Taking Care of Your Children’s Teeth – Dr. Sarika Explains

Taking care of your children’s teeth is a critical aspect of their health and well being and while as parents we try to do our best, we often miss out on small and simple stuff that can help make our little ones smile brighter. Here in this video, Dr.Sarika, one of the top pediatric dentist in Hyderabad shares her tips about common teeth problems that children and how to take care of them.

Invisalign: a solution of transparent braces

Patients undergoing orthodontic treatment in the current generation not only demands a beautiful smile at the end of the treatment but also are equally concerned with appearance during treatment. As there is an increasing demand for an alternative to conventional braces, clear aligners are the new age aesthetic orthodontic treatment. Invisalign is a virtually invisible treatment that uses an innovative approach to gently yet effectively straightens your teeth. Invisaligns are thin transparent removable plastic aligners formed with CAD-CAM laboratory techniques for moving teeth into the required position.

Find more on Invisalign treatment in Hyderabad, India.

How do traditional braces differ from Invisalign

Traditional braces are:

  1. Visible (unaesthetic)
  2. Food restrictions have to be followed
  3. Uncomfortable metal wires
  4. More difficulty in maintaining oral hygiene
  5. Requires extraction of premolars in some cases

Advantages of Invisalign over traditional braces

  1. Virtually invisible – gives confidence to patent to smile
  2. Maintain good oral hygiene as they are removable
  3. Comfortable – individually customized
  4. Ideal for retreatment/relapse cases
  5. Shorter dental appointments
  6. More precise treatment duration than braces
  7. Non-invasive appointments during recall visits
  8. Uses 3D computer modelling technology to create a customised treatment plan
  9. Can visualise the progressive movements and expected final results using 3D SOFTWARE

Limitations of Invisalign

  1. Personal motivation of the patient is required
  2. It should be worn 20-22 hours a day
  3. Devices should be removed during meals

Common teeth straightening issues that can be fixed with Invisalign aligners

Gapped Teeth
Gapped teeth occur when you have extra space with your jaw.


Cross Bite
Cross bites occur when the upper and lower jaws are misaligned.

cross bite fixed with aligners

Deep Bite
A deep bite occurs when upper teeth overlap significantly with lower teeth.

deep bite with clear aligners

Open Bite
Open bites occur when upper and lower teeth do not overlap normally.

Open Bite treated with Invisalign

Crowned Teeth
Crowding occurs when there is no proper arch space in the jaws.

crowned teeth with invisalign treatment

Treatment Process for Clear Aligners / Invisalign

  1. Consultation with your dental provider to determine if Invisalign is suitable for you.
  2. Using Align technology’s proprietary software, your doctor creates a customized 3D treatment plan and explains you regarding pre and post-operative treatment result.
  3. Your aligners will be custom made and shipped to your dentist’s clinic
  4. Your series of custom made aligners will be given to you
  5. You need to visit the dentist for check-ups every 6-8 weeks
  6. Congratulations! you have finished your treatment. Maintain your newer, better smile with the use of retainers.

Frequently Asked Questions About Invisalign

What is the duration of treatment with Invisalign

The treatment can last between 28-48 weeks depending upon the type of the dentition and severity of the malocclusion. The aligners need to be changed every two weeks. The initial appointment involves the opinion of orthodontist followed by which, clinical pictures will be taken for treatment plan. In the next visit, impressions are taken to allow the construction of accurate cast, which can be scanned to produce a virtual 3D model. The 3D model can then be manipulated by the dentist and malocclusion is nearly treated using proprietary software. After which, within 3-4 weeks aligners will be ready for usage.

Is the time reduced when compared to conventional braces

Yes, braces are adjusted much less often compared to Invisalign. Hence the time is reduced compared to conventional braces. The patient is advised to wear the aligner for approximately 20 hours per day. Each set of aligner will shift the teeth around 0.25 to 0.3 mm.

What is Invisalign made of?

Invisalign clear aligners are made of a patented thermoplastic material called smart Track which is FDA approved. They are comfortable and easier to put on and take off. It is free of BPA, BPS, latex, gluten.

What is this Smart Track Material

Smart track material is a highly elastic orthodontic material, its elastic properties allow it to return more closely to programmed aligner shape. It is made of polyurethane resin and does not contain bisphenol – A, an industrial chemical better known as BPA.

How long do we need to wear Invisalign in a day

Invisalign aligners need to be worn between 20 -22 hours per day. They should remain in the mouth as much as possible for the treatment to be effective. Each aligner needs to be replaced approximately every two weeks. During your Invisalign treatment, each aligner slowly moves your teeth in to correct position as you wear them.

How does Invisalign help in maintaining  oral hygiene

Since Invisalign is removable in contrast to conventional braces oral hygiene can be maintained efficiently. Aligners need to be removed while eating or drinking.

What precautions are needed during treatment?

Eating or drinking should be strictly avoided with Invisalign. Eating sticky foods can pull and tug at the aligners, possibly breaking or damaging them, while drinking specific drinks can potentially stain aligners.

Is there a particular age range / best age for using Invisalign?

Invisalign can be started after the child attains complete dentition of permanent teeth which is around 12-14 years of age. While the skeletal and dental components are more conducive to straightening.

Does Invisalign give Lisp / difficulty in speech?

In some patients, it can cause lisp/speech defects which can alter pronunciation initially. Mild discomfort might be present initially after starting the treatment with a fresh set of aligners and gets better as we use them.

What if I stay out of the country?

The initial appointment with orthodontist will give an idea about the treatment plan. Then, the virtual 3D model can be constructed using the software. This is used to produce a series of clear aligners that steadily correct the malocclusion, which is shipped to your home address.

Are Lingual braces better than Invisalign?

Lingual Braces Invisalign
Similar Cost Similar Cost
Difficult to maintain oral hygiene Easy maintenance of oral hygiene
Fixed Removable
Discomfort with braces No discomfort
Prolonged treatment duration Reduced treatment duration

Who are the Right Candidates for Teeth Whitening

Tooth whitening is a procedure to lighten teeth and remove stains and discolorations. The peroxide in the bleaching agent penetrates the enamel and breaks down the complex stains(which are darker in nature) into smaller products thereby making the tooth appear lighter in shade.

How do teeth become stained?

There are many reasons why teeth become discolored

  • Discoloration can result from a traumatic injury(such as when the tooth gets hit in an accident) resulting in darkening of the tooth because it gets devitalized, trauma or infection of the related primary tooth can also cause irregularities in enamel color of its subsequent permanent tooth.
  • Intrinsic discoloration/ staining i.e. discoloration that occurs within the dentinal layer of the tooth is due to excessive fluoride content present in drinking water leading to fluorosis and use of certain medications like tetracyclines during the developmental stage of fetus or during childhood can result in staining.
  • Teeth get stained from metals like iron supplements or consumption of stain-causing beverages like tea, coffee, soft drinks, alcohol, and certain foods like dark-colored berries, tobacco use can result in tooth discoloration.

Some causes of yellowing teeth are beyond our control like discoloration that occurs during ageing. As we age, the tooth enamel thins, thus making our teeth to appear more yellow in colour.

Bleaching for Teeth Whitening Works Best

Extrinsic stains i.e., superficial stains that occur on the outer surface of the tooth are easier to treat compared to intrinsic stains whether they are congenital or acquired. In most cases, professional teeth whitening treatments can restore your smile’s former glory and give you back the ability to smile without feeling embarrassed. Severe discolorations may be best treated with microabrasion and subsequent bleaching to achieve desirable results. Dental whitening may be accomplished by using either professional or at-home bleaching modalities.

Patient Examination for Tooth Bleaching

Before a decision is made that tooth bleaching is the best possible treatment available for the patient, the dentist takes a thorough patient history that would include the patient’s opinions regarding the cause of tooth discoloration, any history of allergies, especially to the ingredients used in bleaching materials, information regarding any past problems with tooth sensitivity which has to be investigated carefully to determine the cause(s) and whether treatment before tooth bleaching will benefit the patient.

Additional examination considerations include tooth/enamel cracks, exposed root surfaces and other smile considerations such as translucency or defects in tooth form or anatomy.

Some tooth discolorations may be the result of a disease or condition that requires root canal therapy, restorations or dental surgery.

Examination of tooth function and para-function may reveal conditions such as bruxism (involuntary grinding of teeth) or temporomandibular joint dysfunction. If not examined properly, these conditions may be aggravated by the use of bleaching trays that are prescribed by dentists.

Patient habits (tobacco, alcohol, food habits) and lifestyle, as well as the presence of removable or fixed appliances,  should also be considered during an examination.

When not to do dental bleaching

Pregnant & Lactating Women

In pregnant or lactating women, teeth whitening is not recommended as in these cases, due to hormonal changes gums become inflamed and sensitive and the bleaching agents used can aggravate the condition.

People who have restorations such as fillings implants, crowns and dental bridges

Tooth-colored fillings and resin composite materials used in dental restorations like the crowns, veneers and bridges do not whiten. Therefore, using a whitening agent on teeth that do and do not contain restorations will result in uneven whitening. The teeth without restorations appear lighter than those with restorations. Therefore, any whitening procedure should be done prior to the placement of composite fillings, veneers, crowns, dentures, or porcelain restorations in order to best match the degree of whitening to your new tooth color.
For the enamel to remineralize and optimize the bonding strength, a minimum of 2 weeks following a whitening procedure should be allowed before any prosthesis is given. Tooth colored fillings will have to be replaced after the bleaching process is completed so as to avoid shade mismatch.

Children under 16 years of age

Bleaching is not recommended in children under the age of 16 because the pulp chamber, or nerve of the tooth, is bigger and wider until this age. Teeth whitening under this condition could irritate the pulp or cause it to become sensitive. Also, the enamel of a primary tooth is thinner when compared to the permanent tooth, because of this tooth coloration within a dental arch may vary significantly during the mixed dentition stage of the patient. If a full arch cosmetic bleaching is done during this developmental stage, it would result in mismatched dental appearance once the child is in the permanent dentition stage. Adolescents have unique dental needs to maintain their self-image. Tooth whitening has been a
successful procedure for adolescent patients.

Patients with gum disease, worn enamel, tooth decay, exposed roots due to receding gums, defective restorations

Patients with these conditions should always consult with their dentist prior to using a tooth whitening system. Individuals with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth whitening procedure because bleaching aggravates sensitivity in such patients.
Tooth decay has to be treated before undergoing any whitening procedure because the whitening solutions can penetrate into the decay and the inner areas of the tooth, which can cause sensitivity. Also, whitening procedures will not work on exposed tooth roots because roots do not have an enamel layer to absorb the bleaching agent. Roots resist the bleaching agents.

Allergic to peroxide

People who are allergic to teeth whitening agents like peroxide are contraindicated for bleaching procedure.

Individuals with Sensitive teeth

Such patients are also contraindicated in whom sensitivity occurs due to cracked or chipped teeth.

Sometimes tooth becomes sensitive when vital bleaching is done. This is due to permeation of enamel and dentin by hydrogen peroxide resulting in a mild, transient inflammatory response. It should not be used at high concentrations and for extended period of time. This kind of tooth sensitivity can be managed with the use of non-steroidal anti-inflammatory drugs (NSAIDs), fluoride, casein phosphopeptide-amorphous calcium phosphate or potassium nitrate containing products.

Unrealistic Results

Individuals who expect their teeth to become brilliant white may be disappointed with the results of bleaching. Bleaching definitely makes the teeth 2 shades lighter but not completely white. In the case of smokers, limited results will be seen unless the habit of smoking is ceased, particularly during the bleaching process.

The Right Candidate for Tooth Bleaching

Taking all the above-mentioned details into consideration, it can be concluded that, the best candidates for professional teeth whitening are those who have healthy teeth without fillings or restorations and healthy gum tissues. Better results with bleaching can be seen in patients whose teeth have a yellowish shade.

Zirconia Crowns for Kids

Over the past few years, the demand for cosmetic services escalated among adults and it is understandable that the same need is demanding for cosmetic procedures in their children’s teeth as well. With this there is an advent of zirconia crowns into pediatric dentistry as well. So, what are zirconia crowns and when to choose them will be discussed for better understanding.

What is Zirconia Crown?

A crown (also known as tooth cap) is the one which covers the visible part of the child’s tooth. Zirconia is basically made of ceramic which is extremely durable with a highly polished surface.

When can Zirconia Crowns be used in children?

  • In cases of badly broken down molar teeth (back teeth) after pulp therapy or a filling to protect it.
  • In the front teeth which are badly broken down due to early childhood caries.
  • Also for teeth that are broken after a fall.
  • In upper front teeth after the pulp therapy is completed.

zirconia-cap zirconia-crowns

Availability of Zirconia Crowns

You can always ask your pediatric dentist for these crowns. They are available in six to seven different sizes. Some crowns are also available in 2 different shades for milk teeth.

How is it done?

Placing a cap on the tooth involves making space and that is achieved by trimming the tooth all around. In the same way the milk tooth is also prepared to accommodate the zirconia crown. Once the tooth is prepared the appropriate size that will fit the tooth will be selected and checked. Unlike the metal crowns, zirconia crowns are passively seated. Once the final adjustments are made, it is then fixed with a glue like cement permanently.

Advantages of Zirconia Crowns over Steel Crowns

  • Zirconia crowns are found to adapt beautifully within a few days to the gums around it and so special care is not required.
  • They also have an excellent finish that helps in clearing the debris while brushing.
  • It is a very durable material and hence is strong even in reduced thickness thereby requiring less trimming of the tooth.

Possible Disadvantages of Zirconia Crowns

As manipulation is not possible with these crowns, it cannot be given in cases where the child has crowding or overlapping teeth.

Common Questions about Zirconia Crowns

Is it really necessary to cap the milk teeth?

Yes, it is.In cases of decayed teeth and where pulp therapy is completed, tooth becomes brittle and weak. Biting on something hard can lead to fracture of the tooth making it difficult to repair leading to early removal. Hence, it is advised to always get a tooth cap done after these procedures.

Should we remove the caps at the time of teeth shedding

No, it is not necessary that we remove the cap because as mentioned a cap will be placed only on the visible portion of the tooth. When it is time, the tooth along with the cap will fall or shed.

Few case photos where Zirconia caps are placed

before-after-zirconia-cap1 zirconia cap

Change your Smile Instantly with Veneers

Dental veneers

Dental veneers are one of the most popular cosmetic dental procedures to keep your smile flawless.

Porcelain veneers are thin shells of ceramic that are attached to the front surfaces of teeth for an immediate smile transformation. They are custom made for each patient and closely resemble natural enamel.

Dentists use veneers for cosmetic enhancements like teeth whitening, close gaps between teeth, fix chipped teeth.

Types of Veneers

There are 2 types of veneers

Composite veneers

These are applied directly to teeth and can be done in a single appointment

Porcelain veneers

These are fabricated in the lab and needs two appointments with the dentist.

When does a dentist recommend a veneer?

Dentists would typically recommend veneer for patients who have chips, cracks, gap between their teeth or minor misalignments.

When should you not use Veneers

Veneers are not for patients who have tooth decay, gum disease, root canal infection, grinding and clenching habits.

In order to have porcelain veneers placed, the patient should:

  • Have good oral hygiene
  • Have a sufficient amount of healthy enamel.

The procedure is typically permanent and irreversible as the dentist removes a layer of enamel before fixing your veneers. It is important, you consult with your dentist and make up your mind properly before going through with the procedure since the lost enamel cannot be replaced.

Benefits of Composite Veneer

  • Less expensive
  • Easy to repair if needed

Disadvantages of Composite Veneer

  • Discoloration over time

Benefits of porcelain veneers

  • Very natural, life-like translucency
  • Do not change colour over time
  • Long-lasting

Do veneers mess up your teeth?

No veneers do not ruin your real teeth! They are not made of enamel like the front of your natural teeth. In fact, they actually have an advantage over natural teeth in terms of resistance to damage or staining.

Cost of Dental Veneers in India compared to the USA, UK and other parts of Europe

Cost per Tooth India (INR) USA (USD) UK (GBP) Europe (Euro)
Porcelain Veneer 8000 – 15000 925 – 2500 800 – 1000 280 -350, 495 for CEREC
Composite Veneers 1000 – 2000 250 – 1200 195 – 295  


The final cost of veneer depends on

  • Brand e.g. CEREC, Procera, Emax cad, Emax
  • Where you choose to get your treatment done.

What to expect during a Veneer Procedure?

  • Your dentist will remove a small amount of tooth surface to permit placement of the veneer
  • An impression is made and sent to the laboratory
  • The dental veneer is then made to fit the tooth and mouth
  • The veneer is then bonded to the tooth using resin cement.

How long do veneers last?

Veneers generally last between 7 and 15 years, depending on quality. After this period they need to be replaced.

Dental veneers are an excellent way to hide discolored, crooked or damaged teeth, but it’s important to weigh the pros and cons that come with the territory before getting them. Make an appointment with your dentist to find out if dental veneers are a fitting solution for you.

Tooth Friendly Food & Foods That Can Cause Tooth Decay

Healthy teeth – Healthy you.Yes! it is true that keeping teeth healthy will help you stay healthy… 

We as doctors and you as parents always insist on the child to brush twice, floss, rinse the mouth. However, the secret to healthy teeth lies in your child’s diet as well..! Food has always shown a great deal of impact on teeth-for better or for worse. This blog will help you discover the tooth-friendly food that you should include in your child’s diet and as well the food that should be avoided..!

Tooth Friendly Food

Fruits & Vegetables Containing Fiber

vegetablesChewing apples and other high-fiber containing fruits can clear the soft deposits from your teeth. Also as a benefit, fruits are full of essential vitamins and minerals.

Carrots, cucumber and other vegetables containing fiber when chewed also stimulate saliva secretion which in turn washes away the acids and food deposits naturally from the tooth surface.

Drinking Water with Fluoride

Drinking plenty of water is always recommended as it not only clears the food remnants but also the harmful bacteria. Also, fluoride present in water is an essential mineral for the health of teeth since the time of birth and it is essential in forming a stronger enamel surface which is more resistant to the acids secreted by plaque bacteria. However, optimum values of fluoride in water should be constantly kept under check. All drinking water almost contains fluoride but some bottled varieties do not.


An egg is an excellent source of vitamin D, protein and calcium, which are all important for oral health. Vitamin D is the most essential vitamin for absorbing calcium from the food consumed. This calcium will, in turn, build a stronger jaw for holding the teeth in place and maintains healthy and strong teeth.

Dairy Products

dairy-productsDairy products such as milk, cheese, and yogurt are all very rich in minerals like calcium and phosphorous. They also contain casein which has an important function of building a strong enamel thereby preventing cavities. Minerals like calcium and phosphorous work by neutralizing the strong acids that are produced by the plaque bacteria.

Calcium is just not needed for the teeth in their formative stages but also throughout life. When the diet contains low calcium, the body leeches calcium from teeth and bone making them weak thereby increasing the chance of cavities. Weaker bones also may leave your teeth with less support.

Green Leafy Vegetables

green-leafy-vegetablesLeafy veggies have a very high level of vitamins and minerals such as vitamin A, vitamin C, beta carotene, phosphorus, calcium and magnesium. For example, spinach is rich in calcium. Phosphorous from these veggies get deposited into your teeth and bones thereby strengthening them.




Carbohydrates, when consumed, gets deposited on the teeth irregularities due to their sticky nature. On the other hand, chewing nuts secrete saliva thereby washing the food deposits. Almonds, peanuts and cashews, can also protect teeth by replenishing the lost minerals.

A note on Balanced Diet

A balanced diet is the one that gives your body the essential nutrients which are necessary to function properly. The following food pyramid categorizes different kinds of food which are important to maintain a healthy diet.

It is also important to understand that the number of servings when increased will increase the risk of cavities as the teeth are exposed to risk for multiple times.

What foods can cause tooth decay

Sugary Drinks

sugary-drinksAnything that is consumed in excess is always harmful and the same applies to the sugars as well. The oral germs present inherently in the mouth start to feed on these sugars and eventually convert them into acids, which further dissolves tooth enamel and causes decay. Also, carbonated soft drinks, sugar-free diet sodas, non-carbonated sports drinks are all acidic in nature which causes the same damage when consumed.

Citrus Foods and Juices

Citrus fruits are definitely a good source of Vitamin C and other nutrients. It helps in the repair of the body and plays a major role in maintaining healthy gums. However, these citrus fruits are again highly acidic and they erode tooth enamel. It is recommended that juices made of citrus fruits be diluted when consumed on a daily basis and drinking water immediately after will also help to reduce the harmful effects.

Chewy Candy

chewy-candyWe have seen that sugars cause cavities and candies are full of it. Of all, the most damaging are the ones which are sticky in nature. They have a tendency of getting embedded in the deep crevices of the tooth and harbour bacteria at a later stage. So, it is always advised to rinse with water to clean the tooth surfaces and gums. Extra chewy candies like toffees, gummy bears, jellies and caramels also stick to teeth for a long time even after rinsing and brushing. This is where sealants play a preventive role in cavity formation.

Chips, Bread and Pasta

breadsSnacks which are made from white flour are carbohydrates and we have already discussed the ill effects of these earlier in the blog. Chips not only are unhealthy but also have a tendency of adhering to the teeth and promote cavities.

Right food for healthy teeth

What you consume not only makes your body stronger and healthier, it is also playing a major role in the health of your gums and teeth. So, it is not always just consuming the right kind of food but also knowing how and when to eat them. Few tips….

  • Eating a raw vegetable at the end of your meal will secrete more saliva and also scrubs the teeth surfaces.
  • Make sure you drink water after every meal which help wash away the sugars and acids present on the teeth surfaces
  • Few foods that are good for your teeth (milk) also contain sugars. So it is important that you rinse or brush and floss afterwards.
  • Brush twice a day and also remember to visit a dentist every 6months for checkups.

Ten Things You Must Know About Clear Aligners or Invisalign

What are clear aligners?

Clear Aligners, often most well-known by the brand Invisalign, is a series of transparent, customized orthodontic devices which fit over your teeth and straighten the irregularly placed teeth.

How do Clear Aligners look like?

clear aligners India

Invisalign India

What are the advantages of clear aligners / Invisalign over conventional braces?

  • Efficient in smile outcome as it is unique and customized for your teeth
  • Shorter duration of treatment time
  • Better esthetics as they are transparent and invisible.
  • Minimal maintenance
  • Removable – they can be removed anytime and hence wouldn’t affect your oral hygiene and eating habits

Who can use clear aligners / Invisalign?

After you get your teeth checked, the orthodontist will take a call if aligners can be used.

What care should be taken while using clear aligners / Invisalign?

  • They are easy to maintain.
  • Care should be taken not to clench on the aligners when in place.
  • When removed, they should be placed in the box provided to avoid damage.
  • Using a soft toothbrush, it has to be cleaned every day.

What are the Different types of Clear Aligners Available in the Market

  • K Clear
  • Dentcare Clear Aligner
  • Invisalign
  • Clearcorrect
  • Orthoclear
  • Flash Orthodontics

How long do I have to wear the aligners in a day?

In order to get the desired smile, aligners have to be worn for a period of at least 20 hours in a day.

How do Clear Aligners work?

The aligners will be customized and changed every 15 days which efficiently moves your teeth into the desired position and are straightened by applying gentle pressure and minimal discomfort.

What outcomes can I expect from using clear aligners / invisalign?

A picture is always the best way to showcase the impact of clear aligners. Here’s a case – 

Before Treatment

After Treatment


How long do I have to use the clear aligners?

Depending on the severity of mal-aligned teeth, the duration of use of aligners can vary from patient to patient.

Pit and Fissure Sealants : Everything You Need to Know


What are Pit and Fissure Sealants?

A sealant is a protective plastic coating, which is applied to the chewing surfaces of the back teeth.
The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the
teeth and causing decay. They are the cornerstones of modern preventive dentistry in the prevention of
caries susceptible teeth.

Which teeth should be sealed?

Sealants are only applied to the back teeth – the molars and premolars. These are the teeth that have
‘pits’ (small hollows) and ‘fissures’ (grooves) on their chewing surfaces. Some teeth naturally have deep
grooves which will need to be sealed; others have shallow ones which will not need sealing.

What is the process involved?

The process is usually, taking minimal time. The tooth is thoroughly cleaned, prepared with a special
solution, and dried. The liquid sealant is then applied and allowed to set hard – usually by focussing a
specialized light onto it.

Is Pit and Fissure a Painful Treatment?

It is totally pain-free, generally there is no difference felt afterwards.

How long does pit and fissure sealants last?

Sealants usually last for many years, but your Doctor will check them regularly may call you for regular
checkups to make sure that the seal is still intact. They can wear over time, and sometimes the dental
team needs to add or replace some sealant to be sure that no decay can start underneath it.

How do Pit and Fissure sealants work?

The sealant forms a smooth, protective barrier they cover all the little crests and troughs on the surface of the tooth. Dental decay may easily start in these grooves if they are not sealed since these grooves serve as a harbour for bacteria and food particles. Once we seal them, the chance of food getting stuck to them is negligible.

When should you do a Pit and Fissure sealant

Sealants are often applied as soon as the first permanent teeth start to erupt in the mouth. This is
usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be
any time between 11 and 14 years of age.

Do we still have to clean those sealed teeth?

Yes. It is mandatory still to keep the teeth clean. The smooth, sealed surface is now much easier to keep
clean and healthy with normal brushing. Using fluoride toothpaste, the last thing at night and at least one other time during the day will help to protect your teeth. Pit and fissure sealing reduces tooth decay and the number of fillings your child might need.

Key Indications of Pit and Fissure Sealants

  • Deep retentive pit and fissures
  • Stained pit and fissures
  • Caries free pit and fissures
  • Increased caries indices
  • Routine dental care

Contraindications of Pit and Fissure Sealants

  • Well cleansing pit and fissures
  • Radiographic or clinical evidence of interproximal caries
  • Tooth not fully erupted
  • Life expectancy is limited

Different types of sealants for Pit and Fissure Treatment

  • Fluoride releasing sealants
  • Clear pit and fissure sealants
  • Coloured sealants
  • Fluorescing pit and fissure sealant
  • Sealants with ACP

Choosing the Right Type of Dental Implants

Dental implants are the best treatment modality for replacement of missing teeth.

Choosing the right type of implants plays a vital role in the rehabilitation process and prognosis. Below are different types of implants available, the time frame involved and case selection.

Different Types of Dental implants

Single Piece /One Piece Implants

Single piece implants are implants that are designed in such a way that the implant and the abutment are connected in one piece. The bridge of the crown can only be cement retained.

Advantages of Single Piece Implants

Single piece or One Piece Implant prove to be a cheaper option for a patient when making a choice because the implant and abutment are made as one piece during their fabrication and this reduces the abutment cost when compared to a two piece implant.

Disadvantages of Single Piece Implants

Abutments cannot be customised. The company manufactures the abutment with implant. Hence no customisation possible. The Single or one piece implants can only be bended. They can never be made parallel to the adjacent implant abutment which is possible in the laboratory by CAD CAM Designing. We used to do lot of trimming and abutment shaping in the patients mouth. This leads to lot of titanium dusting which is not good if swallowed.

After the implant placement the abutment milling have to be done directly in the mouth itself. Milling in the mouth requires lot of chair side time, keeping the implant patient’s mouth open for a very long time which is more traumatic to the patient. This leads to lot off stresses on the implant, affecting the healing of the bone around the implant. Abutment milling in Single piece implants is done with the airotor-handpiece with Tungsten carbide burs which is not precise, Moreover leads to lot of frictional heat generation which is not good for bone healing around the implant or Osseo-integration . Abutment milling in the mouth immediately after implant placement when the stability of the implant is not very good can lead to failure of the implant.

The tip and abutments of these implants are very thin and they tend to break. Removal of the implants becomes difficult if proper stability is not achieved. These implants are not easily retrieve able.

Two Piece Implants or Delayed Implantation

Delayed Implantation is a more conventional technique where the techniques used are not flapless and are time taking. One has to put up with a waiting period of almost 3 months and upwards for appropriate Osseo-integration to take place after which the crowns are given.

The two piece implants are implants where the implant and the abutment are designed separately. Unlike single piece implants, the two piece abutments allow a lot of scope for customization.

Advantages of Two Piece Implant
Two piece implants essentially prevent the need for abutment milling to be done in the patient’s mouth and provides an ideal environment for better Osseo-integration and is ideal for the immediate loading protocols.

Disadvantage of Two Piece Implant
Rough surface is till the crest, so chances of the implant to be affected are more because of the gum shrinkage over period of time.

Hybrid Implants

Hybrid Implants have advantages of both One piece implants and two piece implants. Smooth machined surface at the collar to prevent peri implantitis and rough surface is helpful for osseointegration.

The implant abutment junction has a multi lock hex design to prevent screw loosening. There are no micro movements at the junction. At The Dental Specialists we use advanced Hybrid Implants taking surgical advantages of Single piece for immediate loading and screw retained prosthetic solutions applying the concepts from two piece implantology.

Immediate Implants & TTPHIL

Immediate Implantation

Immediate implantation techniques are novel approaches developed to make the implant experience less tedious and comfortable to the patient. The techniques are flapless and use surgical and radiographic guide stents which make it possible for us to perform immediate loading.

We use a unique protocol called the Tall and Tilted Pin Hole Immediate Loading ( TTPHIL) Technique and give permanent teeth in 2-9 days. TTPHIL- ALL TILT™ Technique is innovative and is more reliable than traditional implant surgical techniques as we aim for minimal time loss and discomfort for our patients.

Edentulous Type Loading Protocol Implant Type
Single Tooth Immediate Hybrid Implants
Multiple Tooth Immediate Hybrid Implants
Complete Edentulous Immediate Hybrid Implants