PERIODONTOLOGY
Periodontology is the specialist area of Dental Medicine aimed at preventing, diagnosing and treating diseases which affect the periodontum, in other words, the set of tissues which include, in addition to the gum, the bone and the periodontal ligament, responsible for maintaining the firmness of teeth in the upper jaw.
Periodontal diseases are brought about by the accumulation of bacteria in the tissues of the oral cavity. The depositing of bacterial plaque and tartar (calcified bacterial plaque) on the furrow existing between the gum and the teeth brings about a chronic inflammation which destroys the tissues supporting the teeth.
Periodontal diseases can be divided into two major groups: Gingivitis and Periodontitis.
When gingivitis is not correctly diagnosed and treated, the bacterial infection may progress, becoming a more complex problem which affects other tissues besides the gums. Periodontitis causes the irreversible loss of bone, causing teeth to move, being the main cause of tooth loss in adults. Emotional stress, smoking or systemic diseases like diabetes may serve as risk factors in the appearance of the disease.
Diagnosis and Treatment of Periodontal Diseases.
The diagnosis and consequent treatment of periodontal diseases allows an improvement in the oral health and aesthetics of patients. In the case of gingivitis, treatment involves the removal of all bacterial plaque and accumulated tartar, thereby eliminating bad taste and oral odours. During treatment the patient learns the procedures for correct oral hygiene.
In the case of Periodontitis, it is not possible to replace the bone which has already been lost. The objective is to halt the progression of the disease by eliminating the infection. To this end, the deposits of bacterial plaque and tartar are removed from the periodontal pockets. In more complex cases, periodontal surgery is required during which the roots are exposed so that cleaning can be carried out properly. Having completed the treatment, it is incumbent upon the patient to comply with the maintenance programme which includes specific hygiene measures and regular visits to the dentist.ç
RESTORATIVE & AESTHETIC
Restorative and Aesthetic Dentistry is the specialist area of Dental Medicine responsible for the restoration of teeth which are suffering from caries lesions, alterations in shape or colouring and the resolution of fractures, thereby restoring the original appearance of the teeth.
In addition to contributing to an improvement in oral functions using the most varied techniques, Dentistry gives back to the patient a healthy smile which looks good, contributing to an increase in aesthetics, self-confidence and social involvement.
Restoration of Teeth with Caries
Caused by bacteria, dental caries is the disease which most frequently affects the oral cavity, particularly developed in the fissures of the occlusal surfaces of the posterior teeth, between the teeth or alongside the gum line. If not treated, caries may become a complex problem, destroying dental tissue. Treatment consists of the removal of affected area and the reconstruction of the original anatomy of the tooth, using compound resins, allowing excellent aesthetic results to be achieved as they imitate the natural tooth.
Correction of Teeth with Fractures and the Closure of Diastemas
Compound resins with high mechanical and aesthetic performance are also used in the reconstruction of fractured teeth or conoid teeth. Conoid teeth are a genetically inherited problem which particularly affects the lateral incisor teeth and is characterised by teeth which are smaller than normal and in conic format. In the case of diastemas (gaps between the teeth), dentists should evaluate whether it is appropriate to see to their closure with resin or opt for orthodontic treatment, referring the patient to the respective specialist doctors.
Whitening of Vital and Non-Vital Teeth
Although the natural colouring of teeth varies from person to person, certain factors such as tobacco, coffee, wine, pigmented foods, carbonated beverages or tartar, may contribute to alterations to tooth colouring. Dental whitening sets out to restore natural colouring and may be carried out at the surgery or at home after a clinical and radiological evaluation of the dental and periodontal condition.
At present, treatment at home performed by the patient under the supervision of the dentist is the most common. Based on the mould, a teeth-mould which the patient fills in with whitening gel and which, for around 2 weeks, it shall insert for a time period to be defined by the dentist. The treatment time depends on various factors, including the original colour. Darker colours tending to take a few more days to whiten. In the case of non-vital teeth (after endodontic treatment), the internal whitening must be executed by the dentist as it is necessary to introduce the whitening agent inside the dental parts.
Removal of Stains
The so-called intrinsic stains may take various forms and be caused by various factors. The ingestion of too much fluoride or certain antibiotics in the tooth formation period may influence the appearance of stains. With non-vital teeth it is frequent for a brownish, greyish or black colouring to be acquired. In some cases, the teeth ageing process may also result in dental darkening. To solve any of these situations, aesthetic veneers made of ceramics or compound resins, may be used.
ENDODONTICS
Endodontics is the specialist area of Dental Medicine aimed at treating pulp pathologies.
Dental pulp is located inside the tooth and is surrounded by hard tissue – dentin – being responsible for dental nutrition and sensitivity by way of the constituent blood vessels and nerves.
Dental pulp lesions may originate from traumatisms, fractures or deep caries. Indicative symptoms of an endodontic problem include spontaneous pain, prolonged sensitivity to cold and/or heat and discomfort to the touch and chewing and one of the most common signs may be the presence of an abscess or fistula.
In cases of necrosis or irreversible inflammation of dental pulp, endodontics is the only solution to save the tooth and avoid other complications.
As well as eliminating the pathology of the pulp, endodontic treatment allows, in conjunction with the subsequent reconstruction, the chewing function to be returned to the tooth. There is also the possibility of carrying out endodontic retreatment which consists of a new treatment of the root canal system. It shall always be the first treatment option in teeth whose previous endodontic treatment has failed.
With retreatment, all of the existing content inside the root canal system is removed, carrying out a new cleaning and shaping and three-dimensional filling. Having finished the retreatment is performed the restoration of the tooth.
PEDIATRIC DENTISTRY
Pediatric Dentistry is the specialized Dental Medicine field exclusively dedicated to the maintenance of the oral health of children, adolescents and patients with special needs.
This specialist area combines a strong preventive component with the curing element since monitoring the development of the so-called “milk teeth” is vital, not only to ensure correct phonetic and chewing functions but, first and foremost, for the early diagnosis and prevention of any problems, ensuring a healthy set of final teeth.
Although some treatments are similar to those of adults, Pediatric Dentistry affords exclusive treatments, bearing in mind the specific characteristics of the age group in question: small bodily and oral dimensions, skull and jaw bone still growing, the dynamic process of tooth eruption and the presence of milk teeth, among others.
Dental problems can arise at a very early age and so it is recommended that the first appointment should be when the first teeth come through, usually between 6 months and 1 year old.
Treatment of Caries
The frequent ingestion of sugars along with poor brushing usually leads to the appearance of caries. If not treated, caries may cause the early loss of milk teeth, often having consequences in terms of the positioning and alignment of the final set of teeth. In addition to treatment, during the appointment the child and his/her parents are advised about healthy eating habits and oral hygiene.
Topical Application of Fluoride and Sealants
Fluoride is a vital component in the prevention of dental caries and it is recommended to take it between 6 months and 16 years old. When visiting the Odontopediatrician, the doses of fluoride are defined and the respective modes of administration (tablets, gel, drops, mouthwashes), depending on the specific needs of the various age group.
To prevent the appearance of caries, the application of sealant is frequent. Sealant is a varnish which when applied to healthy teeth protects the chewing surface, preventing the appearance of caries. Speedy and painless, it is possible to seal the majority of the teeth of a child at just one appointment.
Oral Health Guidance
During the appointment, children and their parents are provided with guidance about oral health which includes tips about the advantages of diet which is low in sugars, as well as indications about the procedures for correct oral hygiene. In addition to preventing the appearance of caries and bacterial plaque, proper brushing also prevents the appearance of problems in the gums.
Control of Bacterial Plaque
Bacterial plaque derives from the accumulation of bacteria in the oral cavity. Its control is vital for the maintenance of oral health, particularly as regards the prevention of caries. In addition to providing indications about oral hygiene procedures for preventing and eliminating bacterial plaque, in specific cases the Odontopediatrician may also get rid of it using mechanical processes.
PROSTHODONTICS
Prosthodontics is the specialist field of Dental Medicine aimed at the re-establishment and maintenance of the functions of the maxilo-mandibular complex, to wit in terms of chewing, phonetics and aesthetics.
Working in close cooperation with other specialist areas like Oral Surgery, Implantology, Endodontics, Dentistry, Orthodontics or Periodontology, Prosthodontics is responsible for the re-establishment of oral functions, both by way of the reconstruction and repair of damaged teeth as well as the placement of dental prosthesis (single, partial or total) which are intended to replace the missing teeth.
Regardless of the clinical record or the type of prosthesis, at the start of the treatment moulds are carried out which constitute a way of ensuring the clinical information gets to the laboratory. This is followed by the manufacture of provisional prosthesis made of acrylic or composite which enable the maintenance of oral functions and serve as a study for the final teeth. In this way, at the fitting appointments and in collaboration with the patient, the dentist carries out the necessary adjustments so that the final solution ensures a high level of quality and comfort.
Reconstruction and Repair of Damage Teeth
In those situations where damaged teeth have roots in a good state of repair, crowns are applied, cementing them to the roots or to the remaining crown. Produced by computerized techniques, alumina or zirconia ceramic crowns not only afford great aesthetic excellence, they also enable the recovery of oral functions. Other materials such as metal-ceramics are also used. In teeth with minimum wear, veneers may be applied, small ceramic blades which allow major improvements to the placement, form and minor dental misalignments.
Replacement of Missing Teeth with Crowns or Bridges on Implants
When a tooth is missing or whenever teeth are not recoverable the ideal solution involves the placement of implant-supported unit crowns or bridges.
ORAL HYGIENE
Oral Hygiene is a specialist field aimed at the diagnosis, prevention and therapy of oral diseases, playing a decisive role in the maintenance of treatments carried out in other specialist areas. In this context, there is also an education element which, by teaching and demonstrating specific techniques, contributes to an improvement in oral health.
Good oral hygiene is a factor which is decisive for the prevention of the majority of diseases which affect oral health, being characterised by the correct elimination of food residues, and not allowing a series of bacteria to become affixed to the teeth and gums which, if not removed, will give rise to the formation of bacterial plaque and tartar, the main causes of caries and periodontal diseases.
For correct prevention and maintenance, visits to the oral hygienist must be regular (at least every 6 months) and the daily care recommended by the doctor/hygienist must be followed. This care includes correct brushing (at least twice a day), the use of dental floss (at least once a day, preferably at night) and the use of elixirs/mouthwashes.
If you suffer from symptoms like constant bleeding or pain in the gums during brushing, bad breath and sensitivity, book an appointment with your dentist/hygienist.
Maintenance of Treatments Executed
Regular trips to Oral Hygiene appointments are vital for maintaining oral health and the integrity of the treatments carried out at the Clinic. During the appointment, implants, crowns, bridges, fixed prostheses over natural teeth or implants, as well as restorations, orthodontic braces and endodontics treatments are evaluated so as to achieve an early diagnosis of any complication. All the preventive and therapeutic procedures carried out during these appointments contribute to the longevity of these treatments.
Scaling
Treatment which consists of the removal of bacterial plaque and tartar from the dental surfaces using ultrasonic equipment. The objective is the elimination of the factors responsible for the majority of gum and teeth problems.
Application of Fluoride
Procedure used for the prevention of caries and the reduction of tooth sensitivity, applying a gel to the teeth surfaces with a high concentration of fluoride. This chemical compound acts on the dental enamel, remineralizing it and strengthening its structure.
Application of Sealants
Treatment for the prevention of caries whereby a fluid resin is applied to the chewing surfaces of the teeth and which, after photopolymerization (incidence of a blue led light) hardens, forming a surface which is smoother and easier to hygienise.
