WHAT KIND OF DENTAL PROBLEMS REQUIRE ORTHODONTIC TREATMENT?

Orthodontics is the branch of dentistry that deals with crooked or misaligned teeth. Straightening of teeth or correction of misaligned teeth requires orthodontic treatment. We have listed out the common problems which require orthodontic correction.

1. Crowding – teeth which are crookedly placed and not aligned properly require orthodontic correction. These teeth, on account of their misalignment, can cause gum problems, decay, etc. orthodontic treatment can help in alignment thereby helping in the maintenance of proper oral hygiene and in general better health.

2. Spacing- this is the opposite of crowding. Teeth which have gaps between them give an unaesthetic appearance and require orthodontic treatment to close the spaces between them.

3. Proclination- this kind of dental problem involves jaws in which the upper front teeth are very forwardly placed in comparison to the lower front teeth. Along with giving an anesthetic appearance, these teeth are also prone to injury. Orthodontic treatment is required to correct this underbite.

4. Deep bite – when the upper front teeth completely overlap the lower front teeth this condition is called a deep bite. In an ideal bite, the upper teeth overlap the lower front teeth by 2-3mm. when the overlap is more it leads to a deep bite where the trauma from the lower front teeth on the upper gums can lead to further problems.

5. Cross bite- in a normal bite the upper teeth overlap the lower teeth. In conditions where this is reversed, it is known as a crossbite. It can be in the front teeth or the back teeth and requires orthodontic treatment for correction.

6. Other problems include-

• TMJ issues- such as jaw pain, jaw locking, limited movement, and jaw clicking
• loose teeth
• receding gums
• increased sensitivity
• excessive wear of tooth enamel
• asymmetrical growth of the face and jaw

 

What is a Root Canal and why do I need a Root Canal Treatment?

A root canal is a treatment of the pulp of the tooth that is infected, inflamed, or dead. The dental pulp is a soft substance in the center of the tooth that consists of the blood vessels, nerve, and connective tissue. and this is connected to the surrounding tissue of the tooth. Some roots have more than one root canal, but all have at least one canal.

Step 1:

The first step is to Examine the x-ray of the teeth to see the extent of the decay and infection. If it involved the center core of the tooth called pulp the patient require root canal treatment. The first step is to give local anesthesia to numb the tooth and the surrounding area of the tooth.

Step 2:

Once the tooth is numb, the second step is the removal of the damaged area of teeth and infected pulp.

Step 3:

This is followed by disinfection and shaping of pulp canals using small instruments. Once the infected pulp is cleared out then shaping of the canal.

Step 4:

Clean and disinfected canals are then sealed and filled with an inert biocompatible medicated material known as Gutta-Percha and core portion is filled with a restorative material.

Step 5:

Then the core portion of the teeth is covered by crown placement.

If there is not adequate crown structure, a post is placed into the root next to the gutta-percha. This gives the crown more support.

Why is a root canal necessary?

1. Deep cavity: when the decay extends beyond enamel, dentin and touches the pulp patient suffer from continues and radiating pain.

2. An abscess (infection):  The vacant space filled with pus is called abscess, at that time the pulp of the tooth is necrotic and infected with bacteria and all this necrotic tissue collected below the root form pus. Sometimes swelling will be there or patient feels like a mild swelling on the gum from where pus is coming out.

An abscess that is left untreated will continue to infect the bone around the root of the tooth. It may spread into surrounding bone and tissues.

3. Trauma: If a tooth is hit with great force, the nerve of the tooth dies.  This could happen immediately after the traumatic accident, or it may happen over many years following the trauma.

4. Fracture: If the fracture extends to the pulpit require root canal treatment. if there is not too much tooth structure left above the gum line for the crown then post is required to retain the restoration.

5. Root Resorption: In the case of root resorption also root canal is required.

Two types of root resorption are there,

a) Defect starts from outside of the root and goes inward called external resorption

b) Defect start from middle or inside of the tooth and goes outward called internal resorption.

Resorption occurs as a reaction to injury, trauma, tooth replantation or aggressive tooth movement during orthodontics.

Resorption usually causes no pain and its diagnosed using x-rays

Resorption defect is typically repaired with a mineral trioxide aggregate(MTA).

What Cause Tooth Discoloration?

Discoloration happens due to habits and physiological changes within the tooth.

Classification of discoloration of teeth:

• Extrinsic discoloration

This occurs when the outer layer of the tooth (the enamel) is stained by extrinsic stains from coffee, tea, colored soft drinks or foods. Smoking also causes extrinsic stains.

• Intrinsic discoloration

Intrinsic discoloration happens due to the changes within the tooth structure during tooth development.

Causes include:

1. Excessive exposure to fluoride during early childhood causes mild to severe fluorosis.

2. The maternal use of tetracycline antibiotics during the second half of pregnancy and the use of tetracycline antibiotics in children 8 years old or younger cause brown stains on teeth.

3. Traumatic discoloration happens when the blood supply to the tooth cut off during trauma. Your teeth become gradually yellowish then brown and black.

4. Developmental disorders like amelogenesis and dentinogenesis imperfect cause grey, amber or purple discolorations.

• Age-related discoloration

The enamel that covers the teeth gets wear off with age, which allows the dentin more transparent thereby tooth looks yellowish in color.

Diagnosis:

• No special tests are needed. A dentist can diagnose tooth stain by looking at the teeth.
• If the discoloration happens due to trauma then the dentist may advise going for an x-ray even if you don’t have pain.

Treatment:

• Extrinsic discoloration can be removed by teeth cleaning and polishing. In-office bleaching and home bleaching also removes the extrinsic stain.
• Mild fluorosis case can be treated with bleaching whereas moderate to severe fluorosis case-patient have to go for veneers or crowns.
• For medication-induced tooth discoloration and developmental disorders, veneers and crowns are the best treatment option for esthetic purpose.
• Traumatic discoloration can be treated with Intra coronal bleaching followed by root canal treatment/crown placement followed by root canal treatment.