Regular

How does the treatment of a filling go?

1. Determining the desired color white

The first step is to determine which shade of filling material best suits your tooth. There are many shades of white available. By combining different colors, it is almost always possible to create the right color.

2. Grinding the tooth

If a filling in a molar is to be replaced, the old filling is removed first. If a tooth is being filled for the first time, only the affected part of the tooth is ground away. If the filling is being used to enhance the appearance of a tooth, very little, if anything, of the tooth needs to be removed.

3. Drying

For the filling to adhere to the tooth, the tooth surface must be dry. Wadding rolls and sometimes a small suction device is used to “dry” the area.

4. Sticking technique

Before the filling material is applied, the tooth is first treated with acid, after which a bonding layer is applied. Exposure hardens the adhesive layer.

5. Filling

The filling material is applied to the tooth in several layers. The white filling is placed on the bonding layer. Next, the filling material is hardened by exposure.

6. Finishing

Finally, the surface of the filling is adjusted in height and polished smooth.

Crowns and bridges are intended as durable replacements for teeth and molars. They fulfill the original form and function as much as possible. Treatment for a crown or bridge is more complicated than for a filling. You will have to return to your dentist several times.

What’s a crown?

A crown is a metal and/or porcelain cap that fits precisely over a chipped tooth. The cap is glued to the tooth. A crown restores the tooth to its original shape and function.

When might a crown be needed?

1. There is not enough support for a filling. Tooth decay may have caused the loss of a large portion of the tooth.
2. Improve appearance. It can be an improvement for both colors and stand.

What is a bridge?

A bridge is made to replace one or more missing teeth and/or molars. A bridge is attached to two or more pillars. These are abraded teeth or molars on either side of the gap of the missing tooth or molar. A bridge consists of two or more crowns that fit onto pillars and a bridge component also called a dummy. This consists of one or more artificial teeth and/or molars which are placed in the place of the open space.

When might a bridge be needed?

1. To chew better.
2. Improvement of appearance.
3. To prevent teeth and molars from becoming crooked and/or growing out.

If teeth are missing, the teeth of the other jaw may grow toward the open space. Also, the teeth on both sides of the open space can grow toward each other, causing them to be crooked.

What types of bridges are there?

Ordinary bridge:

In an ordinary bridge, the piers are located on both sides of the open space.

Free-standing bridge:

In a free-standing bridge, the pillars are located on one side of the missing tooth.

Etch Bridge:

An etching bridge is usually possible when the teeth on either side of the gap are virtually intact. An intact tooth means that no treatments have been performed on it before. For this construction hardly anything needs to be polished off the smooth teeth. The etching bridge is mainly used to replace one or two teeth. The bridge is utilizing metal fixing plates with a special glue invisibly pasted to the inside of the teeth. An etching bridge can, if necessary, usually be removed quite easily.

What material are crowns and bridges made of?

Porcelain:

Crowns and bridges made of porcelain can be used in many situations. The material is tooth-colored and looks very natural.

Metal porcelain:

Metal is used as the base. A layer of tooth-colored porcelain is applied over the visible metal for appearance.

Metal:

Sometimes crowns and bridges are only made of metal. This material is very strong and resistant to wear and tear. They are then given a gold or silver-colored gold alloy. Because of the color, we only place them in the back of the mouth.

How does the treatment of a crown or a bridge proceed?

The treatment of a crown or bridge is done in steps. It requires two or three visits to your dentist. A crown or bridge is not made directly in your mouth but in a dental laboratory. This takes about three weeks. Under the heading Cerec, you will find a crown option that can be fitted in one sitting.

The treatment in steps:

1. Tooth removal: first, part of the tooth is removed until there is enough space to make a crown or bridge. If necessary, you will be given a local anesthetic.
2. Superstructure: If your tooth is not stable enough for a crown or bridge, your dentist may first make a superstructure. He or she glues the superstructure into the root canal with a pin.
3. Impressions: three impressions are then made: An impression of your entire jaw that accurately shows the eroded tooth. An impression of the opposite jaw and an impression of the bite registration. With these three impressions, the dental technician will start making the crown or bridge.
4. Determine color: together with your dentist you will choose a suitable color, sometimes you will have to visit the dental technician to find the right color together.
5. Emergency appliance: The dentist makes an emergency appliance (temporary crown) to protect the erupted tooth. You will receive a letter with tips and instructions for the temporary restoration. If the temporary crown becomes loose, contact your dentist.
6. Fixation: On the inside of the crown or bridge, the dentist applies a self-curing cement. He then slides the crown or bridge into place and presses it firmly.

Maintenance of crowns and bridges:

Daily oral hygiene is especially important for crowns and bridges. The gums around the crown in particular must be cleaned thoroughly. The edge of the crown is a vulnerable area. Plaque can easily remain on the edge. Plaque causes cavities along the edge of your crown or bridge and inflammation of the gums. Brush this area carefully with a soft toothbrush and use interdental brushes and/or floss. The dentist or our prevention assistant can advise you on this.

How long does a crown or bridge last?

The materials are so durable that a crown or bridge will last at least ten years. Good oral hygiene has a great influence on durability. A crown or bridge can of course be damaged prematurely by an accident.

Will I experience any post-treatment pain during treatment for a crown or bridge?

After placement, a tooth that has been crowned or bridged can sometimes be sensitive. This is usually temporary. If the sensitivity persists or becomes more severe, please contact our practice.

What does a crown or bridge cost?

The cost of a crown or bridge depends on the type of crown or bridge and the number of teeth that need to be replaced. The material used and the costs for the dental laboratory. It is also important to know whether construction is needed. Ask your dentist for an estimate in advance.

Are crowns and bridges covered by the insurance?

Reimbursements vary depending on your health insurance policy. For more information, please contact your health insurance company to find out what reimbursements you are entitled to.

Extraction of a tooth

Preparation for tooth extraction

Just eat right beforehand if you need to have a tooth pulled by your dentist or oral surgeon. Are you taking any medications? Then just take them. If you are taking anticoagulants, you should report this well in advance.

How is a tooth extracted?

Once the anesthetic is well absorbed, the dentist uses an instrument to make a twisting or prying movement on the tooth. The procedure is painless. Stitches are not always necessary. It depends on the size of the wound.

How quickly does the wound heal after a tooth extraction?

It takes about ten days before the wound is completely closed. If the blood in the wound can clot properly, the wound will heal best. Rinsing removes the coagulating blood. Therefore you cannot rinse your mouth the first day. Drinking is of course allowed. After the extraction of the tooth, you will always receive an information leaflet about what you should and should not do to the extraction of the tooth.

What’s bad for healing?

Alcohol and smoking slow down the healing of the wound. Therefore you should refrain from doing so. Don’t let a painkiller melt on the spot either. Some painkillers can cause extra irritation at the wound site.

When can you eat again?

Once the anesthetic has worn off, you may eat and drink with care. Always wait with chewing until the anesthesia has worn off completely. Otherwise, you may bite your cheek or lip.

When can you brush your teeth again?

You can brush your teeth normally again after an extraction. Be careful to brush the area where the tooth has just been extracted.

What symptoms can occur after a tooth extraction?

Pain

After one to three hours the anesthesia wears off. It is normal for you to feel some pain at this point. As soon as you notice that the anesthetic is wearing off, you can take a painkiller. Paracetamol, a painkiller that is for sale in pharmacies and drugstores, is usually preferred. Your dentist may also give you a prescription for a painkiller.

After shooting

Sometimes the wound bleeds afterward. Does the bleeding not stop after about two hours? Then place a double folded bandage or a rolled-up cotton handkerchief on your wound. Bite on it for about fifteen minutes. Does the bleeding not stop? Please contact our practice.

What is an implant?

An implant can best be compared to an artificial root. An implant replaces an absent tooth root and is inserted into the jaw like a screw. Implants are made of a body-friendly material. The implant provides a hold for a crown, bridge, or snap prosthesis.

When are implants used?

• In the absence of one tooth. The dentist places a crown on the implant.
• In the absence of some teeth. In this situation, the implants are fitted with a fixed bridge. A bridge is a non-removable replacement of one or more missing teeth for the patient.
• If all teeth are missing, an overdenture can be placed on implants (usually two). The prosthesis is clicked onto the implants.

When is treatment with implants possible?

In principle, everyone with a fully grown jawbone (from about eighteen years of age) can have an implant placed. For a successful treatment you must meet some conditions:

• You must have sufficient jawbone for the anchoring of the implants.
• Your jawbone must be healthy.
• The gums of the remaining teeth must be healthy. If this is not the case, it will be treated first.
• You must be prepared to maintain the fitted facilities properly.

The dentist uses x-rays to assess whether you have sufficient jawbone and whether it is healthy. Nowadays it is possible to create new jawbone in places where there is too little of it. Smoking and excessive alcohol consumption have a very negative influence on the success of the treatment.

How does the treatment with implants work?

The implant is inserted under the gums, after which the gums are closed. This way there is less chance of post-operative pain and less chance of infection. The gums are opened up again when the crown, bridge, or prosthesis is fitted.

The dentist inserts the implants.

1. First, you will be given a local anesthetic around the area where the implant will be placed.
2. Then the gums in the place where the implant is to be placed are loosened so that the jawbone becomes visible.
3. Then a hole is drilled into the jawbone.
4. The implant is screwed into this.
5. The gums are then sutured.

If you need more than one implant, they are almost always inserted during the same treatment.

After insertion of the implants

Experiences with the treatments are mixed. The bone itself has no feeling, but the gums can be somewhat painful. If necessary you will be prescribed a painkiller.

Three to six months after insertion the implant is firmly anchored in the bone. You should not put any weight on the implant during this period. A temporarily placed device will guarantee the chewing function and aesthetics as much as possible.

After one or more implants have been anchored in the jawbone, the dentist will place the crown, bridge, or prosthesis on them. Under local anesthesia, he sometimes first removes a small section of the gum tissue above the implant.

Oral hygiene with implants

An implant under a crown or bridge is anchored in the bone. You must clean the transition from the crown or bridge to the gums thoroughly. Brush this area carefully with a soft toothbrush and use brushes and/or floss. If you have poor oral hygiene, you may lose your implant.

Implants that serve as pillars under an overdenture should be cleaned with a soft toothbrush, brushes, and/or (super) floss. Brush twice a day the part of the implant that sticks out above the gums. Pay extra attention to the transition from the implant to the gums. Clean the area under the splint with brushes and/or super floss as directed by your dentist or prevention assistant. If you don’t remove food debris and plaque around the implants, the gums will become inflamed. Over time, this causes them to lose their grip, become loose, and may cause pain.

Aftercare of implants

Good daily oral hygiene and regular check-ups by the dentist are necessary after your implant has been placed. The dentist will indicate when he wants to see you again for checkups. The dentist pays attention during the checkup to:

• The health of your gums.
• The situation of the jawbone around your implants.
• Wear and tear of the crown, bridge, or prosthesis.

Cost of implants

What you have to pay for the treatment depends on the extent of the work and your health insurance. Ask your dentist for a quote and always discuss this with your insurer.

How does the treatment go from your teeth to dentures?

• The dentist will begin by pulling your molars. Then, the gums are allowed to heal and recover.
• The dentist or dental technician then makes an impression of your jaw. Your denture will be made based on this impression.
• When the prosthesis is ready, the dentist will extract your teeth. Then you can try on the prosthesis. You will get the prosthesis fitted immediately, so that you do not have to walk around without teeth.
• In the first period some adjustments will be made, to make sure your prosthesis fits as well as possible. The first prosthesis is often a temporary one, also called an immediate prosthesis. After one or two years you will get a definitive prosthesis.

Cleaning of your dentures

Your dentures are still new and beautiful. Of course, you want to keep it that way. That is why you should take care of your dentures in the same way as you do with your teeth. If you do not clean them regularly, food particles will remain. On top of your dentures and underneath them. If you do not remove them, your gums may become inflamed in the long run. You should therefore clean your dentures carefully after every meal. Use a special denture brush, such as one from Lactona or Oral-B, and water to remove food residue properly. Do not use toothpaste. It may rub off too much. Clean dentures always feel smooth. Do not let the smooth dentures slip from your hands during cleaning. They will break. To be safe, first, fill the sink with water and clean your dentures over it. You can also clean the denture with green soap or washing-up liquid.

Place your dentures in a cleansing agent (vinegar) at least once a week for a night. This will prevent tartar from forming on your dentures. Afterward, brush your dentures thoroughly and rinse them with water. Never put your dentures in hot water and certainly do not use bleach or abrasives.

Clean your mouth too

Clean not only your dentures but also the mucous membrane on which your dentures rest: your jaws, palate, and the transition from the jaw to the cheeks. Otherwise unpleasant inflammations may develop. And again, prevention is better than cure. Massage the mucosa at least once a day with a soft toothbrush and pay extra attention to your palate. Use regular fluoride toothpaste to clean your mouth.

Take your dentures out at night

When you go to sleep, your jaws should get some rest too. Therefore, take your dentures out when you go to bed. That is better. Do you find it unpleasant to sleep with an empty mouth? Then only remove your bottom teeth. Would you prefer to wear your entire set of dentures day and night? If so, have your dentist check your mouth and your dentures at least once a year.

Do you not have dentures in your mouth? Then keep it in a glass of water. Change the water every day. Always rinse the denture thoroughly with water before putting it back in your mouth.

Getting used to dentures

The dentures may only be removed from your mouth after the first day. Depending on what you have agreed upon, this may be done by your dentist or by you. Be careful with the wounds if you are allowed to do it yourself. Rinse and brush the dentures. To clean your mouth, rinse it gently with lukewarm water. You may want to add a little salt to that. You can also use a chlorhexidine mouthwash, such as Perio-Aid, which is available from pharmacies. Rinsing with lukewarm camomile tea is also a good idea. After a few days, the wounds will start to heal and the pain will go away. You will then slowly get used to your dentures. This takes time. Some people will get used to them faster than others.

Food

Eating with your new dentures is somewhat uncomfortable. Especially in the beginning, you will have to be careful. You will find out for yourself what you can and cannot eat. In the first few days, you should eat soft foods such as puree, minced meat, and soft fruit. It is better not to bite off pieces of food with dentures. You should therefore cut your food into pieces and chew calmly and evenly with your new artificial teeth.

Talking

At first, you may feel uncomfortable with your new dentures. You may slur for example. Or certain sounds may sound different from what you are used to. It is as if you are talking with a full mouth. This is normal. Your mouth still has to get used to your new dentures. Usually, you will feel much better after a few days.

Adhesive pastes, adhesive powders, and other aids

There are all kinds of adhesive pastes, adhesive powders, and ‘liners’ on the market to give dentures more grip. These products are all emergency solutions. They do not remove the cause of the problem. Never put cotton wool under your dentures. This will only cause your jaws to shrink more quickly. Are your dentures becoming loose? Then go and see your dentist. He or she will usually be able to see what is wrong straight away and can give you the best advice.

Once a denture, forever?

After a while, you will get used to your new artificial teeth. So well, that it will seem as if they have always been there. But it doesn’t stay that way. Your mouth is changing because your jaws are shrinking. Your dentures will remain the same size. This means that there is space between your dentures and your jaw, which in time will cause your dentures to loosen. If your dentures no longer fit properly, they may start to press harder in some areas of your jaw than in others. This may cause pain. If this happens, please contact your dentist. Do not sand or file your dentures yourself! In such a case your dentist will adjust your dentures. He may add a new layer or ‘lining’ to your dentures, making them more solid again.

The plate or frame prosthesis

If one or more teeth need to be replaced

A plate or frame prosthesis, also called a partial prosthesis, is a replacement of one or more teeth. It is a good solution if your lost teeth or molars cannot be replaced by a bridge, crown, or implant. You can take the prosthesis out of your mouth. Bridges, crowns and implants cannot. They are fixed in the mouth.

The plate prosthesis

The plate prosthesis is made of a pink, gum-colored synthetic resin. The artificial teeth and molars are anchored in it. The whole prosthetic plate rests on the mucous membrane of the mouth. If necessary it is attached to the remaining teeth with anchors.

The frame prosthesis

The frame prosthesis is made of metal. On the metal, a gum-colored resin is applied. The artificial teeth or molars are placed on top of the resin. The denture mainly rests on a part of the remaining teeth. Depending on the design the denture will restless or more on the mucous membrane. The dentist can attach the denture in two ways. Either by using metal anchors which are clamped around some teeth or by using a kind of clasp. In a clasp, one side is attached to a crown, tooth, or molar and the other side is attached to the frame prosthesis. This way you can slide the denture into the clasp. The clasp is usually on the inside of the teeth and is therefore not visible from the outside. Anchors are often slightly visible.

Differences between the plate and frame prosthesis

A plate prosthesis is cheaper than a frame prosthesis, but it also has disadvantages. Because the plate prosthesis rests completely on your gums, it can easily lead to gum problems. Your gums have to absorb the force caused by chewing. Also, food can easily get stuck under the implant. This can lead to inflammation of the gums. The frame prosthesis rests mainly on your remaining teeth and to a lesser extent on the gums. Therefore your natural teeth absorb the chewing forces and the gums are spared more than with a plate prosthesis. Which one is most suitable for you, differs per person. You can make your choice in consultation with your dentist.

Making a plate or frame denture

Depending on whether your dentist is fitting a plate or frame denture, he may grind the teeth or modify them in some way. Then he will take impressions of your jaws. This is done using an impression tray filled with special impression material. In the dental laboratory, the impression is filled with plaster. This creates a plaster model. This is then used to make a properly fitting impression tray made of synthetic resin. This impression tray is used to make another impression to obtain an even more accurate plaster model. Your plate or frame prosthesis will be made on this model. In total, you will need five or six dental visits to have the plate or frame prosthesis made to measure. All in all, it takes about five weeks. For the frame denture, it usually takes a few weeks longer.

The first days with a plate or frame prosthesis

A few days after the dentist has placed the plate or frame denture in your mouth, he will check the fit. You may still talk a little awkwardly when you first wear the denture. Some sounds may be a little different. This is normal and will go by itself. You just have to get used to the plate or frame prosthesis. Are there still complaints? Then please contact your dentist. If your prosthesis fits well, the dentist will check it during the six-monthly check-up.

Cleaning of a plate or frame prosthesis

Reining is the same as denture cleaning.

Do I have to take off the plate or overdenture at night?

Some people grind their teeth in their sleep or press their molars firmly together. This can give unnecessary pressure on the plate or frame prosthesis and the gums. In addition, at night the gums recover better when you remove the denture. Talk to your dentist about the best thing to do.

Check

The starting point of our dental treatments is to keep your teeth healthy for a lifetime. Regular checkups are therefore very important. These check-ups ensure that any potential caries (tooth decay) are detected early and can be remedied without invasive treatments.

In adults, the correct interval of cleaning (cleaning, removal of tartar and deposits) and brushing and nutritional advice can be worked towards optimal oral health. This interval is determined by the dentist in consultation with the assistants.

We take small photos (Bitewings) every two years to keep everything up to date and a large overview photo (OPT) every 6 years.

Tartar

Tartar removal and polishing

If plaque remains on the tooth surface for an extended period, it can become calcified and hard. This is called tartar. Tartar mainly forms just below the gums and behind and between your teeth. These are the areas that are often forgotten when brushing your teeth. Tartar cannot be removed by proper brushing and should be professionally removed.

Tartar Removal

Once tartar has formed, it can be removed by an oral hygienist, prevention assistant, or dentist. In our practice, we have a prevention assistant and if necessary we can refer you to the oral hygienist. Tartar can be removed in two ways: with the help of a hook – where the tartar is scraped away – or with a device that emits ultrasonic vibrations. The vibrations cause the tartar to vibrate away.

Tooth Polishing

After the treatment, your teeth can be polished. Polishing is done with a brush in combination with a polishing paste. This polishing paste is applied to your teeth and then the teeth are polished with the brush.

Effects of the treatments

Tartar removal addresses one of the causes of gum disease.  Maintaining good oral hygiene after dental cleanings can help restore gum tissue. Polishing can remove unwanted deposits and restore aesthetics.

Why remove tartar and polish?

Tartar can eventually cause problems with the gums. Therefore, it is important to remove tartar. Even better is to prevent tartar from forming. Brush your teeth with a fluoride toothpaste at least twice a day and, if advised, also clean the spaces between your teeth.

Fear of the dentist + tips

Fear of the dentist

Being afraid of the dentist is not uncommon. A quarter of the Dutch population is afraid of the dentist. About 800,000 people are so afraid of the dentist that they are afraid to go (dental phobia). There is a great chance that they will eventually have problems with their teeth and gums. Fortunately, this fear can be overcome.

Causes of dental anxiety

The causes of dental anxiety can be very diverse and often go back to childhood. In many cases, a person with fear has had to endure a lot at the (school) dentist. In other cases, the fear has been passed on to the parents or originates from ‘horror stories’ at school.

Most people who dread going to the dentist thankfully go. However, they are still afraid of the drill or the anesthetic injection. Others are afraid of the pain and constantly think that the dentist is going to puncture a nerve or their tongue.

Preventing anxiety at an early age

To minimize anxiety later in life, you must take your child to the dentist as early as possible. Research shows that the earlier a child gets used to the dentist, the less likely it is that anxiety will develop later.

Some tips for during your child’s treatment:

• For young children, it is good if one of the parents is present during the check-up or treatment. Older children can try to do it on their own. This gives them more self-confidence.
• Will you be there as a parent? Then leave as much as possible to the dentist. Don’t make any false promises like You won’t feel a thing. If it does hurt, your child may feel betrayed.
• You can reward your child when it keeps its cool. Give them a small gift, let them stay up an extra hour, or come up with something else fun. Always reward afterward and do not promise things in advance (“If you do what the dentist says you will get…. “). This often leads to difficult negotiations with the child.

Tips for people with anxiety

Dental technology has evolved greatly in recent years. The ghost stories of the past are long gone. In principle, everything can be done virtually painlessly nowadays.

Some tips to reduce your anxiety:

• Whatever the cause of your fear, create an atmosphere of mutual trust between you and your dentist
• If you are afraid to undergo treatment, talk to your dentist about it. He is then prepared for it and can take extra time for you.
• Get informed about the type of treatment you are about to have, what will happen and why. Consider whether it would be more comfortable for you to watch the treatment in the mirror if you can.
• Are you afraid of pain? Then insist on being sedated.
• Everyone needs control. For this reason, agree with the dentist on a sign, such as raising your hand, which will allow the dentist to interrupt the treatment. This gives you the feeling that you are in control of the treatment.
• Try if you can benefit from relaxation or breathing exercises. Distraction often helps even more. Ask for music, and make an effort to listen to it well. As your attention to the treatment is less, any unpleasant feeling will be less.

Tips for people with dental phobia

If you put off going to the dentist for a long time, your teeth will visibly deteriorate. Poor dental health is certainly not good for your self-confidence or your social life. You probably realize more and more that

More than all kinds of things need to be done to your teeth, which makes the threshold higher and higher. So you will have to do something about the fear. And sooner rather than later. It is better to do this as soon as possible because the damage is always less than if you postpone it even longer. Several things are important here:

• Talk to others about it. Use the help of others to motivate you and find the right help. They can support you in an important step: the beginning of the restoration of your teeth and the end of your misery.
• You must make the first appointment yourself. Make an appointment for a dental checkup, but agree with the dentist that nothing will be done the first time. The first time is to get acquainted and to see if we click personally.
• Engage others to help you keep the appointment. They can continue to motivate you to go, to drive you, and to support you during such an initial visit or speak up if necessary.
• Prepare your appointment with the dentist well. What do you want and what do you not want? Do you have preferences about how dentists should treat you or other relevant information? Make sure the new dentist has this information. If you’re afraid you’ll forget to mention it, write it down.