Cleaning and Gum Treatment / Periodontics

What is the difference you ask?

Scaling and polishing is usually done at regular 6 monthly intervals to remove plaque and tartar from above the gum line and to remove stains from red wine, tea of coffee that have built up over the part few months. The removal of stains and tartar will give you nice white teeth while the removal of the bacteria in plaque can prevent more severe forms of gum disease from occur-ring

Root planing is similar to scaling and polishing in the sense that your dentist will also remove plaque and tartar from your gums. However, in root planing, your dentist will have to go UNDER the gum line (usually with local anaesthesia) to remove the plaque and tartar that have accumu-lated in the gum pockets associated with Periodontitis.

Periodontitis occurs when bacterial plaque, a sticky white film composed of food debris and bac-teria forms on the teeth. If the plaque is not removed, it can turn into a hard substance called calculus or tartar in less than two days. Tartar then acts as a further bacteria trap due to its rough surface.The bacteria in plaque infect the gums, and release toxins that cause redness and irritation. It can cause the bone surrounding the teeth to dissolve. When this happens, the gums separate from the teeth, forming pockets that fill with even more plaque causing even more in-fection. A vicious cycle now ensues. And it leads to shaky teeth and bad breath from the build up of bacteria in the gums.

Dental Crowns & Bridges / Prosthodontics

How do I know if I need a crown?

Crowns are most often used when

  1.  A direct filling (amalgam/composite resin) may not be strong enough to repair the tooth with anymore. Usually the case when the cavity has grown too large and the remaining natural tooth structure too little or too weak to withstand normal biting forces.
  2. To protect a structurally compromised tooth from further wear and tear. This could be due to a very large preexisting filling (Point 1) or perhaps a tooth with history of crack and/or fracture that is starting to break down. This buys time to allow your teeth to live to bite another day!
  3. To cover and re-contour otherwise misshapen or discoloured teeth as a form of aesthetic recovery. A crown can help to restore both form and function in these situations. Yes, sometimes you can have your cake and eat it.
  4. After endodontics (root canal treatment) of a tooth (so as to achieve any or all of Points 1, 2 and 3)
  5. To restore an implant. Again, this helps in both form and function. An implant would be missing a biting and smiling surface and not really complete without a Crown.

Crowns not only come in different shapes and sizes but also materials.

Each material of course comes with inherent benefits and drawbacks. As with most things in life, there is no one size fits all. Your dentist will of course be more than happy to explain each material to you and come to a combined decision with you as to which is the best material to suit your needs.

Crown materials can perhaps be broadly and simplistically classified into

  1. Metallic crowns – Gold alloys and other Metal alloys. Traditionally the more lasting stuff with the obvious trade off being appearance and aesthetics. Subjective of course but not everyone may want a shiny metal tooth.
  2. White crowns – Full Ceramic/Porcelain crowns and Zirconia crowns. The more pretty stuff if you will. With advances in materials research, modern ceramics and zirconias are actually no slouch and may surprise you with their strength and longevity as well.
  3. Combination – Porcelain fused to Metal crowns where porcelain is layered over a metal substructure. A halfway house serving up a combination of both advantages and disadvantages of the metallic and white crowns.

Unlike Crowns, Bridges are more a means of tooth replacement rather than tooth protection, somewhat like the case of a Crown in an implant restoration. A Bridge is in essence two or more Crowns at the ends of a gap or row of missing teeth, joined by other false teeth (also known as Pontics). Sort of like an architectural bridge! See the resemblance now?

Bridges vary in design and complexity and can range from a traditional bridge involving two Crowns linked by a span of Pontics as described above, to something like an Acid-Etched Bridge or Maryland Bridge which involves a Pontic and wings to hug the adjacent teeth without any Crowns to hold onto – often used in the case of a single missing tooth.

Materials used for Bridges are very similar to those of Crowns and again your dentist would be in the ideal position to discuss with you what bridge design and material choice would best satisfy your situation.

Diet Counselling

A healthy diet is a balanced diet that includes the major food groups such as fruits, vegetables, grains, meat and beans, and milk in the right servings. A healthy balanced diet is not just essential for overall growth and development of a child but also required for teeth and gums to develop properly.

Frequent intake of a diet high in sugar puts a person at extra risk of tooth decay. Sugar can be found in soda, juices and many foods especially the processed foods. It can also be found in milk. We have to look beyond the sugar and candy dish when checking for sugar. This does not mean that we have to give up all foods with sugar; the key is to select and serve wisely. Foods that are sweet and sticky have more potential to cause cavities. Sugary foods are safer for teeth when eaten with a meal than as a snack. You can ask your paediatric dentist to help assess your child’s diet.

Aesthetic Dentistry

Aesthetic dentistry (aka Cosmetic Dentistry) is the integration of three ideals – looking good, good health and a healthy, enduring smile. The bonus is that typically you will be looking younger as well.

There are a variety of aesthetic dentistry/cosmetic dentistry treatments which can improve your smile – from replacing old amalgam (silver) fillings with tooth-coloured bonding material, to dental veneers which restore shape and colour to the teeth, or crowns and implants to replace irreparable loss. The important thing is, you do have simple, cost effective aesthetic dentistry/cosmetic dentistry options.

Veneers for aesthetic dentistry / cosmetic dentistry

Veneers are a great solution for misshapen or broken teeth. Dental veneers are thin, tooth-coloured shells made from porcelain or resin, which are carefully crafted to bond to and cover the front of unsightly teeth. While porcelain veneers will have a more lustrous and durable finish, composite resin veneers also create an attractive finish.

Composite resin is not a new material. It has been around since the 1960s, however modern techniques have allowed us to use this material in unique ways. Composite resin is primarily made of a nano-sized (one thousandth of a millimeter) glass-like particle matrix. It is a paste material that once set by a blue light (UV or LED), will harden to the texture and hardness of enamel.

Advantages of porcelain veneers for aesthetic dentistry / cosmetic dentistry

  • Porcelain veneers create a more life-like tooth effect. Porcelain has a translucency that is similar to your natural teeth, and while teeth lose this luster as you age, porcelain veneers retain their beautiful, natural and youthful look.
  • Porcelain veneers are stain-resistant, which is particularly important for those who smoke, or drink black coffee or red wine.

Advantages of resin veneers

  • Resin veneers can be placed on the tooth directly, so a final result is achieved in a single visit. Porcelain veneers are constructed in a lab, so you need to make two visits.
  • Resin veneers are molded by the dentist into the ideal shape directly onto the tooth. Porcelain veneers are fabricated in the lab based on the impression taken by the dentist.
  • Resin veneers are very conservative, that is, only a very small amount of your original tooth needs to be pared back for the veneer. Porcelain veneers require a little more of the tooth to be pared.
  • Resin veneers are easily re-shaped, repaired, polished and maintained.
  • Resin veneers are cheaper as there are no dental lab costs are incurred.

Resin veneers are best done on teeth with minor to moderate size or shape defects on teeth. If your teeth have been untouched by any fillings, and you are not sure how much smile improvement (i.e. aesthetic dentistry/cosmetic dentistry) you want, resin dental veneers are best. They are strong, durable and cost effective, and there is always the option of ‘upgrading’ to porcelain later.

Dental Implants

Dental implants/Tooth Implants are the single most important advancement in dentistry.

Tooth extraction is quite common due to poor dental health and gum disease. Leaving the missing tooth space empty may not sound too serious, but the consequences of not filling in the space can include:

  • Adjacent teeth changing position
  • Shrinking of the jawbone, making the face appear prematurely older
  • Reduced self-confidence and a less appealing smile

What are dental implants?

Dental Implants are small titanium screws placed in bone to replace the root of a missing tooth. The titanium dental implant becomes integrated with the bone in a process known as osseointegration.

The abutment, and a crown or bridge, restores the missing part of the tooth/teeth above the gum.

The dental implant-supported restoration looks, feels and functions virtually like a real tooth. It is a permanent replacement solution for a missing tooth and can be used to replace dentures anywhere in the mouth. Dental implant supported restorations can truly increase the quality of life and allow you to enjoy food better.

Types of dental implant restorations:

  • Crowns
  • Bridges
  • Dental implant-supported hybrid dentures
  • Dental implant-retained bridges

A dental implant should be considered when:

  • A tooth is beyond repair and requires an extraction
  • Teeth are missing
  • The number of teeth is insufficient for a tooth-supported bridge
  • Upper and lower jaws are edentulous
  • Dentures are loose or uncomfortable

Who is suitable for dental implants?

Basically, if you are healthy enough to have a tooth taken out, you are probably healthy enough to have a dental implant placed.

Patients are usually concerned about being too old for the procedure. There is no maximum age limit to who can receive a dental implant, only a minimum age limit. Patients who are still growing are usually not suitable for dental implant procedure.

Who is not suitable for dental implants?

Patients with the following conditions must be carefully evaluated:

  •  Uncontrolled diabetes
  • Steroid therapy
  • Connective tissue disorders

Kid’s Dentistry / Paedodontics

Kid’s or Children’s Dentistry also known as paedodontics involves the management and care of children’s teeth and their related conditions. The age range is wide and may be anytime from birth to adolescence. 

The focus of course differs from infants and toddlers to older children and adolescents. However, early detection is key when treating children in order to avoid painful complications and invasive remedies downstream.

Bring your children in once their first milk tooth starts to erupt and start their preventive care early!

Root Canal / Endodontics

Endodontist / Endodontics

Endodontics is the area of dentistry that deals with issues involving the innermost region of each individual tooth. Within the walls of every tooth, comprising the enamel and dentine, is a space containing the pulp. This space is called the pulp chamber, which extends into the roots of the tooth, making up the root canals. The pulp has many tiny blood vessels and nerve endings and it is this that make teeth “sensitive”.

When the pulp of a tooth is irritated, it becomes inflamed in a process called pulpitis.

If the irritation is persistant or severe, then irreversible pulpitis ensues and the symptoms can be severe toothache. The most common cause of such irritation is dental caries or tooth decay with cavities. Other causes include trauma (eg accidents) or severe wear and tear leading to attrition and cracks. Teeth with fillings which are very deep or teeth with crowns and bridges may also subsequently develop pulpitis due to prior damage to the pulp. In some situations, the pulp may become infected and a dental abscess or gum boil may form even in the absence of pain. Discolouration or darker coloured teeth can also be indications of root canal problems.

Treatment for irreversible pulpitis or infection of the root canals is called root canal treatment. This involves cleaning and re-shaping the root canals so that medicaments can be placed in them. The root canals will subsequently need to be obturated or sealed up to prevent ingress of germs which can cause infection. Analgesics or pain killers are often prescribed to help to resolve the painful symptoms. Antibiotic therapy is sometimes necessary to help fight infection. Root canal treated teeth often require crowning to restore them to function and to prevent further damage to the teeth.

Sometimes, previously root canal treated teeth can become infected if the seal of the root canal filling is breached by bacteria. Re-treatment of the root canals may become necessary. Surgical treatment, where the infection around the root tips are treated by a procedure called apicoectomy, is sometimes indicated.

The alternative to root canal treatment is usually extraction of the teeth, which is why Endodontists are often considered specialists in saving teeth.

What are root canal treatments?

Root canal treatment saves your teeth! “Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. One of the most common endodontic treatments is root canal treatment.

Inside a tooth is a soft, living tissue called the pulp (also called the “nerve”). The pulp contains blood vessels, fibers and nerves. A root canal treatment is needed when the pulp becomes inflamed or infected. The endodontist (root canal specialist) will remove the inflamed or infected pulp, carefully clean and shape the inside of the root canal, then fill and seal the space.

Your dentist or prosthodontist will then place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to look, feel and function like any other tooth.

Fluoride Application

What is Topical Fluoride?

Topical Fluoride is a natural element which is found as an active ingredient in many dental products such as toothpaste, mouthwash, gels and varnishes. It is used routinely to prevent tooth decay.

Topical Fluoride prevents the loss of minerals from tooth enamel and encourages remineralization. It forms a more acid resistant surface which is less prone to acid attacks by the bacteria.

The use of Topical Fluoride to prevent and control decay has been proven to be safe and effective. Nevertheless, ingestion of excessive fluoride in young children can lead to fluorosis of the developing adult teeth. Fluorosis is usually mild, appearing as white streaks or specks on the tooth surface. In severe cases, the teeth may be pitted and discoloured brown. Check with your paediatric dentist for the right amount of toothpaste to use for your young children. Parents should always dispense toothpaste for their young children to prevent them from swallowing excessive amount.

Application of Topical Fluoride

Professionally applied topical fluoride is a preventive agent that contains fluoride in high concentration. It can come as a gel that is placed on a foam tray and held against the teeth for a few minutes or as a varnish that is painted on the enamel of the teeth. Varnish is useful for young patients and those patients who may not be able to tolerate the foam tray.

Braces / Orthodontics

Types of braces at TP Dental:

There are many different types of braces that are available at TP Dental ranging from removable braces (commonly known as ‘retainers’), expanders, fixed metal braces, fixed clear braces and “invisible” Invisalign braces. To find out more about each brace, please scroll down the page.

Who provides braces at TP Dental?

All orthodontic treatment at TP Dental is carried out by SPECIALISTS in Orthodontics. There are many general dentists who carry out braces treatment in Singapore. However, in our dental surgery, orthodontic treatment is ONLY provided by fully qualified orthodontists who are listed on the Ministry of Health (MOH) Dental Specialist list.

For children or growing adolescence

Removable braces (commonly known as “retainers”)
These are braces that can be removed by the patient him or herself. Majority of removable braces are used for growing children but some are suitable for adults too. Removable braces are used to correct many orthodontic problems including crossbite, expansions and deep bites (to name a few).

Growth or functional braces

These are braces that are used during the adolescent stages to encourage growth of the jaw bone to a more favourable position. Examples of these are:

  • To correct protruding teeth (“bugs bunny” teeth)
  • To improve a smaller jaw
  • Correct reverse bite (protruding lower jaw)
  • Correct asymmetric (“lopsided”) jaw

This type of growth modification treatment can start as early as four years old and as late as 13-14 years old depending on the patient’s growth status. Your orthodontist will decide on a case to case basis to advise you on the best time to start such braces for your child.

Fixed Expander

These are braces that are fixed onto the molar teeth to encourage expansion of the upper jaw. A fixed expander is great for making spaces in crowded mouths and also for correction of crossbites.

Habit Breaker

If you have a child who has a thumb-sucking habit and is finding it difficult to stop, please speak to one of our orthodontists. We have a range of devices that may be used to encourage children to stop this habit. Prolonged thumb-sucking habits may cause:

  • Protrusion of teeth (teeth to “stick out”)
  • Development of a crossbite (one side or both sides)
  • Cause teeth to develop in the wrong position

Fixed braces

These are what majority of people call ‘train-track’ braces. These braces are fixed onto the teeth and can be metal braces or ceramic (aesthetic) braces. Metal braces can be silver (metal) coloured or patients can opt to have them in a variety of other colours ranging from primary colours (blue, green, red) to rainbow colours. Ceramic (aesthetic) braces are tooth-coloured braces that can be paired with tooth-coloured wires to make it less visible.

Fixed Metal Braces - TP Dental
Fixed Metal Braces

Fixed Metal Coloured Braces - TP Dental
Fixed Metal “coloured” braces

Fixed Ceramic Braces - TP Dental
Fixed ceramic braces

Invisalign
Yes, you read it correctly. Invisalign treatment can be used for teenage patients and we offer ‘Invisalign Teens’ for our growing patients. Of course these will be dependent on the child’s compliance and motivation to wear the aligners all the time except during eating and brushing their teeth.

Invisalign Braces for Teens - TP Dental

For Adults
We offer our adult patients a choice of fixed metal braces, ceramic (aesthetic) braces or Invisalign braces depending on their lifestyle choice.

Fixed metal braces

The advantages of fixed metal braces are:

  • Fixed onto the teeth therefore not dependant on patient’s compliance
  • Patient does not need to remove it for eating
  • Pressure on teeth is applied all the time (24hours/day)

Fixed Metal Braces - TP Dental
Fixed Metal Braces

Fixed ceramic (aesthetic) braces

The advantages of fixed ceramic braces are:

  • Better aesthetics (as they are almost tooth-coloured)
  • No difference in functionality as compared to metal braces
  • No difference in duration of treatment, result and degree of discomfort as compared to metal braces

Fixed Ceramic (Aesthetic) Braces - TP Dental
Fixed ceramic braces

InvisalignThe advantages of Invisalign braces are:
  • The most aesthetically pleasing
  • Easier to keep clean as these aligners are removable by the patient
  • Less discomfort – no wire poking

Invisalign Braces for Teens - TP Dental

Dentures

What are dentures

Dentures are artificial teeth that can be removed. Many people who are missing one tooth, several teeth or all their teeth, benefit greatly from denture teeth. Made from the latest polymer resin materials, dentures are very natural looking and they can be matched in color and appearance to your other teeth.

Why do people need dentures?

Without support from teeth and dentures, facial muscles sag, making a person look older. With dentures, you’ll be able to eat and speak – things that people often take for granted until their natural teeth are gone.

Types of dentures

A complete denture is for people who have no teeth in their lower jaw or upper jaw, or both jaws. Complete dentures should be removed and cleaned daily to keep your gums healthy and to allow your tissues to relax.

Partial dentures are for people who have some natural teeth remaining, or who only need to replace a few teeth. The benefits are the same as for full denture wearers: your facial muscles will be supported, your smile improved and your ability to chew and speak will be enhanced. The dentures should be removed and cleaned daily to keep your gums healthy and to allow your tissues to relax.