The rubber dam

At Omega Clinic we use on a daily base the so called “rubber dam”. Most of our new patients don’t know about it, in spite the fact that its use is mandatory in dentistry.
Its function is to insulate the teeth being treated from the surrounding oral environment – saliva, tongue, cheek. In this way it provides a comfortable and above all dry work field, without the moist that could jeopardize the treatment.

Although nowadays no self demanding dentist can renounce using it, the rubber dam is not new: it was invented in 1864 by New York dentist Dr. Sandford C Barnum.
It consists of a thin sheet of latex (vinyl in latex allergy cases) fixed around one or several teeth by clamps. It’s placement takes a few minutes.

Why is the use of a rubber dam so important? Two examples:

Fillings: The use of the rubber dam is essential in order to avoid the failing of the aesthetic composite fillings, as the composite layer technique requires an environment free of moist, hard to obtain in any other way.



Root canal treatment: Without the rubber dam, the saliva contaminates the dental canal system and the treatment almost certainly fails.
As a plus, the rubber dam avoids potentially serious accidents as the swallowing or even worse, lung aspiration of the tiny instruments used during the treatment.
Using the rubber dam also avoids the nasty sensation of liquid accumulating at the back of the throat, and the constant need to swallow. The patient feels much more relaxed and secure.

In short, the rubber dam is the ideal complement if one wants to achieve excellence in ones treatments and to keep the patient safe from potentially serious accidents.
It’s understandable many of our patients’ reaction: “What a big idea! Is it something new?
Well, as new as the washing machine (XIX century), and I would say at least as useful!

The video will help you to better understand it’s use and it’s function.

Inflammatory dental cyst

Often enough, after a routine radiographic check-up we find an inflammatory lesion called a “cyst” or a “granuloma” surrounding one or several teeth. The cyst slowly destroys the bone in the vicinity of the tooth’s roots. The patient seldom feels any pain, but if let untreated, the cyst keeps growing slowly and leads to abscesses (big collections of infected pus) or fistulae (abnormal opening ways through which the pus discharges into the mouth causing foul taste and breath). These openings are sometimes seen as little lumps over the gum at the level of the tooth’s root.



In Magdalena’s case we found such a cyst without her knowing anything about its existence. She told us though that for many years she visited many dental offices and had many treatments but nobody ever told her that she had a cyst, which doubtlessly has been evolving for a long time.
In the radiography the cyst appears as a darker spot surrounding the dental root’s points. We drew its outline in the right image as to help you spotting it better. Click on the image to expand it.



What is the treatment? As the cause is the infection of the dental pulp (“nerve”) all along the canal system of the tooth’s root, the treatment is what we call Root Canal Treatment. In the image we can see the result as a whiter filling within the canals.

After finishing the Root Canal Treatment, we take a final control radiography as to be able to radiographically follow the healing of the cyst at the future check-ups. The cyst should disappear and be replaced by healthy bone.
Here you can see the three months check-up radiography (to the right) compared whit the control (immediately after) one (to the left). An obvious improvement is seen in this short span of time, taking into account that complete healing requires at least 6 months, as the bone formation is a slow process.




Again, the outline will help you to appreciate the decrease in the cyst’s dimensions. We can conclude that the treatment is giving good results. We make sure in this way that the cyst is completely disappearing and the healing is complete.



See also What is Root Canal Treatment?

Esthetic crowns

Ana came to our office to get her teeth done. She had several old, bad fillings in her front teeth which gave her a poor looking smile.
While making the treatment plan for her, we took into consideration her wish to have both her dental health and her aesthetics improved. Consequently, after solving her oral health problems, we placed porcelain crowns. These are not only strengthening her teeth weakened by cavities and repeated feelings, but also change her smile for the better.






A change that pleases Ana very much.

I want a beautiful smile

Helen knew very well what she wanted: a good looking smile allowing her to laugh without self-awareness.
After studying attentively her case, we decided that the best option for her were the porcelain veneers. Veneers are a very conservative option, allowing the improvement of the dental aesthetic wile avoiding massive modifications of the tooth’s structure (which could entail its debilitation).
This is how Helen looked before treatment:





During the first session we prepared the teeth and took the impressions which were to be used to produce the pure porcelain veneers. In the meanwhile, Helen had temporary veneers placed. A few days later, she had already her final veneers done. And a new smile allowing her to laugh without hiding her mouth. This is Helen’s new look after her veneers were put in place:






Now, Helen, all you need is to smile often enough!

A good result in a tough case

Many times a dentist is forced to make the best decision in a difficult case for which his options are limited by the patient him/herself.
Maria’s case is a good example. She came to us after having searched a long time for a solution in other clinics. But not one of them seemed acceptable to her, and rightly so (it was even proposed to her to have the teeth extracted and bridges placed).
We initially proposed the ideal treatment, beginning with the orthodontic rehabilitation (replacing the teeth in the correct position) but she wasn’t ready to wear brackets. So, within the limitations imposed by the patient, the fastest, cheapest and the most conservative solution was the placing of porcelain veneers to improve the aesthetic appearance of the teeth.
The initial situation of the patient was the following:








Due to the large space between her teeth, at first we placed trial veneers allowing her to anticipate the result and take her decision without hurry. She nevertheless decided to go ahead the same day. Porcelain veneers are a very good solution for the closing of the spaces between teeth and bettering their aesthetics.
In order to improve the veneers’ adaptation we had to minimally remodel the gums’ outline (another solution would have been enlarging the hight of the dental crown, but Maria didn’t accept this either).
This was the final result:



The adaptation of the gums around the porcelain is wonderful and gives an agreeable sensation of naturality.



The change is important and Maria is satisfied. As he walked from the clinic, she said:
“I’m very pleased, it was well worth the waiting”. Maria’s satisfaction is our motivation to keep searching for the best solutions.

I'm new, babe!

Kate is a nice blue-eyed girl and she always comes to our office with her boy friend.
Kate has though a problem: as a little girl she lost her 2 lateral superior incisors and at that moment she had a couple of fake ones by sticking them to the adjacent teeth.
We recommended her as the best option the placement of implants, but she refused it on personal grounds and preferred the second best option, the one of an aesthetic bridge.
This is how Kate looked at the first appointment:





And this is the final result, after the placement of the aesthetic bridge. Kate was very happy about the result, and she said to her boy friend: “I’m new, babe!”

Black or esthetic fillings?

Nowadays our patients request their restorations to be aesthetic ones, as the ugly silver filling belongs to the past. Present day materials have sufficient quality as to allow us to use aesthetic fillings even for the back teeth where chewing force is greater.
So, is it recommendable replacing old dark fillings with aesthetic ones?
In many instances it is even convenient - the dark filling is much harder than the tooth and acts like an edge which favours the fracture of the surrounding dental material.
So why do some dentists still prefer the old dark fillings? Because the “white” aesthetic filling requires a much more refined and demanding technique allowing no errors. If correctly done, the aesthetic filling works very well and can last many years. It is recommended though to have yearly check ups in order to detect early any filtration that could jeopardize the tooth’s health and integrity.
At Omega Clinic we apply the technique by the book, step by step. The composite is placed in thin layers and is photo polymerized (hardened) under a special light in a saliva-free environment created by placing a special kind of operative field (the green one in the photo) called rubber dam (a great invention but seldom used).







The aesthetic filling works…when it’s correctly placed

Se also esthetical filling on a broken front tooth.

What is Root Canal Treatment?

See also 'Root Canal Treatment'

A happy surfer

Juan is a nice young man and he came to us the very day he broke his superior incisive tooth while surfing.



As one easily see, the tooth had a pretty bad fracture, and at the exploration a pulp horn exposition can be seen.



We had to do him a Root Canal Treatment and an almost complete reconstruction of the broken tooth, so he had put up with a pretty fine and laborious treatment. Luckily, many of our patients fall asleep during the treatment! That day when he left our clinic he was painless and with his tooth in one piece again.



We recommended him though that he should come again to have a crown placed as it is the only way to prevent a new fracture in the future. We opted in this case for an all porcelain crown that assures an unmatched aesthetic effect. What a pity he didn’t let us reconstruct him the edge of the adjacent incisive!

He had no choice

Pedro is a patient to whom we recommended some years ago a periodontal treatment (for periodontal disease). When he came to us he already was in a pretty advanced faze and some teeth had some mobility. After the scaling and root planning sessions the improvement was obvious. Pedro has though something against him: he smokes heavily and it’s already well known that smoking is the great enemy when it comes to the health of the gums, supporting bone and teeth. For some years we didn’t hear from him, until one day he came back with an incisive tooth in his hand.

Abandoning completely his dental care meant for Pedro a drastic worsening of his situation. Faced with it, we had to adopt a quick decision as to avoid him having to leave the clinic toothless. He needed the extraction of some adjacent teeth because their great mobility. Between the two options we gave him (both of them “fixed”), placing a bridge over an implant or a bridge over his natural teeth, Pedro chose the later one. For him, this was a more rapid and cheaper solution. This is Pedro before the treatment.





In the first session we proceeded with the extractions and we placed a temporary bridge which immediately improved his aesthetics and the oral function. He then had to come back for the resuming of his periodontal treatment.



Some days later the job was finished and he was able to smile confidently.

Determined to change

For years, Fernando was postponing going to the dentist. As we the dentists aren’t precisely everybody’s favorite, taking this step can be difficult for some patients. His mouth was, though, ever worse, with lots of cavities, infections, pain, bad breath, bleeding gums, and so on. So one day he decided he couldn’t stand it any more and came for the first visit.





His treatment required several appointments, but was worth wile. Every day he was more and more pleased with himself. He told us that after having his gums treated, they stopped bleeding, and the bad breath was gone. His treatment included the addressing all the cavities, doing the necessary root canal treatments and reconstructions, and placing fixed crowns in order to replace the absent teeth and improving his looks. Step by step we managed to give him something he never had but always wanted: a nice natural looking smile, and a healthy mouth. Now he is always keen to smile. He’s following our advises about personal care and even his shaving improved! He just regrets not coming before.

Supernumerary tooth

The patient is a 55 y.o. woman who comes to our clinic with the desire to improve her image. The exploration reveals an extensive dental destruction by caries and a number of previous failed treatments.

Before treatment

She also has a supernumerary tooth (extra tooth) between her superior central incisors, a condition of which she wasn’t even aware.

Before treatment showing supernumerary tooth

After a detailed examination a diagnostic is established and a treatment plan is made, which consisting in the extraction of the anomalous tooth and the rehabilitation of the mouth with porcelain crowns.

After treatment - a perfect smile

The treatment supposed some technical difficulties related to the need of closing an abnormally big space between the central incisors, but the end result was satisfactory for both the patients and us.

After treatment - a happy solution

The result improved not only the patient’s smile and her oral health, but above all her self esteem. Her new looks gave her more self confidence which helped her to improve her personal situation.