Oral diagnosis is the branch of dentistry that studies the diagnosis of oral and systemic diseases that show symptoms in the oral cavity along with their treatment planning.
Cavities or gingiva infections are not the only oral diseases. Diseases concerning all soft tissues of the oral cavity, jawbones and junctions, salivary glands and tongue are all among the studies of dentistry. These tissues and structures compose a complex anatomical structure even though covering a small amount of space.
Many systemic diseases also show significant symptoms in the mouth. For example, gingival diseases progress rapidly in diabetes. Recurring and numerous aphtous ulcers in the oral cavity can be the initial symptoms of Behçet’s disease.
For these reasons, a branch of dentistry had to be found for the diagnosis and treatment planning of oral diseases. Therefore, Oral Diagnosis and Radiology undertakes this important task.
Dental radiographs, meaning x-rays of teeth, are the major aids in the diagnosis of intraoral diseases concerning hard tissues like teeth and jawbones.
The most common dental radiographs are periapical radiographs (small sized radiographs displaying two or three teeth) and panoramic radiographs covering the whole jawbone and surrounding tissues (larger sized radiographs displaying both the lower and upper teeth and jawbones). The most common dental radiographs are panoramic radiographs. In addition, cephalometric films for orthodontic means, hand-wrist films and AP-PA (front and rear-facade head films) and TMJ films which examine jaw joint are used in diagnosis and prognosis of treatments.
Diagnosis and Treatment
Through these radiographic methods, we can identify the remaining 2/3 of a tooth aside from the 1/3 that is visible, along with infections that exist inside jawbone as well as impacted teeth easily. A correct diagnosis enables correct treatment planning.
Therefore, all necessary treatments are determined in advance and greater potential problems are prevented from occurring in the future.
In Oral Diagnosis and Radiology department, subsequent to the initial recordings of patient information, clinical examinations are carried out in detail Depending on the treatment necessities, appropriate dental radiographs are taken and the patient’s treatment is planned.
According to treatment planning, patients are directed to specialists in our clinic for the initiation of their treatment. Answering questions about duration or anything else about treatment planning is the responsibility of our department.
An implant is an artificial tooth root placed into jaw bone to restore the function and aesthetic that is lost due to tooth loss.
Teeth are important components of facial aesthetics; therefore loss of teeth induces psychological and sociological problems as well as difficulties in digestion, mastication and phonation.
Tooth loss can be restored with implant supported prosthetics as well as conventional systems like fixed prosthetics (bridgeworks) or removable dentures.
In order to do a bridge restoration, intact teeth need to be reduced in size for capping and since bridges have to be renewed after some time; this might create an economical burden for the patient in the long run. Instead of a bridge restoration, by placing implants into these areas, treatment without performing any procedures on the adjacent intact teeth is feasible.
Through implant supported dentures, comfort is achieved for edentulous patients who cannot use removable dentures due to gag reflex or insufficient resistance.
Examination and planning:
Implant procedures are performed with a multidisciplinary approach. A dental surgeon, who places implants into the bone, and a prosthodontist, who plans implant prosthetics, cooperate.
Implants are suitable for almost everybody except for those who have uncontrolled systemic diseases like uncontrolled diabetes. Due to their titanium structure and their resemblance of a natural tooth root, implants are biocompatible and no allergic or toxic reaction is evident.
Performing a detailed oral examination, elements like the relationship between upper and lower jaws, teeth and gingivas are evaluated. In complicated cases, along with conventional radiographs, 3D tomography is used to get an exact model of the patient’s jaw and implant sites are planned to assure maximum accuracy. Treatment planning and procedures are explained in detail to the patients.
For a successful treatment, accurate planning is essential. It is also important that the following procedures are performed by an experienced team with adequate equipment and in a sterilized environment. Implant placement is performed under local anesthesia just like any other dental operations. But general anesthesia and sedation can be used in anxious patients or with patients who do not have adequate bone for implant placement and when long surgical operations involving tissue replacements called “grafting” are necessary.
Making of Dental Dentures:
After surgery, waiting for a while is appropriate for the connection of the implant called osseointegration to bone surface. This time depends on the structure of the bone. After this time is completed, the superstructure is performed. Temporary dentures are made for the durability of aesthetics and function after surgery.
The teeth play an important role on mastication. Aging affects our teeth and gingivas just like any part of our body and eventually tooth loss can occur.
Tooth loss can be treated with various types of prosthetics, depending on loss number.
Fixed prosthetics are the type of prosthetics in which missing teeth that occurs with time are fixed on adjacent teeth and patients perceive their fixed prosthesis as their own natural teeth. Crowns that restore a single damaged tooth or the bridges that restore several missing teeth are called fixed prosthetics.
Damage resulting from caries or trauma, causes considerable amount of loss in tooth tissues and evidently weakens its structure. In such cases, fillings are not adequate. The teeth need to be capped with a metal-ceramic or an all-ceramic restoration to reinforce its strength. This restoration which gives color, shape and function to the damaged tooth is called a crown.
Bridge prosthetics is another way of restoring missing teeth. Missing tooth/teeth are restored by fabricating a bridge using the support of the adjacent teeth.
For this reason, the abutment teeth are reduced in size. Bridges are usually composed of an esthetic porcelain material that is supported with a metal substructure to resist mastication forces. However, with today’s technology, it is also possible to make all ceramic dental bridges on some conditions.
Removable prosthetics are frequently used to restore teeth loss. It is applied when number of missing teeth could not compensate with fixed prosthesis. When the prosthetic replaces one or more teeth in an arch, it is called a removable partial denture; when it replaces all the teeth in an arch, it is called a removable full denture.
All patients worry that their dentures are apparent and noticed easily. However with today’s technology, it is possible to provide a natural look with dentures and satisfy patients’ expectations and concerns about aesthetics.
If you lost several or all of your teeth, dentures improve your appearance, mastication, biting and phonation.
If the missing teeth are not replaced, the remaining teeth are prone to incline towards the edentulous area; upper teeth can be inclined lower and lower teeth can be inclined upper. This situation prevents the biting and mastication functions of remaining health teeth. Prosthetics can be applied right after tooth extraction; such prosthetics are called immediate dental prosthetics.
Cleaning of Removable Prosthetics:
If you have a removable denture, it is important to keep it clean. Cleaning dentures is easier than cleaning natural teeth
Clean your denture in a pot filled with water so that if it drops, it doesn’t fracture. Use a brush with bristles of medium hardness to brush the denture every day. You can use toothpaste or soap but wash it sufficiently before placing in mouth. You must remove dentures before bedtime and put a bowl of water so that the tissues in mouth contact with saliva and provide ventilation.
Implant supported prosthodontics
Implants are a method used to replace missing teeth. A component of an implant is placed into the bone with a surgery; therefore the patient perceives and uses the implant as his own tooth. This process generally carries on with local anesthesia. If you desire, this process could be applied in our hospital in operation environment by general anesthesia or sedation. Following fusion with the jawbone implants, fixed or removable dentures are carried on.
If you are applying for information, dentists will give you detailed information about all of the treatment process.
Oral surgery focuses on pathologies such as cysts and tumors related to teeth and oral cavity, tooth and jaw fractures, extractions or orthodontic movement of impacted teeth, modifications of soft and hard tissues of oral cavity for prosthetic purposes. Pain in maxillo-facial area, temporomandibular joint disorders and salivary gland diseases are included in oral surgery practice. Determining oral symptoms of particular systemic diseases and their treatments are also within the context of oral surgery practice.
Positioning dental implants, which are frequently used in dental practice in recent years, advanced implant surgical procedures like using bone grafts in cases where bone level is not adequate for the implant placements are also included.
Another subject of oral surgery is congenital or acquired maxillo-facial anomalies. These are most commonly lip-palate clefts, conditions arising from posterior or anterior positioning of upper or lower jaw in which mastication and aesthetic aspects are disrupted.
Oral surgeons use conventional diagnostic methods like radiographs as well as advanced methods supported with tomography that enable to obtain a 3D model of the patient’s exact bone structure. Therefore a definite diagnosis is made before the operation and the surgical process can be planned accurately. A multidisciplinary approach with other dental specialties like orthodontics and prosthodontics is essential for a successful diagnosis and treatment.
Surgical operations related to oral diseases can be performed under local anesthesia as well as general anesthesia. Patients undergone a major surgical operation are hospitalized and kept under observation. Before performing a surgical operation; patient comfort, current diseases, anxiety and concern due to treatment are considered and patients are treated accordingly.
The objective of cosmetic dentistry is creating artificial teeth in their natural form and color that is consistent with the rest of the face.
Artificial teeth in exaggerated forms and colors can be recognized easily even by an amateur eye. Therefore, a comprehensive preparation and planning phase is necessary in cosmetic dentistry.
Clinic and radiographic examination:
Before moving on to cosmetic solutions, a general examination of the mouth and dental health is performed. A complete radiographic examination (panoramic x-ray) of the patient’s mouth is performed to decide onto following procedures.
Casts: Impressions of lower and upper jaws are taken to produce casts of the teeth and surrounding tissues. Assessments are carried out for these casts.
Photography: By taking photographs of the patient’s face, smile, profile and intraoral tissues, every feature is recorded for a better evaluation.
Planning: With the aid of casts and photographs of the patient, problematic areas of teeth and gingivas are evaluated for cosmetic aspects considering the whole facial appearance. During these evaluations, problematic areas are shown to the patient on casts and photographs; solutions on how to fix these problems are explained and the cosmetic treatment of the patient is planned.
When an extensive treatment is necessary to overcome present aesthetic problems, specialists on orthodontics and periodontics are consulted. Considering the patient’s expectations, a new smile that is consistent with the lips and facial features of the patient is designed. The smile makeover can be shown to the patient before the beginning of the treatment through impressions and casts that are prepared at the laboratory. Also, photographs of previous smile makeovers can be shared so that the patient can see clearly the difference between the previous appearance and the achieved results.
Gingivectomy (Reshaping of gingiva lines) It is common that when a person smiles, the gingivas can be extremely apparent due to insufficient height of teeth or gingivas can look asymmetrical. A specialist in periodontics can solve this problem with a minor procedure called gingivectomy, in which the gingivas can be reshaped symmetrically and the height of teeth can be increased. After achieving harmonious gingivas, with the contributions of prosthodontists in necessary conditions, various aesthetic designs can be accomplished.
Natural dark teeth or discolored teeth due to various reasons can be improved by bleaching.
Two main methods at present are:
At-home bleaching: An impression is taken from the patient and a mouth tray is prepared. Then the patient applies tooth whitening gel provided by the dentist via the mouth tray on a periodic basis.
In office (clinical) bleaching: The gingivas are isolated and the bleaching agent is applied to teeth. A special curing light is used to activate the agent
Porcelain Dental Veneers
Unlike conventional dental prosthetics, little abrasions on only the front surface without downsizing whole tooth are sufficient for a porcelain dental veneer. 0.3 to 0.7 mm of tooth tissue is removed during application and the impression is taken. A thin porcelain layer is fabricated and then cemented on the tooth. Dental veneers are the most conservative and protective prosthetic procedures due to minimum tissue removal during preparation.
All ceramic Crowns and Bridges
Although fabricated as esthetically as they can be, metal supported ceramic crowns and bridges reflect natural light at the surface and therefore prevent the transmission of light from the teeth to gingivas. This can cause an unnatural look compared to natural teeth and Shadowing on gingival tissues.
All-ceramic restorations with a ceramic substructure can be used in patients allergic to metals or in restoring anterior teeth like maxillary central incisors that are essential for an aesthetic look.
Porcelain is the most compatible material with gingivas and teeth. As porcelain inlays do not discolor in time like composite fillings and they maintain an aesthetic look along with protective features for many years.
Orthodontics is a specialty of dentistry that aims to prevent dental and maxillofacial irregularities, and focuses on intercepting the progress of any existent ones and treat them along with creating better esthetics and function (biting, mastication, phonation, and laugh).
What are the causes of orthodontic irregularities?
• Genetic factors
• Birth defects (lip-palate clefts etc.)
• Malfunctions (mouth breathing etc.)
• Harmful habits (thumb sucking, long use of pacifiers etc.)
• Early loss of deciduous teeth cause of dental caries
• Because of Trauma as teeth grinding or crashes
Why should the orthodontic irregularities be treated?
Smooth teeth and jaws are an integral part of a good facial aesthetics and a beautiful smile.
• Help efficient biting, mastication and phonation.
• Reduces susceptibility of gingival diseases and caries and contribute to healthy teeth and gingivas.
• Intercepts in the formation of functional disorders such as temporomandibular joint disorders, and forms an integral part in the treatment of these disorders.
When should an orthodontic examination be carried out?
Orthodontic treatment can be applied at any age. However, if there are some problems especially related with jaws, children must be examined before age of puberty (10-12 ages) for benefiting from the growth and development. For children with the age of 5-6, orthodontic examination is useful for early diagnosis of problems which may impair growth and development. In such cases, although problems are determined early, orthodontics specialist could wait for the most proper time for treatment by controls
Protective and preventive orthodontic treatments that can be applied at these ages, prevents irregularities that requires comprehensive treatments with relatively simple and short interventions. If the irregularities of jaws are not treated early, could be treated with orthodontic treatment which combines with jaw surgery and could be applied after age 18.
Preventive Orthodontic Treatment
The purpose of these treatments is to acquire enough space for permanent teeth. Retainers are prepared to maintain the spaces created by the early loss of deciduous teeth. In addition, follow-up is recommended by pedodontist for children who are prone to tooth caries.
Interceptive Orthodontic Treatment
In order to prevent potential problems due to harmful habits like thumb sucking and abnormal swallowing or to obtain the space required for permanent teeth, various removable appliances are prepared to help quitting these habits.
Fixed Orthodontic Treatment
Orthodontic treatment after the growth of the permanent teeth is performed with the braces that are now affixed and not removed during treatment and with the wires that go through these braces.
Braces can be metallic silver color, gold color, transparent/tooth color or colorful like pink/blue according to preference. For some dental irregularities, the implementation of the braces is applicable to inner side of the tooth and thus they can be completely invisible (Lingual Orthodontics). Fixed orthodontic treatment can be applied to individuals of all ages with healthy teeth and gingivas. To protect the results that obtained with the treatment requires application of various passive devices and long-term practices with invisible wires.
Invisible Orthodontic Braces
The ‘’Lingual’’ word defines the inner side of the teeth; "Lingual Orthodontics" is, unlike traditional dental wires that are affixed to the outer surfaces of the teeth, the term for the orthodontic treatment applied with wires attached to the inner surface. The appearance of the mouth remains extremely natural while teeth crowding are corrected by braces that are ‘’invisible’’ due to affixation inner side.
Who should choose Lingual Orthodontics?
If the appearance of your tooth is important for you and you don’t feel comfortable with the traditional brackets, Lingual orthodontics may be an excellent option for you. If customer relations hold an important place in your life or for example if you have business presentations frequently, you may want to beautify your smile and also preserve the professional look. In this case, the lingual braces will be the right choice. You should get examined by an orthodontist who is specialized in lingual treatment to learn if the orthodontics is appropriate for you.
Is Lingual Orthodontics Applicable at Any Age?
Lingual braces are applicable at any age in principle. But new grown teeth of children may be short in length. Lingual braces may not be applicable to the adults whose teeth are smaller. Also gingivas and teeth should be extremely healthy to use the lingual braces.
How long does Lingual Treatment Take?
The duration of treatment may vary between 6-24 months depending on the irregularities of teeth.
Your doctor will make a detailed treatment plan that is proper for your situation and your estimated treatment duration will be determined according to this plan. However, lingual treatment usually takes longer than a few months compared to treatment with conventional brackets.
Does Lingual Braces Hurt?
Lingual braces make you feel discomfort during the first one or two weeks just alike regular braces. The braces that are attached on the outer side initially irritate the lips and cheeks, similarly, braces attached on the inner side irritate the tongue. Tongue completely gets used to the presence of the braces at the end of a two-week period.
Teeth are more sensitive while biting and chewing as they start to move. You should prefer soft foods, should cover the braces with the wax that your doctor give, should gargle with the salt water and take painkiller if necessary until this time pass.
Does Lingual Orthodontics prevent speaking?
Lingual braces do not prevent speaking.
But generally after braces are affixed a difference is felt in speaking, you will notice that you could not properly pronounce the sounds as ‘’s, ş, c, ç’’. This situation will be recovered in 3-4 weeks.
How the teeth are cleaned with Lingual Braces?
Complete cleaning of your gingivas and teeth is very important during the treatment. That’s why, you should devote more time to brush your teeth, and use products such as dental floss, interface brush and mouth douche, mouthwash in addition to toothbrush. Your teeth should be controlled frequently by your doctor, dental scaling in every 3-4 months should be done.
Do teeth get irregular again after treatment?
Our teeth move with the forces of chewing during life. Therefore, no orthodontist can guarantee that your teeth will not come back to their former versions. A protective wire is affixed to inner side of the teeth to protect the beauty of your smile after every orthodontic treatment and this unobtrusive brace is asked to always remain in place.
Periodontology is the branch of dentistry which studies surrounding structures of teeth, inflammatory diseases and their treatment.
Periodontitis is an inflammatory disease, characterized by the destruction of teeth and structures supporting them (periodontal ligaments, cementum, and alveolar bone). The disease involves inflammation of the gingiva reaching to the alveolar bone. Periodontitis is caused by bacterial plaque and it can be treated mechanically. But genetic, environmental and systemic factors can affect the development of periodontal diseases. These systemic factors may involve diabetes, cardiovascular diseases, epilepsy, Down syndrome, AIDS, and hematologic diseases. Periodontal disease is very common in society. The first symptom of a periodontal disease is gingival bleeding. Gingivas are swollen, red and along with a shiny surface.
Halitosis, itching and bleeding of gingivas and sensitivity of teeth are also among these symptoms. Periodontal diseases may affect people of all ages from children to elder ones; in different severities. It may proceed without any symptoms since the patients most commonly do not have any problems like pain. When the patient has a complaint, healthy teeth without caries are lost by flapping, due to damage in supporting structures.
The main purpose of periodontal therapy is to preserve unhealthy teeth in the mouth. Different treatment methods are available according to the severity and the type of the disease. These can be summarized as oral hygiene education, removal of calculus, root planning, and regenerative, reconstructive and mucogingival operations.
Creating aesthetic gingivas for individuals with high lip line is also among periodontal therapy. Type and severity of the disease, patient habits, cooperation between patient and doctor, and oral hygiene standards affect the treatment planning and its success directly.
When necessary treatments associated with early diagnosis are applied, periodontal therapy is the dental service which has the highest success and patience satisfaction rate. It should be noted that no restorative treatment can be applied to periodontally unhealthy teeth.
Endodontics is a main discipline in which main root canal treatment are particularly carried out.
When endodontic treatment is mentioned, root canal treatment comes to mind. The most feared dental treatment among tooth treatment procedures is generally root canal treatment. Today, root canal treatment for live teeth is completed in a single session; and two sessions are usually required for devitalized teeth.
Anatomy of the Tooth
The visible part of the tooth is called crown, and not visible part that is inside the bone is called root. Our teeth consist of several layers. The outmost layer of the crown that is visible in the mouth is called enamel. Enamel is one of the hardest tissues in our body. The root of the tooth which is under gingiva and surrounded with bone is covered with cement layer. There is a dentine layer which is under enamel and cement layers. The characteristic of the dentine is being the largest layer of the tooth and contains the nerve endings in contrast to enamel layer. This characteristic has an effect in the pain mechanism. There is a dental pulp of the tooth under the dentine layer. There are vessels and nerves of the tooth in this layer.
Dental pulp has an important role in the eruption and development of the tooth. Additionally, it transmits us the problems that our tooth faced with pain mechanism after eruption.
How is dental pulp get inflamed?
Every person has bacteria in their oral cavity. Bacteria are not harmful unless unfavorable conditions are formed. Bacteria form acids when combined with the food we eat. If these formed acids are not removed from our mouth, tooth enamel gets damaged and tooth decay is formed on enamel layer. If the tooth decays formed on enamel are not treated, they pass onto the dentine layer which is under enamel layer. If the tooth decay is not treated even though dentine layer has warned us with pain, microorganisms move onto dental pulp. In the meantime, dental pulp activates several ways to protect itself. One of these ways is to warn us with the pain. But if the tooth does not get treatment again, microorganisms create inflammation after a while by harming vessels and nerves.
Another reason of inflammation in the dental pulp is traumas. A blow on the tooth can cause a breakage of vessels and nerves that go from root apex to root of the tooth, and thereby the vitality loss of the tooth. Addition of microorganisms to this condition in any way causes dental pulp inflammation. Another reason of dental pulp inflammation is the presence of the long-term periodontal disease (gingiva and its surroundings) around the tooth.
How to understand if a tooth is inflamed?
Inflammation and the beginning of the inflammation may be determined when pain and tenderness occurs upon cold and hot food and beverage consumption and during eating. Also, extreme color changes that occur on teeth can be perceived as a sign of inflammation. Apart from these, for teeth that are not treated even though decay reaches into dental pulp, inflammation goes from root tip to jawbone and small or large swellings (panicula) on the face can be seen. In this case, the use of antibiotics is also suitable as well as the interventions of the dental practitioner for fighting against inflammations. General opinion dictates that the tooth which causes the panicula should be pulled out when panicula has calmed down. However, this idea is fairly outdated. Even teeth that cause these kinds of inflammations may be recovered and kept in the mouth with root canal treatment and it can serve you as a healthy tooth for years.
Phases of the Root Canal Treatment
1. Determination of the problematic tooth with Radiography.
2. If the tooth is alive, administration of local anesthesia and destruction of sensitization in the tooth and surrounding tissue.
3. The creation of a cavity reaching to dental pulp by cleaning the tooth decays on enamel and dentine layers.
4. Determination of the working length by using electronic devices and verification with radiography.
5. Extermination of microorganisms on inflamed dentine layers in root canal by using rotary tool systems.
6. Extermination of microorganisms with various disinfectants while using rotary tool systems in root canals.
7. If the tooth is not alive in the beginning of the root canal treatment, applying an antiseptic that settles in the root canal and filling the root canals at next treatment session.
After root canal treatment, fixing the damage that occurred at surrounding tissues of the tooth is aimed in order to prevent the recreation of the inflammation through cutting the tooth’s relation with surrounding tissues.
Sufferable pain or some pain that occurs when the tooth is pressed on can occur subsequent to root canal treatment, especially if it is an alive tooth. This is a normal pain observed after root canal treatment. Contemporarily, success rate for root canal treatment applied with proper treatment is almost 90 %.
Halitosis is a common problem in our society, however, it is not expressed due to social and cultural reasons. Although there is no data on its incidence in our country, it is known that prevalence of halitosis in western countries vary between 10% and 50%. Halitosis is perceived differently in different cultures, although odors that described as normal for some cultures, can be described as irritating for others. Bad breath is considered different by different social levels even in same society. Especially in the family, individuals get used to each other’s bad breath and ignore the possibility that it can be bad breath.
Bad breath affects the position of the individual in society and often it is tried to be suppressed rather than receiving treatment. The products on the market to suppress the odor mitigate the smell when they are used but their effects are not permanent. Suppression of the odor is a temporary solution as long as the source is not treated because the problem is not treated.
What is the Source of Bad Breath?
Bad breath can be divided into three main groups according to the source. These are can be separated as: the odors that are sourced from inside the mouth, the odors that are sourced from breathing and respiratory tracts and the odors are sourced from digestive system. Odors coming from the digestive tract are fairly less frequent than what is believed, and mostly occur when stomach loses gas. Some reflux-caused bad breath cases are found. Odors caused by breathing and respiratory tract form approximately 10% of bad breath cases and emerge as a result of some serious diseases or their precursor. Diabetes is the first of these diseases that come to mind. Factors such as chronic respiratory tract infections and tonsil stones can cause bad breath. However, the source of odors from the mouth is often problems in the mouth.
Including foods such as onions and garlic and also cigarettes in the reasons of bad breath is not proper. Because the odors of these substances are far from typical bad breath and do not create a problem as long as they are not consumed. Eating these odor-forming foods frequently reduces odor sensitivity and creates the vision that bad breath is not the issue even though these foods are consumed. However, these odors cannot be removed as easily as it is thought and they strongly disturb other people.
On the other hand, cotton mouth, long-term hunger, diseases in the mouth, inflammation and bacteria accumulated on tongue are actually responsible for bad breath. Untreated tooth decay, foods stuck between teeth, poorly made dentures, gingival diseases and improperly applied oral care can be counted as the other causes of bad breath.
The source of the odor should be accurately determined and the cause should be eliminated in order to treat bad breath. In our institute, special devices are used to determine the level of the bad breath. Thus, the level of your bad breath is determined at the application and changes of your bad breath will be recorded after required treatments are applied.
The treatment of odors caused by mouth is prepared individually specific to the requirements and mostly consist of elimination of food stuck in the mouth, cleaning of the tooth decays and inflammations, and decreasing the bacteria amount inside the mouth with oral care methods. These treatments are performed in our institute, on the other hand with oral care education and practices completely elimination of the odor is provided.
For Continuous Oral Care:
Using only a toothbrush is not sufficient as oral care, to get rid of the bacteria and negative effects that caused by bacteria; dental floss, bridge floss and tongue scraper should be used. Using of antibacterial oral rinse is useful if required.
How to apply these applications will be explained practically by your doctor with the content of oral care package suggested for you, therefore, the most suitable approach for you will determined.
Along with a ten bed capacity, we have a fully equipped operation room in our hospital where we perform both surgical procedures with general anesthesia or sedation (tooth extraction, gingival treatments, implant procedures, bone cyst operations, bone graft operations etc.) and nonsurgical treatments (fillings, root canal treatment, etc.).
Denistanbul Private Dental Hospital
Along with a ten bed capacity, we have a fully equipped operation room in our hospital where we perform both surgical procedures with general anesthesia or sedation (tooth extraction, gingival treatments, implant procedures, bone cyst operations, bone graft operations etc.) and nonsurgical treatments (fillings, root canal treatment, etc.).
What is sedation?
The patient is relaxed with the combination of some sedatives (Diazem like) and narcotic analgesics (morphine like), along with a hypnotic medicine on some occasions. A short period of amnesia (loss of memory) is induced and dental treatment is carried out rapidly under local anesthesia.
What is general anesthesia?
Known as Narcosis among people, General Anesthesia is induced with a combination of three medicines:
Temporary loss of consciousness due to hypnotic medicines
A painless operation due to narcotic analgesics (morphine like) even tough the patient is unconscious
Muscle relaxants (Curare) relax all the muscles and provide a comfortable surgery. All the muscles including the respiratory ones are paralyzed temporarily with muscle relaxants. The respiration is maintained by a small sterile tube named “endotracheal tube” that is placed into the respiratory tract (trachea) along with an anesthesia device (respiratory device) under the surveillance of an anesthesiologist.
Continuity of the general anesthesia is maintained by the inhalation of oxygen/air or oxygen/air/nitrous oxide combination or with volatile agents (Sevorane etc).
Complications of Anesthesia
Due to innovations in medicine, side effects of drugs used in anesthesia are few and these drugs are eliminated from the body rapidly. Owing to the current medical technology, all vitals of a patient can be observed closely with anesthesia devices or through patient monitoring. For these reasons, with experienced doctors and under appropriate conditions, complications due to anesthesia (general anesthesia or sedation) are very few. But what every anesthesiologist fears the most is when the patient is satiated before the operation. If the satiated patient vomits under general anesthesia and the vomit pass to lungs through respiratory tract, this could lead to pneumonia, a condition that is severe and fatal. Therefore the patients are required to be fasting for at least 8 hours prior to surgery. The first rule of minimizing complications is to do the preoperative anesthesia examination in detail.
Patients applying to our hospital have their treatments planned in related departments and then they are examined for anesthesia preoperatively. During anesthesia examination, a detailed history (operations done in the past, past diseases, regularly used drugs etc.) of a patient is recorded and physical examination is carried out. After completing the necessary examinations, operation date is determined.
Risk groups for anesthesia
ASA-I: A normal healthy patient, with minimum risk.
ASA-II: A patient with a mild systemic disease like diabetes or hypertension whose vital functions are not affected by the disease.
ASA-III: A patient with a severe systemic disease like a heart deficiency or a respiratory deficiency whose vital functions are affected by the disease, this is a high risked group.
ASA-IV: A patient with a severe systemic disease that is a constant threat to life like severe heart, liver, kidney or respiratory deficiencies.
Patient groups suitable for general anesthesia and sedation:
ASA-I and ASA-II, adult and infant patients can be considered in 5 groups:
Infants aged under 4 - Dental treatment through persuasion is difficult in these patients.
Infants or adults with developmental deficiencies
Adult patients with advanced phobia (fear)
Surgical operations that necessitate general anesthesia (bone grafting, bone cysts etc.)
A patient group demanding several surgical procedures completed in a short period of time (2-3 hours) under general anesthesia that cannot be performed under local anesthesia with a single operation.