GENERAL DENTISTRY

Our adult general dentistry care

The dentists at THE DENTAL EXCELLENCE are able to provide all dental care, from the simplest to the most complex for both adults and children.

The Dentist ensures the prevention, diagnosis, and treatment of all congenital or acquired anomalies and diseases, of the mouth, teeth, jaws, and related tissues. He or she is often referred to as a “dentist” for convenience (adult general dentistry).

The team of dentists at THE DENTAL EXCELLENCE is mostly made up of specialist dentists who are able to treat all of your oral problems in a professional manner. But for certain specific interventions, they can rely on specialists, who have more advanced training in certain fields:

DENTAL CARE AND HYGIENE FOR ADULTS AND CHILDREN

1. Dental Assistant

The dental assistant will scrape, polish, and fluoride your teeth and screen for dental problems if necessary (x-rays). It also customizes the instructions for a good brushing technique at home, as well as the means of interdental cleaning. The assistant thus contributes to your well-being through the prevention of periodontal and carious diseases.

Scaling is the removal by
ultrasonic or manual means of tartar that is deposited on the teeth. In case of dental
hypersensitivity, local anesthesia can be used to make the procedure gentle and
pleasant.

Polishing makes the surface
of the teeth smoother, which slows down the reappearance of tartar. It
eliminates superficial staining from coffee or tobacco: you will be happy to
regain white teeth and a radiant smile.

Fluoridation remineralizes
tooth enamel and helps to prevent caries. For your comfort, it also reduces any
temporary tooth sensitivity that may occur after scaling.

WHY IS SHE IMPORTANT TO YOUR HEALTH?

Dental Hygiene

Oral hygiene is a set of practices to remove the plaque that
permanently forms on the surface of the teeth.

The removal of plaque
prevents periodontal disease. Indeed, bacteria are responsible for gum
irritation: gingivitis. Gums become red, swollen, or ulcerated. They bleed
profusely at the slightest mechanical stress via a toothbrush, brushes, or
dental floss. Caused by bacteria under the gums, this situation can degenerate
into periodontitis, leading to the
appearance of tooth mobility due to bone loss and subsequent tooth loss.

In addition, a number of bacteria present in dental plaque
convert sugars into lactic acid. The action of this acid on the dental enamel
leads to demineralization of the tooth and the appearance of a cavity: caries.
Dental tartar, which consists of mineralized dental plaque, can no longer be
removed by simple brushing. It has to be removed at the dentist by scaling.

To avoid gum problems or
cavities, the dentist/dental hygienist will remove the above and below the gum
line (scaling), polish and fluoride your teeth, and screen for dental problems
if necessary (x-rays). It also customizes the instructions for a good brushing
technique at home, as well as the means of interdental cleaning. The assistant
thus contributes to your well-being through the prevention of periodontal and
carious diseases.

1.            DENTAL Anesthesia

ADULT DENTAL ANESTHESIA

Dental anesthesia

Dental pain can sometimes be severe and difficult for patients to manage. The fear of pain can sometimes be even stronger, and 54% of patients experience feelings ranging from simple apprehension to deep phobia. Today we have a complete solution (dental anesthesia, conscious sedation), allowing us to act both in the prevention and treatment of pain and anxiety.

1. Drug
treatments

A.
PAINKILLERS

For
mild pain, simple painkillers such as paracetamol are usually sufficient. The effective dosage is 1000 mg every 6 hours, if there are no contraindications.

B.
ANTI-INFLAMMATORY DRUGS

For more severe pain, or if paracetamol is ineffective, the prescription of anti-inflammatory drugs such as ibuprofen or mefenamic acid often gives better results than paracetamol. It also helps to reduce post-operative side effects (oedema or trismus), although these depend to a large extent on the type and duration of the operation.

C. ANXIOLYTICS

Stress and fatigue are aggravating factors for many patients. The goal is to obtain the physical and psychological comfort of the patient in order to facilitate the realization of
the care.
The molecule of choice will be nalbuphine hydrochloride or a benzodiazepine-like drug. The prescription of anxiolytics in anxious patients allows a better efficiency of painkillers and anti-inflammatory drugs, as well as anesthesia, which allows for the reduction of the postoperative effects. The disadvantage of anxiolytics is the duration of their action. They require to be accompanied and it is strongly advised not to drive a vehicle on the day of the operation.

2. Local anaesthetics

To avoid feeling pain
during an operation, the dentist injects a solution that stops all pain. If today many interventions can be done without anaesthesia thanks to the progress of the technique, some patients prefer to have systematic anaesthesia for their comfort during the intervention. The techniques differ depending on the tooth treated and the type of procedure, with variable side
effects. In any case, these are rare and temporary (hematoma, numbness of the cheek and lip for a few hours). The sensation of the injection is also minimized thanks to the use of specific equipment. In particular, we use a pre-anesthetic gel to massage the gums prior to the injection.

DENTIST WITH LOCAL ANESTHESIA

A local anaesthetic stops the excitability of sensitive nerve fibers, in a temporary and reversible way. It, therefore, allows the pain to be inhibited for a given time. In the formula used, we find the local anesthetic: it is one of the molecules ending with the suffix “-caine” like lidocaine or Articaine, more modern. In addition to the anaesthetic, there is adrenaline for its vaso-constrictor effect, which will reduce bleeding, increase the concentration of the product locally and prevent its spread to neighboring areas, thus allowing a longer time of action.

Dental surgeons are trained to know exactly where to prick for each type of dental procedure, because it is a matter of more or less localized numbness, and of numbing this or that type of nerve.

METHODS AND SUPPORT FOR A BETTER EXPERIENCE OF THE INTERVENTION

Methods have been worked on to accompany the patient both in his anxiety about the injection but also in the pain it may cause:

·         Pre-anaesthesia or surface anaesthesia

It is indicated for children and very anxious patients. The mucous membrane is anaesthetised before the injection, either by using an anaesthetic spray or gel at the site where the injection is to be made or by using a cryogenic spray (which causes intense localized cold) to block sensitive receptors in the mucous membrane.

·         Osteo-central anesthesia (Quicksleeper)

It is an interesting alternative. Based on the injection of the anaesthetic into the cancellous bone surrounding the tooth, it uses the blood flow within the Volkman canals to diffuse both mesially and distally. Because of the low diffusion to the mucous membranes, soft tissue anesthesia is very rarely present, which avoids disturbing younger children and removes the risk of self-biting so common with infiltration techniques. In children, the bone cortex is thin and its passage is done by simple pressure and without pain.

3. Conscious sedation techniques

A. MEOPA OR NITROUS OXIDE

Nitrous oxide is used in anxious patients for its analgesic, sedative and anesthetic properties.

It is effective on small pains (thanks to it, one does not feel the pain of an injection, or the sensitivities related to a scaling). It allows the patient to relax, and its amnesia effect allows not to remember the intervention.

A one-hour session often seems to last between 20 and 30 minutes.

The advantage of MEOPA is its rapidity of action, it acts after 2 to 3 minutes of inhalation. In the same way, its effect dissipates quickly and the patient can leave alone, driving his vehicle if necessary.

Possible side effects are nausea/vomiting, dizziness, and excitement.

B. INTRAVENOUS SEDATION

Intravenous conscious sedation is a technique consisting of the injection of one or more drugs into the vein to reduce the consciousness of the patient undergoing a dental procedure. The patient remains conscious, responding to stimuli and questions from the dentist.

The advantages of intravenous sedation are its effectiveness (over 99.99% success rate) and safety. The amnesia it provides the patient is real, and the recovery time is shorter than with oral anxiolytics, but the patient must be accompanied.

The disadvantages are the need for an infusion, which may be difficult for some patients to accept, and the need for more monitoring than with other methods.

4. General anaesthesia in dental practice

DENTAL CARE FOR PEOPLE WITH DISABILITIES

General anesthesia is possible in the case of major surgery, a long operation, or for disabled patients or those with certain pathologies.

DENTIST WITH GENERAL ANESTHESIA

The anaesthesia is performed by a physician-anaesthetist, but the procedure is ambulatory, i.e. it does not require an overnight stay.

This type of anesthesia renders the patient unconscious and insensitive to pain. The procedure can last up to 2 hours for children and 4 hours for adults. A rest period of about 45 minutes follows. The patient must always be accompanied, and remain so throughout the day.

The risks associated with general anaesthesia are nausea, headaches, momentary disorientation, and haematomas at the injection site. Important decisions (contracts to be signed, legal decisions) should be avoided for 24 hours. In rare cases, general anaesthesia can be followed by serious, life-threatening complications. This is why they are carried out under the supervision of a resuscitating anaesthetist, with monitoring of the patient.

1.           Dental Caries

PREVENTION AND CARE OF DENTAL CARIES

Dental caries

Cariology is a specialty of Dental Medicine that consists of the prevention and care of dental caries. The Dentists of THE DENTAL EXCELLENCE are able to treat all cases of caries in adults and children.

They will ensure that their presence is detected as quickly as possible through annual clinical and radiological checks, and will also provide you with valuable advice on how to prevent their appearance, in collaboration with the Dental Hygienist.

THE CARE

To treat a cavity, the dentist first removes the affected tooth tissue. It then replaces them with the latest technology sealing materials called Composite Resins. These resins can restore the original shape and shade

Composite resin reconstitution following a cavity under an old gold filling

 This composite resin technique can also be applied when a tooth has been fractured as a result of an accident. It can also be used to change old amalgam fillings that are poorly adapted or not aesthetically pleasing

Composite reconstruction after trauma