In the first appointment, a full medical and dental history is taken followed by a thorough extra-oral and intra-oral examination. Digital radiography may be employed if necessary. Furthermore with the use of intra-oral microcamera connected to the monitor of the operating chair, the patient can have a complete image of his or her dentition, so that treatment modalities can be explained with the patient being aware of both the initial problem and the various solutions available.
To further promote a more relaxing appointment, there are special goggles from which the patient can watch a movie, or listen to music through eyepieces.
In more detail, the treatment options provided are as follows:
Composite resin restorations (tooth-colored restoratives)
With the use of modern materials and techniques, these restorations have an increased structural strength and markedly improved aesthetics when compared to amalgam restorations. They also have a far greater adhesion to the tooth surface, protecting the remaining structure from fractures. Their benefits are greater and more visible if a good oral hygiene is followed.
When a tooth is severely decayed, or an older large restoration has failed, it is ideally restored with these indirect (laboratory-fabricated) restorations. After taking impressions of the dentition, dental laboratories can create a filling, exactly matching the color and contour of the missing part of the tooth either with reinforced resin (Gradia) or porcelain. These indirect restorations have better structural strength than the directly-placed composite restorations and have equally good aesthetics.
With composite veneers it is possible to change the appearance of multiple teeth in only a single appointment. It is possible to change the shade and/or the shape of teeth, to close gaps and visually correct misaligned teeth.
Porcelain veneers are thin layers of porcelain which are bonded on the tooth in order to change its shade, shape and size, just like with the composite veneers mentioned above. This approach requires two appointments, one to take impressions, and the second to adhere the veneers. Although they are very thin, once bonded they have the same structural strength as the tooth itself and they have very good aesthetics which can last for a very long time due to the materials’ resistance to staining factors present in various drinks and foods.
Dental bleaching, or simply, tooth whitening with the appropriate materials and under the supervision of the dentist is a safe way to increase the aesthetic of a smile without compromising the integrity of enamel. Two different methods are followed. The first is with the use of custom thin transparent trays inside which the patient will place the whitening agent provided by the dental practitioner and will wear for 1,5 to 2 hours daily for 10 to 20 days. The second, and more efficient method is performed with the Luma Cool Whitening System device. The whole procedure can be completed in two appointments each one lasting 30 minutes, and the shade changes progressively and controllably.
Prosthetics (crowns & bridges)
With crowns and bridges, extensively damaged teeth or even teeth that are missing can be restored or added respectively. Crowns are usually made of a metallic base on which porcelain is added. Although porcelain has excellent aesthetic results, such metal-porcelain crowns have the disadvantage that with the passage of time as the gum line recedes the metallic edges or the crown become visible, reducing a lot the high aesthetic result of the crown. In order to avoid this drawback, crowns can be constructed in such manner so that the final metallic edge is covered by porcelain. In isolated crowns and mostly for the anterior dentition, there is an even better result with the use of all-ceramic crowns, which have strengthened porcelain as a base rather than metal. This option offers the best aesthetic results.
Implants are being used in dentistry for more than 30 years and are now a routine treatment option. With implants we can replace a missing tooth without having to intervene to the neighbouring teeth with the feel, functionality and aesthetics being similar to a natural tooth. Also implants can be used to support large bridges when multiple or all the teeth are missing, with better longevity and prognosis than supporting the bridge on other teeth. In order to replace the teeth on a fully edentulous jaw, 5-7 implants need to be added. Lastly, implants can be used to support dentures with improved functionality since the dentures can now “lock” onto the implants and not move during speech or mastication. In order to place a denture on implants, 2-4 implants are needed. Implants are placed in the practice by maxillofacial surgeons specialised on this field of dentistry.
Root canal treatment
When the pulp (the blood and nerve supply of a tooth) becomes irreversibly damaged, it needs to be removed and the now empty pulp chamber(s) needs to be disinfected and sealed with an inert material (gutta-percha). This procedure along with other treatments surrounding the pulp of the tooth falls under the field of Endodontics. Signs of a compromised pulp include increased sensitivity to hot, cold and sweet stimuli, or pain that can reflect to both upper and lower jaw at the same side, or even the ear and/or the jaw joint. During this period of inflammation the patient cannot isolate which tooth causes the problem, however when the inflammation progresses to the surrounding tissues pain becomes localised, the tooth becomes sensitive when biting down and it may even swell. In cases of older, failed endodontic treatment, symptoms are also pain on biting (more, or less intense), inflammation, or a general discomfort in the area of the previously treated tooth when chewing. All root canal treatments and re-treatments are performed in the practice by a colleague specialised in the field of Endodontics, and with the use of modern techniques and equipment a pain free and effective therapy is provided in the least amount of appointments possible.
All surgical procedures on hard and soft tissues are performed in the practice. Specialised personnel can place implants, extract impacted wisdom teeth, handle difficult extractions, perform apicectomies and many other specialised therapies as necessary.
Teeth are supported by alveolar bone, an extension of the primary bone forming the jaws. Gingivitis is the inflammation of the gums whereas Periodontitis concerns also the inflammation of the alveolar bone. Symptoms include bleeding of the gums, tenderness and swelling, formation of abscess, up to mobility of a possibly intact tooth. Periodontitis is today the primary cause of loss of teeth and therefore it is necessary to be diagnosed and treated early as well as to monitor closely to ensure that the condition does not progress any further. A specialised Periodontologist handles all appointments and recall visits, which are specific for each patient according to the severity and characteristics of each case.
The aim of modern-day dentistry is to enhance prevention as much as possible and if necessary intervene early before extended damage takes place. With this in mind, special programs and treatment options are available for our younger patients not only to prevent, but to also educate and make them feel at ease when visiting the dentist. Care for the primary dentition starts when the teeth erupt, around the age of 6 to 8 months. The first visit to the dentist should take place when the child becomes 1 year old, where upon the first evaluation of the dentition is made, advise is given to parents on how to take care of the teeth properly and also what and how to eat as well as the use of pacifiers etc. The second visit should be at the age of 2,5-3 years old when all the primary teeth have erupted. The aim of this visit is to check if all teeth have erupted normally, if any tooth has become carious, if the preventive program is followed correctly and if any changes need to be made. The third visit is done in the age of 3,5-4 years old and from then on the child needs to be seen every 6 to 12 months for the necessary fluoride pallications. Around the age of 6 years, when the first teeth of the permanent dentition erupt, fissure sealants are placed in order to prevent caries formation. It is a white or transparent material, which is placed on the natural pits and fissures of the first permanent molars.
This field of dentistry focuses on moving and aligning the teeth in order to achieve not only a pleasant smile, but a healthy and fullu functional dentition. Age is of no factor in orthodontics, meaning an adult can achieve the same results as can a younger individual. Now more than ever the mechanisms can be very discrete ranging from transparent or tooth-colore braces, fully transparent mechanisms (Invisalign, clear aligners, orthocaps) or even placing braces at the lingual side of the teeth making them completely discreet. The appropriate age to start an orthodontic treatment is not after all the permanent teeth have erupted as is wrongly believed. Because prevention is the best form of therapy, the American Orthodontic Association suggests that the first visit to the Orthodontist should be around the age of 7 in order to asses beforehand when the orthodontic treatment should start. Early diagnosis and treatment may reduce the need to extract teeth in the future, reduce the chance of fracturing in cases anterior teeth that are protruded, and maintain spaces for the permanent teeth to erupt or to be guided into erupting in the correct place. The mechanisms employed are either fixed on the dentition or removable, and possibly even combinations of both throughout the treatment period to achieve the necessary results.
More information about the methods and techniques used you can find at www.greatsmile.gr