This is a very subjective question. The current technology allows us to place the teeth over the implant in the same sitting. However these are provisional restorations and need to be changed after a certain period of time. However, immediate placement of teeth over implants depends upon many factors and cannot be generalized to all the patients.
Conventionally, the duration of implant treatment may vary between 2 months to even more than a year depending upon the quality and quantity of bone present.
Diagnosis: You may have to undergo certain radiological (X-ray, CBCT) and haematological (blood test) investigations before the treatment. This helps us in treatment planning and gives us a very close estimate of the time and duration of treatment. The treatment options are discussed with the patient and treatment plan is finalized only after that.
Phase 1 (Surgery): This involves placement of dental implants or/and bone regeneration procedures if required. Healing screws or temporary teeth may/may not be placed in the same sitting, depending upon many factors which are explained in detail to the patient.
There has to be a gap of 2-6 months between Phase 1 and Phase 2
Phase 2 (Surgery): This phase is dedicated to placing healing screws or bone trainers to make a healthy channel of gums around the path from which teeth would be connected to the implants inside the bone. It takes 3-6 weeks for gums to heal around the gingival formers. However, in most of the cases, this phase is integrated with the first phase.
Phase 3 (Placement of teeth): Phase 3 can start immediately after Phase 2 gets over. Once the implants have united with the bone (osseointegration), the next step is to place the teeth over them. This phase may take anywhere between 5 days to 3 months. It depends on the number of teeth, the make of teeth, the requirement of temporary teeth, requirement of any adjuvant procedure.
The cost of the treatment varies and depends upon many factors
Company of implant: It is one of the major factors determining the cost of the procedure. Implants of companies of worldwide repute like Straumann, Nobel biocare, Dentium, Osstem, Biohorizon, Dentsply, etc are all available at Indiadens.
Type of tooth: It is the second most important factor in determining the overall cost of the procedure. For eg. A casted PFM over ready-made abutment costs less than an all-ceramic crown over a custom zirconia abutment.
Complexity of the procedure: Sometimes we have to do additional surgical procedures to enhance bone or modify soft tissue around the implant which may not be very important for immediate results but are extremely necessary for long term function and success of an implant. These procedures also add on to the overall cost of the implant prosthesis.
Infrastructure and technology: It is an extremely important component which determines the success rate of implants. A sterile operative setting equipped with the latest armamentarium which is upgraded regularly is the need of the hour.
The experience and expertise of the doctor: This is one of the paramount factors which would determine not only the success rates but also the cost of the dental implants.
Location of practice: An office located in a major city like Delhi would have more overhead expense compared to a semi-urban practice.
We at Indiadens offer a unique blend of all the above virtues at highly affordable rates. The cost of a single implant at Indiadens starts from Rs 18000/- only
Kindly fill up our implant analysis form and receive your free quote (estimate of treatment).
It can be immediately after placement of implants (0-3 days) or as late as 6 months to one year. You need to understand two terminologies before you get an answer to the above question; Immediate placement and immediate loading. The immediate placement and immediate loading are two different concepts.
Immediate placement is the placement of dental implant immediately after removal of the tooth from a socket. It is possible and preferred in most of the cases. However, in very few cases we need to wait for 3-6 months before placement of dental implant.
Immediate loading is the placement of the tooth over an implant immediately after placement of dental implant. Usually, a waiting period of 2-6 months is recommended for placement of teeth after insertion of dental implants. It is proven that this is the time taken for dental implants to unite with the jaw bone.
However, modern technology has permitted us to place the teeth immediately with predictable results in many cases. These teeth are temporary in nature and ideally should be replaced after a certain period of time (normally 6months to 1 year). This concept of immediate placement of teeth has several limitations and should not be generalized to all the patients. If applied in the wrong cases, it has the potential to cause failure of dental implants. So, the decision is taken based upon many factors and immediate loading/placement of teeth cannot be generalized to all the patients. Please remember that implants are a long term substitute for your natural teeth and planning and execution of treatment should be done keeping that in mind.
This concept is utilized in cases where the whole jaw needs replacement. This requires strategic placement of 4 or 6 implants in each arch over which 12-14 teeth can be placed. When a full arch (single jaw) receives fixed teeth over 4 implants, it is called “All-on-4” and similarly if the number of implants increases 6, it is called “All-on-6”.
The teeth which are placed over these implants are supported by a single framework made of metal or PEEK. So, it is a single-piece hybrid screw retained prosthesis over multi unit abutments. This concept has gained a lot of popularity in recent times. More number of implants is preferred but the final treatment plan depends upon the availability of bone and willingness of the patient for grafting procedures.
In our practice, we personalize the treatment plan based on many factors such as availability of bone, quality of bone, medical condition of the patient, willingness for bone grafting procedures, age of the patient, dietary considerations, built of the patient, etc.
As they say “Age is just a number”. It doesn’t mean that age is not at all a factor to be taken into consideration. Medical fitness or general health of the patient is more important. A patient may be medically fit to undergo dental implants at the age of 90 and may be deemed unfit even at 45-50 years of age.
The eldest patient operated on for dental implants by doctors working at INDIADENS (Dr Ujjwal Gulati) has been 89+ years.
There are hundreds of companies that manufacture dental implants. At our practice, we have shortlisted few companies based on the following criteria
1. Global presence
2. Global reputation
3. Long term research-based success rates
4. Best quality in respective price segment
5. Good service and availability in India
It is a very common question that how long are my implant teeth going to last. It is a general belief that implant supported teeth are life time. The term “life time” is very subjective. “Life time” has different meanings for a 70 year old and 20 year old patient. Literature suggests long term success rates of implants in high nineties. The success rate not only depends upon the skill of your implant surgeon and quality of dental implant but also the medical condition and maintenance by the patient. Poor oral hygiene/uncontrolled systemic disease/use of tobacco in any form, etc are a few factors which potentially contribute to success or failure of dental implants.
These procedures are necessary if the bone volume is deficient for an implant of adequate diameter and length to be placed into the bone. These can be categorized into three main headings for the purpose of understanding
Sinus lift surgery: The upper jaw(maxilla) has air filled space called “maxillary sinus” present above the roots of posterior(back) teeth. This space tends to increase at the expense of bone if the teeth have been absent for a long time. Also, chronic loss of teeth causes disuse atrophy of bone. These two factors cause the bone volume to become deficient over a period of time.This deficiency doesn’t allow adequate/recommended diameter of the implant to be placed. In such cases, bone substitutes are placed between the membrane of sinus and bone (sinus floor).These bone substitutes when placed with proper technique and in sterile settings, mature into dense bone which allows the implants to be anchored into it. The sinus lift surgery is of two types: Direct/lateral window and crestal/indirect. Direct/lateral window procedure is used when the bone is highly deficient. Both of these procedures have very high success rates when done in a proper sterile environment.
Guided bone regeneration: There can be instances where the bone is deficient over the crestal area or absence of a wall (complete or partial) in cases of immediate extraction or extremely low width of bone for accommodating the recommended diameter of an implant. In such cases, the bone graft (from the patient's body/animal bone/synthetic bone) is placed alone or in combination with a thin layer of tissue called a membrane. This helps in regeneration of bone in a desired region. This may be done along with the implant if the bone volume deficiency is not beyond a certain limit. Else, first the bone has to be regenerated and once that has happened, the implant can be placed.
Ridge split procedure: In case of deficiency of width of bone, one of the procedures involves widening of the bone of mandible by splaying apart the two hard layers of bone and placing implant in between. The empty space left is filled with bone graft and covered on top with a membrane.
IMPACTED WISDOM TOOTH
Wisdom teeth (third molars) are usually the last new teeth you get, normally when you are over 16. Often there is not enough room in your mouth for wisdom teeth, so they do not grow normally. When this happens, your wisdom teeth are said to be ‘impacted’. Wisdom teeth are usually impacted forwards into the tooth in front or backward into your jaw bone.
An impacted wisdom tooth can cause a number of problems so it may be necessary to have it removed.
The most common problems are:
- Repeated infections in the gum surrounding your wisdom tooth. This causes pain and swelling.
- Food packing, which causes decay in either your wisdom tooth or the tooth adjacent to it.
- Cyst or tumour formation around your wisdom tooth. You get a cyst when fluid fills the sack that normally surrounds a developing wisdom tooth.
Surgery is mostly performed under local anesthesia which is attained by means of an intra-oral injection. In rare situations, it may have to be done under general anesthesia which requires hospitalization. Once anesthesia is achieved, your gums may need to be cut to expose the tooth. This may or may not be followed by the removal of some surrounding bone and splitting your tooth into two or more pieces. After removal of the tooth, two or more stitches may be required for better and faster healing of the wound.
The main benefit of removing your impacted wisdom tooth is that it will get rid of any existing infection and prevent further infection in the future.
It is mostly done in a dental clinic. However, in rare situations, you may require hospitalization if general anesthesia is required.
Your doctor/dentist will discuss with you how to prepare for your operation at the preoperative assessment. It is important to discuss the operation with your doctor/dentist so you know what to expect. You may need to arrange for a friend or a relative to come with you.
You are likely to have some discomfort and swelling both on the inside and outside of your mouth after surgery. This is usually worse for the first three days but it may take up to two weeks for the soreness to go away. Your surgeon will prescribe you effective painkillers. You may also find that your jaw is stiff and you may need to eat only soft food for a week or so. There may be some bruising on your face that can take up to two weeks to fade away. It is important to keep the extraction sites as clean as possible for the first few weeks after your surgery. If you find it difficult to clean your teeth around where your tooth was removed because it is sore, you can keep the area free of bits of food by gently rinsing with a mouthwash after each meal. Alternatively, you can rinse your mouth with a solution of warm saltwater. Simply dissolve a teaspoon of table salt in a cup of warm water and start using this on the day after your surgery.
Detailed instructions and precautions can be discussed with the surgeon/attending doctor.
We usually advise you to stay off work and avoid strenuous exercise for a few days.
- Bleeding – Although you may have a little bleeding during the procedure, this usually stops very quickly and is unlikely to be a problem if the wound is stitched. If the area bleeds again when you get home, you can usually stop it by applying pressure over the area for at least 10 minutes with a rolled-up handkerchief or a swab of cotton wool. If the bleeding does not stop, please contact us.
- Nerves – There are two nerves that lie very close to the roots of your lower wisdom teeth. One of these nerves supplies feeling to your lower lip, chin, and lower teeth. The other supplies feeling to your tongue and helps with the taste. Sometimes these nerves may be ‘bruised’ when a wisdom tooth is taken out. This can cause a tingling or numbness in your lip, chin, or tongue and, more rarely, altered taste.
About one in 10 people will have some tingling or numbness that can last several weeks. Fewer than one in 100 will have problems that last more than a year. These risks may be higher if your tooth is in a difficult position. Your surgeon will tell you if you are considered to be at increased risk.
If you find that your lip or tongue feels numb or tingles in the days following your extraction, please contact us.
- Infection – Although there is a small chance of infection, this is Uncommon.
The only other option is to take medicines whenever symptoms precipitate. However, this approach has the potential to worsen your problem further. There are no satisfactory alternatives to removing the cause of the infection – your wisdom tooth. If you do not have your tooth removed, you may get painful infections/recurrent pain.
BRACES AND ALIGNERS
Orthodontic treatment usually takes 18 – 24 months. Some patients may finish treatment earlier and others may take longer to complete. Factors determining the duration of treatment include the severity of the problem, the type of treatment rendered, and the patient’s cooperation.
Wearing braces is called the active part of orthodontic treatment. Once that phase is over, the braces are removed, and retaining appliances are fitted to hold the teeth steady in their new position. These appliances may be removable (plates) or fixed (wires) fitted behind the teeth.
Retainers play an important role in the treatment. If they are not worn according to instructions, the teeth may move back towards their original position. They are usually worn for a year or more as determined by the orthodontist. The corrected teeth are then observed periodically for about five years after the retainers have been phased out.
- A beautiful and healthy smile is more attractive and boosts your confidence
- It is much easier to brush, clean, and floss well-aligned teeth. Hence, there is a reduced risk of tooth decay
- Protruded/prominent teeth are more prone to injury. So orthodontic treatment helps prevent trauma to the teeth
- There is reduced grinding and chipping of teeth as they are in proper alignment
Take a nail file/emery board and use it to smooth the edge that is scratching your gums. If that does not work, please make an appointment to see our orthodontist to adjust your clear aligner.
In the event that a clear aligner is lost or broken, please schedule an appointment with our office as soon as possible, and we will evaluate whether we need to order a replacement clear aligner.
While waiting for your next appointment with us, try the next aligner. If you can get it to fully seat, continue wearing the next aligner. If the next aligner does not fully seat, go back to your previous aligner, and we will order you a replacement clear aligner.
Make sure to keep all your clear aligners for this reason. Sometimes, if teeth are not moving as they should, our orthodontists may request for you to move back to a previous clear aligner.
In the event that an attachment is lost or broken, please schedule an appointment with our office as soon as possible. Attachments are vital for the tooth movement to occur predictably, so we will need to replace it as soon as possible.
Most patients feel some tooth soreness for the first few days when starting clear aligner treatment. This is normal. The soreness should gradually go away after a few days. Over-the-counter pain medication can be used as needed following the medication’s instructions.
ROOT CANAL TREATMENT
You may not feel any pain during the early stages of infection.
In some cases, your tooth may darken in colour, which could mean that the nerve (blood supply to the tooth) is dying.
It is important to know that you may not have any symptoms in the early stages of infection, and every tooth will respond differently when it comes to tooth decay.
Root canals are needed in a tooth with a deep cavity, or secondary infection beneath a pre-existing filling, or in a tooth cracked from injury or genetics. There are a few symptoms that mean you might need a root canal—
- Lingering sensitivity to hot and/or cold food and sweets, even after the sensation has been removed
- Throbbing pain while chewing or biting
- Pain that worsens when you lie down
- Tooth pain that radiates to the head and ears
- Pimples on the gums/swelling around the tooth
- A chipped or cracked tooth
- Deep decay or darkening of the gums
A root canal treatment will be performed after administering local anesthesia which makes the tooth numb. Make sure you eat a light meal before you visit Indiadens for your treatment. You will be advised against chewing and biting until the numbness wears off.
Although you will most likely be numb for approximately 30-60 minutes following the procedure, most patients are able to return to school or work directly following a root canal treatment. However, it is advised against eating for one to two hours until the numbness has completely gone to avoid biting your lip/tongue.
There is nothing like your natural tooth! If you get your tooth extracted, you must get it replaced by either a fixed tooth in the form of an implant or a bridge to restore chewing function and to avoid the adjacent or opposing teeth from shifting into that space. These procedures tend to cost a lot more than endodontic treatment and appropriate restoration.
However, an implant is the next best thing to a natural tooth and if need be, is the top replacement option these days. You can read more about it here.
It is essential that patients take adequate care of their teeth following a root canal treatment to prevent further damage to the tooth, gums or surrounding teeth.
After an RCT at Indiadens, we recommend patients to:
- Brush their teeth twice a day with a fluoride toothpaste
- Floss teeth daily (especially around the treated tooth and crown region)
- Schedule regular dental appointments to check dental health
Patients are educated about certain signs post treatment, that may indicate that intervention is required. This helps to ensure that any complications are picked up and treated early, before they cause significant damage to the teeth.
All the teeth which undergo root canal treatment do not require caps/crowns. The teeth which have lost significant tooth structure due to caries or fracture and have become weak to an extent that they are more likely to break or fracture with application of chewing forces, are given a crown or cap to reinforce their strength and hence prolong their functional life.
Crowns/Caps are of following types:
- PFM (Porcelain Fused to Metal)- It is a type of crown with porcelain layered on top of the supporting structure of metal. This makes it a stronger restoration than porcelain alone. However it requires more removal of healthy tooth structure to accommodate the restoration. It is considered highly resistant to wear and tear but it does not match the translucency of the natural tooth as well as the all ceramic restoration. Hence its use in the front teeth is limited.
- Laser-sintered (DMLS): Highly advanced laser sintering technology is used to make the inner coping of the crown which significantly improves the precision and hence the fit and longevity.
- Zirconia(Metal free)- Layered: All ceramic layered restorations are preferred at places where better esthetics is the primary concern because their colour and translucency resemble that of a natural tooth.The strength of these restorations depend on the thickness of porcelain and the ability to bind to the tooth surface. They are highly resistant to wear and tear but can undergo fracture if placed under high impact or tension. These are mostly used in front teeth. Monolith: When dealing with posterior teeth, the all-ceramic restorations with high strength are preferred. Their esthetics are relatively lower when compared to the layered all ceramic prosthesis, but the strength is higher, which is required for biting food especially with posterior teeth.
Indiadens is a child-friendly dental clinic with dentists who generally prefer to keep the first dental visit with little or no treatment. We intend to build a trusting rapport with the child first and help him build a basic dental orientation with us. Our clinic is also dedicated to help young patients overcome dental anxiety by using conscious sedation during the treatment, if required.
Usually on the first visit to Indiadens, the parents are educated about proper gum and teeth care for their child and the correct brushing/gum cleaning techniques so that they can further guide their child. Topics like appropriate nutrition and tooth-friendly snacks and meals for toddlers or little kids are also discussed at Indiadens. Many parents also have other concerns around things like feeders and pacifiers, which can be sorted out during this initial visit. The advice from dentists about teeth and gums can be important for future cavity prevention.
For the dental examination, the parents might be asked to first sit on the dental chair and show their kids that it’s not scary. They can also be asked to sit on the chair with the child on their lap. We then actively detect existing problems, if any, like cavities, teeth alignment or your child’s bite. We also check the current status of oral health, gum and jaw position, or any other possible developmental flaw. If necessary, we clean your child’s teeth and provide a fluoride application on the teeth as a prevention program for tooth decay.
Our dentists are dedicated to helping young patients to overcome dental anxiety. In spite of our best efforts, kids can develop a fear of the unknown environment and people, white coat phobia, needle phobia, etc. Indiadens is equipped with the provision of ‘inhalation sedation’ (nitrous oxide and oxygen inhalation). The AAPD (AMERICAN ASSOCIATION OF PEDIATRIC DENTISTRY) recognizes it as a safe and effective technique to reduce anxiety and enhance effective communication between the child and the dentist. This makes the child relaxed and comfortable to carry out dental procedures.
If you think inhalation sedation will be beneficial to your child, you could read more about the process by clicking here.
The best way to ensure a pleasant and successful first dental visit is to take a little time to prepare your child and set expectations about what will happen. Simply follow the following guidelines to avoid the jitters associated with the first dental visit.
- Start with having a positive attitude yourself. Children are amazingly perceptive when it comes to the attitudes of others, and they will mirror your reactions to the situation. Make sure you are calm, relaxed, and cheerful. Even if you are not a huge fan of the dentist, don’t let it show in front of your kid. Try to avoid talking about any bad experience at the dental clinic. Always chat about the dentist in positive terms. When you enter our clinic, interact as politely as you can with the staff here. Try to project the attitude that a dentist’s visit is fun, and that the dentist is a friend who is there to help.
- Talk to your child, in an age-appropriate way, about the sequence of events expected during the visit. For example, start by “First we’ll say hi to the receptionist, then we would have to wait a little while they get ready, then we’ll go into a little room and there will be a big chair…” When kids know what to expect, they are much more able to deal with each event as it happens.
- Create a ‘ritual’ surrounding the experience. For example, you could bring some of their favourite toys to play with or special books to read while in the waiting area. Or perhaps you can pick out a special “going to the dentist” outfit. These rituals will help build a routine for your child and he/she will start relating the dental visits to these
- Don’t forget to have them brush. The dental visit will go more smoothly if your child has already brushed their teeth before the visit. This makes it easier for the dentist to examine your kid’s teeth, and to see how well he or she is brushing. So, try to remember to have your child brush before heading out to the dentist!