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 Best Dental Service in Dhaka 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 field
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.
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.
2. Dental Caries
PREVENTION AND CARE OF 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.
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
3. Aesthetic 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
4. Inlay or onlay
If the destruction of the decayed tooth is too great and it cannot be reconstructed directly in the mouth with a simple composite resin, the Dentist will make an inlay or onlay. Manufactured in the laboratory, it guarantees a solid and aesthetic reconstitution of the tooth.
After removing the decayed tissue from the tooth and preparing the tooth cleanly and evenly, the Dentist will make an impression of the teeth. He will then give them to his technician to “make” the resin or ceramic inlay/onlay. Once the inlay/onlay has been made, the dentist can glue the inlay/onlay to the tooth in another session.
Today, thanks to new technologies, and in particular intra-oral scanners and CAD/CAM, these reconstitutions can sometimes be performed in 1 session to increase your comfort and pleasure.
5. Dental Prosthesis
When a tooth has been extracted or devitalized, it must be replaced or consolidated. A tooth that is too fragile could break in the short or medium term and then have to be extracted. A dental crown or denture is a fixed prosthesis made of ceramic in the same shade as your other teeth. Crowns allow for the aesthetic and solid restoration of severely decayed or fractured teeth, teeth with endodontic treatment, or large defective fillings, but can also be placed on an implant.
The dentists of The Dental Excellence replace it with a bridge, which can be of 2 types:
1. Ceramo-metal: a framework (metal part) and on top of it is made the aesthetic ceramic part (tooth color).
2. Ceramic-ceramic: the entire crown or bridge is made of ceramic (no more metal, aesthetic and biocompatible
Ceramic-ceramic crown (metal-free)
Zirconium crown
As an alternative to the fixed prosthesis, the dentist can also make a partial or total removable prosthesis. There are two types of removable prosthesis:
1. The removable partial denture is held in place by hooks that grip onto the neighboring teeth. They can replace several missing teeth.
2. The total prosthesis or denture, which replaces all the teeth. While removable dentures have the advantage of cost, they have disadvantages: they are mobile, bulky, and often difficult for patients to accept. Finally, when a tooth has been broken or poses an aesthetic problem (colour, shape, position…) the Dentists at The Dental Excellence can proceed with aesthetic operations such as veneers or whitening.
6. Root Canal Treatment
Dental root canal treatment, also called endodontics, is a specialty of Dental Medicine that consists of treating diseases of the dental pulp.
Diseases of the dental pulp are manifested either by infection or inflammation of the root canal system that contains the pulp. In popular parlance, it’s the famous toothache. In order to eliminate this inflammation or infection, the Dentist therefore performs an endodontic treatment, i.e. a devitalisation under local anaesthesia.
It starts by removing all traces of infection inside the tooth root by mechanical and chemical (medication) action. Then, once all the root canals of the tooth are clean, he proceeds to fill them with biocompatible and waterproof products.
THE CARE
The tooth is considered dead, but treatment of the root allows a crown or an onlay to be placed on the tooth without the need for an implant.
7. Anxiety Management
DON’T BE AFRAID OF THE DENTIST ANYMORE
Who doesn’t know that little pinch in the stomach just before going to the dentist? About 30% of the population says they feel apprehensive before going to the dentist. Traumatic experiences in childhood are sometimes at the root of this phobia, which can manifest itself through heart rate increases, sweating, and high heart rate, but also through insomnia the night before the appointment. The Dental Excellence will help you to manage your anxiety before each appointment.
Dentist phobia is often a primitive, inexplicable fear. The fact that today’s dentist “doesn’t hurt anymore” is often not very helpful for people affected by this phenomenon, who are often not taken seriously with their anxiety.
The vehement refusal, linked to this apprehension, to go to the dentist can have catastrophic consequences on the dental condition as well as on the general physical and psychic state.
Gentle and stress-free treatments
Gentle, pain-free treatment should be a matter of course today, and not only for anxious patients.
The effectiveness of local anaesthesia has progressed so much that dental treatments, such as more extensive procedures, can be performed absolutely painlessly. An anaesthesia technique and equipment adapted to each situation, allows for rapid and satisfactory results in all cases, minimising the pain of needle insertion as much as possible.
Our staff are trained to perform “gentle” treatments and are sensitive enough to recognize patients’ needs in time, for example when the patient wants to take a break during treatment or rinse their mouth.
Drug Sedation
Other drug-based sedative procedures have become established in dentistry, offering a proven alternative to laughing gas. These are generally active ingredients from the benzodiazepine or antihistamine groups, which have been used for decades as tranquilizers. The best-known preparation is :
· Dormicum (active ingredient: Midazolam)
Midazolam, which is easier to control and metabolize within a few hours, has become increasingly popular in recent years. In our practice, we have been treating anxious patients (dental phobia / oral phobia) with midazolam sedation for many years, although in some cases we also administer Nalbuphine hydrochloride.
Midazolam initially causes a calming of anxiety (anxiolysis) accompanied by a pronounced relaxation of the muscles and a slight euphoric effect. A higher dosage leads to drowsiness: the patient is no longer aware of what is going on around him or her and hardly reacts when spoken to. In this phase, the treatment goes smoothly.
The disadvantage of this method is that, due to the residual effect (hang-over) of the drug, patients always need an accompanying person (even when using public transport) to be able to go home. Driving is allowed only 12 hours after the procedure.
Security
Sedatives, which have been used for decades, are very safe and have few side effects, provided they are applied appropriately and by an experienced practitioner. The correct dosage is not easy to achieve, as it must be adapted to each individual patient. Some patients need a very high dose to achieve sufficient sedation, while for others half is enough to put them into a deep sleep.
8. Tooth wear and bruxism
Treatment of cases of severe tooth wear due to bruxism, acid attacks or overly vigorous brushing.
Bruxism is an aimless unconscious movement of the braces, either by squeezing or by lateral movements, then called teeth grinding.
What is dental abfraction?
Tooth abfraction is defined as tooth wear caused by a factor outside the mouth. This tooth wear occurs at the neck of the teeth, close to the gum, and eventually forms a concavity inside the tooth. Untreated, tooth abfraction exposes the tooth nerve and subsequently causes infection, abscess and tooth sensitivity.
The simplest solution for correcting tooth abfraction is to cover the wear with an composite filling.
What is dental attrition?
Tooth attrition is a more pronounced and widespread wear of teeth, affecting both upper and lower teeth. It affects the chewing surface of the teeth (top) and causes a progressive shortening of the teeth.
The consequences of dental attrition:
· dental sensitivity to cold and air;
· Unsightly appearance of shortened teeth;
· dental cracks and fractures;
· infection and dental abscess caused by nerve exposure;
· Difficulty chewing more solid foods.
The primary cause of dental attrition is bruxism (teeth grinding and clenching). The treatment of dental attrition is more complex: it is possible to cover the worn-out area of the tooth with a composite or, better yet, a custom-made ceramic filling. However, since wear is widespread in the mouth, worn teeth cannot be covered without a thorough analysis of the occlusion (i.e. how the teeth come into contact when we close the jaw). Without this analysis, there is a risk of unbalancing the jaw and causing a deformity of the jaw. This is what we call an occlusion balance. In addition, once the teeth have been restored, it is recommended that they be protected against a recurrence of dental attrition by wearing an occlusal splint or night guard.
9.TMJ Disorder
TEMPOROMANDIBULAR JOINT DYSFUNCTION
Having a cracked jaw: this happens relatively frequently. TMJ disorders, for temporomandibular joints, are indeed common, and their causes are often multifactorial.
A temporomandibular joint dysfunction is a set of symptoms that can manifest themselves in a very variable way, associating one or more of the following manifestations:
· Painful manifestations (ear pain, headaches in the temples, jaw pain).
· Articular manifestations: articular noises (clicks when opening the mouth, squeaks), painful or not painful limitation of the mouth opening, discomfort to chewing and feeding, feeling of articular instability, blockage with mouth closed or on the contrary blockage with mouth wide open.
· Other manifestations such as ringing in the ears (tinnitus) or neck pain.
TMJ disorder: what causes it?
The various mechanisms that trigger temporomandibular joint dysfunction are complex, but there are a variety of risk factors, often interrelated, that are known to cause this dysfunction.
1. Abnormalities of the dental joint (the way the upper and lower jaws articulate with each other).
2. Trauma and fractures of the face (especially the jaw), the skull or the cervical vertebrae. They can lead to lesions of the temporomandibular joint.
3. Stressful life events, high levels of anxiety seem to be able to aggravate the symptoms.
4. Parafunctions are unconscious or unconscious hyperactivity of the jaw muscles sometimes associated with tooth wear and night-time grinding (this is the case with bruxism). They are often related to the stress of everyday life and to abnormalities of the dental joint.
5. Hyperlaxity is due to the presence of ligaments that are too loose, too distended. It is common in young women. It results in a maximum opening of the mouth that is too large. It favours blockages with a wide open mouth (dislocation of the jaw).
6. Rheumatic disease can occur in the jaw joint.
10. Tooth Whitening
Tooth whitening is a process that aims to lighten the staining of enamel and dentin by means of a gel based on hydrogen peroxide (hydrogen peroxide).
However, no whitening treatment should be carried out without a prior oral check-up, during which your dentist will make sure that there are no contraindications (untreated caries, devitalized teeth, weak enamel, gum irritation, etc.).
Bleaching is a technique that lightens the internal colour of teeth to give them a more attractive shine and brilliance.
TOOTH WHITENING Dhaka : IMPORTANT INFORMATION BEFORE MAKING AN APPOINTMENT
Results may vary depending on the nature of my enamel and my oral hygiene habits. Bleaching is not intended to lighten crowns, veneers or any other dental restorations, and therefore, these restorations may show a shift in shade from natural teeth following bleaching.
Pain – Sensitivity: Certain conditions can increase or prolong the sensitivity that normally occurs in the first 24 hours following the start of bleaching, including dentine hypersensitivity, gum recession, dental fissures, caries, and defective fillings.
11. SMILE TRANSFORMATION:
First session: The practitioner performs a pellicular preparation on the external surface of the patient’s teeth, removing only a tiny layer of enamel (0.2 to 0.5 mm). The procedure is often painless.
An impression of the prepared teeth is taken and sent to the laboratory with instructions for the desired shade and shape.
Second session: The ceramic veneers developed a few days later are tried and then glued to the teeth enamel. The practitioner will be able to play again on the shade at this time using more or less light-coloured bonding resins.
This technique is completely reliable, thanks to the use of adhesives that are very resistant over time and to the ceramic material whose vitrified surface allows the colour to be permanently maintained over the years.
Dental implants
The introduction of dental implants began in the late 1960s on a confidential basis, but slowly became widespread in the 1980s.
It is therefore a safe technique because the clinical hindsight is important. However, it is also an innovative technique because it is regularly improved, whether in terms of the chronology of the treatment, the materials used, the shortening of healing times or the number of operations required.
The basic principle of implantology is to replace a dental root with an artificial titanium root, which will serve as a support to hold an artificial tooth, most often made of ceramic.
Thus, whatever the reason for which you lost your tooth (decay, tooth loosening, fracture in an accident), you will be able to recover both the function and the aesthetics of your natural tooth.
Why replace his missing teeth?
YOUR TEETH FORM AN INTEGRAL WHOLE
Your 32 teeth form a stable unit, each tooth is held in place by leaning against its neighbor to the side and opposite.
When a tooth is missing, the neighboring teeth will try to fill the space left free. In a few months or years, but inexorably, they will move, leaving enough space on either side of each tooth to hold food waste that will cause the bacteria that cause cavities to build up. That’s why teeth that are close to toothless are often decayed.
It is imperative to replace missing teeth before this unavoidable process is even started.
The benefits you can derive from it are multiple:
– Comfort first: Implant Bridge are mostly fixed, you can eat on them any food just like your natural teeth. Implants can sometimes be placed simply to stabilize a removable appliance (a denture), and the comfort also increases considerably compared to a mobile prosthesis.
– Aesthetically, a tooth on an implant is not different from a natural tooth. It is the perfect replica of your tooth and will blend into your smile as if nothing had happened.
– Longevity: a dental implant cannot have cavities, it will not need to be devitalized, and it is much stronger than a natural tooth. It can therefore last a very long time if you take good care of it.
– From a biological and ecological point of view, your dental implant, by being independent of the natural teeth, will not weaken them but on the contrary, will help to preserve them for longer: your chewing forces will be spread over a higher number of teeth, so they will work less.
The operating protocol may
include a reduced or increased number of sessions. This is determined after a
detailed oral and radiological examination, with analysis of residual bone
volume and gum status. In the best case, an immediate
extraction/implantation/esthetics can be performed: in this case, in the same
session we can remove the damaged tooth, place the implant and make a
provisional crown. In other cases the treatment will require several successive
operations.
GUM GRAFTS
Overly vigorous brushing, malocclusion, bruxism or sometimes orthodontic treatment can cause gum retraction. At an advanced stage, these can cause pain, aesthetic discomfort (visually long tooth), or even endanger the preservation of the tooth on the jaw. It is then possible to perform a gingival graft, which consists of removing a small amount of gum from the palate under local anesthesia and adding it to the area where it has disappeared. In the area of the palate where the gum has been removed, the gum will grow back on its own within a few weeks. These techniques allow a longer conservation of the teeth and sometimes an improvement of the aesthetic aspect of the gums.
Bone grafting & Regeneration
In some cases, it is not possible to place a dental implant directly due to bone insufficiency.
In these cases, a pre-implant (before implant placement) or per-implant (at the same time as implant placement) bone grafting must be performed.>
WHEN SHOULD A BONE GRAFT BE PERFORMED?
Around the dental implant (screw form) there must be enough bone to anchor it firmly in the jaw. Unfortunately, sometimes the jawbone is insufficient to ensure the correct placement of the implant.
This is why it is sometimes necessary to proceed with a bone reconstruction in height and/or thickness. The technical solutions that can be applied to compensate for the lack of bone are different depending on the nature of the lack (height and/or thickness) and its location in the oral cavity (upper or lower jaw, anterior or posterior sector).
When bone failure is significant, the reconstruction procedure must precede implant placement. A waiting period of 4 to 6 months is then necessary before implant placement.
When the bone insufficiency is moderate, reconstruction and implant placement can be performed at the same time.
SINUS FLOOR ELEVATION
For the placement of a dental implant, an alveolar ridge height of 8 to 10 mm is required. In the upper jaw, this height may be insufficient, in which case a sinus floor design is required.
A small opening is made in the ridge, and a bone substitute is gently inserted under the sinus
When the height is sufficient, the implants can be placed
After 4 to 6 months, the sinus is pushed back, the height of the jawbone has increased, and bone has re-formed around the implants. The teeth can now be made to measure and fixed to the implant
Extraction of wisdom teeth
The third molars, commonly called “wisdom teeth”, appear as early as adolescence. Because they have less space in the dental arch than other teeth, they are more at risk of complications, so wisdom teeth sometimes need to be extracted.
They may be either included: not visible in the oral cavity, covered by gum and bone or semi-included: partially visible.
WHY AND WHEN TO REMOVE A WISDOM TOOTH?
Wisdom teeth need to be extracted when there is no room for them to come out normally. Cases include pericoronitis: inflammation of the gum around the partially erupted tooth if there is bone loss or decay on the adjacent tooth. The following symptoms may be experienced: pain in the posterior region of the oral cavity swelling, presence of pus, decreased mouth opening, fever.
CHILDREN DENTAL CARE
Children’s dental caries
Tooth decay, also known as early childhood tooth decay, is an aggressive infection of the baby teeth that begins just after tooth eruption in children aged 0 to 5 years.
Without proper oral hygiene, cavities go unnoticed because they appear as a white line near the gums and are often covered with plaque.
THE BAD HABITS THAT ARE RESPONSIBLE FOR THIS DISEASE:
– Allow the child to sleep with a bottle containing milk or sweetened drinks.
– Breastfeeding on demand at night
– Give a diet high in sugar (> 3 times a day)
– No tooth brushing or unsupervised brushing. As a guideline, until a child writes his or her name correctly, he or she does not know how to brush effectively.
– Do not use fluoride toothpaste
– Encourage oral bacteria transmission from mother to child by kissing her child on the mouth or eating from the same plate.
HOW TO AVOID CAVITIES IN CHILDREN?
Certain rules should be followed to prevent the appearance of cavities:
Practice good oral hygiene
Choosing a toothbrush and toothpaste adapted to your child’s age.
Limit sugar
Make regular monitoring visits
A first check-up with the dentist and/or a dental hygienist is recommended from the age of 2 years. Thereafter, an annual control is essential but if necessary, closer visits may be indicated.