This is the concluding part of the previous interview with Dr. Sanjay Shah who speaks about the various aspects of dentistry. In this article, he throws light on specific dentistry methods such as Laser Dentistry, Preventive Dentistry and also provides other helpful tips which will help you smile confidently and show off that glistening set of teeth.
Laser Dentistry is believed to be a very precise and effective way to perform many dental procedures. Laser treatments are said to be a very efficient and painless form of treatments, as compared to the former traditional types of treatments used. Dr. Sanjay Shah meticulously follows this type of treatment. As a part of continuation to the previous part of the Interview, he has thrown further light on this topic.
Dr. Sanjay Shah: There are a lot of sites on Google, which can enlighten the patients on lasers and their positive traits for us. We can do miraculous things with lasers. In lasers hard-tissue drills are available, where the need to inject for deep drilling has faded. Since the laser itself can drill and it can actually remove the dentine without causing any pain to the patient, as compared to the other treatments. The only problem is that it is extremely expensive for the dentist, so in turn the treatment will be very expensive for the patient. And it’s also a very noisy machine. These are the two factors, which we are combating. I am sure with new research, better and cheaper machines will come up in the near future. The laser which I personally use is the Diode laser, it is excellent for any soft-tissue procedure, like surgeries; gingivectomy, where the gums are cut; or Smile Designing. Many a times, to design a smile we have to cut the gum to get the smile line properly. A lot of patients having gummy smiles come to us for this treatment. When they smile, a lot of gum is visible. Here, we remove a part of the gum so that more tooth, and less gum is visible. So the smile instantly becomes better without even doing any bleaching.
The best part about laser dentistry is that, it can even be performed on people suffering from diabetes, high blood pressure and even on pregnant women; where conventional treatments and surgeries are not possible. Lasers cut out the use of antibiotics, numbing agents, and injections. There is no risk of excessive bleeding also, because the laser cauterizes the gum while cutting, so this curbs bleeding instantly. Though it’s not entirely blood free, but there is no active heavy bleeding.
Earlier, the patient had to be injected, and with the use of a blade, the gum had to be opened up. This resulted in a large amount of bleeding; where the whole mouth would be filled with blood. Thus diabetics, pregnant ladies and blood pressure patients could not be treated earlier. But, with lasers all this is possible now. Laser is an absolutely fantastic product.
So there is no pain, while cutting the gums?
No, absolutely not. If we are cutting the gum, like in gingivectomy, we do give a small injection shot, but in minor surgeries we don’t need to inject, we just spray a Lidocaine jelly or a spray, which topically numbs that area. We don’t even use sprays for some patients, and they don’t experience any pain. Normally lasers are painless. Only when deep procedures are required we numb that area slightly.
In Porcelain Laminates, thin layers of porcelain are specially shaped, which are then placed on the patient’s desired teeth. This type of treatment is usually used to cover up tooth deformity. The doctor explains Porcelain Laminates further in detail.
Dr. Sanjay Shah: We do a lot of porcelain laminates on our patient’s teeth, who have very yellow, mal-aligned or crooked teeth. If they don’t want to undergo a normal orthodontic treatment, we do porcelain laminates for them. Supposing, a patient comes to me, who has to perform a big stage show next week and his teeth are in bad shape and crooked and he wants immediate results within a week, for that laminates are the best. Laminates are basically the coatings that are done on top of the tooth. This is very similar to the process where ladies go to the beauty parlor to get their nails enhanced. We don’t actually change the shape of the teeth, just porcelain laminates are used to coat, and make the teeth look aligned.
Are laminates temporary?
No. If you are using the Empress laminates, they last for a long time. However, they are quite expensive. They could cost around Rs. 10,000 a piece. But they should last for around 10-15 years, without any problems. I have even done laminates on my wife, some eight years back, and they are still surviving. They look as if they were done yesterday. So there is absolutely no problem. Most of the film actors come and get laminates done. Laminates are the best solution to fantastic looking teeth. Obviously there are other laminates as well; like light cure laminates; ceramic based composite fillings, etc. There are laminates which are chair-side procedures; however they are not as strong as the Empress laminates. They have a life of around 5-7 years whereas the Empress laminates last for around 10-15 years.
Dr. Shah is a strong believer of Preventive Dentistry. Wish to know what Preventive Dentistry is? Hear it directly from the expert himself.
Dr. Sanjay Shah: Preventive dentistry is growing rapidly. It’s become very popular. I have been doing preventive dentistry since the past 15-20 years. It is catching on now. Basically, there are two main things in preventive dentistry. First, is the Fluoridation of teeth, where fluoride gel is put on the tooth surface; this is especially done for kids. However anyone can use this gel. Fluoride gel makes the teeth enamel stronger. Enamel’s chemical name is calcium hydroxyapatite. With the use of this gel, the enamel gets converted into calcium fluorapatite, which is a much stronger layer. Hydroxyl is replaced by fluorine that is why it gets converted to fluorapatite. This makes the enamel much more resistant to decay. Regular fluoridation results in an 80% reduction in caries incidence. We normally advise fluoridation every 4-6 months to all our patients. Obviously, fluoridation should be fortified by using fluoride toothpastes, because the daily usage of fluoride toothpastes is also good.
Fluoride mouthwashes are also available in the market now. We give concentrated fluoride mouthwashes to patients whose teeth are in a very bad shape. This helps their teeth to harden further. Second, is a treatment called the PITS and FISSURES SEALANT. Here, we seal the pit and fissures of the teeth. Grooves are present on the teeth’s occlusal surface, which can actually be sealed with these materials. They are basically tooth-colored liquids which are put on to the grooves and then cured with specific UV rays light, which we use for light cure materials also. Once we cure them properly, that area is sealed in order to curb the accumulation of food particles, which lodge inside those pit and fissures and thus prevent the cavities from forming. The life of these pit and fissure sealants is around 3-5 years. After 3-5 years we may have to repeat the procedure. But having no cavity is a better option than treating a cavity. Even regular clean ups and regular check ups are a part of preventive dentistry.
So basically this treatment has to be done before one develops a cavity?
Absolutely! It’s like a vaccination. Why do you have a vaccination for measles and small pox, because you don’t want to develop that disease, and then find a cure for it. No one would prefer first getting an ailment and then try getting rid of it. So basically we advise our patient’s, irrespective of age, to undergo preventive measures. I, myself, have undergone preventive treatment for my own teeth.
A few know-hows on Dentistry and other aspects:
If denture-using patients stop using dentures for a long period of time their gums smoothen out. So is it possible for them to again start using dentures?
Absolutely! There are many ways in which we can have more retention in dentures. There are certain particular techniques that we use; there are even particular adhesive agents that we use for dentures.
Implants can be done. Though implants have started in India around 5-10 years back, they are getting very popular now. An implant can be placed inside the bone, where a denture is then made in such a way that the implant head would be able to hold the denture very firmly. If the patient’s bones are thick enough to tackle the implants, then they can go for it. There are special small implants also available, where we put those small button implants inside and then make a denture. Through good techniques some good dentures can also be made, which can then, with the help of special adhesives, get fixed on to the patient’s gums.
Is it painful?
The implant procedure is not painful because it is done under local anesthesia. It’s a chair side procedure. You don’t have to get admitted to a hospital and get sedated. After the effect of the injection wears out, then there may be some soreness and pain. But no extreme pain is experienced. We even provide the patient’s with anti-inflammatory and antibiotics.
Implants are a great way of conserving your teeth. But the best way is to save what God has given. What He has implanted cannot be competed with. We as dentists, just do some patch work. If I go into the detail of tooth structure, it’s quite a miracle.
After every meal, the mouth should be rinsed with mouthwashes or just plain water will suffice?
Plain water will do. Use mouthwash only once or twice a day. Don’t overuse any mouthwash. It is not required.
Do you have any piece of advice or word of caution for our readers?
Doctor, thank you so much for your valuable information. And also for giving us some of your precious time and throwing light on certain blurry topics for us.
My pleasure, you are most welcome.
Those of you, who would like to know more about dentistry or treatments, can contact the doctor at his clinic:
Dr. Sanjay Shah,
1st floor Jamuna Vihar,
Block No. 8, Next to BMW showroom (Navnit Motors),
Juhu Lane, Andheri (West),
Mumbai – 400 058.
Office No.: 022-2620 79 17/ 9820