PREVENTION AND CARE
Professional oral hygiene is the first and fundamental intervention to protect mouth health and it is the basis of any prevention strategy. Our mouth is an environment naturally rich in bacteria, in direct contact with the "external world" and with the digestive system. It is therefore easy for inflammatory situations to arise.
Proper oral hygiene helps to limit the bacterial load and restore optimal balance.
Thanks to correct periodic dental hygiene, in fact, the development of caries can be avoided; in addition, the gums are protected from inflammation and bleeding, to reduce the onset of any periodontal disease that could cause tooth loss.
The dental hygienist plays a fundamental role in reporting any problems; he explains to the patient what tools and techniques to adopt in daily hygiene, without which prophylaxis in the studio would lose much of its effectiveness. The dental hygienist is also able to promote the maintenance of the osseointegrated implants through maneuvers and deep cleaning interventions of the implant pillars that are added to those performed daily by the patient.
Fluoroprophylaxis is also practiced in our hygiene sessions: an application of concentrated fluorine capable of remineralizing the initial enamel descaling lesions caused by bacteria. In addition to combating caries and strengthening the enamel, fluorine is used to complete dental hygiene because it reintegrates the treated surfaces while reducing post-treatment root sensitivity.
There are cases in which periodontal disease (periodontitis or pyorrhea) occurs in an unusually premature way, with consequent reabsorption of the bone support and gingival retraction until the tooth is lost.
In DentalBreraClinic we can perform a test to identify any genetic predisposition well in advance. Some mucous cells are taken inside the cheek by rolling a cotton swab. The bacterial samples present in the gingival pockets are also collected, sending them to specialized laboratories that analyze the samples and indicate which drug therapy is most suitable for bacterial elimination.
In this way, the risk factors for the development of the disease are reduced and its course slows down. Screening must always be combined with a correct oral hygiene and gum care program.
Commonly called pyorrhea, periodontal disease affects the supporting tissues of the teeth (bone and gum), with symptoms ranging from bleeding to the onset of tooth sensitivity and increased tooth mobility, leading to loss of teeth that are no longer adequately supported. There are some treatments that can be done to slow down or even eliminate the disease.
The main cause of the problem is the presence of bacterial plaque and subgingival tartar. It is therefore important to set up targeted preventive therapy through regular hygiene sessions, during which the dental hygienist removes the residues that accumulate in the gum pockets in a deep and accurate way. The duration and frequency of periodic checks must be established and strictly respected, under penalty of recurrence of the disease.
A technique for the prevention of caries is the sealing of the occlusal grooves of the teeth, particularly effective and recommended especially in children who have not yet acquired good manual skills and awareness of the importance of correct oral hygiene. The seals represent a mechanical and non-invasive trick to hinder the formation of caries at a time when the risk is very high, thanks to the sugar supply and a dental anatomy that is difficult to clean. This technique consists of cleaning the superficial furrows and closing them with sealing and protective paints that eliminate local anatomical conditions in the development of caries.
The same practice also applies to treating the teeth of adults who, due to personal characteristics - high bacterial load, very deep grooves, difficulty following a regular home hygiene practice - have a tendency to develop caries.
There are also interproximal seals, the result of more recent research, which has developed a type of effective protection against demineralizations that can affect two contiguous teeth. This area is the most critical as it does not benefit from the self-cleaning that occurs with chewing. In the space between one tooth and the other the only way to reach the plaque is the dental floss, an instrument that is too little used, or used incorrectly.
Anyone wishing to lighten the tooth colour can undergo a professional whitening session. In DentaBreraClinic this procedure is performed by applying a gel based on carbamide peroxide on the surface of the enamel. If necessary, additional home treatment of one or more weeks can be envisaged. For this purpose, customized masks are made for the daily application of the material, which must be kept overnight or for a few hours in the day.
Teeth devitalized from the inside can be treated with bleaching, in order to lighten even a single tooth and uniform the colour with the rest of the teeth.
This technique has no effect on ceramic-coated teeth and fillings, but does not present any risk of damage to the enamel.
The only possible side effect, however temporary, may be an increase in sensitivity in the days following the treatment; effect that can be mitigated with the use of a fluoride mouthwash or with applications of fluorine directly on the teeth.
When, despite treatment and prevention, the tooth becomes carious, the best solution is always the least invasive.
If the lesion caused by the bacteria is limited to the enamel, or deepens in the dentine but remains at a distance from the pulp of the tooth, it will be sufficient to remove the caries and then reconstruct the tooth with the use of the latest generation composite materials that imitate the natural color of the enamel.
All tooth surfaces can be affected by a filling; however the interproximal area is the most insidious and difficult to reach during the treatment phase. The fillings can also be used to repair abrasions in the collar area, due to incorrect use of the brush.
If the caries is very extensive, an inlay is preferably used, ie a small ceramic or resin “sculpture” of the portion of the missing tooth. The inlay is made in one piece by a dental technician, following the taking of a traditional or digital impression of the cavity. Finally, the dentist proceeds to cement the inlay: the final aesthetic and functional result will be indistinguishable from the rest of the tooth.
When caries reaches the pulp, i.e. the internal and innervated part of the tooth, devitalization becomes indispensable: the pulp is removed, the channels of the tooth are cleaned and finally the space is filled with an inert material that seals the canal. This procedure is essential to prevent the bacterial load of the infection from causing more serious and chronic consequences. This is the case of granulomas, which can form at the apex of the tooth root due to incorrect devitalization.
Devitalization still allows you to avoid tooth extraction, letting it continue to do its job in the original position, as if it were still perfectly healthy.
Bruxism, night grinding, overly acidic feeding and gastric reflux are all causes of abrasion or erosion of the teeth, which appear to be worn as if they had been filed. If the phenomenon is still at the beginning, the dentist is able to highlight it and help the patient understand the reasons that cause it.
The negative consequences of dental abrasion are manifold: by reducing the height of the teeth and arches, malfunctions in the chewing function may occur; if the abraded part discovers the internal portion of the teeth, there are annoying sensitivity problems. In addition, the thinning of the protective layer of the enamel due to erosion facilitates the onset of caries.
It is therefore essential to intervene immediately with appropriate measures, according to the degree of erosion and the musculoskeletal balance of the patient. In the simplest cases, it is possible to resort to the addition of modeled material directly on the teeth, suitably prepared. The Table-Top technique instead involves the creation of ceramic restorations that are cemented on the teeth. Finally, in more serious situations, more complex prosthetic rehabilitation can be used. In all cases, the aesthetic result will be surprising.
If dental abrasion is caused by bruxism (grinding), it is essential to protect the teeth by means of a personalized bite that the patient will have to wear at night. It is a rigid resin appliance that avoids contact between the teeth of the two arches and therefore wear resulting from grinding. Over time, the bite allows the chewing muscles to relax, inducing the alleviation of many disorders resulting from bruxism, such as muscle pain, headaches and dizziness.
