Category: Oral hygiene

Category: Oral hygiene

Dental extractions

Reasons for dental extractions

There are many reasons why dental extractions are necessary, the main ones being tooth damage, due to breakage or decay especially when they are associated with toothache. Dental extractions are also referred to as exodontia or exodontics.

Sometimes wisdom teeth are impacted (stuck and unable to grow normally into the mouth) and may cause recurrent infections of the gum (pericoronitis). In orthodontics if the teeth are crowded, sound teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened.

Procedure

Tooth extraction is usually relatively straightforward, and the vast majority can be usually performed quickly while the individual is awake by using local anesthetic injections to eliminate pain. While local anesthetic blocks pain, mechanical forces are still felt. Some teeth are more difficult to remove for several reasons, especially related to the tooth’s position, the shape of the tooth roots, and the integrity of the tooth.

Dental fear

Dental phobia is an issue for some individuals, and tooth extraction tends to be feared more than other dental treatments such as fillings. If a tooth is buried in the bone, a surgical or trans alveolar approach may be required, which involves cutting the gum away and removing the bone which is holding the tooth in with a surgical drill. After the tooth is removed, stitches are used to replace the gum into the normal position.

Post extraction

Immediately after the tooth is removed, a bite pack is used to apply pressure to the tooth socket and stop the bleeding. After a tooth extraction, dentists usually give advice which revolves around not disturbing the blood clot in the socket by not touching the area with a finger or the tongue, by avoiding vigorous rinsing of the mouth, and avoiding strenuous activity.

Sucking, such as through a straw, is to be avoided. If the blood clot is dislodged, bleeding can restart, or alveolar osteitis (“dry socket”) can develop, which can be very painful and lead to delayed healing of the socket. Smoking is avoided for at least 24 hours as it impairs wound healing and makes dry socket significantly more likely. Most advise hot salt water mouth baths which start 24 hours after the extraction.

Other reasons

  • Severe tooth decay or infection – (acute or chronic alveolar abscess, such as periapical abscess – collection of infected material (pus) forming at the tip of the root of a tooth.). Despite the reduction in worldwide prevalence of dental caries, it is still the most common reason for extraction of (non-third molar) teeth, accounting for up to two thirds of extractions
  • Severe gum disease – which may affect the supporting tissues and bone structures of teeth
  • Treatment of symptomatic impacted wisdom teeth – who have or cause certain diseases such as non-restorable caries or cysts
  • Preventive/prophylactic removal – of asymptomatic impacted wisdom teeth
  • Supernumerary teeth – which are blocking other teeth from coming in
  • Supplementary or malformed teeth
  • Fractured teeth
  • Cosmetic – to remove teeth of poor appearance, unsuitable for restoration
  • In preparation for orthodontic treatment – (braces)
  • Teeth which cannot be restored endodontically
  • Prosthetics – teeth detrimental to the fit or appearance of dentures
  • Lower cost – compared to other treatments

Types of extraction

  • Simple extractions – are performed on teeth that are visible in the mouth, usually with the patient under local anaesthetic, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. Typically the tooth is lifted using an elevator, and using dental forceps, rocked back and forth until the periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened to make the tooth loose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force.
  • Surgical extractions – involve the removal of teeth that cannot be easily accessed, for example because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction the doctor may elevate the soft tissues covering the tooth and bone, and may also remove some of the overlying and/or surrounding jawbone tissue with a drill or osteotome. Frequently, the tooth may be split into multiple pieces to facilitate its removal.

Replacement options for missing teeth

Following dental extraction, a gap is left. There are various options to fill this gap including a bridge, implant or dentures.

Dental extractions in Poland

The cost of extractions in Poland are much less than in the UK. Typically, an extraction will cost £30 in Poland compared to £125 in the UK. Surgical extractions can cost as little as £65 compared to £295 (UK).

 


What is a dental bridge?

Dental bridge in Poland

If you have missing teeth, your dentist can close or bridge the gaps in your smile with a dental bridge. This treatment is widely available in Poland and much cheaper than in the UK.

  1. What is a dental bridge?

    A bridge is a fixed dental restoration (a fixed dental prosthesis) used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants. It will literally bridge the gap created by one or more missing teeth.

    Dental bridge

  2. What types of dental bridges are there?

    There are four main types of dental bridges, traditional (or conventional), cantilever, Maryland & implant-supported.

  3. What is a traditional bridge?

    A traditional bridge is the most popular type of dental bridge and can be used when you have natural teeth on both sides of the gap created by your missing tooth. If you have a natural tooth on each side of the gap caused by the missing tooth or teeth, then a cantilever or Maryland bridge may be used.

  4. What is an Implant-supported dental bridge?

    Implant-supported bridges use dental implants instead of crowns or frameworks. Typically, one implant is surgically placed for every missing tooth, and these implants hold the bridge in position.

  5. Why do I need a dental bridge?

    When you have a missing tooth or missing teeth, a bridge can benefit you in many ways e.g. it can restore your smile, correct your speech, help you to chew properly & maintain the shape of your face.

  6. How Long do Dental Bridges Last?

    With good oral hygiene and regular checkups, it is not unusual for the life span of a fixed bridge to be over 10 years. Poor oral hygiene could reduce this to between 2 and 5 years.

  7. How much do dental bridges cost in Poland?

    A traditional bridge in Poland will cost around £320 on average. In the UK, the typical price is around £700.

Dental treatment in Poland

If you are considering coming to Poland for dental treatment, please read our article – How to use this website?

 


Oral hygiene

Prevention better than the cure

Oral hygiene is the practice of keeping one’s mouth clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth and cleaning between the teeth.

It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay (cavities, dental caries) and gum diseases, including gingivitis, and periodontitis.

Prevention is better than the cure and following the guidelines below will hopefully prevent the necessity for a dental tourism trip to Poland.

General guidelines

General guidelines suggest brushing twice a day: after breakfast and before going to bed, but ideally the mouth should be cleaned after every meal. Cleaning between the teeth is called interdental cleaning and is as important as tooth brushing. This is because a toothbrush cannot reach between the teeth and therefore only removes about 50% of plaque off the surface. There are many tools to clean between the teeth, including floss and interdental brushes; it is up to each individual to choose which tool he or she prefers to use.

Sometimes white or straight teeth are associated with oral hygiene, but a hygienic mouth may have stained teeth and/or crooked teeth. For appearance reasons, people may seek out teeth whitening and orthodontics.

Tooth cleaning and decay

Tooth decay is the most common global disease. Over 80% of cavities occur inside fissures in teeth where brushing cannot reach food left trapped after eating and saliva and fluoride have no access to neutralize acid and remineralise demineralised teeth, unlike easy-to-clean parts of the tooth, where fewer cavities occur.

Teeth cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, gum disease, and tooth decay. Severe gum disease causes at least one-third of adult tooth loss.

Dental sealants

Dental sealants, which are applied by dentists, cover and protect fissures and grooves in the chewing surfaces of back teeth, preventing food from becoming trapped and thereby halt the decay process. An elastomer strip has been shown to force sealant deeper inside opposing chewing surfaces and can also force fluoride toothpaste inside chewing surfaces to aid in remineralising demineralised teeth.

Tooth brushing

Between cleanings by a dental hygienist, good oral hygiene is essential for preventing tartar build-up which causes the problems mentioned above. This is done through careful, frequent brushing with a toothbrush, combined with the use of dental floss or interdental brushes to prevent accumulation of plaque on the teeth. Powered toothbrushes reduce dental plaque and gingivitis more than manual tooth brushing in both short and long term.

Sources of problems

Dental plaque – also known as dental biofilm, is a sticky, yellow film consisting of a wide range of bacteria which attaches to the tooth surfaces and can be visible around the gum line. It starts to reappear after the tooth surface has been cleaned, which is why regular brushing is encouraged. A high-sugar diet encourages the formation of plaque. Sugar (fermentable carbohydrates), is converted into acid by the plaque. The acid then causes the breakdown of the adjacent tooth, eventually leading to tooth decay.

If plaque is left on a subgingival (under the gum) surface undisturbed, not only is there an increased risk of tooth decay, but it will also go on to irritate the gums and make them appear red and swollen. Some bleeding may be noticed during tooth brushing or flossing. These are the signs of inflammation which indicate poor gum health (gingivitis).

The longer that plaque stays on the tooth surface, the harder and more attached to the tooth it becomes. That is when it is referred to as calculus and needs to be removed by a dental professional. If this is not treated, the inflammation will lead to the bone loss and will eventually lead to the affected teeth becoming loose.

Preventative care

Routine tooth brushing is the principal method of preventing many oral diseases, and perhaps the most important activity an individual can practice to reduce plaque build-up. Controlling plaque reduces the risk of the individual suffering from plaque-associated diseases such as gingivitis, periodontitis, and caries – the three most common oral diseases.

The average brushing time for individuals is between 30 seconds and just over 60 seconds. Many oral health care professionals agree that tooth brushing should be done for a minimum of two minutes, and be practiced at least twice a day. Brushing for at least two minutes per session is optimal for preventing the most common oral diseases, and removes considerably more plaque than brushing for only 45 seconds.

Toothpaste with fluoride is an important tool to readily use when tooth brushing. The fluoride in the dentifrice is an important protective factor against caries, and an important supplement needed to remineralise already affected enamel.

Flossing

Tooth brushing alone will not remove plaque from all surfaces of the tooth as 40% of the surfaces are interdental.

One technique that can be used to access these areas is dental floss. When the proper technique is used, flossing can remove plaque and food particles from between the teeth and below the gums.

Interdental brushes

Interdental brushes come in a range of color-coded sizes. They consist of a handle with a piece of wire covered in tapered bristles, designed to be placed into the interdental space for plaque removal.

Studies indicate that interdental brushes are equally or more effective then floss when removing plaque and reducing gum inflammation.