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Dr. PRATIK NARSIKAR

Implantologist(MDS)

Dr. Pratik Narsikar completed his Masters from the prestigious JSS dental college, Mysore through the post-graduate entrance exam in 2017 in which he stood 36 in the state. He also is a fellow in Esthetic medicine from the University of Greifswald, Germany. He has worked with leading hospitals like Fortis and operated on a variety of major cases like facial trauma, cysts and tumors, pathologies, and esthetic procedures like orthognathic surgeries. He also has an international publication to his name. His special interest lies in dental implants with the experience of having dealt with over 350+ implant patients.
He constantly keeps himself upgraded in the latest advances in the field by attending conferences and conducting Implant workshops where he shares his knowledge with his colleagues.

Expert in:

1. Dental Implants

2. Wisdom teeth removal

3. Facial Trauma

4.Pathology

5.Facial esthetic procedures

AFTER BRACES ALWAYS RETAINERS

Why retainers?

After your orthondontic treatment is finished, and your braces are removed, you will need retainers to hold your teeth in their new positions.

For how long do I need to wear retainers?

It takes time for the bone and all the tissues around your teeth to reorganise and therefore it is necessary to use retainers until your bite stabilises. In the first month after the braces are removed, the risk of relapse is very high.

Relapse means that the teeth can take up to one year or more to stabilize after treatment. If you had gaps between your teeth before treatment, the retention period will be longer.

Usually, retainers are worn for as long a time as you have had your braces. If your teeth move back to their original positions, you may need fixed braces again to correct them.

What Will My Retainers Look Like?

The retainers are individually designed to prevent teeth from reverting to their original positions. Retainers can take the form of a removable appliance or a fixed wire bonded at the back of your front teeth.

Do I have to Wear Them All the Time?

Your orthodontist will prescribe the retention plan that is best for you. Some retainers are used full-time for the first 6 months; after that, the retainers are worn only at night, for a few years. Other retainers are worn full-time for about a week, and solely at night thereafter. Fixed retainers are normally kept in place for 5 years.

Is it Important to Use Your Retainers as Instructed?

Removable retainers should be taken out during eating, contact sports and  when you brush your teeth. To clean the retainers, remove them first and brush them in tap water using a toothbrush and some toothpaste. Brush your teeth after this.

The safest place for your retainers is in your mouth. If you are not using the retainers they should always be kept in a box. There is a great risk of losing retainers if they are wrapped in tissue paper after you remove them from your mouth.

How Will Retainers Affect My Daily Life?

A removable retainer has a wire holding the front teeth. It will be visible but much less than the fixed braces.

If you have a removable retainer in your upper jaw, it will take you one to two days to get accustomed to them and speak properly. It is normal to experience a lot of saliva in your mouth with a new retainer.

Always bring the box to store your retainers to be kept  should you need to remove them. If you have a fixed retainer, you should spend more time to brush the back of your teeth. You have to brush all around the wire so that calculus will not form. You will be instructed on how to use dental floss with a floss-threader. Do remember not to use your front teeth to for biting hard foods or objects. Fixed retainers do not affect speech.

Will my teeth never change when the period of retention is over?

Bone has the capacity to change and remodel for as long as we live; that is why a broken bone can heal.

From 20 to 50 years of age, faces mature and teeth continue to push forward, causing crowding of the lower front teeth. This happens regardless of whether you have had wisdom teeth removed, extractions of teeth or previous orthodontic treatment for crowded teeth.

To avoid the risk of late crowding, removable retainers can be worn at night for a longer period and fixed retainers kept in for more some years.

The Final Stretch: Getting your braces off & Post-braces Oral Care 

How long will it take to get my braces taken off?

About an hour.

Will I have advance notice that my braces are going to come off?
Our orthodontist will most likely have told you at your last adjustment that he expects youll be ready to have your braces removed at the next visit. However, this is only their best guess – if your teeth move unexpectedly, or not enough, between appointments, removal may be postponed.

Will it hurt?

No. You should feel a little pressure when the braces are being removed, but no pain.
However, your new retainer may hurt a bit.

What should I expect?

The orthodontist will use pliers to remove all the brackets, thoroughly scrape and clean all the glue off your teeth, and take a mold for your new retainer.

What will my teeth look like?

How your teeth will look depends entirely on how well you cared for them while wearing braces. They may look perfect if you cared for them well, or they may be stained with yellow tartar and marks called "white scars" if you did a poor job.

Whats next?

Dont expect to be completely finished with the orthodontist - almost all patients need to wear a retainer after they get their braces off to hold the teeth in their new positions.

How should I care for teeth afterwards?

Wait at least a month before any sort of bleaching or whitening treatment. This will give the newly exposed enamel time to become less sensitive.

Your teeth and gums will be a bit sensitive at first. Dont immediately rush out and binge on crunchy and chewy previously forbidden foods – ease into it.

Schedule a dental cleaning – there are likely areas that have been neglected over the past couple of years (although paying close attention to your oral hygiene will have helped with this).

Tips for dealing with your new retainer

It will be difficult to speak at first, and you may have a lisp. If you practice speaking, reading aloud, or singing as much as you can, this should go away in a day or so. It may feel embarrassing, but its the best way to get your mouth used to working around the plastic and wires.

You may also find yourself drooling or dealing with extra saliva at first. This is normal and will go away after the first day or two.
When taking your retainer out for a meal, do not leave it on a napkin! This is the most common way that retainers are lost because people accidentally throw them in the trash.

You may need to wear a mouth guard or a mouth splint at night. These devices prevent tooth movement by evening out the pressure in your mouth. Your Orthodontist will guide you whether you need to wear a Mouthgaurd.

A mouth guard or splint also creates a physical barrier between your upper and lower teeth to protect them from further damage. They also help reduce any grinding noises that you make at night.

Mouth guards are similar in appearance to those used in sports such as boxing. They are usually made out of bendy rubber or plastic and can be made by your dentist to fit your mouth. You will usually have to pay for this type of custom-made dental appliance.

If you need ROOT CANAL treatment youre not alone. Millions of teeth are treated and saved each year with root canal, or endodontic, treatment. Learn how root canal treatment can relieve your tooth pain and save your smile.

To understand a root canal procedure, it helps to know about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.

Endodontic treatment treats the inside of the tooth. Endodontic treatment is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

How does endodontic treatment save the tooth?

During root canal treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. Afterwards, the tooth is restored with a crown or filling for protection. After restoration, the tooth continues to function like any other tooth.

Saving the natural tooth with root canal treatment has many advantages:

  • Efficient chewing
  • Normal biting force and sensation
  • Natural appearance
  • Protects other teeth from excessive wear or strain

Endodontic treatment helps you maintain your natural smile, continue eating the foods you love and limit the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last as long as other natural teeth and often for a lifetime. 

What is Veneers?

Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile. This procedure can greatly enhance your smile and can heighten self-esteem.
 
Why a veneer?  

Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooths color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.
 
What happens during the procedure?  

Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding.Its critical that you take an active role in the smile design. Spend time in the planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.
 
To prepare the teeth for the veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about half a millimeter of the tooth is removed, which may require a local anesthetic. Composite resin veneers are generally done in one appointment. After the tooth is prepared, the dentist carefully bonds and sculpts the composite material onto your teeth. For ceramic veneers, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed, at an additional cost.
 
When your ceramic veneers are ready, the dentist places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam hardens the cement.
 
How about maintenance?
 
For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. Brush and floss daily. After one or two weeks, your dentist will ask you to return for a follow-up appointment.
 
What are realistic expectations?  

Veneers are reasonable facsimiles of natural teeth, not perfect replacements. Its not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem.

Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:

A crowded mouth. Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend pulling it.

Infection. If tooth decay or damage extends to the pulp -- the center of the tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal therapy (RCT), but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.

Risk of infection. If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant) even the risk of infection in a particular tooth may be reason enough to pull the tooth.

Periodontal (Gum) Disease. If periodontal disease -- an infection of the tissues and bones that surround and support the teeth -- have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth.
Continue reading below...

What to Expect With Tooth Extraction

Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before pulling the tooth, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed. If you are having more than one tooth pulled or if a tooth is impacted, your dentist may use a strong general anesthetic. This will prevent pain throughout your body and make you sleep through the procedure.

If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.

Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches -- usually self-dissolving -- to close the gum edges over the extraction site.

Sometimes, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.

An aesthetic dental trend that’s becoming a classic? Dental jewels are becoming very popular with younger generations, which are worn on central or lateral incisors. There are lots of variations and types: dental jewels can be made of gold, platinum or crystals, but a combination of precious stone and metal is also not unheard of. It can be shaped as the one’s initials, symbols or whatever that helps express the personality of its owner. Leading jewellery manufacturers have seen the opportunity early enough, so each manufacturer now offers its own collection of dental jewels. It only enhances the demand for these gimcrack ornaments that an increasing number of media stars, popular with the youth, are wearing jewels on their teeth.

A few years ago, the installation of dental jewels took up to half an hour, and during the process they used corrosive liquids to clean the enamel. Today, the process takes much shorter time and is greatly simplified. It can only be performed by a qualified dentist – do not try it at home! – Who places the chosen jewel on a properly cleansed tooth with a harmless adhesive. The process now days take few minutes, with no drilling or any pain, and requires no special preparations. However, it is recommended to have the teeth whitened prior to getting a dental jewel, as the shiny little ornament will only look good on impeccably white teeth.

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available -- Complete and Partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Complete Dentures

Complete dentures can be either "conventional" or "immediate." Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.
Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.

Partial Dentures

A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed (permanent) bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This "bridge" is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.

How Are Dentures Made?

The denture development process takes about three to six weeks and several appointments. Once your dentist or prosthodontist (a dentist who specializes in the restoration and replacement of teeth) determines what type of appliance is best for you, the general steps are to:

  1. Make a series of impressions of your jaw and take measurements of how your jaws relate to one another and how much space is between them.
  2. Create models, wax forms, and/or plastic patterns in the exact shape and position of the denture to be made. You will "try in" this model several times and the denture will be assessed for color, shape, and fit before the final denture is cast.
  3. Cast a final denture
  4. Adjustments will be made as necessary