Apical Surgery

Sometimes, a procedure called apical surgery is needed to remove an infection from the tip of the
root of a tooth. Root canal surgery is usually needed if there has been an infection in the tooth’s pulp, or it’s been damaged in some way.

The vast majority of root canal complications these days are treated non-surgically, but in some cases conventional root canal treatment doesn’t get rid of the infection or damaged root tip. Left untreated, the infection could turn into a painful abscess, and even get into the jaw bone. Other possible treatments for an infection are antibiotics and removal of the tooth, but most dentists will advise you that carrying on with antibiotics that haven’t been effective can simply cause the infection to get worse, so they usually advise either apical surgery or removal of the tooth completely.

What happens in apical surgery?

Apical surgery usually involves removing the tip of the root of one or more teeth, along with any infected tissue around it. It’s a way of trying to save your tooth if root canal work hasn’t worked, or isn’t possible.

Some dentists offer conscious sedation for the procedure, which is carried out under a local anaesthetic like a filling or extraction. In some complicated cases, you can opt to have the procedure in hospital under a general anaesthetic. Once you have been anaesthetised, your dentist will start by making a small cut into the gum area, over the root of your tooth, and then lift your gum away from your jaw bone. The dentist then takes away a small piece of bone using a drill, so that they can get to the infected area.

Once they’ve got to the affected area, the dentist will clean away any infected tissue from the tip of the root and then remove 2-3mm of the root tip itself. The root is then sealed with a small filling and your gum is stitched back into position with dissolvable stitches.

After the surgery, you might feel some discomfort for a few days, but it should be less painful than the infection, and will allow you to keep the tooth. If you’ve had conscious sedation, you’ll be advised to take the day off work and take it easy for 24 hours, but you should be able to return to normal the following day.

Dental Implants

Dental implants are a popular and highly effective form of dental treatment, designed to replace natural teeth for cosmetic purposes or if a tooth has been lost through accident or decay. They are normally used to support crowns, bridges and dentures.

The implant replaces a tooth’s natural root, and is tapped or drilled into a socket made in the jawbone by a dentist. To be effective, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant.

Implants are suitable for most people with good dental health, although if you are a heavy smoker or drinker, it can cause problems. Some dentists won’t fit implants in heavy smokers because of the risk of complications. Implants are designed to fuse with your jawbone over a period of several months, after which the dentures, crowns or bridges can be attached, so they work best if your mouth is free from gum disease, abscesses or decay.

How many implants do you need?

In your upper jaw you would probably need at least six implants to replace all your teeth and in your lower jaw four to six. One implant can support more than one replacement tooth, so the number of implants you would need depends on how many teeth are being replaced.

Dental implant procedure

In a single-stage treatment, the rod and the ‘abutment’ which connects the implant to the replacement tooth are fitted at the same time. In a two-stage implant treatment, the implant rod will be buried under your gum while your bone heals, and a few months later you’ll have the abutment fitted in another small procedure.

Usually it takes three to eight months for your mouth to heal enough to have the replacement tooth fitted, although you can have a temporary bridge or partial dentures fitted in the meantime. An impression of your teeth will be taken so that any new teeth can be made to match your jaw, bite and even the colour of your existing teeth. Once you’re healed, the artificial teeth are fitted onto the implant. With dentures, in some cases you can opt for a removable denture which allows you to care for the new teeth outside of your mouth, but they can also be permanently secured. Once fitted they should look, feel and work just  like natural teeth.

How long do they last?

If your jaw bone is in good health and you look after the implants properly, they can last for a long time. In many cases an implant can last a lifetime, although you may find that the bridges, crowns or dentures themselves need to be repaired or replaced during their lifetime.

Maintaining a healthy smile

Everybody wants to have that winning smile, and it’s becoming more and more common for adults and children alike to opt for effective orthodontic treatments which help them to achieve the healthy smile they want.

Once the work is done, whichever type of appliance you choose to have fitted will need to be maintained, along with good oral hygiene, if you want to make sure that you get the optimum benefit from your orthodontic treatment. Here’s our guide to caring for your teeth after the work has been done.

Straight after fitting

Having your bracket, positioner or dental appliance fitted isn’t at all painful, but as the appliance starts to take effect, naturally your teeth will start to move around and you might feel a bit of discomfort. This shouldn’t be too serious, and you should be able to take normal painkillers to alleviate any pain.

At first, you might also feel as if your teeth are a bit loose. Don’t panic, this is totally normal and should wear off once everything starts to adjust to its new position. There might also be slight rubbing, although we’ll give you some wax and show you how to use it so that it helps prevent any discomfort until your mouth has adjusted to having the appliance there.

 

How to look after your dental appliance

Even more than usual, after you’ve had orthodontic work it’s important to make sure your diet is as healthy as possible. Avoid the obvious things like fizzy, sugary drinks and sugary food, as you would to prevent tooth decay.

Stick to soft foods wherever possible to avoid breaking your new appliance, cut up hard fruit and vegetables like carrots and apples, and avoid popcorn and things that will get stuck between your teeth. Be wary of eating anything too chewy - toffees, bagels and, liquorice are all off limits, as is gum, anything too crunchy (don’t even think of crunching the ice in your drink) and hard foods like nuts.

Don’t chew the end of your pen, or bite your fingernails either. This can damage your appliance and it will take longer for your treatment to work properly. Because your appliance is stuck on, it can wear down or even break off if it isn’t cared for properly.

Every time it breaks, you can add another two months to your treatment time, so looking after it and preventing breakages will give you a longer lasting appliance and a faster, more effective treatment.

Keep it clean!

Just like you would look after your teeth normally, dental hygiene is even more essential if you have a dental appliance fitted.

We recommend brushing with fluoride toothpaste three times a day, as well as a mouthwash with fluoride and flossing with an interdental brush to keep your mouth, teeth and appliance spotlessly clean.

Looking after your dental health will help your treatment be as effective as possible, and help to ensure a healthy, attractive smile for as long as possible long afterwards, too.

All on Four

Are you putting off dental treatment because you think it's going to be a long, drawn out process that you would rather not have to deal with?

Or are you worried that you'll be left toothless in between treatments, and can't face the thought of spending days going backwards and forwards for more work to be done?

Dentistry needn't be as much of a trial as you think, and it needn't be as painful as you expect it to be, either. The innovative All-on-4 service from Vermilion can give you a better looking smile in just one day.

Many of us suffer in silence with less-than-perfect teeth, but failing teeth can cause pain, discomfort and distress if they aren’t repaired. In some people, teeth can start to loosen and fall out due to advanced untreated gum disease, or in some cases people can find that existing dental work which was carried out many years ago, like crowns and bridges, can fail simply through wear and tear.

Because Vermilion uses a new technique that only needs four implants, the All-on-4 procedure is much quicker than fitting a traditional eight-implant bridge would be, so if you’re stuck with teeth that need replacing or perhaps a loose denture that is giving you grief, there's no need to put off the inevitable trip to the dentist any longer. You can walk away from Vermillion with a brand new fixed bridge on dental implants in just one day. Just turn up at the centre in the morning and leave before the end of the working day with a beaming new smile.

What happens?

Over a number of preparatory visits, you'll have detailed consultations with the clinic™ prosthodontist and oral surgeon, who will also carry out a 3D analysis of your teeth and bone. Once they have talked it all through with you and agreed on the best course of action, either full arch fixed bridgework on a minimum of four implants, or full arch removable bridgework (also on four implants) you will be booked in for your day at the clinic.

The team uses conscious sedation to remove any failing teeth, and then they fit the implants. Conscious sedation means that you might be aware of what i€™s going on, but you will be drowsy and sleepy, and in effect, won't really care!

Your denture will be made by skilled prosthodontists while you have a snooze in the comfortable recovery room, and the provisional bridge will be fitted in the afternoon.

After four to six months, if you’re opting for the fixed bridge, your final fixed bridge will be made, and although you will have to return for four more appointments so that the experts can make sure all is well, they will then fit the permanent fixed bridge and leave you with a long-lasting smile.
Now, that didn't hurt much at all, did it?