The development of digital technologies has brought new dimensions to dentistry in imaging, measurement, design and production. Digital applications, which started about thirty years ago with CEREC – CAD CAM systems, have made it possible to measure with maximum precision, to deliver models to the laboratory untouched and instantly, to design in maximum detail on the computer and to produce three-dimensional production untouched. We doctors can use digital methods in surgery and dental crowding as well as in filling and prosthetic restorations.
With digital possibilities, it is also possible to experiment with the size and shape of teeth on the images of our patients. In the restorations to be made, we can take our measurements in a very short time with the cameras we circulate in the mouth and fillings, porcelain restorations, temporary restorations produced for trial purposes, prostheses can be produced on the same day by modeling again on the digital models.
Apart from restorations, digital design and artificial intelligence have brought a new dimension to orthodontic treatment, and this development, which started with invisalign, has now made it possible for us to provide wire-free orthodontic treatment with plates with three-dimensional design and production even in advanced orthodontic disorders.
Surgical implants, which are produced individually with digital design, can be placed in a single session even in cases where there is no bone and have provided the opportunity to send our patients with their teeth. At the same time, thanks to the surgical guides prepared with digital technology, seamless serial implant placement has also become possible.
Aesthetic dentistry is the application of various treatment methods in the mouth to achieve an aesthetic appearance of the patient’s dental appearance and smile in accordance with their expectations. In this context, teeth, gum tissue and even lip position can be harmonized by taking into account the various characteristics of the person. The patient’s character, face shape and expectations are important factors that play a key role in determining the design. Thanks to aesthetic dentistry applications, the patient can achieve a smile profile with aesthetic features that will make him/her feel happy in a short time.
Which treatments can be applied in aesthetic dentistry?
In aesthetic dentistry applications, arrangements can be made on dental tissue or soft tissues adjacent to the teeth. If only a few shades of change in the color of the teeth is desired, the desired change can be achieved in a short time with various teeth whitening methods. Minimal losses in tooth tissue, asymmetries or minimal gaps between teeth can be arranged with aesthetic filling applications. When permanent and larger changes are desired in one or more of the color, shape or durability features of the teeth, the desired changes can be achieved with full ceramic treatments. In cases where it is sufficient to make arrangements only on the front face of the tooth, porcelain laminate applications can be preferred, where the need for making arrangements is very low. In cases where it is necessary to wrap the prosthesis around the tooth, both aesthetic and durable prostheses can be prepared with zirconium or emax coating treatments. Emax porcelains, thanks to their high light transmission properties, allow natural results to be obtained with aesthetics very similar to the natural appearance of the tooth tissue. Especially when the shape and color changes of the teeth in the front group are planned, this material is frequently preferred thanks to its aesthetic superiority. For Emax porcelain applications, it is usually sufficient to make a minimal arrangement while preparing the tooth surface. Zirconium porcelains, on the other hand, stand out with their lower reflectivity and high durability. This feature of the material is often used to mask the color that disrupts the aesthetic appearance when teeth discoloration problems are at an advanced level. Thanks to its high durability, it is also easily preferred in the posterior group of teeth, which are exposed to various forces to a greater extent during functions, allowing treatments with aesthetic properties close to the natural tooth structure to be applied in the region. Aesthetic problems that occur due to the asymmetry of the gum tissue or its visibility during the smile can be treated with pink aesthetic procedures. In this context, the position of the gum or lip can be regulated by removing some of the gum tissue. Aesthetic dentistry applications can be applied alone or with the combination of several methods.
How Are Aesthetic Dentistry Treatments Performed?
In the first session, all treatment alternatives that can meet the patient’s aesthetic expectations are presented to the patient in detail. Aesthetic dentistry treatments, except for applications that require a design plan, can usually be performed comfortably in a single session by applying local anesthesia depending on the type of procedure. After the treatment method is selected, when a procedure to create a design is planned, impressions are taken from the patient. If necessary, profile images of the patient from various directions can be taken and included in the evaluation. The prepared design can be explained to the patient, shown on the model or rehearsed in the mouth if suitable conditions can be provided. If the design features do not fully meet the patient’s expectations or do not create the ideal harmony with the dental tissues, it is possible to change them. When the final form of the design is decided, the process of arrangement on the tooth surface is started. The necessary abrasions are made to prepare a place for the treatment to be applied on the teeth and the necessary arrangements are provided if changes are planned in the gums. After the adjustments, a new impression is taken to adapt the design to the new form of the tissues in the mouth. Temporary dentures are prepared and applied to the patient so that the patient does not have aesthetic and functional problems until the permanent dentures are completed. When the patient’s permanent prosthesis is arranged to fully harmonize with the tooth, it is permanently bonded to the tooth.
It is the completion of surface, color, shape defects and losses in dental tissues in a way to achieve maximum shape, color and function with minimum preparation while preserving natural tissues. In addition to the basic principles in this field, digital innovations and new generation materials and methods bring us to ideal results. Materials that can imitate tooth tissue in terms of color permeability and hardness, bonding methods that maximize chemical adhesion to the tooth and digital technology support restore lost tissues.
Bleaching is the process of bleaching the color tone of the teeth with certain methods under the control of a dentist. The whiteness provided by these procedures can continue its effect for up to one year with attention to routine oral care. Depending on the patient’s expectations, teeth can be made a few shades whiter than their own color tones with home or office-type teeth whitening methods. In some cases, it may be preferred to apply these two methods in combination. In addition to these procedures, internal whitening of a single tooth can also be applied for the treatment of discoloration observed in teeth that have undergone root canal treatment.
How Are Teeth Whitening Treatments Performed?
Home Teeth Whitening
If the home-type teeth whitening method is to be applied, first of all, an impression is taken from the patient and patient-specific whitening trays are created on this impression. These trays are used daily with whitening gel for the periods determined by the dentist. After each use, they are cleaned by washing with cold water and liquid soap. The tray is kept in its box between applications. In order for the whitening gel to have an effect on the teeth, the tray should be used daily for 4-6 hours. In this case, the treatment can be completed in 10-15 days on average.
Office Teeth Whitening
If office-type teeth whitening is to be applied, the treatment is performed by the dentist in a clinical setting. Since the whitening gel applied in this treatment method is activated on the teeth with UV light or laser, the whitening effect becomes visible on the teeth in a much shorter time. The treatment session can be completed within an average of 1 hour. Depending on the desired whitening effect, multiple sessions can be planned if the teeth are suitable for treatment. If necessary, combined teeth whitening can be applied by supporting the treatment with home whitening. In this case, following the office-type teeth whitening sessions, an average of 2-3 days of home whitening can be planned.
Single Tooth Whitening
In the internal whitening of the teeth applied in color changes due to root canal treatment, the filling on the tooth is removed, the whitening gel is applied into the tooth and the whitening process in the tooth begins by placing temporary filling material in the tooth. The change in color tone is checked by the dentist at three-day intervals. When the appropriate shade is obtained, the bleaching gel is removed from the dental cavity and permanent filling material is applied to the cavity.
Which Criteria Determines the Teeth Whitening Method?
For patients who want to create a minimal shade difference on the teeth or who are undecided about their color expectation, home whitening may be a more appropriate choice. In this process, the whitening process can be spread over days and progresses gradually, so the color tone can be monitored in a more controlled manner. If the tooth color is significantly darker than the patient’s expectations, an effective treatment can be performed in a short time thanks to office-type teeth whitening procedures that can create a significant color difference in a single session. Depending on the color tone of the tooth, one or more treatment sessions can be planned to achieve the desired color. In cases where further lightening of the color tone is possible, this whitening process can be supported by home whitening, depending on the patient’s request.
What is the Process After Teeth Whitening Treatment?
After teeth whitening treatment, minimal tooth sensitivity may be observed on the treated teeth. These effects usually disappear within 24 to 48 hours. In the first two weeks after the application, products that cause staining by leaving color on the teeth such as cigarettes, tea and coffee should be avoided. If you do not pay attention to the consumption of these foods, the whitening effect may decrease in the early period. In the long term, the effect of the treatment can be preserved in the longer term by carefully applying routine oral care and reducing the consumption of products that cause discoloration on the teeth.
It is the replacement of tooth loss with implants made of tissue-friendly titanium that can mimic the tooth root. The implant is chemically bonded to the bone tissue. Over time, with the development of digital technology, implant systems have also developed, and implant systems that allow the completion of missing teeth by wrapping the jawbone in the form of a network, not only a single tooth root, but even in bone deficiencies, have entered our lives. In addition, seamless implants have been developed under the guidance of tomography and three-dimensional measurements and a customized plaque. Since implants complete tooth deficiencies without support from other teeth, they protect other teeth and reduce tooth loss and the use of removable prostheses. Implants, which provide appearance and function close to natural teeth, also protect bone tissue and ensure the continuity of oral health by providing function.
Orthodontic treatment is the treatment of irregularities observed in the teeth and face by applying controlled forces to the teeth and jaw bones. Various appliances can be applied from inside or outside the mouth to create these forces. Although the treatment is usually performed with brackets placed on the front surface of the teeth, aesthetic appearance-preserving treatment methods such as brackets fixed on the back surfaces of the teeth, transparent plates, porcelain brackets can also be applied depending on the needs of the teeth.
How is Orthodontic Treatment with Braces Performed?
In the traditional treatment method, the brackets are fixed on the teeth one by one by applying a special adhesive. This adhesive provides adhesion in the area by activating it with radiation. After the brackets are fixed on all teeth with this method, a wire called archwire is passed through the brackets. Depending on the need at certain stages, the treatment can be supported by fixing with tire applications. It is normal to feel pressure on the teeth in the first period after the braces are attached. This minimal pain, which occurs as a result of the force used to move the teeth, subsides within the week following the application.
How is Orthodontic Treatment with Transparent Plates?
In invisalign treatment, known as wire-free orthodontics, the force is applied with minimal guidance on the teeth with transparent aligners. These transparent aligners, which are prepared individually, are renewed at certain periods and the orientations on the teeth are regulated. These aligners, each of which creates a movement of 0.05 mm, are usually renewed in 15-day periods.
How Long Does Orthodontic Treatment Take?
The treatment time for the first braces session lasts approximately one hour. Follow-up appointments are usually scheduled every 3 to 4 weeks. These sessions can be completed in about 15 minutes to half an hour, unless there is an unexpected situation such as bracket breakage or wire breakage. Completion of the treatment may vary greatly depending on the patient’s compliance with the treatment, the presence of skeletal anomalies in the jaws, the crowding of the teeth, the structure of the teeth or jaw tissues.
At what age can orthodontic treatment be applied?
If orthodontic treatment is planned to regulate the teeth, the treatment procedure can be applied at any age. However, if it is desired to treat crowding caused by anomalies in the jaw bones, these skeletal irregularities can only be treated with orthodontic treatments before the age of 12. In advanced ages, treatment of these conditions can be achieved by combining various surgical procedures with orthodontic treatments.
How is Reinforcement Therapy After Orthodontic Treatment?
Fixed or removable treatment alternatives are available to provide reinforcement. Although wearing these appliances may cause some speech impairment in the first days, this impairment disappears with the adaptation of the tissues. Transparent aligners are often used as a removable reinforcement appliance in reinforcement therapy. These hard molded aligners, which surround the teeth all around, provide a great advantage as they do not cause aesthetic concerns. In order for these aligners to provide reinforcement, they should be used daily for the periods recommended by the dentist. The treatment applied as a fixed reinforcement appliance is realized by bonding wires of various thicknesses to the inner side of the front teeth. Keeping these wires in the mouth for as long as possible is very effective in ensuring the long-term success of the treatment. The duration of the reinforcement treatment may vary significantly depending on the age of the patient, the type and duration of the orthodontic treatment.
Why is Reinforcement Therapy Necessary After Orthodontic Treatment?With active treatment, it is not enough for the teeth to reach the position they should be in for the treatment to end. After the braces are removed after this period, reinforcement treatment is of great importance in order to maintain the new position of the teeth and prevent them from returning to their old position. With reinforcement appliances, the gums, bones and muscles can adapt to their new position.
When dental tissues are damaged due to caries formation or various traumas, it can cause symptoms such as pain or sensitivity. In addition to these symptoms, it can also cause a significant loss of aesthetic appearance. The treatment of tissue damage varies depending on the amount of tissue loss caused by the causative factor. In cases where the health of the nerve bundle inside the tooth can be preserved, conservative treatment (filling treatment) may be sufficient to restore the tooth to its healthy form. However, when the infection spreads to the nerve tissues, the infected nerve tissues must also be cleaned in order to maintain oral and dental health. In this case, endodontic treatment (root canal treatment) applications are an important aid in ensuring healing.
When is conservative treatment (filling treatment) performed?
Filling treatment is the process of removing the damaged areas on the tooth surface and filling the required areas with materials compatible with the tooth structure in cases where the tissue integrity of the tooth is impaired or in order to make arrangements in the aesthetic appearance. Filling treatment can be used to eliminate the loss of form in the tooth due to decay or fracture. In addition, in cases where there is a gap between the teeth, it may also be preferred for aesthetic regulation depending on the distance between the teeth.
How is conservative treatment (filling treatment) performed?
Filling treatment can be applied comfortably in a single session and depending on the depth of the filling, local anesthesia is given to the relevant area. There is no problem for the patient to eat after filling treatments where anesthesia is not required. However, if anesthesia is necessary, the intraoral tissues may be damaged during chewing functions due to the loss of sensation in the area. For this reason, it is necessary to wait for the effect of anesthesia to disappear in order to eat. Although minimal sensitivity may occur after filling, it usually disappears within a week.
What Should Be Considered After Conservative Treatment (Filling Treatment)?
Consumption of hard and crusted foods should be minimized as they may cause fractures in the fillings; problems such as nail biting and teeth clenching should be treated. Since acidic foods may cause deterioration in the structure of the filling over time, their consumption should be limited.
Tobacco products containing nicotine such as hookah and cigarettes should not be used. Regular routine oral care practices are sufficient for the maintenance of the filling treatment. There is no need for an extra oral care application.
When is endodontic treatment (root canal treatment) performed?
Due to various factors, the nerves in the tooth may lose their vitality and create a favorable environment for infection. In this case, root canal treatment is applied to protect the health of the tissues around the tooth and to relieve the pain caused by the tissues where the infection has spread. This application includes cleaning the nerves that have lost their vitality, disinfecting the tooth canals and filling them with special filling material. In teeth that need root canal treatment, the disease sometimes progresses without symptoms. In this case, damage to the tissues can be detected through radiographic examinations and can be included in the treatment plan. In cases where there are symptoms, spontaneous pain, hot-cold sensitivity, and discoloration of the teeth can be observed. The fact that the pain intensifies at night and cannot be controlled with the use of painkillers are important indicators of the presence of infection in the nerve tissues. If infections are not treated in the early period, they may cause abscess formation in the future.
How is Endodontic Treatment (Root Canal Treatment) Performed?
Root canal treatment is usually completed in two sessions. Depending on the spread of the infection, a single session may sometimes be sufficient, while severe infections may need to be treated in several sessions. Teeth whose nerve tissues have been removed are highly resistant to impacts before filling procedures are performed. For this reason, hard and sticky foods should be avoided until the treatment process is completed. After the treatment, mild pain and sensitivity may occur in the tooth until the tissues heal. This situation decreases and disappears within a few weeks.
What Should Be Considered After Endodontic Treatment (Root Canal Treatment)?
Teeth with root canal treatment may show less resistance to fracture than teeth with filling treatment. In cases where the loss of tooth tissue is minimal, the practices taken into consideration after filling treatment are also sufficient for the tooth treated with root canal treatment. However, in cases where tissue loss is greater, the resistance of the tooth tissue against fracture can be increased by applying a coating on the tooth.
It is the branch of science in which disorders involving soft and hard tissues in the mouth, jaw and facial region are healed by medical and operational methods. It includes diagnosis, diagnosis and application methods for the treatment of diseased or disease-causing tissue section removal, reshaping of defective tissues, placement of biomaterial to complete the tissue.
It works in problem areas such as congenital anomalies, traumas, inflammatory formations, tumoral formations, aesthetic anomalies, bone deficiencies, sinus-related problems, soft tissue deficiencies, salivary gland problems, pathological formations, impacted teeth, cysts, improper positioning of the jaws, tissue disorders as a result of trauma, soft tissue disorders.
Gum treatments are procedures that involve restoring the soft tissues surrounding the teeth and implants to their health in case of damage and organizing them for aesthetic purposes when they are healthy. Gum health is of great importance in order to maintain the health of the tissues in the mouth and to perform and maintain other dental treatments successfully. It is also very effective in maintaining general health. A disease of the gums can exacerbate existing heart disease, diabetes or respiratory diseases. Depending on the aggravation, these systemic diseases may become more difficult to treat.
How Does the Mechanism of Gum Disease Progress?
The healthy tissue of the gum is matte, pale pink in color and firm in appearance. If the health of the tissue deteriorates, bleeding, pain, swelling and recession can be observed in the gums. Teeth may become loose or displaced. Bad breath problem may occur. The main factor that causes diseases in the gums is various harmful bacteria that settle in that area. Due to inadequate or improper oral care, these bacteria adhere and accumulate in the relevant areas and form bacterial plaque on the tooth or implant surfaces. With the realization of this formation mechanism, inflammation may occur in the gums and destruction may occur in the surrounding bone. The progression of this gum disease can be accelerated due to systemic diseases such as smoking, diabetes or hereditary characteristics.
In Which Situations Are Gum Treatments Performed?
Gum treatments can be applied to heal damaged tissues, to increase the contribution of healthy tissue to oral functions or to regulate the aesthetic appearance. The most important point to be considered in order to ensure the effectiveness and continuity of the treatments is the correct oral care. Regular brushing and flossing with the correct technique is sufficient to ensure ideal oral care.
What are the Procedures Applied within the Scope of Gum Treatment?
Tartar Cleaning and Deep Cleaning: Dental calculus, also known as tartar, is plaque that adheres to the visible surface or roots of the tooth and hardens with the ions in the saliva. These formations play an important role in exacerbating gum diseases by causing plaque to accumulate more. Dental calculus and plaque attached to the visible surfaces of the teeth can be removed from the surface with special ultrasonic devices and cleaning tools. If these formations are observed on the tooth roots under the gums, a deep cleaning procedure called subgingival curettage is applied. Deep cleaning is performed without incision with appropriate cleaning tools if sufficient cleaning can be achieved. In rare cases where an incision is deemed necessary, surgical treatment can be performed under local anesthesia.
Gingivoplasty/Gingivectomy (Gingivoplasty/Gingivectomy): Gingivoplasty or gingivectomy can be performed for aesthetic appearance or to regulate limited intraoral functions. With these procedures, which can be performed painlessly with local anesthesia, treatment of gingival growth or recession, gingival aesthetics (pink aesthetics) applications or regulation of the connection areas of soft tissues can be performed. With gingival recession treatments, the sensitivity of the teeth can be reduced, and plaque accumulation can be minimized by facilitating the cleaning of the area by removing excess tissue from the area in gingival growths. With the regulation of soft tissue connection areas called frenulum, speech problems or gingival recession caused by these areas being larger than normal can be controlled and treated. The application of treatments performed with gingivectomy or gingivoplasty can usually be performed in a single session and the healing process can be completed in an average of 10-14 days.
Pediatric Dentistry (Pedodontics) is a branch of dentistry that follows the jaw facial development and oral dental health status of the individual from birth to adolescence, deals with the diagnosis and treatment of certain congenital or acquired problems due to factors such as caries and trauma, and also includes some preventive treatments applied to prevent the formation of these acquired problems. The treatments in this branch are undertaken by pedodontists, who are pediatric dentists. Pedodontists (Pediatric Dentists) are physicians who have specialized in pediatric dentistry for 3 years in addition to 5 years of dentistry education.
Which Treatments Are Performed Within the Scope of Pediatric Dentistry?
The main treatments that fall within the scope of Pediatric Dentistry can be listed as follows:
- Training on proper oral hygiene practice
- Diet and nutrition regulation
- Some applications such as fissure sealant, fluoride gel, fluoride varnish, which are protective measures against tooth decay
- Treatment of dental trauma
- Tooth extraction
- Placeholder application
- Practices to eliminate bad habits (such as finger sucking, nail biting, tongue thrusting)
- Fillings in deciduous teeth and newly erupted permanent teeth
- Root canal treatment
- Amputation
- Preventing the fear of dentists in children through the application of behavioral guidance techniques
- Carrying out the treatment of very young children, children with anxiety and fear that would prevent treatment, or disabled children under general anesthesia or sedation
Which Age Group of Patients Does Pediatric Dentistry Deal with?
Pediatric Dentistry treatments cover children between the ages of 0-15. This process includes the toothless period before the eruption of milk teeth, the period of eruption of milk teeth, the period when the eruption of milk teeth is completed, the mixed dentition period when permanent teeth begin to erupt and milk and permanent teeth are together in the mouth, and finally the period when permanent teeth are completed.
What is the Importance of Children’s Milk Teeth?
The greatest importance of milk teeth is to ensure nutrition and thus healthy growth and development of the child. They are also important for the development of speech and the regular arrangement of permanent teeth, but they are also extremely valuable for the psychological development of children as they provide aesthetics.
What is Early Childhood Caries, also known as Baby Bottle Caries?
Baby bottle caries is a rapidly progressive and widespread caries seen in children, especially in the upper front group of milk teeth. The biggest cause is inappropriate nutrition in children. The things to be done to prevent bottle caries can be listed as follows:
- Babies should stop the habit of using a bottle when falling asleep at night,
- After each feeding, the inside of the mouth should be cleaned with a clean cheesecloth or finger brushes, and if this is not possible, the baby should drink water,
- Sugar-containing foods such as molasses and honey should not be added to the bottle,
- The pacifier should not be soaked in foods containing sugar before use.
What are the preventive treatments available for children?
One of the most important aims of Pediatric Dentistry is to prevent future caries formation in children. For this purpose, treatments such as fissure sealants and fluoride application fall within the scope of preventive treatments.
Fissure Sealant Application
With fissure sealant application, the grooves on the teeth that the brush cannot reach and therefore cannot be cleaned completely are closed. In this way, the possibility of caries formation in the future is prevented. Fissure sealants applied between the ages of 6-7, when the first molars erupt, and between the ages of 11-13, when the second molars erupt, greatly prevent possible future caries formation.
Fluorine Application
Fluorine is incorporated into the structure of the teeth and increases their resistance to decay. It is a fast and simple treatment method that can be applied for the treatment of initial caries and prevention of its progression. The frequency of application is decided according to the child’s caries risk.