Conservative dentistry is concerned with the prevention and treatment for consequences of the most common tooth disease, that is dental caries. Dental caries involves the following symptoms: from unaesthetic carious spots on teeth, through dental cavities that may lead to irritation and damage of internal dental tissue (pulp) when untreated, which may be associated with pain, and may exclude the tooth involved from its masticatory function. In extreme cases untreated caries may lead to tooth decay, which not only compromises one's smile, but also may affect health of the whole body, being a focus of hidden infection. The ultimate management in treatment of the consequences of caries is tooth extraction, which is a considerable loss, as even the most excellent restoration is not an ideal replacement for your own, healthy teeth. Patients visiting Villa Nova Dental Clinic are provided with professional, reliable advice and care, irrespective of the development and extent of dental caries in their teeth. Modern conservative dentistry may be divided, according to the stage of disease development, into three, strictly associated fields:
- Prevention - prophylaxis of the development of dental caries and periodontosis;
- Cariology - treatment of simple caries (not complicated by reaction of the pulp);
- Endodontics - treatment of dental caries complicated by inflammation, death or gangrene of the pulp.

PREVENTION

The prevention of caries allows the most excellent results to be obtained, i.e. healthy strong dentition. The main goal of the prevention is to combat dental plaque, the main cause of dental caries development. Prevention also increases the resistance of dental tissues to oral acids. Fluorine is a scientifically proven weapon of dentists, widely used in dental prevention. Dental prevention includes:
- Instruction in oral hygiene;
- Nutritional guidelines;
- Professional tooth cleaning - removal of plaque, deposit and tartar;
- Individual dental fluoridation.

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TREATMENT FOR SIMPLE CARIES

The following procedures are applied in the treatment of simple caries, depending on the stage of caries process development (carious spot, cavity in hard dental tissue):
- Remineralisation - in the case of initial caries, manifesting itself as a carious spot, fluoride formulas are rubbed on the affected surface; this procedure to prevent further caries development should be repeated several times every few days.
- Preparation and filling the carious cavity - the procedure consists of the removal of caries-affected tooth tissues and filling of the cavity with special material.

ENDODONTIC TREATMENT

Endodontic treatment, applied in cases of caries complicated by inflammation, necrosis or gangrene (disintegration) of the dental pulp, is routinely the last and only chance of saving a tooth. The treatment consists of the removal of infected or dead pulp from the pulp chamber and root canals, mechanical dilatation and disinfection of canals and tight filling of these spaces with special material. In the Villa Nova Dental Clinic the most recent technical solutions are applied in order to achieve success in canal treatment:
- Modern tools for canal preparation, both manual and mechanical (K3 ENDO, PROFILE);
- Systems for filling the dental cavity (OBTURA, THERMAFILE);
- Endodontic microscope (Carl Zeiss) consisting of the most modern technology in endodontic treatment. Thanks to this device, many teeth that would otherwise be removed may be saved. The microscope, providing an enlarged image at great big depth, a wide field of vision and very good illumination, allows the observation of details invisible to the naked eye. The application of the microscope is of particular assistance in seeking root canal openings and in the localisation and removal of broken canal tools. A video camera included in the set allows image transmission and recording of the procedure.
The correctness of any procedure performed may be immediately verified by X-ray taken at the scene, in our X-ray laboratory.

COURSE OF TREATMENT

The first visit is designed for an examination of the patient and a determination of his or her needs and expectations. The initial stage of the diagnostic process involves recording the patient's medical history and entering the data obtained in the patient's file. Then our dentist performs a detailed assessment of the condition of the patient's dentition, mucous membrane and tissues adjacent to the teeth (periodontium) and the correctness of occlusion. A routine panoramic X-ray is taken to provide additional information on the examined area. Having obtained the necessary information, our dentist develops an individual treatment plan, including the list and sequence of necessary procedures, and refers the patient to other specialists (surgeon, prosthetist or orthodontist) if necessary. When the patient has been informed of the treatment plan and has approved it, the actual treatment begins. Commonly the first step of the treatment is professional teeth cleansing and training in oral hygiene.

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FAQ

1. What is dental caries?
2. How the development of caries can be prevented?
3. Is it necessary to stop eating sweets to maintain healthy teeth?
4. What type of toothbrush should I choose?
5. How frequently should I replace my toothbrush?
6. How should I brush my teeth?
7. Is a toothbrush alone sufficient?
8. What toothpaste should I choose?
9. What are the advantages of the application of fluorine varnish?
10. Does teeth treatment have to be painful?

1. What is dental caries?

Dental caries is a disease of the hard tissues of the tooth. The main cause for caries is the dental plaque, consisting of residual food and bacteria, which are deposited on teeth after each meal. The bacteria contained in the plaque transform sugars in the food into acids, which wash out minerals (calcium, phosphorus) from dental enamel. This results in weakening and damage to the enamel, allowing the further development of caries.

2. How the development of caries can be prevented?

To prevent the development of caries efficiently, you should take care to strengthen the hard tooth structures by:
- a well-balanced diet (rich in vitamins and minerals) in pregnant women and children from birth until the end of tooth development;
- fluoride prevention: teeth varnishing, the use of fluoride toothpaste and mouthwash, fluoride drops and tablets (the decision to introduce a fluoride preparation into a child's diet should be taken only by a dentist);
- tooth sealing - sealing of the tooth's pits and fissures with special material (for more information, see CHILDREN'S DENTISTRY.
On the other hand, as the main cause for caries is dental plaque, the primary method of prevention against caries is the efficient and systematic removal of the dental plaque.

3. Is it necessary to stop eating sweets to maintain healthy teeth?

Sugar in the food is in fact a prerequisite for dental plaque bacteria on the production of acids, and thus commencement of the carious process. However, it is impossible to eliminate sugar from the diet completely. So you should remember that the frequent eating of sweets (the time they remain in your mouth) and their texture are more important than the overall amount of sweets you eat. The most harmful for your teeth is the frequent eating of sticky products that adhere to teeth, such as toffee, crisps, etc. Thus, you do not have to deprive yourself completely of the pleasure of sweets; it is important to observe regular meal times, limit snacking between meals and to clean your teeth immediately after eating sweets.

4. What type of toothbrush should I choose?

The selection of an appropriate toothbrush is of significant importance to oral hygiene. As there is a huge diversity of toothbrushes available, you may have some problem in choosing the most suitable. The most important is that the size and bristle hardness of the toothbrush is matched individually to the patient's needs. The toothbrush should not be too big and should have a long thin neck, allowing access to molar teeth. Usually medium or medium-hard toothbrushes with multiple bunches, made of synthetic bristle of gently polished and rounded tips, are recommended. In the case of any periodontal disease, a soft toothbrush with a flexible neck that reduces pressure on the gums should be used. There are various versions of bristle pattern. The bristle may be of various lengths or serrated to improve cleansing of dental gaps (longer tips easily penetrate between the teeth) and to massage the gums.

5. How frequently should I replace my toothbrush?

In general your toothbrush should be replaced every two months. After that period the bristles stiffen and irritate gums. Some toothbrushes have a wear indicator in the form of a bristle bunch in a different colour, which discolours as the toothbrush wears. To function properly, the toothbrush needs to be taken care of. After brushing your teeth, the toothbrush should be thoroughly rinsed and stored in a place where it can dry. You should also pay attention to whether the bristle in your toothbrush is crushed, if it is, this indicates that you press your toothbrush against your teeth too firmly.

6. How should I brush my teeth?

In general, each method of brushing the teeth is good provided that it is efficient and not harmful to teeth and gums. Ideally, the tooth brushing technique should be chosen individually by a dentist or hygienist depending on the patient's needs, the condition of his or her dentition and gums and dexterity. Regular tooth brushing should last at least three minutes. The minimum frequency of the procedure should be twice a day: in the morning after breakfast and in the evening after the last meal. However, in some circumstances, e.g. in patients wearing permanent braces, teeth should be brushed after each meal.

7. Is a toothbrush alone sufficient?

Efficient tooth care requires that all their surfaces (facial, lingual, masticatory and interproximal ones) be cleaned. However, only the first three of them are accessible to a toothbrush; thus, a toothbrush alone is not sufficient for maintaining appropriate oral hygiene. You should use additional tools:
- Dental floss - a bunch of waxed silk threads formed into a band, used for cleaning interdental spaces where teeth are close together;
- Dental toothpicks made of soft, non-splintering wood and saturated with fluorine compound are designed for people with spaced or missed teeth;
- Interdental toothbrush - a bristle spiral used similarly to a toothpick, and also for maintaining oral hygiene in people with permanent braces;
- Dental irrigator - a device producing a water stream that cleans interdental spaces and gingival pouches, as well as massaging gums;
- A single bunch toothbrush used for cleaning difficult to reach back teeth.
There are also electric toothbrushes available which are very easy to use and reduce the time required for brushing the teeth compared to conventional toothbrushes.

8. What toothpaste should I choose?

The selection of toothpaste is not as important as the selection of the toothbrush; however, the use of an appropriate toothpaste may improve the efficiency of brushing. Most of the toothpastes marketed conform to basic requirements and contain clinically proven substances, such as polishing agents (help in the removal of dental plaque and deposit), foaming agents, fluorine compounds (sodium fluoride, calcium fluoride or amine fluorides). In particular circumstances you may choose a toothpaste containing appropriate additional ingredients:
- protective toothpastes containing fluorine;
- herbal toothpastes containing herbal extracts that relieve the gums;
- whitening toothpastes that remove food-related discolorations (caused by tea, coffee, smoking and red wine);
- multi-action toothpastes, that include the above-mentioned properties.

9. What are the advantages of the application of fluorine varnish?

Currently, the most commonly used fluorine varnishes are Fluor Protektor and Duraphat (the latter is recommended particularly for children). Such varnishes are used commonly in the protection of both the entire dentition and selected teeth. Thanks to its long-lasting advantages, such as good adhesion to dental enamel and the slow release of fluorine, they provide up to 40% reduction in dental caries. Fluorine applied in the form of such varnish:
- strengthens the enamel in adults and children;
- reduces the build-up of dental plaque;
- prevents the development of secondary caries (adjacent to fillings);
- prevents the development of caries during treatment with permanent braces;
- reduces hypersensitivity of the necks of the teeth.

10. Does teeth treatment have to be painful?

The Villa Nova Dental Clinic always offers treatment under analgesia to patients, if the planned procedure may cause pain. The intensity of pain sensation related to dental procedures depends significantly on the depth of the carious cavity and the individual sensitivity of the patient; thus, our dentists determine the dose and type of analgesia/anaesthesia on an individual basis. The Villa Nova Dental Clinic is equipped with specialised equipment for local analgesia (the Wand) that guarantees a unique painless analgesia technique.
The Villa Nova Dental Clinic is equipped with specialised equipment for local analgesia (the Wand) that guarantees a unique painless analgesia technique.

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Our specialists in conservative dentistry:
Beata Świderska-Weremko
Aneta Witt