General Dentistry

General Dentistry: Dental Care is a Lifetime Commitment

A Smiling Place through our general dentistry services can help you maintain your natural teeth and protect your brilliant and beautiful smile. Our highly qualified team is more than happy to provide you with the following general dentistry treatments:

• Comprehensive Dental Examinations
• Periodontal Disease (Gum Disease)
• Endodontics (Root Canal Treatment)
• Bad Breath Solutions

Comprehensive Dental Examination starting with a relevant medical and dental history and a discussion of your concerns and objectives. It includes a periodontal analysis, digital X-rays (dental radiographs), oral cancer screening and soft tissue analysis and evaluation of the temporomandibular (jaw) joints and associated musculature of the masticatory system. Areas of concern are identified and recorded and a plan of treatment is formulated based on yours and ideal objectives. Ideal objectives are to build a treatment platform based on sound foundations – infection and pain is managed first, then dental cavities that are likely to lead to the first objective and finally cosmetic and global functional issues are addressed. Everything else being equal treatment can generally be commenced and completed within relatively short time frames, in a relaxed and comfortable environment. We provide a personalised and flexible service. If time is a priority we can work with that; if comfort is a priority we can work with that; if attention to detail is a priority we can work with that; if finances are a priority we can work with that.

Dental Rejuvenation (Scale, Clean & Polish)
Depending on the state of the teeth the teeth, calcified deposits can be removed by ultrasonic and/or hand instruments, the teeth polished and fluoride applied to strengthen them against acid attack and decay

Periodontal treatment*
If gum pockets or periodontal disease is diagnosed then the cleaning process is a little more involved with the objective always being to remove soft and calcified plaque (calculus) deposits superficially as well as from under the gums from the root surfaces at identified diseased sites. These root surfaces are then smoothened, polished and treated and home preventative measures discussed to help healing from the condition and future prevention and stop recurrence. Other periodontal surgery services include gum re-shaping (gum lifts) for a better cosmetic/functional result and various grafting procedures.
*The worst thing to do is to have a simple superficial Scale & Clean done when you have a periodontal condition as deep calcifications will be left behind under the gums and these remain isolated and form the seeds of a more insidious, greater problem.

Preventive Services
Understanding is usually the first step to prevention and every step is taken to show and explain what we see if required. Practical advice can be given on risk factors and prevention of potential or diagnosed conditions. Additionally simple preventive treatments can be tailored to the individual. Single arch or bi-maxillary sporting Mouthguards can be made to fit as appropriate.

Relaxation & Hypnotherapy or Hypnosis for dental anxiety, fear, phobias and destructive habits or behaviours is extremely effective and quickly fixes most of these conditions. In a nutshell this is done by teaching you the techniques of Self Hypnosis and how to get back control of your subconscious brain for your benefit instead of being a slave to it. It also helps considerably in just relaxing, chilling out and having a good time at your dental visit.   

Cosmetic Services
The first thing is to decide whether the problem is  

1. tooth colour,
2. tooth shape or
3. tooth position or
4. the condition and position of the gums or
5. a combination thereof

The gums play a big part in the cosmetics of a smile much like a frame does to a picture or painting and sometimes this needs simple or complex attention. The lips and mouth also play a very significant part.
The process and steps to a perfect smile are usually A) Photos, B) Study models, C) Diagnostic waxup, D) Treatment.

1. Treatment Options then are  
2. Tooth Whitening
3. Cosmetic Recontouring (Simple and Superficical Reshaping) of teeth
4. Snap-On Smile®
5. Gum Lifts
6. Composite Resin Veneers
7. Lumineer® Porcelain Veneers (0.1-0.5mm)
8. Porcelain Veneers (0.5-1.5mm)
9. All Ceramic Crowns
10. Porcelain Fused to Gold Crowns

 The teeth can be re-shaped (COSMETIC RECONTOURING), whitened via non invasive tooth whitening procedures or even painted by special resins (LumiBriteTM Bleach Free), and be modified or reconstructed using bonded Tooth Coloured Resin Veneers (Composite Resin), minimal or no preparation ultra thin porcelain veneers (Lumineers®), thin (standard) Porcelain Veneers, Porcelain Inlays or All Ceramic Crowns and Porcelain Fused to Metal/(precious or non-precious alloys) for strength.  

Orthodontics
This can also be used to cosmetically or functionally fix teeth that are out of position.

Repair of Damaged Teeth due to Decay (plaque acid attack with/without bacterial contamination)/ Trauma (acute (accident) or chronic (habits))

Mild damage can be reversed or fixed very conservatively by early intervention and home care regimes.
Moderate damage can be very conservatively managed by repair with bonded tooth coloured resins (Composite Resin).
Advanced damage can be fixed using Composite Resin, Porcelain or Porcelain Fused to Metal (precious alloy) PFM Crowns for strength.

Lasers
Lasers can be used as diagnostic devices (Helium Neon Laser) to gently and non invasively detect decay in teeth by detecting changes in the optical properties of enamel/dentine affected by decay. This is measured objectively as a reading based on sounding the tooth with the laser. This definitely beats the old way of looking for decay by pressing with a sharp probe to find “sticky” spots – indicating soft decay.
Hard tissue lasers (Erbium YAAG) can be used to cut away decay from a tooth.
Soft tissue lasers (Carbon Dioxide, Diode) can be used to sort tissue surgery

Endodontic therapy (Root canal treatment)
If the Advanced damage has extended into, and the integrity of the pulp or nerve of the tooth has been compromised, then endodontic treatment can very effectively and dependably restore the tooth to a healthy, pain-free state almost immediately.

Dental Implant therapy
If the advanced damage is critical and the tooth cannot be reliably treated then the tooth can be replaced with an implant. This involves removing the compromised tooth, replacing the root portion of the tooth with a biocompatible titanium implant and securing a custom made porcelain or porcelain fused to gold crown to it.
This procedure can be performed for a single missing tooth or a mouthful of missing teeth.
Mini Implants or MDI’s are another form of implant therapy but are generally reserved for stabilizing and retaining dentures. Loose dentures can also be fixed by this method. This allows them to be locked and secured instead of floating aimlessly giving much greater confidence and peace of mind to the wearer; not having to worry about dentures dropping when talking, eating, laughing, smiling or falling out when coughing, sneezing, vomitting etc.
SIMPLANT® is a highly specialized state of the art software planning tool utilizing Cone Beam Computerised Tomography (CBCTs) that allow us to 3 dimensionally analyse, study and plan implants and then create extremely accurate surgical guides (NAVIGATOR®). These guides give us a level of precision never before available and allow us to execute a precise keyhole approach to implant surgery. This makes the procedure incredibly minimally invasive and fast and it is not unusual for patients to report that they hardly know they have been operated on as early as the day after surgery. Where appropriate it is also possible to have a tooth built up on an implant immediately (Immediate Loading). We have been operating with implants for over 23 years and they have a very reliable and proven track record as a mode of treatment.     

Oral Surgery
Wisdom teeth, orthodontic extractions or general extractions simple or surgical services are also provided.

Fixed or Removable Dental Prostheses
Missing teeth can be replaced by fixed or removable prostheses (dentures); and these can be Partial Dentures (replacing one/some teeth) or Full/Complete Dentures (replacing all teeth in either arch – Upper and/or Lower).

Removable Dentures
These are the simplest and cheapest way of replacing missing teeth. However they tend to be much larger than fixed dentures as they need the largest possible surface area of coverage to stabilize and retain them and therefore affect a larger area of the mouth and more teeth. They tend to interfere more in speech and function. They are easily removed by the wearer and ideally must be removed for about 8 hours every 24 hours to rest the gum tissue and to allow it to breathe; as they tend to cover and apply pressure to the gum tissue and the underlying bone. Also the jaw bone gets stimulated and strengthens with tension but it gets eaten away (resorbed) with pressure. Because of this removable dentures tend to lead to greater bone loss over time. Removable Denture teeth can be made of either acrylic or porcelain. The framework of removable dentures are generally either Acrylic (thicker but cheaper) or Chrome Cobalt (stronger, thinner, smaller and less intrusive). Removable dentures can be stabilized and retained by one of three ways – Tissue Borne (suction pressure only), Tooth Borne (slightly more stable), Implant Borne (these can be mini or full bodied implants; and depending on the number of implants can be very secure and minimally intrusive to the wearer)

Fixed Dentures
This generally refers to dentures that are fixed and require a dentist to remove and check.

Bridges
A Bridge is a term generally (but not exclusively) reserved for a prosthesis that is designed so it never has to be removed (unless it fails or if it needs to be replaced when it has worn out). As the name suggests it basically consists of a support or more (teeth or implants) and a suspension (to replace a missing tooth or teeth). Bridges are generally made of Porcelain Fused to Metal (usually precious alloys such as gold, platinum, palladium). The metal substructure gives it strength while the porcelain gives it the aesthetics. They can also be made of all Porcelain or all Gold.

Bruxism
This refers to a habitual clenching or grinding of teeth. Specifically it does not refer to eating, rather, the non-functional contact of teeth. This causes wear facets to form on teeth as the enamel gets worn down leading to the total loss of enamel. This leads to chipping and exposing sequentially of the dentine and wearing down of the teeth to the gum line and finally even exposure of the nerve of the tooth. Ironically many people who clench or grind are not aware that they do it and usually it’s someone else in the house or room that notices the gnashing noises they make with their teeth in their sleep (nocturnal bruxism). Or they may brux during the day, usually when day dreaming (diurnal bruxism). As the changes to the teeth occur slowly it may not be readily noticeable. Also the TMJs (jaw joints) may be sore, or make noises or occasionally lock. A Bite Splint can be fitted to diagnostically monitor and assess the problem while protecting the teeth and joints from damage. Ultimately an Occlusal Equilibration may be performed to effectively fix the discrepancy between the functioning of the jaw and the teeth. Untreated this can lead to a collapse of the bite and overclosure of the jaws. A simple tell tale sign is little furrows forming in the corners of the mouth which, over time, tend to pool saliva and can lead to cracking and fungal infections due to the constant wet state of the external skin.

  
Dental Care for Life – Lifetime maintenance of a happy healthy smile.
Personalized service by a team of professionals.
Dedicated to make you feel at ease
Smile……because you can!
 

Dr Suresh Rashid
1st September 2010

We here at A Smiling Place are looking forward to be your lifetime partner in caring for your teeth and making sure that you will always have a beautiful and sparkling smile.

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From beginning to end, your experience at A Smiling Place will make you smile bigger, brighter and more confidently than ever. Contact us today for an obligation-free consultation if you are interested in General Dentistry and rediscover yourself.