of a tooth, it is necessary to use extraction. The most frequent cause for which should be extracted a tooth is the destruction by caries, and secondly the periodontal disease (pyorrhea).
 However, there are other situations where it is accurate extraction of a tooth, although less frequent than the previous ones:

  1. Fractured teeth: When a trauma occurs on the face it can happen that some of our teeth are affected. If this fracture or break occurs in the root below the gumline, it is not possible to restore the tooth or tooth, so should be removed.
  2. Extraction of healthy teeth for orthodontic treatment. With a bad position of the teeth that need to be aligned by an orthodontic treatment, it may happen that there is a significant lack of space. In these cases the only way to get enough space for proper placement of our teeth is the extraction of any tooth, usually the first premolars.
  3. Extraction of teeth to facilitate the construction of a prosthesis. A tooth or molar in a bad position can hinder the placement of a prosthesis to be able to rehabilitate the jaws.
  4. Temporary impacted teeth. If baby teeth are not changed in due time, they can cause an alteration in the position or eruption of permanent teeth, so they must be removed.
  5. Impacted teeth (unerupted). Unerupted teeth are teeth that have not erupted during normal period of eruption. In these cases we must rule out any kind of pathology and make a panoramic radiograph to determine the cause of this delay in the eruption. The most common inclusions are those of the uppper or lower third molars (wisdom teeth) and the canines (fangs), especially in the upper jaw.



Back to top

86.What are the risk factors for extraction?

  1. Smoking
  2. Heart or blood disease
  3. High blood pressure
  4. Alcoholism
  5. Poor nutrition
  6. Use of some prescription and non-prescription; Inform your doctor of any medications or supplements you are using or have used in the last month



Back to top

87.How extraction is done?

If the tooth is impacted, the dentist removes the overlying gum and bone tissue to expose the tooth. Using forceps, the dentist will hold the tooth and gently rock it back and forth. This action releases the tooth of alveolar bone (jaw) and breaks the ligaments that hold the tooth in place. The tooth is pulled and a blood clot usually forms in the gap. The dentist places a gauze sponge there.

Occasionally the dentist places a few stitches near the edges of the gum.



Back to top

88.Is the treatment painful?

Anesthesia prevents pain during the procedure, but may feel some pain in your jaw once the anesthesia wears off. Often extractions are feared by the patient even more than other surgical procedures unrelated to the mouth. The advancement of modern techniques of local anesthesia makes today extractions can be made without any pain and with less discomfort for the patient. On the other hand, if there is some fear of intervention, there are a variety of drugs that allow the patient is relaxed during surgery and is not in tension or nervousness.



Back to top

89.And, after the extraction?

In the first 24 hours after extraction, expect some swelling and residual bleeding. The healing period usually takes between 1 and 2 weeks. It will grow new bone and gum tissue in the hole. Having a loose tooth can cause displacement of the teeth, bite improperly or difficulty chewing. Your dentist may attempt to restore the area with an implant, fixed bridge or denture.



Back to top

DENTAL HYGIENE TIPS

90.Why should I care for my dental hygiene?

91.When can we clean teeth?

92.What we clean teeth?

93.How can we remove plaque?

94.How should I brush my teeth properly?

90.Why should I care for my dental hygiene?

Dental hygiene will enable us to prevent gum disease and prevent caries largely. But dental hygiene should be performed in the manner and with the right tools. In addition, it should devote the necessary time to be effective.



Back to top

91.When can we clean teeth?

Ideally, brush your teeth after every meal (breakfast, lunch and dinner). It is essential to do so thoroughly at least once a day. Production of saliva and tongue movements help to remove plaque from buccal surfaces during wakefulness. During sleep decreases the production of saliva and tongue movements, so the formation of plaque is favored if not done a good dental hygiene. Thus, we can never forget to wash your teeth before go to the bed and if we can only clean teeth once a day, at this time will be essential.



Back to top

92.What we clean teeth?

We need to clean the teeth:

    1. Toothbrush. It should have a rounded and small head for easy access to all teeth. Their threads should be smooth and rounded tips to avoid injuries on the gums. If using it wears out or twist not cleaned well, so we should replace this brush with a new one. It is estimated that brushes will last about three months in optimal conditions.
    1. Toothpaste or dentifrice.It contributes to leave us a greater sense of cleanliness. They are presented in a paste or liquid gels and incorporate detergents agents, and almost all of them have flavoring agents. With this composition the use facilitates the dental cleaning and leaves a pleasant feeling clean. Currently and knowing the importance fluorine has in preventing caries, it is desirable that fluorine be incorporated into dentifrices formula, since this has a clear role in protection against caries. There are special pastas on the market to treat tooth sensitivity incorporating potassium nitrate.
    1. Dental floss. It is a silk thread, ribbon-shaped or cord, waxed or not, the use of which ensures clean the sides of the teeth. To use it properly should follow a series of steps that may seem complicated, but in practice are very simple and can be seen below.
    1. Interproximal brushes.They are used when there is space between the teeth, or because they have lost any part or for loss of alignment or dental rotations. In this case, they are used in place of dental floss to ensure cleanliness of the side faces of the teeth.



Back to top

93.How can we remove plaque?

Daily plaque removal must be done following a series of steps:

  1. Tongue cleaning. The tongue accumulates a large amount of bacteria so cleaning it is necessary for maintaining oral health. For cleaning it we can rub it gently forward using the toothbrush or you can use a tongue cleaner.
  2. Spaces between the teeth cleaning. The cleaning of the spaces between the teeth (interdental spaces) is different depending on each situation. Dental floss is used if there is little space between teeth (is the ideal situation). If there is enough space between the teeth (lost or dental movements), you must use a special brush called interproximal brush.
  3. Teeth cleaning. It is done by using the toothbrush and toothpaste. Brushing will remove not only the remains of food but also the invisible bacterial plaque. There are several techniques of brushing, which are directed to clean the inner faces, outer and chewing.



Back to top

94.How I should clean my teeth properly?

Teeth brushing removes bacterial plaque (thin, small, sticky, colorless film that contains harmful bacteria that are constantly deposited in teeth), and particles of food, of the deep surfaces of the teeth. Ask your dentist to recommend a good toothbrush.

For general use, a brush of soft bristles and curved finish is recommended, since it allows not to damage the tissue of the gingiva. The size and shape of the brush allow to reach each of the teeth. Toothbrushes for children are different from those used for adults.

There is a varied number of brushing methods, all of them acceptable. Any method used, takes time and must also be carried out using a toothpaste containing fluoride. This brushing should be done twice a day. The following is an effective method to remove plaque:

  1. Support toothbrush center on their teeth with bristles at an angle of 45 ° to the gumline.
  2. Move the brush back and forth in small movements (which do not exceed more than ½ tooth) during several times.
  3. Brush the outer surface of each tooth, up and down, keeping the angle indicated by the gumline.
  4. Use the same method on the inner surface of the teeth.
  5. Brush the surfaces of chewing teeth.
  6. To clean the inner surfaces of the front teeth, place the brush vertically and make movements up and down with the front of the brush.
  7. If you also brush the tongue, it will refresh his breath and clean your mouth removing plaques.

Worn tooth brushes may not be a good teeth cleaning and can injure the gums. Usually toothbrushes should be changed every 3 or 4 months. Brush with small movements and exerting sufficient pressure in order to be able to feel the bristles of the brush above the gums. Brush tips are those that are responsible for cleaning. Remember reposition the toothbrush frequently moving slowly over the entire surface of each of the teeth.

The toothbrush can clean only 1 or 2 teeth at a time. Gums can be harmed if using a hard bristle brush. Be sure to clean your teeth at least 2 times a day, or as often as recommended by your dentist.

Children should brush their teeth by placing the brush with fluoride toothpaste at least twice a day.



Back to top

PROSTHESIS

95.What is a prosthesis dental?

96.What is a prosthesis dental?

97.How a prosthesis improve my aesthetic

98.What types of prosthesis exist?

95.What is a prosthesis dental?

A dental prosthesis is an artificial element intended to restore the anatomy of one or more teeth, also restoring the relationship between the jaws, while returns the vertical dimension, and replenishes both natural dentition and periodontal structures.

Commissioned to design, develop and manufacture these devices or artificial elements, it is the dental technician, who does his work in a dental laboratory receiving indications dentist, who works in clinic.



Back to top

96.How a prosthesis improve my health?

The single functionality of the prosthesis means quality of life and therefore health for the patient, but in addition to this, another key objective is to prevent the rest of the dental structures of the apparatus chewer suffer damage, since the prosthetis repair even the dimension vertical of mouth, thus avoiding bad joint positions that have very different effects.

When a mouth lacks all or partiality of the teeth, the different structures that make up the oral cavity are adapting to the new situation, resulting in possible situations unsuitable for healthy teeth or oral health in general. Dental prosthesis take into account the occlusal or masticatory forces, which are the pressures that are performed during chewing food, so that this pressure is distributed and balanced, thus avoiding mechanical suffering of the mouth and triggered future problems.



Back to top

97.How a prosthesis improve my aesthetic?

In today’s society, as in times past, aesthetics pursued by necessity and therefore either an imposed or self-imposed necessity, aesthetics and good looks, it will become another key for the prosthesis. When it comes to aesthetics in this field, you may receive the error relate what better and more beautiful with the most perfect, white teeth, teeth aligned perfectly without any wear, etc. However, the prosthetist objective will get a denture aesthetics, but not as perfect as other natural, taking into account the patient’s age, sex of the patient, the patient’s facial morphology, size of the face and the patient’s own teeth.

The teeth should be placed in the same color and shape as the natural pieces, especially if the patient partially retains its denture. Aesthetically, a complete and healthy teeth is important, however, prosthesis are not limited to restore dentures, but also restore the vertical dimension of the mouth and the overall appearance of the face. At the time of making a prosthesis, should take into account the midline (which lets you know where is the first central), the smile line (which allows you to set the length of the teeth), and the line of canines (which allow determine the extent of the previous group).



Back to top

98.What types of prosthesis exist?

The prosthesis can be:

Tooth-supported:

Those that are supported by teeth pillars, or remnants of the patient, which are natural teeth which it still retains. The teeth may fully preserve its structure, or may be (in most cases) previously cut teeth by the dentist.

  1. Fixed prosthesis: The dentist carving teeth that will serve as a support, called teeth pillars and located at the ends of each zone edentulous (without teeth), in which will be cemented carefully adjusted fixed prostheses. To do this in the clinic, the dentist takes impressions and bite registrations later sent to a lab where the technician empty or positive impressions in plaster, and manufactures on the resulting models the structures of the fixed prosthesis with wax. These waxed will be included in special high temperature resistant coatings, and it is casting in metal with different alloys. The last step would be to mount the ceramic on metal structures, depending on the type of prosthesis fixed to make, as there is also the possibility of making crowns and bridges in pure porcelain (no metal) or on a base of white material called alumina or zirconia. There will be several tests in the mouth, and after achieving the three key objectives of a prosthesis, the dentist will cement the result mouth, without this can be removed by the patient. The dentist will cement in the mouth the result, and this can not be removed by the patient.
  2. Crown: A crown is a restoration for a single tooth in particular. Sometimes they are also called “sleeves”, especially for the patient, who does not see itself as a prosthesis. This is so because in reality, the crowns are placed on the patient’s natural tooth, which have been previously cut, as if a case is involved. As in all fixed prosthesis, the teeth are made by hand, personified for each patient and sticking to the needs of the dentobucal anatomy.

Tissue-supported:

Those supported on the alveolar process, in contact with the gum tissue is fibromucosous. Fully tissue-supported prostheses are typical “dentures”. Resin removable dentures are made with acrylic resin (or other plastics) and can be placed and removed by the patient. The development of these dental prosthesis has to meet both functional and aesthetic criteria, and we must invite the patient to carry out a careful hygiene, both oral cavity and the prosthesis, which must be removed for cleaning.

  1. Complete removable prosthesis: Commonly known as dentures. They are performed when the patient has no teeth being therefore tissue-supported in the absence of pillars to hold. The support of the prosthesis is taken from a wide base, extending over the surface of the mucosa in the alveolar processes. They can be unimaxilares or bimaxillary; ie, top, bottom, or both if the patient has no teeth in either of the two arches. In this type of prosthesis, it is necessary achieving a balance of the upper occlusal joint with the lower taking into account the mandibular movement, chewing, the stability of the prosthesis, etc.
  2. Partial removable prosthesis: They are performed when the patient has any remaining tooth, which will contribute to the retention of the prosthesis using forged or cast retainers and is therefore tooth tissue-supported. They are not very used since metal partial removible prosthesis offer a higher quality and better functionality. Often simply they used as temporaries prosthesis.

Tooth tissue-supported: Tooth tissue-supported: Those that combine the two types of supports above, i.e. are supported both remnants of the patient’s teeth and alveolar process.

  1. Metal removable prosthesis: Also known as skeletal, are Tooth tissue-supported partial prostheses, that is, both are fixed on teeth and the mucosa, and are performed when the patient still retains some natural teeth. These prostheses are removable, or what is the same, can be extracted and placed by the patient. They are made by casting metal structure (which may be of different alloys, both noble and non-noble) from a wax pattern performed manually, and with the use of preforms on the model coating. The teeth and reconstructions gums are made of acrylic resin.
  2. Resin removable prosthesis: Those groups which are made with acrylic resin (or other plastic), and which can be placed and removed by the patient. The development of these dental prosthesis has to meet both functional and aesthetic criteria, and we invite the patient to carry out a careful hygiene, both oral cavity and the prosthesis, which must be removed for cleaning.
  3. Mixed prosthesis: They consist of a part that is fixed in the mouth and one that the patient can remove and place.

Implant supported:

Prosthesis on implants are implant supported prosthesis, ie, are held in dental implants, so the patient must first undergo a surgical operation. These can be fixed prosthesis (implant supported) or removable (implant tissue suppported).



Back to top

MAXILLOFACIAL SURGERY

99.When orthognathic surgery is indicated?

100.How do I know if I have a maxillofacial deformity?

101.Do I need orthodontic and orthognathic surgery?

102.What is orthognathic surgery minimally invasive?

103.What are the new technologies?

104.How long is the procedure?

99.When orthognathic surgery is indicated?

When one or more bones of the face (upper jaw, jaw, chin, nose and cheekbones) are too big, too small or asymmetrical, the face loses its ideal proportions and also the teeth located in these bones do not fit well. It is a maxillofacial deformity. If we look at the people around us, we see that is quite frequent, up to 20% of the population has some discrepancy.



Back to top

100.How do I know if I have a maxillofacial deformity?

If your facial proportions are not harmonious due to a problem in the bones of the face (jaw, jaw, chin, nose, cheeks) it is likely due to a maxillofacial deformity. The teeth in the mandible and maxilla, also does not fit right.



Back to top

101.Do I need orthodontic and orthognathic surgery?

When the teeth are in an altered position due to a maxillofacial deformity, we need to place them in their normal position to make the intervention and get the best possible result. The orthodontist decompensation forced tooth position and places them in a healthier and more functional position.



Back to top

102.What is orthognathic surgery minimally invasive?

In the beginning, in the 70s, orthognathic surgery was supposed to long surgeries and post-operative unpleasant. Today, with new technological advances, and an anesthetic equipment used to these treatments, interventions last between 45 minutes and 2 hours and very rapid recoveries. We have developed techniques and approaches minimally invasive based on small incisions that allow through some tunnels to the zone to operate. Postoperative recovery accelerated with physiotherapy and personalized diet.



Back to top

103.What are the new technologies?

Birbe Clinic is a pioneer in the 3D virtual simulation of orthognathic surgery. Starting from a cone beam scanner, “operate” through a program the scanner and we have a simulation result on facial and dental level.



Back to top

104.How long is the procedure?

Depending on the type of intervention, from 45 minutes to 2 hours. After the intervention the patient passes to your room in clinic, after anesthetic recovery time. The duration of clinic admission ranges from a couple of hours a day.



Back to top