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Endodontics and Conservative Dentistry

Dental caries is known as cavities shape diseases on tooth-hard tissues which are  enamel, dentin and cement, which are more often associated with dark or opaque (white) colorations .

Bacteria in the mouth use acid secretions to obtain food sources of their own needs from the mouth residues of foodstuffs. These acids dissolve the mineral texture of the teeth, causing the disruption of the tooth enamel and, finally, the beginning of tooth decay and the spaces that dentists call cavity.

Those who have high rates of acidic and sugary foods in their diet also if the fluoride ratio in water is very low , they are under much more risk of caries .  Although saliva against acid-generated by the bacterial plate creates a natural defensive mechanism, it cannot prevent rot by itself. Diseases or drugs that reduce the flow and amount of saliva also accelerate the formation of caries. For this reason, dentists often recommend sugar-free chewing gum as it increases the saliva flow.

Brushing teeth after breakfast and in the night before go to bed , regular use of dental floss is the most effective way . The toothbrushes should be selected as small heads because food residues mostly accumulate at the pits on the chewing surfaces of the teeth and at the interfaces where the teeth touch each other .The internal surfaces of the teeth, the external surfaces, the chewing surfaces and the dorsum of the tongue  should be brushed and the dental floss  should be used at the interfaces. The brush must be moderately hard or soft-bristle and should be replaced at regular interval . The brush bristles must not be worn and must be kept in a way that does not carry bacteria. In addition to helping tooth brushing, fluoride mouthwashes  can also be used to remove malodour and provide an antiseptic effect, freshness and cleanliness.

Trying to consume sugary and acidic foods at main meals and trying to eat nothing between meals is another precaution.

Nowadays, tooth decay is more frequent than in the past. For example, in studies conducted, the rate of caries in ancient people's teeth did not exceed 5%, but today this rate can reach up to 95%. The reason for this is that eating habits change. Ancient people were fed with hard and natural foods, so they had a natural way of cleaning their teeth. Nowadays with the development of the ready-made food industry, consumption of such foods has also increased. These foodstuffs, such as biscuits, sugars, chocolate, cola, which are present at all times, are considered to be the main responsibility of the increase in tooth decay nowadays, because they are the substances that remain on the teeth and become acid forming .

Applying regularly to the dentist is the best way to prevent caries  or to catch early. Also to consult a physician without delay in such cases hot and cold sensitive teeth or painful teeth or initial caries in chalky color, brown colorings and cavities , will change the treatment modalities and reduce the difficulty .

Another method  to prevent tooth decay is to strengthen the dental structures procedures . The most effective substance used to strengthen tooth structure is "fluorine" compounds. The fluorine compounds provide a more resistant structure against caries by entering into the structure of the enamel  when they are applied during  the teeth are developing or after the eruption of  teeth are seen in the mouth.

The anti-caries effect of fluorine compounds occurs mainly in four ways;

  • By adding certain amount of fluoride compounds to drinking water, 
  • By giving the children the fluoride tablets that are ready to be sold on the market, 
  • Taking advantage of the fluoride compounds added into the common salt ,toothpaste, mouthwashes 
  • To stuff gel-shaped special fluorine compounds on the teeth by dentist at clinics .

The easiest method of application is morning and evening  brushing teeth with a fluoride toothpaste from 3 years old and using fluoride mouthwash after 6 years of age . Other applications are not yet widely used in our country, nor do they have an adequate infrastructure. For example, there is no clear standard study of the fluoride content of drinking water in most of our regions and the amount of fluoride taken in the diet. Fluor is a necessary element for the body. However, when taken too much , teeth can change color or cause deformations in bones . For this reason, applications outside toothpaste and mouthwash must be done under physician control.

The treatment of  damage that occurs in teeth as result tooth decay , trauma , various genetic and immunological diseases  consists of two main parts, conservative and endodontic.

Conservative dental treatments are operative treatments in which the part of the teeth that can be seen with unaided  eye  in the mouth and the teeth are more concerned with enamel and dentin parts. In these treatments, after the tooth parts which have been damaged by caries or other reasons are cleaned and removed with special high-tech devices used in dentistry, the remaining living and durable tissues are isolated with special isolation materials and the operation is finished after  restored with filling materials so as to imitate natural tooth structure. Although many materials have been tried to date as permanent fillers , amalgam (metallic) and composite (white) fillers  are most commonly used today .

Amalgam fillings are also referred to as silver fillings. Amalgam is obtained by mixing silver, tin and copper alloy with mercury . The mercury, which constitutes 45-50% of the mixture, binds the metals and creates a durable filling material .Amalgam fillings have been developed since 150 years in dentistry  and still frequently  used . The biggest reasons why amalgam fillings are preferred are; it is a harmless, long-lasting and inexpensive filling material. Besides that, Another advantage is that the application can be done easily and in a short time .

However, the biggest disadvantage is that amalgam fillings contain toxic substances such as mercury and are not aesthetic . In many studies to date , no consensus has been reached regarding  the poisoning of mercury in  amalgam fillings .Many researchers have pointed out that the amount of mercury released from amalgam fillings as a result of chewing  and grinding  is much less than the amount taken with water , air and nutrients . When the amalgams were dismantled , it has not been scientifically proven that some diseases are claimed to be cured thought to be caused by mercury .

It is a plastic blend with silicon dioxide particles in it. They are defined as white fillings because they are in tooth colour. In the 1960s they used only the front teeth, they can be successfully applied to the posterior teeth as a filling material which is resistant to chewing pressure and less ablation by further development of the material

Composite fillers are placed in layers in prepared cavities and each layer is cured with a special light . After this process the composite fillings are shaped and corrected according to the tooth. All these processes take longer than amalgam filling. Recently, the length of stay in mouth and durability of composite fillings have been closed to amalgam life .

The greatest advantages of composite fillings are aesthetic. In addition, since these fillings are firmly attached to the teeth, they support the dental tissues and prevents breaks and temperature transmission. Composites can be used not only for restoring caries but also for cosmetic effects by changing the color and shape of the teeth. The main disadvantage is the post-processing sensitivity. The colors of the fillings can also change slightly with materials able to dye   such as coffee, tea.

Polish process can be applied to composites in the same session. However, in massive restorations or series restorations made for many teeth, it is better to invite the patient to check once more and make the necessary corrections if they are both aesthetically and functionally much better.

With these materials, very large losses can be restored in the front teeth, for this reason it is necessary to explain to patients  that to bite carefully will prolong the life of these restorations. It should be reminded again, especially after the applications on the front side, that drinks and foods able to dye   can change the colours of the fillings, no matter how well polished . More attention should be paid to the teeth restored with the reason of wear, to propose non hard toothbrushes  to patient and to enable them make corrections in brushing methods .

Endodontics is the branch of dentistry who deals with problems advanced to the dental pulp. When mentioned endodontic treatment, usually root canal treatment is understood. Among the dental treatment procedures, the most feared treatment is usually the canal treatment. The part of the tooth that appears in the mouth is called the crown , the part that does not appear in the mouth, and the part that remains in the bone is called the root . Our teeth consist of several layers. Outside the crown section, so the seen part in the mouth is called enamel. Enamel is one of the hardest tissues in our body. The cementum layer is covered on the root part of the tooth, which is under the gingiva and is surrounded by bone. Below the enamel and cement layers there is also a dent in layer. The feature of dentin is the largest layer of the tooth, and unlike the enamel layer, it contains nerve endings. It plays a role in the mechanism of pain with this feature.

There is pulp of the tooth   under the dentin layer. This section contains the veins and nerves. Pulp plays an important role during tooth eruption  and odontogenetic . It also tells us the problems that we have encountered with the pain mechanism after the tooth has been erupted. The pulp is located in the center of the tooth and in the channels of each tooth root. Consist of periodontal ligament, blood vessels and nerves. After the tooth is formed, the pulp can be safely removed from the pulp chamber and root canals. Endodontic treatment is the process of removing pulp, which is also known as root canal treatment .

Can be mentioned pain and sensitivity to cold and hot foods and drinks in the teeth, pain during eating, inflammation and beginning of inflammation. Excessive color changes that occur in the teeth may also be perceived as inflammation. Apart from these , caries reached to pulp but in untreated teeth , the infection may come from the root apex  to the jawbone and may cause small or large swelling  in the face . In this case, antibiotics as well as dentist-assisted procedures are suitable for fighting infections.

The general conclusion is that the tooth forming swelling on the face should be extract after the swelling goes  down . However, this is a very old idea.

Even the teeth that cause such large infections can be kept in the mouth by root canal treatment and this tooth can serve you for years like a healthy tooth in the same mouth.

Root canal treatment can be done in one or two session depending on the condition of the tooth.For an infected tooth, several sessions may be required to ensure that the infection is completely removed .Treatment may be difficult depending on the position of the tooth . Furthermore, the presence of multi-rooted teeth and curved root teeth  makes it difficult to process  the treatment .An uncomplicated channel therapy is usually completed in a session . After the canal treatment, if necessary, the tooth is covered with a crown or restored with a filling.

After canal treatment, especially after the treatment of vital teeth, sufferable toothache for a few days or  pain  when pressed onto the teeth can occur . This is a normal pain that occurs after root canal treatment. With a little protection of the channel treated tooth, it will be disappearing shortly. For today, the success rate in root channel therapy with the correct treatment method reaches 90%.




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