• Cosmetic facial surgery.

• Cranio-maxillofacial trauma.

• Craniofacial surgery/pediatric maxillofacial surgery/cleft surgery.

• Head and neck cancer – microvascular reconstruction.

• Maxillofacial regeneration (reformation of the facial region by advanced stem cell technique) Surgical Procedures Include.

• Dentoalveolar surgery (surgery to remove impacted teeth, difficult tooth extractions, extractions on medically compromised patients, bone grafting or preprosthetic surgery to provide better anatomy for the placement of implants, dentures, or other dental prostheses)

• Surgery to insert osseointegrated (bone fused) dental implants and maxillofacial implants for attaching craniofacial prostheses and bone anchored hearing aids.

• Cosmetic surgery of the head and neck: (rhytidectomy/facelift, browlift, blepharoplasty/Asian blepharoplasty, otoplasty, rhinoplasty, septoplasty, cheek augmentation, chin augmentation, genioplasty, oculoplastics, neck liposuction, hair transplantation, lip enhancement, injectable cosmetic treatments like botox, fillers, platelet rich plasma, stem cells, chemical peel, mesotherapy.

• Orthognathic surgery, surgical treatment/correction of dentofacial deformity as well as management of facial trauma, and sleep apnea.

• Diagnosis and treatment of:

1) benign pathology (cysts, tumors etc.)

2) malignant pathology (oral & head and neck cancer) with (ablative and reconstructive surgery, microsurgery)

3) cutaneous malignancy (skin cancer), lip reconstruction.

4) congenital craniofacial malformations such as cleft lip and palate and cranial vault malformations such as craniosynostosis, (craniofacial surgery)

5) chronic facial pain disorders.

6) temporomandibular joint (TMJ) disorders.

7) dysgnathia (incorrect bite), and orthognathic (literally "straight bite") reconstructive surgery, orthognathic surgery, maxillomandibular advancement, surgical correction of facial asymmetry.

8) soft and hard tissue trauma of the oral and maxillofacial region (jaw fractures, cheek bone fractures, nasal fractures, LeFort fracture, skull fractures and eye socket fractures).

Complications after a dental procedure that include swelling and pain, dry socket, osteomyelitis, bleeding, and osteonecrosis of the jaw comprise another set of urgent dental problems that require prompt attention. Swelling and pain

Swelling is common after certain dental procedures, particularly tooth removal (extraction) and periodontal surgery. Holding an ice pack can prevent much of the swelling. Ice therapy can be used for the first 18 hours. Cold should be held on the cheek for 25-minute periods and then removed for 5-minute periods. If swelling persists or increases after 3 days or if pain is severe, an infection may have developed, and the person should contact the dentist. Pain after a dental procedure can be moderate to severe. People can take various pain relievers. Dry socket (alveolitis)

A dry socket (exposure of the bone in the socket, causing delayed healing) may develop after a lower back tooth has been extracted and the normal blood clot in the socket is lost. Typically, discomfort lessens for 2 or 3 days after the extraction and then suddenly worsens, sometimes accompanied by an earache. Although the condition goes away by itself after 1 to 2 weeks, a dentist can place a dressing soaked with an anesthetic in the socket to eliminate the pain. The dentist replaces the dressing every 1 to 3 days until no more pain is felt after the gauze has been left out for a few hours. Alternatively, dentists often use a commercial dressing that does not need to be removed and that contains an antimicrobial and a pain reliever in addition to an anesthetic. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be taken by mouth if additional pain relief is needed. Dry sockets are much more common among smokers. If at all possible, smokers should not smoke for several days before and after the extraction is done. Women (especially those taking oral contraceptives) also have a high rate of developing dry socket. Osteomyelitis

Osteomyelitis is an infection of the bone and is usually caused by bacteria. When osteomyelitis occurs in the mouth, it typically occurs as an infection of the lower jaw. People usually have a fever, and the affected area is tender and swollen. Doctors or dentists use an x-ray to make the diagnosis. People with osteomyelitis need to take antibiotics for an extended period of time. Bleeding

Bleeding after a tooth is removed is common. Bleeding in the mouth may appear worse than it is because a small amount of blood may mix with saliva and appear to be more blood than is actually present. Usually, the bleeding can be stopped by keeping steady pressure on the surgical site for the first hour, normally by having the person bite down on a piece of gauze. People may have to repeat the process two or three times. Keeping the gauze (or a tea bag) steadily in place for at least an hour is important. Most problems with bleeding occur because the person frequently removes the pack to see whether the bleeding has stopped. If bleeding continues for more than a few hours, the dentist should be notified. The dentist may need to clean out the bleeding area and surgically close it with stitches (sutures).

People who regularly take an anticoagulant (a drug that prevents clots) such as warfarin or aspirin (even if they take only one aspirin every few days) should mention it to the dentist a week before surgery because these drugs increase the tendency to bleed. The person’s doctor may adjust the drug dosage or temporarily stop the drug a few days before surgery after consultation with the dentist. Osteonecrosis of the jaw

• Tooth extraction.

• An injury.

• Radiation therapy to the head and neck (osteoradionecrosis).

• Use of bisphosphonate drugs in high doses or for long periods.

Maxillofacial prosthodontics/prosthetics

Maxillofacial prosthetic is a sub-specialty (or super-specialty) of prosthodontics. All maxillofacial prosthodontists first specialize in prosthodontics and then super-specialize with a one year fellowship exclusively in maxillofacial prosthetics. Maxillofacial prosthodontists treat patients who have acquired and congenital defects of the head and neck and maxillofacial region due to cancer, surgery, trauma, or birth defects. Maxillary obturators, speech-aid prosthesis (formerly called as pharyngeal/soft palate obturators) and mandibular-resection prostheses are the most common intra-oral prostheses planned and fabricated by Maxillofacial prosthodontists. Facial prostheses include artificial eyes, nose, ears and other facial prostheses fabricated by the clinician or in conjunction with an anaplastologist. Treatment is multidisciplinary, involving oral and maxillofacial surgeons, plastic surgeons, head and neck surgeons, ENT doctors, medical oncologists, radiation oncologists, hospital dentists, speech pathologies (speech therapists), clinical psychologist, occupational therapists, physiotherapists, and other healthcare professionals.

A typical treatment for incorrectly positioned teeth takes about 1 to 2 years to complete, with braces being altered slightly every 4 to 10 weeks by the specialists called orthodontists. Orthodontists are dental specialists trained in the prevention, diagnosis and treatment of dental and facial irregularities. They provide a wide range of treatment options to straighten crooked teeth, fix bad bites and align the jaws correctly. Multiple methods exist for adjusting malocclusion. In growing patients there are more options for treating skeletal discrepancies, either promoting or restricting growth using functional appliances, orthodontic headgear or a reverse pull facemask. Most orthodontic work is started during the early permanent dentition stage before skeletal growth is completed. If skeletal growth has completed, jaw surgery can be an option. Sometimes teeth are extracted to aid the orthodontic treatment (teeth are extracted in about half of all the cases, most commonly the premolars).

Fixed appliances are, for example, used to rotate teeth that don't fit the arch shape of the other teeth, to move multiple teeth to different places, to change the angle of teeth, or to change the position of the root of the tooth. It is not preferable if the patient has poor oral hygiene (as that can result in decalcification, tooth decay, and other problems), if the patient isn't motivated (as treatment lasts several months and commitment to oral hygiene is required), or if the malocclusions are mild.

Braces

Braces are usually placed on the front side of the teeth, but may also be placed on the side facing the tongue (called lingual braces). Brackets made out of stainless steel or porcelain are bonded to the center of the teeth using an adhesive. Wires are placed in a slot in the brackets which allows for controlled movement in all three dimensions. Apart from wires, forces can be applied using elastic bands, and springs may be used to push teeth apart or to close a gap. Several teeth may be tied together with ligatures and different kinds of hooks can be placed to allow for connecting an elastic band. Clear aligners are an alternative to braces and can be looked as an effective option though costly.

Treatment Duration

The time required for braces varies from person to person, depending on the severity of the problem, the amount of space available, the distance the teeth must travel; the health of the teeth, gums, and supporting bone; and how closely the patient follows instructions. On average, however, once the braces are put on, they usually remain in place for one to two years. After braces are removed, most patients will need to wear a retainer all the time for the first six months, then only during sleep for some time.

Headgear

Orthodontic headgear sometimes referred to as an "extra-oral appliance" is a treatment approach that requires the patient to have a device strapped onto his or her head to help correct malocclusion typically used when the teeth do not align properly. Headgear is most often used along with braces or other orthodontic appliances. While braces correct the position of teeth, orthodontic headgear which as the name suggests is worn on or is strapped onto the patient’s head is most often added to orthodontic treatment to help alter the alignment of the jaw, although there are some situations in which such an appliance can help move teeth, particularly molars. Whatever the purpose, orthodontic headgear works by exerting tension on the braces via hooks, a facebow, coils, elastic bands, metal orthodontic bands, and other attachable appliances directly into the patient’s mouth. It is most effective for children and teenagers because their jaws are still developing and can be easily manipulated. Thus Headgear is typically used to treat a number of jaw alignment or bite problems such as overbite and underbite.

Palatal expansion

Palatal expansion can be achieved using either fixed or removable appliances.

Jaw surgery

Jaw surgery may be required to fix severe malocclusions. The bone is broken during surgery and is stabilised with titanium (or bioresorbable) plates and screws to allow for healing to take place. After surgery, regular orthodontic treatment is used to move the teeth into their final position.

Post treatment

After orthodontic treatment has completed, there is a tendency for teeth to return, or relapse, back to their pre-treatment positions. Over 50% of patients have some reversion to pre-treatment positions within 10 years following treatment. To prevent relapse, the majority of patients will be offered a retainer once treatment has completed, and will benefit from wearing their retainers.

• Sucking the thumb or fingers, or other oral habits which gives a social setback
• Crowded, misplaced or blocked-out teeth does not look good on me
• Jaws that shift, make sounds, protrude or are recessed
• Speech difficulty
• Biting the cheek or biting into the roof of the mouth
• Protruding teeth
• Teeth that meet in an abnormal way or don’t meet at all
• Facial imbalance or asymmetry (features out of proportion to the rest of the face)
• Grinding or clenching of teeth
• Inability to comfortably close lips

Removable retainers

Removable retainers are made from a clear plastic, and they are custom-fitted for your mouth. It has a tight fit and holds all of your teeth in position. There are many types of brands for clear retainers. Hawley retainer is also a removable orthodontic appliance made from a combination of plastic and metal that is molded custom to fit your mouth. Removable retainers will be worn for different periods of time depending on patient need to stabilize the corrected dentition.

Fixed retainers

Fixed retainers are a simple wire fixed to the tongue-facing part of the incisors using dental adhesive and can be specifically useful to prevent rotation in incisors. Other types of fixed retainers can include labial or lingual braces, with brackets fixed to the teeth. lips

It is observed that certain dental treatments like Pulpotomy, Pulpectomy, Space maintainers, Fillings etc are effectively modulated by Pedodontist as some Pediatric patients are handled more efficiently by Pedodontists. Once fully trained, pediatric dentists have the following skills: Interpersonal skills – patience, adaptability, and compassion are critical to explaining complex medical topics to young patients and listening to their concerns

Pedodontist is a word that was used for some time to describe the specialty of dentistry devoted to the treatment of children. "Pedia-"or "pedo" means child or children, and "-dontist" denotes one who studies teeth. Since some found “pedodontist” to be confusing (they thought it meant foot doctor) the more commonly-used term is “pediatric dentist.” Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Preventing dental problems and tooth decay is a big part of being a pediatric dentist. Dentists who work with children also treat pediatric periodontal disease and treat injuries to the teeth from trauma. They may also assess and treat older children for problems with their bite or crooked teeth. Pedodontist also work with the child’s parent to educate how to ensure their child performs a proper oral hygiene routine, and will also discuss treatment plans for the future. They have the experience and qualifications to care for a child's teeth, gums, and mouth throughout the various stages of childhood. Children begin to get their baby teeth during the first 6 months of life.

They can also treat patients with severe gum problems using a range of surgical procedures. In addition, periodontists are specially trained in the maintenance of dental implants. During the first visit, the periodontist usually reviews the patient’s complete medical and dental histories. It is extremely important for the periodontist to know if any medications are being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.

At Delhi Dental Hub our periodontist examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. The periodontist will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets, this helps the periodontist assess the health of the gums. X-rays may also be taken to observe the health of the bone below the gum line.

Moreover as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases of aging, periodontal treatment may necessitate a greater understanding and increased level of expertise by a trained specialist. Patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, will be best managed by a partnership between the dentist and periodontist. Poor oral hygine leading to bone loss and eventually leading to tooth loss is what one major problems and can definitely be managed efficiently. We at Delhi Dental Hub educate our patients with Audio- Visual Aids making them understand the importance of God Gifted Natural Teeth.

In some instances, a family dentist can effectively treat early symptoms of gum disease and other related oral issues, as long as the problem hasn’t advanced past a certain point. If you’re not sure whether your oral health issue is serious enough to require treatment from a periodontist, look for the following 5 signs:

1. Yes I have noticed change in your bite and spacing in between the tooth.

If your teeth feel different while looking, chewing, talking or brushing, you should see a periodontist. Change in the bite pattern can point toward issues that can cause long-term problems if not treated at right time. Periodontist At Delhi Dental Hub can help you to analyze the possible reasons for these changes and suggest best available treatment options that can help overcome the problem.

2. Yes I have boggy red, swollen and bleeding gums.

This is one of the most cardinal signs that your gum attachment is in problem and one should see a Periodontist to the earliest. Watch closely to see if your gums bleed when you water floss or brush them. If they do, seek input from a qualified Gum Specilist, so that minor issues can be addressed relatively earlier before they evolve into more expensive and severe painful problems.

3. Yes my teeth feel loose than before they are shaky and are unable to take load.

Loosening of teeth can be a sign of thinning bone/bone loss leading to serious infections, such as periodontitis. If you have noticed that your teeth are unable to take load and have begun to feel a little loose, you should definitely visit a Specialist at DDH. Even if you think it is just your imagination, it’s a good idea to schedule an examination, since this could be a very early sign of serious gum disease and underlying bone damage.

4. Yes my gums are receding thus making tooth appear relatively longer.

Although our gums naturally recede as we age, it shouldn’t be very noticeable. If you think your teeth look longer when you look in the mirror, this could be a sign of advanced gum recession resulting from periodontal disease. Book an appointment with a local periodontist to find out for sure.

5. Pain and discomfort in your gums.

Dental pain can usually be traced to a specific tooth in many cases. One can be pain due to cavity but if you notice discomfort within, around or underneath your gums, this could be a sign of a Gum Disease. Schedule an appointment with Delhi Dental Hub for the same, so you can get it treated in time.

As Hippocrates once said, “Healing is a matter of time but also sometimes a matter of opportunity.” As a dentist or an oral health expert, we are blessed with the opportunity of providing a healing touch to a million lives in a zillion ways, and being an Oral Medicine, Diagnosis and Radiology (OMDR) specialist adds wings to that dream. Oral medicine is the specialty concerned with “dental” and medical related disorders of the oral and facial region, including orofacial manifestations of systemic diseases. As defined by the American Dental Association, “Oral and Maxillofacial Radiology is the specialty of dentistry and discipline of radiology concerned with production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region.”

The cornerstone of any healthcare expertise is the ability to diagnose. Diagnosis and a holistic treatment plan play a yeoman's role in providing relief to an ailing patient. If diagnosis is the key to unlock the labyrinth of hydra headed diseases, then OMDR is the master key. So that brings an OMDR specialist at the helm of treatment. The advent of modern clinical research in oral medicine and advancements in the field of radiodiagnostics has heralded a new era in dentistry thereby widening its horizons way beyond one can imagine. That is what empowers and equips us as an OMDR specialist.

As specialists, we can work in primary health centers too, which is one of the best possible avenues to serve the people at the grassroots level and in the remotest of geographies. The trickledown effect of the expertise of an OMDR specialist working as a counsellor and consultant can act as a savior of countless lives that are lost every year due to lack of awareness. Early detection would not only improve cure rate but would also lower the cost and morbidity associated with treatment. That makes the job of an OMDR specialist an indispensable one. OMDR specialists form a very important part of every government healthcare setup. Similarly, in the private sector, the multispecialty and superspecialty hospitals take pride in having an OMDR specialist as a permanent faculty.

As Charaka said, health of the body starts with the health of mouth. So dental health is of paramount importance. An OMDR specialist can play a vital role in shaping the action plan of fighting oral diseases and hence an OMDR specialist must be given his due by giving incentives and increasing job opportunities. Even the team of radiation oncology must necessarily include an OMDR specialist to counter the after effects of radiation. In this manner, an OMDR specialist can bring about a big change in the fabric of overall healthcare of our country.

Many systemic diseases have signs or symptoms that manifest in the orofacial region. Pathologically, the mouth may be afflicted by many cutaneous and gastrointestinal conditions. There is also the unique situation of hard tissues penetrating the epithelial continuity (hair and nails are intra-epithelial tissues). The biofilm that covers teeth therefore causes unique pathologic entities known as plaque-induced diseases.

Example conditions that oral medicine is concerned with are lichen planus, Behçet's disease and pemphigus vulgaris. Moreover, it involves the diagnosis and follow-up of pre-malignant lesions of the oral cavity, such as leukoplakias or erythroplakias and of chronic and acute pain conditions such as paroxysmal neuralgias, continuous neuralgias, myofascial pain, atypical facial pain, autonomic cephalalgias, headaches and migraines. Another aspect of the field is managing the dental and oral condition of medically compromised patients such as cancer patients suffering from related oral mucositis, bisphosphonate-related osteonecrosis of the jaws or oral pathology related to radiation therapy. Additionally, it is involved in the diagnosis and management of dry mouth conditions (such as Sjogren's syndrome) and non-dental chronic orofacial pain, such as burning mouth syndrome, trigeminal neuralgia and temporomandibular joint disorder.

Investigations

Once the surrounding tissues and the immediate management of any lumps/swellings are taken care of, an Image of the full extent of the lesion is needed. This is done to establish what the lump/swelling is associated with and to ensure that any damaging probablitiy is kept to a minimum. There are a variety of imaging technique options which are chosen based on the lesion ie size, location, growth pattern etc. Some examples of images used are: DPT, Scintigraphy, Sialography, ComputedTomography, Magnetic Resonance Imaging and Ultrasound.

As described some lumps or swellings can be in close relation to anatomical structures. Commonly, Teeth are associated in a lesion which brings about the question – “are they still vital?” In order to clarify, any tooth that is associated with a lump or swelling is vitality tested, examined for any pathology or restorative deficiencies in order to determine the long term prognosis of this tooth and how this might affect treatment of the lump/swelling at hand.

Alongside any radiographs which may be justified, Blood tests may be needed in order to obtain a definitive diagnosis if there is a suspicion of potential blood dyscrasias or any endocrinopathy involvement.

Finally, a particularly vital means of diagnosis is a biopsy. These tend to be regularly done in the cases of singular, chronic lesions and are carried out in an urgent manner as lesions of this category have a significant malignant potential. The indications to carry out a biopsy include:

• Lesions that have neoplastic or premalignant features or are enlarging
• Persistent lesions that are of uncertain etiology
• Persistent lesions that are failing to respond to treatment

• LFT
• KFT
• BT/CT/PT/INR
• Biopsy (Incisional/Excisional/Exfoliative)

Biopsy

A biopsy is indicated when the patient’s clinical presentation, past history or imaging studies do not allow a definitive diagnosis. A biopsy is a surgical procedure that involves the removal of a piece of tissue sample from the living organism for the purpose of microscopic examination. In most cases, biopsies are carried out under local anaesthesia. Some biopsies are carried out endoscopically, others under image guidance, for instance ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) in the radiology suite. Examples of the most common tissues examined by means of a biopsy include oral and sinus mucosa, bone, soft tissue, skin and lymph nodes.

Types of biopsies typically used for diagnosing oral and maxillofacial pathology at Delhi Dental Hub are:-

Excisional biopsy: A small lesion is totally excised. This method is preferred, if the lesions are approximately 1 cm or less in diameter, clinically and seemingly benign and surgically accessible. Large lesions which are more diffused and dispersed in nature or those which are seemed to be more clinically malignant are not conducive to total removal.

Incisional biopsy: A small portion of the tissue is removed from an abnormal-looking area for examination. This method is useful in dealing with large lesions. If the abnormal region is easily accessed, the sample may be taken at your doctor’s office. If the tumour is deeper inside the mouth or throat, the biopsy may need to be performed in an operating room. General anaesthesia is administered to eliminate any pain.

Exfoliative cytology: A suspected area is gently scraped to collect a sample of cells for examination. These cells are placed on a glass slide and stained with dye, so that they can be viewed under a microscope. If any cells appear abnormal, a deeper biopsy will be performed.

It is sometimes the case that a diagnosis and treatment regime is possible to determine from history and examination, however it is good practice to compile a list of differential diagnoses. Differential diagnosis allows for decisions on what further investigations are needed in each case

Once a small piece of tissue is removed for the biopsy, it is then microscopically histopathologically examined.

Certain Lab/Radiological Investigations we might require in addition during Oral Pathology Screening are:-

• IOPA/RVG
• OPG
• CBCT
• CT
• MRI
• US
• CBC
• LFT
• KFT
• BT/CT/PT/INR

“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment, or root canal treatment, treats the soft pulp tissue inside the tooth.

Endodontists are highly skilled dental specialists in diagnosing and treating tooth pain and performing root canal treatment. Along with two to three years of advanced training beyond dental school, endodontists have incredible precision and hand-eye coordination, making them highly skilled in performing complex treatments. They use the most specialized and advanced technology to treat tooth pain and perform root canal treatment. No one is better at saving your natural teeth. Endodontists at Delhi Dental Hub use specialized techniques to ensure patients are thoroughly comfortable during their treatments. They are experts in administering numbing medications, especially in patients who traditionally have problems getting and staying numb. In addition to treating you comfortably, patients will be relieved of tooth pain after their root canal procedure when the pulp infection or inflammation heals.

Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Endodontist at Delhi Dental Hub will be happy to discuss the specific type of surgery your tooth requires. In certain cases, a procedure called intentional replantation may be performed. Procedures that endodontists can perform but general dentists cannot include cracked teeth treatment as well as diagnosis and treatment of complex root problems.

Endodontists at Delhi Dental Hub have in house state of the art materials and equipment to make your treatment more comfortable and successful. They use a small sheet of plastic or rubber called a dental dam to isolate the tooth during treatment, protecting the rest of your mouth. Digital radiographs and 3-D imaging allows endodontists to take detailed pictures of tiny tooth anatomy to better see the root canals and any related infections. The space inside root canals is very smaller so endodontists use dental operating microscopes to better see inside the root canals to thoroughly treat them.

Procedures executed by an endodontists are:

Root Canal Treatment

Root canal treatment is a dental procedure used to treat infected tooth pulp which would be otherwise extracted. The pulp is the soft tissue core of the tooth which contains nerves, blood supply and connective tissue necessary for tooth health. This is usually caused when bacteria enter the pulp through a deep cavity or failed filling.

Root canal treatment is required when the dental pulp is irreversibly damaged and involves both coronal and apical pulp. Root canal treatment can also be carried out on teeth with doubtful pulpal state before placing post-retained crowns and overdentures. Root canal therapy is not only performed when pain relief from an infected or inflamed pulp is required. It is also done to prevent adverse signs and symptoms from the surrounding sequelae and promote the healing and repair of the surrounding periradicular tissues. An example of which is if there is trauma to a front tooth which has caused it to be avulsed from the bony socket; endodontic treatment is required following re-implantation to preserve the aesthetics and function of the tooth, even though there may be no adverse symptoms of the dental pulp, or pain present at the time.

Prior to root canal treatment, clinical examination and radiographic examinations are carried out to diagnose and plan treatment. Local anaesthesia is delivered to make the procedure pain free. The tooth to be root canal treated is then isolated using rubber dam. Rubber dam prevents saliva entering the tooth during treatment and protects the airway from the fine files and strong chemicals used. The root canal treatment procedure is often carried out over single or multiple appointments. Root canal treatment involves:

• Removing the damaged and infected pulp
• Shaping the entire root canal system
• Cleaning and disinfecting the entire root canal system
• Filling and sealing the root canal system
• Placing a direct restoration such as composite filling followed by indirect restoration such as a crown / Bridge.

Instrument fractures are common procedural mishaps in root canal treatment. It is essential to prevent instrument fractures. The success of removing of broken instrument depends on the location, direction and type of instrument. Tooth discolouration as result of root canal treatment can occur if the pulpal tissue remnants are not completely removed or if the root canal sealer material containing silver is used.

DOES A ROOT CANAL HURT?

A root canal procedure sounds scary, but with today’s technology, it’s typically not a whole lot more different than having a deep filling. There’s little to no pain because your dentist will use local anesthesia to numb your tooth and gums so you’re comfortable during the procedure. If you need a root canal and have facial swelling or a fever, your dentist may give you antibiotics beforehand to kill the infection. This may also help reduce your pain.

The root canal procedure itself is similar to getting a large filling, but it’ll take longer. Your mouth will be numbed while the dentist cleans out the decay, disinfects the roots, and then fills them in. Your dentist will use a rubber dam around the root canal tooth. This will help prevent any infected material from spreading to the rest of your mouth.

Mouth may feel sore or tender after the root canal. Your dentist may suggest that you take an over-the-counter pain medication. At Delhi Dental Hub we found that pre-treatment pain was high, but dropped moderately within a day of treatment, and then dropped substantially to minimal levels within a week and no pain whatsoever after completion of treatment.

HOW DO I PREVENT ROOT CANAL TREATMENT FOR MY FAMILY?

To prevent a root canal, we recommend all to follow the regular dental hygiene habits that help prevent cavities and other tooth problems. For adequate maintenance keep your teeth healthy and follow the below mentioned habits:

• Brush your teeth at least twice a day brushing thrice shall be great.
• Flossing with the help of Water Flosser is recommended at the Hub.
• Use of fluoridated toothpaste or a fluoridated rinses.
• Regular checkups every 6 months.
• Have your teeth professionally cleaned by your dentist at least once a year.
• Try to limit the amount of sugary food and refined carbohydrates you eat. These foods have a tendency to stick to your teeth. If you eat sugary foods, try to rinse your mouth or brush your teeth shortly afterward.

Periradicular Surgery

Periradicular surgeries involve the root surface. These include apicoectomy (removal of a root end), root resection (removal of an entire root), repair of an injured root due to perforation or resorption, removal of broken fragments of the tooth or a filling material, and exploratory surgery to look for root fractures.

1) Apicoectomy
An apicoectomy is a surgical procedure through which the apex of a root is resected, and a root-end filling is placed, preventing bacterial leakage into the root canal system from the periradicular tissues.An apicoectomy can be carried out when a previous root canal treatment fails, and re-root canal treatment is not possible. This may be as a result of anatomical features, such as root dilaceration, which can compromise the completion of cleaning and obturating the root canal system.
Local anaesthetic is utilised to achieve anaesthesia as well as haemostasis for improved visualisation. A flap in the gum is designed, and then raised to allow for exposure of the periapical lesion. Bone removal (osteotomy) is carried out to enable access to root apex, and diseased tissue is removed at this point through curettage. The root end resection is carried out, removing 3mm apically. The canal is then obturated, and the flap is sutured. There are a number of root-end filling materials available, including zinc oxide eugenol cements, and mineral trioxide aggregate.

Complications that may arise include:

• Pain for which anti-inflammatory agents should be taken
• Swelling for which intermittent ice application and medication given by your dentist
• Ecchymosis (discolouration) might often occur distant from the surgical site
• Paraesthesia usually transient as a result of inflammatory swelling, and sensation will return to normal in 4 weeks
• Infection is rare, but can be treated with antibiotics

Other Procedures

Other non-surgical endodonic procedures include pulp capping, pulpotomy, apexification, and pulpal regeneration and hemisection. Hemisection is a procedure where a root and its overlying portion of the crown are separated from the rest of the tooth and optionally removed, is another (non-periradicular) endodontic surgery.

• Sensitivity to heat and cold food
• Tooth discoloration which implies tooth is dead and degenerated
• Swollen and boggy gums which sometimes drain pus on pressure
• Pain when you eat food and on touching the tooth with finger
• A chipped, cracked or fractured tooth
• Tooth mobility

• Complete blood count (CBC)
• Liver function panel (liver function tests, LFTs)
• KFT
• BT/CT/PT/PTT/INR (coagulation study)
• Pregnancy test
• IOPA/RVG/OPG/CBCT

Online/Teleconsultation with Prof.Dr. Rohit Malik (MDS)

For Whatsapp Chat

1) Coordinate on the given numbers for scheduling an appointment, before initiating teleconsultation. 8700433014/01145561002, 01145561003
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Paytm Number:- 9891373779
TRANSFER DETAILS ARE:-
BANK NAME:- AXIS BANK LTD.
BENEFICIARY NAME:- DR ROHIT MALIK
ACCOUNT NO:- 913020009646202 
ACCOUNT TYPE:- CURRENT ACCOUNT (CA)
SWIFT CODE:- AXISINBBA14
IFSC CODE:- UTIB0000533
MICR CODE:- 110211046
ADDRESS :- A-10 , GROUND FLOOR, MEERA BAGH, PASCHIM VIHAR, NEW DELHI 110087
Team DDH