Treatment Services
ORAL EXAMINATION
The patient’s evaluation begins with a detailed medical and dental history, which might intervene with the dental therapy. The clinician performs a thorough and comprehensive intra-oral and extra-oral examination regardless of the patient’s chief complaint and reasons for the visit. The examination is conducted systematically to ensure that all head and neck structures and oral cavity are examined. This examination is an essential part of a complete assessment of the patient.
The extra-oral examination includes inspection of the face and neck, careful palpation of all cervical lymph nodes and thyroid gland, and assessment of the cranial nerves.
The intra-oral examination includes the visualization and palpation of the soft tissues. The mucosa, the lips, the palate, the oropharynx and fauces, the tongue, the floor of the mouth, the gingivae, the major salivary glands, and muscles of mastication are carefully examined.
Teeth should be examined to evaluate dental caries, fractures, mobility, or other pathologies with inspection, palpation, and percussion.
The temporomandibular joints (TMJs) should also be examined by palpation and auscultation, and finally, the jaws are assessed by inspection and palpation.
All the findings, mainly the abnormal, are noted in the patient’s file. Additional details are recorded, such as the type of the lesions with regard to their size, color, location, surface texture, and consistency.
A thorough medical, history and a careful oral examination will lead the clinician to the correct diagnosis.
SIMPLE TOOTH EXTRACTION
Simple dental extraction involves the removal of a tooth or teeth that are visible in the mouth and can no longer be restored. This procedure is carried out using a local anesthetic to numb the area and eliminate any pain experienced by the patient. Once the tooth is removed, gauze is placed over the socket and the patient is asked to place pressure on the area by biting down. If necessary, the dentist will place stitches to close the socket.
RESTORATION (FILLINGS)
Dental restoration, dental fillings, or simple fillings are treatments used to restore the function, integrity and/or morphology of missing tooth structure resulting from caries or external trauma such as a fracture or wear, thus preventing further damage and loss of the tooth.
To treat a cavity, the dentist will remove the decayed portion of the tooth and then “fill” that area on the tooth with biocompatible materials.
Different materials can be used for dental fillings such as composite resin (tooth or white-coloured fillings), amalgam or silver fillings (both WHO and FDI approve the use of silver amalgam), glass ionomer material, gold and ceramics.
DENTAL X-RAYS
All types of dental radiographic examinations, including intra-oral and extra-oral x-rays, are performed according to each patient’s needs. The Clinic is equipped with the latest technology digital x-ray machines, which permit the imaging of the dentomaxillofacial complex, with minimal radiation dose and maximum quality. Under the supervision of the instructors, and following proper justification, dental students perform and diagnose all necessary radiographic examinations. Oral radiography is a valuable tool at the disposal of dentists and dental students, used for the assessment of the teeth and jaws and the identification of possible pathologies. In combination with information derived from the clinical examination and the dental/medical history of the patient, dental radiographs provide the dentist with additional useful information and enable the diagnosis and the development of a treatment plan to address each patient’s immediate and long-term needs.
ORAL PATHOLOGY
Oral Medicine and Pathology is the field of dentistry that deals with the aetiology, pathogenesis, diagnosis and management of medically related disorders or conditions affecting the oral and maxillofacial region. Furthermore, it is responsible for the oral health care of patients with chronic recurrent and medically related diseases of the mouth, for the dental management of patients with medical complications and the management of oral complications in oncologic patients.
This dental field identifies and promotes the interaction between medical and oral health. The oral cavity serves as a mirror of the patient’s general health. A plethora of systemic diseases manifest clinical features in the oral cavity. Sometimes, their presence could be the first indication of an underlying systemic condition, for example, metabolic disorders, immune-mediated diseases, malignancies, infections, or immunosuppression. Additionally, the oral signs may be the first indication of an underlying local problem such as candidiasis, infection, premalignant or malignant neoplasms.
It is of paramount importance to detect and diagnose potentially malignant disorders or oral cancer since early diagnosis is the key to prompt treatment and eventually survival.
PREVENTIVE CARE
Preventive care starts by creating the dental patient’s profile regarding risk assessment for caries, periodontal diseases and oral cancer.
The design and development of individualized oral disease prevention and health promotion programs include diet counselling, smoking cessation, oral hygiene methods and techniques, topical application of fluoride (varnish and gel), pit and fissure sealants application and oral health promotion for cancer patients. Special protocols apply for disease prevention and oral health promotion in patients with dental anxiety, fear and phobia.
EMERGENCY CARE
Dental emergencies represent conditions that require immediate dental care. The most common situations include uncontrolled tooth pain indicating a highly symptomatic inflammatory response of the pulpal (irreversible pulpits) or periapical connective tissues (acute apical abscess) following tooth infection.
Dental trauma represents another important oral health emergency condition that can cause pain and distress, especially in childhood and requires immediate care to avoid permanent damages. Trauma severity may vary according to the extension of the injury, which may involve hard dental tissues and pulp, the alveolar process, periodontal tissues and oral mucosa.
The aim of dental emergency treatment is to achieve pain relief, infection control, stop bleeding and prevent any adverse effects that in some cases may jeopardise general health status. However, emergency care must be followed by a program of scheduled appointments in order to optimize treatment results, avoid complications and enhance opportunities to prevent oral disease in the future.
CROWN AND BRIDGE
Crowns and bridges are a permanent solution to damaged or missing teeth. A crown is an artificial replacement ‘tooth-shaped cap’ that is placed over a tooth or implant, to recreate its shape and size, strengthen and protect it, and restore its appearance and function. Heavily filled teeth or root canal treated back teeth should be crowned in order to protect them and guarantee their long-term success. The dental crown procedure involves reshaping the existing tooth so that it will fit over it.
On many occasions when teeth are missing, a bridge can be made that consists of a false tooth/teeth positioned between two crowns that slot over the teeth on either side of the gap.
Both crowns and bridges can be made of ceramic, zirconia or a combination of metal and ceramic, gold and non-precious metal. They can last for a very long time if they are properly cared for.
SCALING AND PROPHYLAXIS
Gingivitis can be described as gingival inflammation, redness and swelling of the gingivae along with gingival bleeding upon brushing. It is the most common form of gum disease; 95% of the world’s population will at some point in life suffer from gingivitis.
The main causative factors of gingivitis include the accumulation of bacterial plaque or calculus/tartar on the surface of the patient’s teeth. Bacterial plaque is also responsible for the formation of carious cavities, and, hence, its prevention is of vital importance.
Management of gingivitis includes (a) patient education by providing oral hygiene instruction for prevention of bacterial plaque formation, and (b) removal of plaque or any plaque-retentive factors (e.g. calculus, overhanging restorations) through ultrasonic and hand scaling.
Scaling and prophylaxis of the general population is an integral part of preventing gingivitis formation and progression to more destructive forms of gum disease.
ROOT CANAL TREATMENT
A root canal treatment aims at saving a tooth that would otherwise be extracted. These treatment modalities address the inflammation and infection of the pulpal tissue. The pulpal tissue lies inside the tooth and it is composed mainly of connective tissue that contains blood vessels and nerve fibres. During root canal treatment, the inflamed or infected pulpal tissue is removed, then the canal system is cleaned, disinfected, filled and finally restored.
Sometimes previously root canal treated teeth can become symptomatic (e.g., pain in biting, swelling, fractured crown). In these instances, the treatment alternatives include non-surgical root canal retreatment.
PERIODONTAL TREATMENT
Periodontitis or periodontal disease is a very common form of gum disease. It is caused by the body’s reaction to bacteria that accumulate on the teeth and cause inflammation. If left untreated it may result in loss of teeth and problems while chewing or speaking. Untreated periodontal disease can lead to an increased risk of suffering diabetes, heart disease, etc. Symptoms may include bleeding of gums, bad breath or taste, and mobility or drifting of teeth.
Periodontal treatment aims in reducing the bacteria that cause periodontitis, stabilize oral health and prevent recurrence of the disease. This is mainly achieved by individualized oral hygiene instructions and removing bacteria or calculus from the teeth using modern and proven methods (scaling and root planing).
Maintaining the result of periodontal treatment is essential in the long-term stability of oral health. Regular follow-up appointments and home care need to be followed as well.
DENTURE
Partial dentures are removable prostheses that replace any number of missing teeth when there are still some remaining teeth in good condition. They are made entirely in plastic (acrylic) for lower cost, quicker delivery in a few appointments and easier future modifications; or they may incorporate a metal framework (cobalt-chromium or other alloys) which offers superior retention, greater comfort and durability. Metal-based partial dentures require some minor modifications of the remaining natural teeth to ensure an optimum fit. In some cases, partial denture treatment may be combined with the placement of crowns on two or more teeth to incorporate precision attachments.
Complete dentures are removable prostheses used when all the teeth in a jaw are missing to restore mastication (chewing), speech and aesthetics of the smile and the whole face. Correctly made complete dentures that fit well in the mouth can be used for many years with minor modifications, as modern dental materials present long durability. They are made in plastic (acrylic) and require several appointments to be fitted and adjusted for maximum comfort. Modern denture teeth present a natural-looking appearance and detail, and the patient can select a color of their preference for the teeth.
Overdentures are removable complete or partial dentures indicated when there are only a few remaining teeth that require extensive restorations or which cannot be used in their existing condition to retain a partial denture. In these cases, the teeth may be prepared in a similar way as for crown placement and the overdenture can be placed over the prepared teeth. This significantly improves comfort, as the denture is supported by the natural teeth rather than the gums, while tooth extractions are postponed or avoided altogether. They are usually made in plastic (acrylic) but may also incorporate a metal framework (cobalt-chromium alloy) and in some cases may be anchored using precision attachments.
Immediate/Transitional dentures are removable complete or partial dentures indicated when planning extractions of teeth, which have to be replaced straight away, mainly for aesthetic reasons as well as for facilitating speech and chewing. Usually, this applies to extractions of multiple front teeth. Immediate dentures are fabricated and finished before any teeth are extracted, and are placed on the same appointment as the extractions. During the healing period, immediate dentures are regularly modified to maintain a good fit while the gums are changing shape. Immediate dentures require replacement with a definitive denture after three to six months and are made of plastic (acrylic).
Denture repairs can be made on existing complete or partial dentures to prolong their service life. These include additions of teeth, replacement of broken denture teeth or broken clasps (retainers), repairs of fractures and relining (application of new material on the fitting surface of a denture to improve its adaptation to the tissues). These repairs require the denture to be sent to a dental laboratory for a few days.
PEDIATRIC DENTISTRY
Pediatric dentistry offers a variety of dental services for cooperative children and adolescents, as also for medically compromised children and special needs individuals. More specifically our clinic provides the following procedures: clinical and radiographic examination, oral pathology diagnosis, personalized treatment planning, application of individualized prevention program (cleaning, fluoride application and sealants), restorative treatment (fillings, stainless steel crowns), pulp treatment and extractions. All procedures are performed by respecting the individual needs of each patient.
PREVENTIVE AND INTERCEPTIVE ORTHODONTICS
Preventive orthodontic therapy takes place in young ages with the aim to manage problems related το the premature loss of baby teeth causing loss of space for the eruption of the permanent ones and to the presence of harmful for the development of occlusion habits (e.g., thumb sucking). Space maintenance after premature loss of a baby tooth and interruption of a detrimental habit can be accomplished with the use of removable or fixed orthodontic appliances so that the need of long comprehensive orthodontic therapy at a later age can be avoided.
Interceptive orthodontic therapy takes place also in young ages with the aim to modify dentoskeletal growth, to intercept occlusal and skeletal asymmetries, to stop occlusal trauma, and to normalize oral function. Interceptive orthodontic therapy includes expansion of constricted upper jaw to avoid a functional shift of the lower jaw that will cause occlusal and skeletal asymmetry, elimination of traumatic occlusion of the front teeth which will cause tooth movement and periodontal problems, and protection of upper incisors from fractures due to their increased protrusion.
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