Gingivectomy

This procedure is conducted to remove excess gum tissue that may be overgrown on the teeth to provide a better aesthetic result and a better area to clean the teeth.

Gingiva Overgrowth

Several reasons why there is an overgrowth of gum:

Inflammatory -induced:

  •  biofilm (bacteria) and the host response, resulting in familiar forms of periodontal disease such as gingivitis and periodontitis. Swelling, erythema, and bleeding are signs of these diseases.
  • Usually due to poor oral hygiene, orthodontic appliances 

Some mediation might trigger the growth of the gum tissue, such as:

  • Anticonvulsants (phenytoin, phenobarbital, lamotrigine, vigabatrin, ethosuximide, topiramate, and primidone)
  • Antihypertensives (calcium channel blockers such as nifedipine, amlodipine, and verapamil)
  • Immunosuppressant (cyclosporine)

Systemic diseases such as:

  • Pregnancy or puberty and vitamin deficiencies (mostly vitamin C) are some of the more common causes in this category.
  • Benign neoplasms—such as giant cell granuloma, papillomas, and fibromas—can cause enlargement of the gingiva.
  • Other more serious causes of gingival enlargement include leukemias, malignant neoplasms/carcinomas, as well as many forms of granulomatous diseases.

All these gum overgrowth can be corrected by reduce the cause factors or gum surgery (gingivectomy)

A case of Gingivectomy

A young lady complained that she didn’t have great smile. On examination, we found out that she had a very short teeth. Oral hygiene just moderate.

Using a dental chi gauge, it was confirmed that the patient had a short crown height

Dental scaling was done to improve oral hygiene

After taken radiograh to determain the bone height and biological width, surgical excision of 2mm of gum tissue above the gingiva margin.

Immedate post surgery
2 days after surgery

Read More…

Gingivoplasty

Gingivoplasty

A procedure to correct the gum shape and contour thus improve the smile line. Gingivoplasty surgery is usually done on the upper front teeth (can be up to the premolar region) where the gums here can be seen when smiling.

Most of these gum defects are usually caused by gum diseases (eg. periodontitis). However, in certain cases, the gum recedes due to over brushing or probably just because the gum itself is thin (thin biotype).

In gingivoplasty, a gum graft can be done where the tissue is taken from the roof of the mouth (this is called a graft) and then stitched into place on either side of the tooth that is recessed.

Here, is a case of a young male presented with receded gum due to over brushing…

He didn’t like his teeth and gum for a few aesthetic

reasons:

  • The teeth are uneven
  • The gums on his left are simply too high!!

We found out that he was a right-handed person, using his toothbrush to brush his left teeth too hard!! That causing the gum to shrink upwards.

Secondly, his gums were thin biotype and the previous dentist had over-filled his abrasion cavity  with composite preventing the gum from ‘coming down’

Objectives of treatment:

Correct his over-brushing technique

  • Modified the over-filled composite restoration
  • Correct the Shape of his teeth
  • Gum surgery to thicken his thin biotype gum and bring his gum down at the same time

Final Result

Before Treatment
After Treatment
Continue reading Gingivoplasty

Digital Dentistry

Digital dentistry refers to the use of dental technologies or devices that incorporates digital or computer-controlled components to carry out dental procedures rather than using mechanical or electrical tools. The use of digital dentistry can make carrying out dental procedures more accurate, efficient than using mechanical tools, both for restorative as well as for diagnostic purposes.

Digital dentistry can be use for:

  • Fabricating a veneer, crown or bridge in just ONE DAY. So, patient can have a crown done and cemented in his/her mouth on the same day, without the need of 2 visits or multiple injections or temporary prosthesis.
  • Planning of teeth movement in orthodontic patient. After planning, a series of teeth models will be printed out where the vacumme-formed aligners will be fabricate for patient to wear. This aligners will move the teeth as planned and achieve final result.
  • Planning and creating a new smile for patient in digital smile design. By changing the teeth colour and alignment in the computer, both clinician and patient can immediately appreciate the outcome of the smile design. From there, clinician can give several treatment options for the patient to achieve the final result.
  • Surgical guide for implant placement – making implant surgery safe and precise

Digital dentistry basically involved 3 basic steps:

  • data acquisition
  • data manipulation and analysis; and finally
  • output

Data Acquisition

We need to collect data or information from patient to start the outflow in the digital dentistry, for example:

  • Dental and Face images. Good image of the teeth or oral cavity region, patient’s smile or portrait picture of patient are essential data for planning digital smile design (DSD). These information can be obtained using a SLR Camera in the Photo Studio environment.
  • Intra-oral 3D scan. With a Intra-oral scanner (such as 3hape scanner), 3D images of the oral cavity region can be record and save in the computer.
  • CT-scan or 3D image of the teeth and jaw bone of patient mouth. Cone Beam CT (CBCT) is the radiograph unit acquire the data. With CT-scan

Kids Dentistry

First Visit

It is recommended that every child has an introductory dental visit within 6 months of eruption of their first tooth. As parents, you might think this is too early- even more so when there is no “problem” with your child’s teeth yet. However, starting dental visits early has many advantages:

  • We can assess each child’s risk of developing tooth decay.
  • We can suggest preventive steps that is special to each child’s needs
  • We can have the opportunity to show your child that dental visits can be fun, hence reducing chances of dental anxiety in the future

Quite often, it is a child’s first visit to the dental clinic but he/she is having pain. We understand that it can be stressful and anxious for both parent and the child. For younger children, parents can be present in the treatment room. For older children, it is best that we can see the child by themselves, but if parents are not comfortable with that, parents can be passive observers- allowing us a chance to interact and explain in simple terms that your child can understand. Many studies have shown that when parents are anxious themselves, their child will also tend to be anxious as well.

Depending on the your child’s reaction to his/her dental visit and what treatment needs to be done, we will try our best to provide your child with the best care possible. It is however important for parents to understand that treatment should not be forced or rushed onto a child. We understand that parents are busy and prefer treatment to be done all in a single visit, but it takes a lot of patience and time for us to build a trusting relationship and bond with your child. This is how dental visits can become stress free and fun for your child.

Our services includes

Standard Cleanings and Check ups

The care we provide is the best we can for each child. This means that the cleaning frequency we recommend can vary from individual to individual. Your child might benefit from cleanings every 3 months, or every 6 months.

What happens during a standard cleaning and check up?

  • A standard dental examination
  • Scaling, polishing and flossing
  • Dental x-rays (if needed)
  • Fluoride varnish treatment

Fluoride Varnish Treatment

What is Fluoride? Fluoride helps to strengthen teeth and prevent decay. It is also able to remineralise teeth that have early decay (seen as white patches on teeth). Fluoride can be found in fluoridated toothpaste, and are available in various amounts and concentrations.

Fluoride varnish contains a higher than normal amount of fluoride and it comes in the form of a thick sticky paste that adheres to teeth to minimise swallowing. It is very well tolerated as well. Varnish is proven in many ways to slow, stop and even reverse the formation of cavities. Everyone is at risk of developing cavities, from the young infants to young kids to teenagers. Here are some risk factors:

  • Infants still bottle feeding past one year of age.
  • Infants sleeping with a bottle containing liquids other than water (eg. milk, juices, sweetened drinks like Milo)
  • Frequent breastfeeding without proper mouth cleaning afterwards, especially at night
  • Constant consumption of sugary or starchy foods and beverages
  • Dental history of cavities
  • Developmental disabilities
Application of Fluoride Varnish

Fluoride varnish may be unfamiliar to many patients, so here are some information for parents and children:

  • It will make your child’s teeth look dull and yellowish when leaving the dentist. Their teeth will return to normal as the varnish wears off, usually in 1 day.
  • In order for the varnish to have the most benefit, it needs to remain adhered to the teeth for as long as possible. For that, your child should not brush or floss until the next morning.
  • To prevent early removal of the varnish, avoid abrasive or hard foods for the rest of the day. Soft diet is ideal for the day.
  • Fluoride varnish should be done every 6 months for most children. For children who have a higher risk of cavities, we may recommend 3-monthly application of fluoride varnish.

Tooth coloured fillings

Tooth Colour Fillings

These are white fillings that look beautiful and blend in with the natural color of the tooth. Placement of fillings is fairly quick and easy. First the decayed part of the tooth is cleaned and removed, then the tooth is dried and filled.

Happy Gas

What is Happy Gas? Happy Gas is also known as nitrous oxide/ laughing gas. In our clinic, we use it as a mild analgesic. It works by filling the patient with a feeling of happiness, which helps them feel relaxed and less anxious about dental treatment.

How do we use Happy Gas? We apply the gas through a tube and nose piece that fits over your child’s nose. All he/she has to do is breathe through his/her nose

Why use Happy Gas? Happy Gas is fast acting and wears off quickly. Its effects can be felt within 5 minutes, and when the gas flow stops, those effects wear off within another 5 minutes of breathing oxygen. It is safe, easy to use and can be adjusted easily for your child’s comfort. The only thing that stops it is a stuffy nose. If your child can’t breathe through his/her nose, it won’t work.Children’s Primary Teeth

More Info…

Miller Machine

Digital crown- What is it and how does it work?

With our new Rainbow-Mill Clinic machine, we can now produce natural and functional ceramic indirect restorations (crowns, onlays, inlays) within a day!

Our miller machine!!

The creation and placement of indirect restoration is one of the most commonly performed procedures in dentistry today. Like traditional crowns and onlays, digital crowns and onlays are ideal for teeth which are badly decayed or broken and commonly used as routine finishes for procedures like Root Canal Therapy.

However, anyone who has had a standard crown or onlay done will know that it can be a time consuming process which takes a minumum of 1 week or more for it to complete.

The crown that was millerd out from the hybrid-ceramic block

Normally in the case of traditional crowns, impressions are taken and sent off to a dental lab for crown fabrication. It may take a week or two for the lab to receive the impression, make the crown and send it back to us. The waiting time and having a temporary crown in the mouth are the drawbacks of this method.

With Digital crowns/ onlays, we can shorten the entire process significantly. The biggest advantage of digital crown is that it can be designed and milled right here in our clinic. Using the latest CAD/CAM technology and state of art equipment, patients receive a perfect crown/onlay in just one day! In addition to that, the crowns are incredibly accurate as we scan your tooth instead of taking impressions.

So how does a Digital Crown work?

Your dentisty will prepare your tooth for a crown as per usual and instead of having you bite down on gooey plasticine like impression materials which are messy and uncomfortable, your tooth will be scanned with our intra oral scanner that takes a 3D image of your tooth, which is then fed into a computer programme. After designing your crown, we will use our milling machine to cut out or “mill” the exact crown that was designed out of a ceramic block. Once milled, the crown is then fitted, polished and bonded to your tooth- all on the same day.

A Digital crown fafricated from the unit

So there you go.. now that you know about Digital crowns that can be milled (cut out) in our own clinic, you can consider giving it a go next time to save an extra visit to the clinic! Talk to your dentist about this if you have more questions or make an appointment to find out more.

Digital Smile Design (DSD)

Digital Smile Design

Nowadays, more and more people are concerned about their esthetic. A perfect smile can affect a person’s overall appearance, making them to have more confidence when meeting with people. Recently, Digital Smile Design (DSD) has become more and more popular, providing more predictable results for every patient.

What is Digital Smile Design

DSD is a dental treatment planning tool that helps the dental providers to have improved diagnostic vision, better outcome predictability and improved communication between the providers and patients. With DSD, the dental providers would be able to design a better and beautiful smile customized to every patient and be able to deliver the treatment planning confidently to the patients. With the patients’ complete understanding, they could perform the dental treatments efficiently.

How does DSD work?

When the patients have decided to make their smile look better, the dental providers will communicate with them to understand their expectations and needs from the treatment. Then, the providers will take photos of them and their teeth. Later, all the required photos will be imported into the DSD software.

Then, the software will help the dental provider to analyze the patients’ dental and facial proprotions thoroughly. There are various forms and shapes that can be chosen from the digital library which suits best for the patient. This gives the patients a quick glimpse into what they can expect at the end of the treatment.

Next, the providers will explain to the patients the problem lists. A thorough treatment plan is created based on the problem lists and what dental treatments are needed to achieve the final outcome. The treatment can range from simple restorative procedures, orthodontic treatment to orthognathic surgery.

Case Sample

First, patient is required to take photos of their smile.

Patient with smile
Patient with retracted smile

Next, photos are imported into the DSD software. The providers identify the patient’s smile issues. Then, the software is used to analyze their dental and facial proportion, thus designing a better smile design customized to every patient.

Patient’s smile design
Patient’s close up smile design
Patient’s smile design simulation

Lastly, the final outcome of the smile design is then displayed on the software. Treatment plan based on the design is then discussed with the patient.

What makes DSD unique?

After smile design simulation

Although digital imaging and diagnostic mock-up can show to the patients how will they look like at the end of the treatment, they have their limitations in terms predictability. With DSD, the providers are able to tell the patients exactly what their smile will look like because final outcome of the patient’s smile will be displayed in the software and the accuracy of the the final outcome is high. With these, miscommunication between the patients and providers can be avoided as they will be on the same page.

Who is a best candidate for DSD?

Good news is everyone is a good candidate as long as they want to have a better and beautiful smile.

So, if you have always wanted to do something about your smile, this is the opportunity to bring up your wants and needs.

Invisalign

If you are thinking of straightening out your teeth but not looking forward to having fixed metal braces on your teeth, we can help you achieve that with Invisalign at Prestige Dental Care!

Invisalign — A custom-fitted aligner

Invisalign is a set of custom-fitted aligners that fit over your teeth that slowly pull all your teeth into alignment. With Invisalign, you will be given a set of custom-made aligner trays that are made of BPA-free thermoplastic material.

They are removable, flexible, smooth and almost invisible- this means that you can remove your aligners while eating, avoid the painful monthly tightening needed for metal braces, and the best yet: you no longer have to put up with having ulcers or metal wires poking into your sensitive mouth tissues, or getting food in your braces and subsequently bad odour from areas that are difficult to be cleaned.

How is it done?

At Prestige Dental Care, we will examine your teeth and take the necessary records needed before starting treatment, such as: photos of your teeth and facial profile and dental X-rays. Our clinic is also equipped with the 3-shape intra-oral scanner. Unlike traditional methods of taking moulds of teeth, we use this intra-oral scanner to take digital pictures of your teeth which gives our dentists a very high definition, 3D image of your smile and teeth. This can then be used to custom make your aligners very accurately.

More info

Interceptive orthodontics

What is interceptive orthodontics?

In interceptive orthodontics , we identify and treat crooked teeth as soon as they are detected. According to the American Academy of Orthodontics, all children should have an orthodontic assessment no later than 7 years old.

How is interceptive orthodontics done?

Every child’s condition is different and treatment will be different too. Treatment can be done with at least ONE or a combination of the following:

  1. Removable appliances (eg. expansion screws, springs, labial bows)
  2. Oromyofunctional therapy ( Myobrace + oral exercises to train good oral posture. Read below for more information on oro-myofunctional therapy)
  3. Braces (Depending on suitability, braces can be started earlier to gain more space for teeth in the jaws hence avoiding the need for pulling teeth out in the future)

1. Upper removable appliances (URA)

As it’s name implies, this treatment typically uses a plastic appliance that can be worn on and removed from the teeth. There are many types of removable appliances available and they are custom made according the child’s teeth. Often, we use springs or expansion screws to move teeth. Below are some examples of removable appliances.

2. Oro-Myofunctional Therapy (OMT)

How does Oro-Myofunctional Therapy (OMT) work?
OMT is a pre-braces treatment suitable only for growing children. The treatment aims to improve growing children’s cranial and jaw development by treating the underlying causes of crooked teeth and poor oral posture.

OMT can also improve a child’s general health and prevent Sleep Breathing Disorders.

This treatment involves using a series of removable intra-oral appliances (Myobrace) that are worn for 1-2 hours each day plus overnight while sleeping.

OMT also requires a child to do several oral exercises to train the strength of their lips and tongue and improve their nasal breathing. These exercises are very fun and parents are encouraged to get involved too!

The intra-oral appliance works by correcting poor oral habits that cause negative impacts on the development of face, jaws and teeth, such as mouth breathing, incorrect tongue position, thumb sucking, bottle feeding and swallowing incorrectly.

What Causes Crooked Teeth?

Many Malaysian children are growing up with crooked teeth. This is evidence of poor development of craniofacial structures. Traditional orthodontic treatment such as extractions and braces after waiting for all permanent teeth to come through actually focus on moving teeth without treating the underlying cause for crooked teeth.

Modern research has shown that crowded teeth, incorrect jaw development and other orthodontic problems are not caused by big teeth and small jaws or genetic factors. Rather, it is due to poor myofunctional habits (poor oral habits) like mouth breathing, tongue thrusting, reverse swallowing and thumb sucking that can be evident since the first years of life.

The craniofacial structures develop correctly only when children have the following 4 patterns for straight teeth:

1. Lips together at rest

2. Tongue resting at the roof of the mouth

3. Breathing through the nose (NOT the mouth!)

4. Correct swallowing method (No lip/cheek movement)

Here at Prestige Dental Care, we provide early intervention options for children that improve the underlying cause of crooked teeth with Oro-Myofunctional therapy.

What Oro-Myofunctional therapy does:

Corrects poor oral habits

Develops & aligns the jaws

Straightens the teeth

Optimises facial development

Improves overall health

Promotes healthy eating habits

How does it do this?

By helping the child:

  • Breathe through the nose
  • Swallow correctly
  • Correct his/her tongue posture
  • Keep lips together

Oro-MyoFunctional Training Exercises

How to wear MyoBrace Appliance/MRC Trainer?
Training 1 – Resting Position, Correct Swallow, Breathing Awareness
Training 2 – Drinking, Paces, Remembering game
Training 3 – Lip training, Continuous drinking, Nose opening
Training 4 – Yawning, Water seal, Tongue clicks
Training 5 – Squirt water bottle, Skinny Tongue
Training 6 – Kick, Gargling, Straw drinking

More info

..

Selamat Hari Raya

Selamat Hari Raya to all of our Muslim families, friends and our customers.

We close from 14th June (Thursday) till 18th June (Monday) due to Hari Raya festival.

We will resume business as usual on 19th June 2018 (Tuesday).

Specialist Dental Clinic