Dental Treatments

What is dental treatment?

Dental treatments, or ‘dental care,’ are a field encompassing a variety of procedures aimed at maintaining oral health, diagnosing, treating, and managing oral and dental diseases and conditions.

 

Types of dental treatments :

Preventive treatments:

Preventive dental treatment consists of a variety of procedures aimed at maintaining people's oral health. While aiming to diagnose, treat, and manage oral health and dental diseases and conditions, the main objectives of prevention are to eliminate or prevent diseases. Tooth decay and periodontal diseases are largely preventable. Preventive care is an important part of overall health and well-being.

Preventive dental treatment strategies and practices include:

Daily oral hygiene:

Daily brushing and flossing are vital for oral health and quality of life.

Fluoride applications:

The use of fluoride helps to slow the formation of caries and prevent new lesions. Fluoride can be used in various forms, such as fluoridated toothpastes, mouthwashes, gels, and supplements. The use of fluoride is very important for caries control, especially in patients with low saliva secretion.

Fissure sealants:

Fissure sealants can be applied to reduce the risk of caries.

Nutritional management:

To reduce the risk of caries, the consumption of foods and beverages with high sugar content should be reduced. As some medical conditions or medications may increase the risk of caries, dietary strategies can be adjusted accordingly.

Regular dental checkups and examinations:

Regular dental visits are the most important part of preventive care. Visual and tactile dental visits should be performed at least twice a year.

Professional cleaning:

Professional dental cleanings are part of preventive care. Healthy gums can prevent bleeding and tooth loss.

Dry mouth management:

Drugs or conditions that reduce salivation can cause dry mouth (xerostomia). Dry mouth increases the risk of caries and infection. Artificial saliva, sugar-free gum, special toothpastes, and remineralizing solutions can be used.

Antiseptic mouthwashes:

Antiseptic mouthwashes may be helpful in the control of gingivitis and periodontal disease. They may be particularly useful in immunocompromised patients or prior to certain procedures.

Infection prevention:

Maintenance of oral hygiene and, in some cases (e.g., in immunocompromised patients or before certain surgical procedures), antibiotic prophylaxis or treatment may be used to prevent infections.

 

Restorative procedures:

Restorative dental treatments are methods used to repair decayed, broken, worn, or missing tooth structures and restore their function. These treatments aim to preserve the natural appearance and function of the tooth. It is the treatment method used in the following cases:

• Deep tooth decay
• Broken or cracked teeth
• Falling or abrasion of backfill
• Renewal of old and inadequate embankments
• Strengthening the tooth after root canal treatment

 

Dental fillings (composite, amalgam, porcelain, glass ionomer):

It is the process of cleaning tooth decay and filling the cavity.

Composite (white) filling:

It consists of resin and glass particles. It is used in front and back teeth with small- to medium-sized caries. Natural tooth color aesthetics can be applied in the same session. It is not as durable as amalgam; it can be broken, especially in large fillings.

Amalgam (silver) filling:

It consists of a mixture of mercury, silver, tin, and copper. It is preferred for large fillings in molar teeth. It is long-lasting (15-20 years), durable, and economical. It is not aesthetic, may be incompatible with tooth color, and may cause allergies in some patients.

Porcelain (inlay/onlay) filling:

 These are porcelain fillings specially prepared in the laboratory. It is used as an alternative to filling in large caries. Aesthetic, durable, compatible with tooth structure. More expensive, completed in two sessions.

Glass ionomer filling:

It is a mixture of acrylic and glass and releases fluoride. It is used in milk teeth and root surface caries. Not as durable as composite.

Post (pin) and core filling:

It is used to provide support for weak teeth that have undergone root canal treatment.

Post (Pinye) application:

It is a metal or fiber rod placed in the root of the tooth and prevents the tooth from breaking.

Core filling:

It is the filling made on the post that provides preparation for the coating.

Crowns:

These are prostheses placed over the tooth to protect broken, decayed, or weakened teeth.

Metal-supported porcelain crown:

The substructure is metal and covered with porcelain. It is durable and economical. The metal line may be visible in gum recession.

Zirconium crown:

It contains completely zirconium or a zirconium substructure and porcelain. It is aesthetic, light transmittance is similar to natural teeth, and it does not cause metal allergy. It is more expensive than porcelain.

Full ceramic (empress) crown:

It is completely porcelain and metal-free. Ideal for front teeth. May be fragile in molars.

Metal crown (gold or nickel-chrome):

Completely metal. It is not aesthetic and is usually used in the back teeth. It is very durable and long-lasting.

Endodontic treatments (root canal treatment):

Endodontics is the branch of dentistry that deals with the pulp (nerve, vascular, and connective tissue) inside the tooth. Root canal treatment and related procedures are applied to save teeth damaged by decay, trauma, or infection.

Root canal treatment :

It is the process of removing the infected or damaged pulp tissue inside the tooth and cleaning and filling the root canals.

Application areas of root canal treatment:

• Deep bruises
• Tooth fractures
• Repeated dental treatments
• Pain, abscess or swelling in the tooth
• Teeth that have lost their vitality after trauma

Root canal treatment application method:

• The tooth is anesthetized and isolated with a rubber dam.
• The pulp chamber is accessed from the top of the tooth with special instruments.
• Infected tissue is removed, and canals are widened and disinfected.
• The canal is filled with gutta-percha (natural rubber) and special filling material.
• The tooth is restored and, if necessary, crowned.

Root canal retreatment

In unsuccessful root canal treatments, if there is a cyst/infection at the root tip, re-intervention is performed.

Retreatment application areas:

• Incomplete duct cleaning
• Cavity in channel filling
• New caries or leakage
• Broken tooth root

Retreatment application method:

• Old filling and infected tissue are removed.
• Canals are cleaned and filled again.
• Surgical intervention (apectectomy) is performed if necessary.

Surgical endodontics (apectectomy):

Surgical removal of infection at the root tip.

Application areas:

• Abscess that does not heal despite root canal treatment
• Cyst/granuloma at the root tip
• Broken root tip

Method of application:

• The gingiva is opened, and the root tip and surrounding tissue are cleaned.
• The root tip is cut, and retro filling is applied.
• Suture is placed and removed after 1 week.

Vital pulp treatments (pulp protection):

Protective methods are applied while the pulp is still alive.

Direct pulp coating:

 If the pulp is opened while cleaning deep caries, a special drug (calcium hydroxide/MTA) is placed on it. It is intended to heal the pulp and keep it alive.

Partial pulpectomy:

 Only the infected pulp part is removed; the healthy part is preserved. It is applied to children's deciduous teeth or young permanent teeth.

Revascularization (in young permanent teeth):

In young teeth that have not yet completed root development, it is the method that allows the root to be completed when the pulp dies.

• Root canals are disinfected.
• Root cells are encouraged to come into the root by bleeding from the root tip.
• The canal is sealed with calcium hydroxide or MTA.

Dentures:

Dentures are used to replace missing teeth and restore chewing, speech, and aesthetic functions. Dentures are designed as fixed or removable, depending on the need.

Fixed dentures (non-removable):

Permanently attached to teeth or implants, not removable by the patient.

Dental bridge :

The teeth next to the missing tooth are reduced in size, and a dental bridge is cemented over it.

• Metal-backed porcelain (durable)
• Zirconium (aesthetic and strong)
• Full ceramic (ideal for front teeth)

Fixed dentures on implant:

• Single tooth implant: The missing tooth is replaced with a screw and a crown.
• Implant-supported bridge: If more than one tooth is missing, a bridge is built over the implants.
• All-on-4 and All-on-6: Fixed prosthesis attached to 4-6 implants in complete edentulism.

Removable dentures (removable):

These are prostheses that can be removed and cleaned by the patient.

Total dentures:

Suitable for those who are missing all their teeth. Fits the shape of the palate; adhesive may be required

Partial dentures (partial dentures):

• For those who are missing some teeth.
• Hooked dentures: Attaches to existing teeth with metal clasps.
• Precision-retained dentures: Uses special attachments instead of hooks (more aesthetic).

Implant-supported removable dentures:

It is a removable prosthesis that sits on 2-4 implants, slows bone resorption, and holds better.

Hybrid dentures:

It is a mixture of fixed and removable prostheses. Removable bridges on implants (snap-in prosthesis) are an example of this.

Temporary dentures:

Flipper dentures: It is a lightweight, single-tooth prosthesis used in emergencies.

Temporary dentures after implant: Used during the healing process.

 

Orthodontic treatments:  

Orthodontics is a branch of dentistry that corrects dental crowding, bite disorders, and jaw incompatibilities. It can be applied in both children and adults.

Orthodontic treatment is applied to treat the following problems:

• Tooth crowding
• Malocclusion (bite disorders: open bite, deep bite, crossbite)
• Jaw stenosis (narrow upper jaw, lower jaw advancement/regression)
• Functional problems (chewing, speech difficulty)
• Aesthetic concerns

Types of orthodontic treatment:

Fixed orthodontic treatments (braces):

Metal braces (traditional braces):

• Made of stainless steel
• Attached to the teeth with rubber ligatures (coloured bands)
• Most economical option.
• The risk of breakage is low. However, its appearance is very prominent and may cause irritation in the mouth

Ceramic (porcelain) braces:

• Less visible because they are tooth-coloured
• Not as durable as metal braces.
• It provides an aesthetic appearance, but it is more expensive, and there is a risk of staining.

Lingual braces (invisible braces):

• Attached to the back surface of the teeth
• Invisible from the outside
• May temporarily affect speech
• Difficult to clean.

Self-ligating brackets (self-ligating):

• No rubber ligature is used.
• It causes less pain because there is less friction.
• Treatment time is shorter and more comfortable.

Movable orthodontic treatments:

Transparent aligners (Invisalign, etc.):

• They are transparent aligners that can be inserted and removed.
• Computer-aided design (3D planning)
• Almost invisible.
• Can be removed while eating
• More comfortable than metal brackets.
• Can only be applied in mild to moderate cases
• Must be worn 20-22 hours a day.

Functional appliances:

• Used to guide the development of the jaw
• Usually applied in growing children

Periodontal (gum) treatments:

Periodontology is the branch of dentistry that deals with the gums and bone tissues that support the teeth. Gum diseases (periodontal diseases) can be controlled with early diagnosis and correct treatment.

Stages of gum diseases:

Gingivitis (initial gingivitis):

Symptoms:

• Redness of the gums
• Swelling and tenderness
• Bleeding when brushing

Treatment method:

• Professional teeth cleaning
• Good oral hygiene education
• Antiseptic mouthwashes

Periodontitis (advanced gum disease):

Symptoms:

• Gum recession
• Loose teeth
• Bad breath (halitosis)
• Formation of pockets between teeth and gums

Treatment method:

• Deep cleaning (curettage)
• Antibiotic treatment
• Surgical interventions

Periodontal treatment methods:

Non-surgical treatments:

• Professional scaling (detertraj)
• Root surface smoothing (curettage)
• Local antibiotic applications

Surgical treatments:

• Flap operation (gingivectomy)
• Regenerative surgery (bone grafting, tissue-stimulating proteins (emdogain), guide tissue regeneration)
• Mucogingival surgery (gingival grafting, vestibular deepening, frenectomy)

Advanced periodontal treatments:

• Laser-assisted periodontal treatment
• PRF (platelet-rich fibrin) applications

 

Surgical dental treatments:

Simple tooth extraction:

• Severely decayed teeth
• Fractured and untreatable teeth
• Dangling teeth due to periodontal disease

Surgical tooth extraction (impacted teeth):

• Impacted wisdom teeth
• Partially erupted canines
• Fractured root teeth

Bone graft (bone powder) applications:

• Bone deficiency before implant
• Bone preservation after tooth extraction
• Periodontal bone loss

Aesthetic dental treatments:

Cosmetic dental treatments cover a variety of dental procedures to improve the appearance of teeth and provide a more beautiful smile. The most common aesthetic dental treatments are

Bleaching:

Professional clinical treatments or home whitening kits are used to lighten the color of teeth.

Porcelain veneers:

Thin sheets of porcelain are bonded to the front surface of teeth to correct color, shape, and size. Zirconium veneers are a more durable and natural-looking alternative.

Bonding (aesthetic correction with composite filling):

Cracks, discoloration, or deformities are corrected by applying composite resin to the teeth.

Gum aesthetics (gingivoplasty):

Pink aesthetics: A more symmetrical and aesthetic smile is achieved by adjusting the shape of the gums.

Laser gingivoplasty: Excess gum tissue is removed in a controlled manner with a laser.

Implant prostheses (aesthetic dental prostheses):

Zirconium crowns: Metal-free prostheses that offer a natural tooth appearance.

Empress crowns: All-ceramic restorations that provide high aesthetics and durability.

Orthodontic treatments:

Transparent aligners (Invisalign): Teeth are straightened with invisible aligners.

Lingual braces: Aesthetic concerns are minimized with wires placed behind the teeth.

Tooth filing (contouring):

Minor deformities are corrected by gently filing the teeth.

Smile design (digital smile design):

A personalized smile design is made in accordance with the face and lip structure.

Fillings (aesthetic composite fillings):

A natural appearance is provided with metal-free, tooth-colored fillings.

Full mouth aesthetics (complete mouth rehabilitation):

A comprehensive smile design is made by using more than one method together.

H-3 Dental implants:

A dental implant is an artificial tooth root that is surgically placed into the jawbone to replace a missing tooth or teeth. It is designed to function like a natural tooth. Typically shaped like a screw or cylinder, it is made almost entirely of biocompatible titanium, which the body readily accepts.

Implants also feature an internal thread or post cavity, allowing for the attachment of various components. These components provide a stable foundation for the long-term support of crowns, bridges, or dentures. Situations where dental implants are needed:

Single tooth loss:

An implant can be placed to replace a single missing tooth. This prevents damage to neighboring healthy teeth, because with traditional bridges, neighboring teeth have to be worn down for support. An implant-supported crown offers the closest solution to a natural tooth.

Multiple missing teeth:

In cases where there are multiple missing teeth, implants can provide support for fixed bridges or removable dentures. Implants allow for fixed prostheses, especially when teeth are missing in the posterior regions.

Missing all teeth (total edentulism):

In completely edentulous patients, implants provide a reliable basis for total dentures. Implant-supported total dentures provide much better retention and stability than conventional dentures.

Distal tooth deficiencies:

In the absence of posterior teeth (gaps with distal extension), implants make it possible to construct fixed dentures. Restoration of such gaps with conventional methods is more difficult, and removable prostheses or bridges with long support arms are usually considered.

Improvement of chewing efficiency:

Implants provide a chewing function similar to that of natural teeth. The chewing efficiency of implant-supported dentures is higher than other prosthetic solutions.

Correction of speech problems:

 Missing teeth or removable dentures can negatively affect speech. Implant-supported fixed prostheses contribute to a more natural speech function.

Ensuring a natural appearance:

 Implants offer an aesthetic appearance with artificial teeth (crowns) emerging naturally from the gums. Aesthetic results are of great importance, especially for missing teeth in the anterior region, and implants can meet this expectation.

Improvement of smile aesthetics:

Implants positively affect the overall quality of life by increasing the patient's self-confidence.

Preventing bone loss (Resorption):

After tooth extraction, the jawbone gradually begins to deteriorate. Placing an implant transfers load to the bone, reducing this bone loss and helping prevent facial collapse. Implants stimulate the bone just like natural tooth roots.

Denture stability and retention issues:

Some patients wearing conventional removable dentures experience problems such as slipping or poor fit. Implants provide additional support, significantly improving stability and retention. Implant-supported overdentures are especially beneficial for lower jaw dentures.