Pantomogram

ortopanIn addition to the standard examination with a dentist’s (mouth) mirror, what gives your dentist a much better insight into the overall condition of your teeth is a pantomogram – in digital X-ray technology. By digitalising the pantomogram, the time of exposure to X-rays is reduced, which makes the procedure safer for the patients.

This digital technology enables scanning of individual teeth, craniograms for orthodontic diagnostics and of the temporomandibular joint. The scanning process is short, painless and safe for the patient. During the scanning, the patient should be protected by a lead apron.

Pantomogram is required in the following cases:

  • When there is a suspicion of growth of wisdom teeth, because the pantomogram is the easiest way to verify if the wisdom teeth are formed, in what stage of growth they are currently at, as well as their position;
  • Certain disease of the joints of the jaw are more easily identified;
  • During planning of implant placement, the dentist has to know in detail the condition of the patient’s jaw bone, if it is of sufficiently high quality and if there is enough room for placing the implant. For this purpose, a 3D scan of the jaw is increasingly used nowadays, since it gives all the necessary pieces information to the dentist;
  • If there is a suspicion of jaw fracture;
  • When there is suspicion of jaw infection;
  • Pantomogram may help the ORL specialists if there is suspicion of a disease of the maxillary sinus.
  • With children of the school-going age, if there is a delay in growing of the permanent teeth
  • In the adolescent period, to determine the position of the wisdom teeth in case there is a need for them to be surgically removed.

The scan be momentarily displayed on the computer screen, it can be sent by e-mail or transferred onto a USB flash drive or CD. Digital scan is very precise for all the displayed strictures, which gives insight into more details and enables better diagnostic application. Pathological processes around the root of the tooth are identified more easily, as well as the condition of the bone in the early stages of periodontal disease or lesions on the teeth caused by dental caries. Pantomogram also enables timely diagnosis of teeth and jaw diseases.

Short educational course on health of the teeth

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A few words about teeth

We have them, we take care of them, we like them because they look nice and we need them to feed. But what do we actually know about them? Our teeth grow twice in our lives – by the age of two, we get 20 primary teeth that are later, throughout our childhood, replaced by permanent teeth (32 teeth in total) which are supposed to serve their purpose for the rest of our lives, or at least for the most part of it.

What are teeth made of?

It is generally said that a tooth consists of a crown (the visible part of the tooth), a neck and a root.

The root is a part of a tooth that connects it to the jaw. It is planted deep inside the jaw bone, and it is made up of dentine, a substance covered with a layer of cementum.

Apex of the root of the tooth is very important, because through the opening (the apical foramen) which is located at this spot, the nerve and blood vessels pass through the tooth.

The neck is a part of a tooth that connects the crown – the visible part of the tooth, with the root, which is inside the jaw bone.

As we already mentioned, the part of the tooth visible to us is actually the crown of the tooth. The crown is covered with fissures and cusps that facilitate the food-chewing process. You have certainly noticed the difference between the crowns of incisor and canine teeth and those of the premolar and molar teeth. The crowns of the anterior teeth have sharp edges and their primary function is to bite off chunks of food, whereas the crowns of the posterior teeth have a biting surface whose function is to chew and grind food. The crown is made up of five surfaces: the occlusal (the chewing surface), vestibular (facing the cheek), lingual or palatal (facing the tongue or palate), mesial and distal (the surface of a tooth that touches a neighbouring tooth’s surface). This is why it is very important to use dental floss, in addition to the tooth brush, to clean all the surfaces between the teeth.

Dentine is the basic building material of teeth. Dentine of the crown of the tooth is covered with enamel, whereas in the area of the root it is protected with a layer of cementum. Dental pulp fills out the interior part of the tooth and it includes the tooth nerve, artery, vein and connective tissue. The role of the pulp is to nurture the tooth.
For our teeth to be healthy and long-lasting, we need to take special care of them, to nurture and protect them.

 

Implants – Advice on placement

Implants – implantation procedure

implantBefore implantation, you need to thoroughly prepare your oral cavity with optimum hygiene. Our general recommendation is that you quit smoking at least for a while. Gingiva inflammation and diabetes must be actively treated. Any caries treatment must be completed before starting the implantation procedure. If by any chance insufficient volume of the jaw bone is identified, it will be necessary to perform a preparatory procedure of augmenting the bone mass.

Bone augmentation necessary for implantation

When insufficient volume of the bone tissue is identified, two options exist: either to give up on implantation or to augment the very bone so as to meet essential criteria for implantation and to satisfy the prognostic aspect. This procedure required by implantation is called augmentation. It consists of applying the patient’s bone tissue, some other material that acts as bone replacement or by combining the two. This results in physiological increase of jaw bones that can now handle the burden of implants. During this procedure, we usually recommend preventive antibiotics therapies as protection against potential infections and inflammations.

Preparation for the procedure

First, we disinfect the oral cavity to eliminate risks of pathogen bacteria presence, and the rinsing is done with an antiseptic solution (e.g. chlorhexidine). Presumably, you have already started taking antibiotics therapy because infections and inflammations can result in implants falling out, i.e. they can lead to loss of implants. Preventive action is also recommendable in case of possible bacteria in the blood, the so called bacteraemia.

How are implants placed – Implantation

implantiLike artificial teeth roots, implants are placed inside the very jaw bone with the application of local anaesthesia. This treatment is intraosseus. It means that implants are directly built in into the bone. The planned spot of implantation (the mucosa) is cut, and the foundation is gradually adapted in accordance to the previous implantation plan and depending on the size of the spot dictated by implants. The processing is done by using a rotary tool – a drill, with a small number of revolutions per minute, and with constant cooling of the spot with physiological solution so as to avoid overheating of the bone due to friction. The next step is to place a stitch in the gingiva. The wound will heal within approximately 10 days and then we are ready to remove the stitches.

Bone healing

Time required for the implant to become fully grown onto the bone is individual and primarily depends on the quality of the bone mass. To prevent injures, a temporary dental restoration is placed over the implant to give it functionality during this period of time. Average time of healing is between 3 to 6 months. When the situation allows it, implants can be immediately exposed so as to bring about quicker growing in. The process of growing in of implants is invisible to the patients. It takes place under the gum mucosa. Then a second intervention is performed. It involves exposure of the implant, connecting it with a permanent dental restoration. Further treatment includes placement of a supra-construction, a visible portion of the dental row. Implants are first processed and then, in a few simple stages, a supporting column is placed on top of them, as well as the abutment and a permanent restoration.

Implants – Maintenance

implantiSubsequent maintenance treatments conditioned by implantation

In the immediate period after implantation, implants are risky spots and should not be put under excessive pressure. After implantation, one should also avoid aggressive cleaning procedures and overly intensive methods of oral hygiene around the stitch. The rest of the dental row should be cleaned regularly and with great detail. In the first hours after implantation, prevention of infection is vital. As additional precaution, you can use antiseptic solutions for washing the oral cavity.

Implants require regular check-ups

Even later on, a dentist should regularly check your implants and eliminate any sign of inflammatory processes. Opportune identification of inflammations contributes to a successful treatment and makes therapy easier. Neglected implant-induced conditions may lead to jaw bone deterioration and loss of the entire restoration. Check-ups should be performed every 3 to 6 months. Along with regular and proper oral hygiene, it is also recommendable to clean your teeth with special silk with soft segments that’s used for gaps between the teeth.

What causes loss of implants?

The risky period is just after implantation when the implants still haven’t grown into the jaw bone. Combined with poor and insufficient oral hygiene, individual factors can also cause loss of implants.

Smoking, changes in overall health conditions and different immune processes can cause separation of implants from the bone. All in all, to provide longevity and quality that implants can guarantee, optimum and proper oral hygiene is essential, primarily around the implant, but inside the entire oral cavity, as well.

What causes bad breath?

Bad breath, scientifically named halitosis, is a very common problem that affects many people. Our first association is poor oral hygiene, but it can actually have numerous causes.

They are primarily divided into:

  • pathological causes, and
  • physiological causes.

Due to changes in hormone status, it is possible that bad breath can occur during pregnancy or menstruation. It can also appear during menopause due to dry mouth and reduced secretion from the salivary glands. These factors cannot be changed but they can be simply covered up with certain products. Bacteria that make up desirable microflora normally live inside the mouth. Bad breath is most commonly caused by the presence of anaerobic bacteria within the oral cavity. This environment suits their multiplication and this leads to sediments accumulation between the teeth. This is one of the reasons why dentists insist on using dental floss at least once a day. Normal bacteriological process is decomposition of sediments and releasing compounds such as nitrogen and sulfur. Teeth diseases and various throat infections are also frequent causes of bad breath.

How does food influence the occurrence of bad breath?zadah2

After consumption, certain types of food, such as onion and cabbage, may release unpleasant smells through the lungs. When we predominantly eat greasy and protein-rich food, its decomposition in the bowls can cause bad breath. For the mouth bacteria to multiply and be active, pH value in the mouth is essential. Food with lower pH values helps and accelerates decomposition of sediments and encourages new development of bacterial flora.

Medicaments and diseases

When you take antibiotics for a longer period of time, bad breath can occur as a by-product of disrupted mouth and stomach microflora. Deeper fissures may appear on the tongue, which favours the multiplication of bacteria. Diseases such as diabetes, gingivitis and liver and kidney diseases may also cause bad breath. Poor maintenance of dentures not only causes unpleasant smell but it also has a detrimental effect on many processes in the organism.

Role of saliva in causing bad breath

Given that it’s rich in oxygen and that it prevents anaerobic bacteria to develop and reproduce, the presence of saliva enables a kind of self-cleaning of the mouth. Any condition that leads to reduced secretion form the salivary glands favours the creation of bacterial flora inside the mouth. Bad breath in the morning is a consequence of reduced salivation during the night. All bodily processes that lead to dehydration (medicines, climate changes…) reduce the amount of saliva and are directly responsible for bad breath. Alcohol and cigarettes also make the mouth dry, so apart from their specific smell, they provoke a series of other inconvenience.

How to get rid of bad breath?

The most important is to identify causes of this unpleasant condition. Simple masking and cover-up with rinsing liquids and chewing gums is not enough. The cause is easiest to eliminate if it is related to poor hygiene. Removal of dental plaque and calculus should lead to significantly lower amount of bacteria. Periodontal socket treatment will reduce food supply for the bacteria. Try to avoid tooth pastes that contain sodium sulfate compounds, because these are one of the most frequent causes of lack of salivation. When the causes are systemic diseases, only their complete treatment can lead to improvements of this condition.

Finally, a very important piece of advice: never skip breakfast. Morning hunger can activate unpleasant smells from the stomach and bowls and lead to bad breath. Make sure to drink enough liquid during the day!

Inman Aligner

When it comes to cosmetic dentistry, one of the most common problems is irregular position of the front teeth. Numerous patients, however, give up on the idea of orthodontic treatment (wearing fixed braces), because of the treatment’s duration, price or unwillingness to wear conspicuous brackets. In that case, they opt for a restorative approach such as porcelain facets. On the other hand, there is a very efficient solution that corrects the position of the incisors and canine teeth and at the same time it eliminates inconveniences such as constant pressure and high price.

What is Inman Aligner and how does it work?

fffPatients themselves can place and remove this simple appliance that provides keeping track of the shifting of the teeth to adequate positions. Inman Aligner consists of a nickel-titanium springs placed on the inside and outside of the dental arch that align teeth and help position them properly in a very short period of time.

The two aligner arches mildly oppose one another and shift the teeth to proper positions. The inner arch pushes teeth forward, whereas the outer arch pushes them back inside. These two mild forces produce a substantial shifting range that causes Inman Aligner to quickly bring about effects.

How long does Inman Aligner treatment last?

After taking the anatomic impression of the teeth, the device is custom-made for the patient. Then the appliance is used for 6 to 18 weeks, which is sufficient to achieve optimum results. During this period, the patient should wear the device for 16 to 20 hours a day, and come for check-ups every two weeks to keep track and control the progress. After therapy, we advise retention so as to secure a long-lasting result.

Who is advised to use Inman Aligner?

Since they are safe and comfortable for the teeth, Inman Aligner braces are suitable for anyone who wants to straighten their incision and canine teeth with less crowded dental arches of 3 and not more than 5.5 mm. It is also necessary that lateral teeth, as well as the ones that are to undergo this treatment, are completely developed and erupted. This device also provides an ideal treatment before cosmetic restorations such as lumineers. Once placed, Inman Aligner method guarantees success which further depends on the patients – regular check-ups and hygiene which is not in the least complicated.

Oral hygiene during pregnancy

trudnicaWhat are the effects of pregnancy?

During pregnancy major hormone changes take place and this imbalance can lead to increased risks of development of different types of oral cavity diseases. Bleeding gums signal early stages of disease. The most frequent cause is plaque sedimentation on the teeth. Hormones affect the gingiva sensitivity to bacteria and it becomes prone to inflammatory processes. Scientific name of this condition is pregnancy gingivitis and it can appear in 50% and even 70% of pregnant women during any period of pregnancy.

Symptoms that indicate gingiva inflammation are:

  • gums that bleed and are of intensive red colour
  • when you bite something hard (an apple, for example), your gums start to bleed
  • swollen gums
  • enhanced sensitivity and mucosa irritations.

These symptoms usually appear around the third month of pregnancy and can be an inconvenience up until the eight month.

Oral hygiene advice

  • If you are experiencing morning nausea, under no circumstances should you brush your teeth after each time you vomit. Gastric acid softens the enamel and the brushing then causes micro-fractures that could lead to problems. It is better to rinse your mouth with suitable solutions.
  • Healthy diet is of essential importance and this way you will avoid many potential problems. Reduce consumption of sweets that directly influence the quality of your teeth.
  • You should regularly attend dental check-ups during your entire pregnancy. Avoid x-ray and tell your dentist about your pregnancy before any intervention.
  • Baby’s teeth start to form while it is still an embryo in your womb. Quality of your baby’s teeth will somewhat depend on the quality and balance of the mother’s diet during pregnancy.

Steps towards proper oral hygiene

Pregnancy gingivitis is caused by dental plaque sedimentation and it should be efficiently eliminated. You should make sure to meticulously brush your teeth. For a complete oral hygiene, try to remember the following pieces of advice:

  • on a daily basis, at least twice a day spare two minutes to brush your teeth
  • use dental pastes with fluoride
  • never swallow the remaining paste after brushing
  • to clean less accessible spots, use adequate dental floss
  • for extra protection from dental caries, you should also include rinsing of oral cavity with proper liquids in your daily routine
  • avoid rinsing liquids that contain alcohol
  • you must quit smoking, because apart from its effect on the health of your gums, this ugly habit is detrimental to the development of the foetus