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What is Root Canal Treatment? Case Study

Root canal treatment is designed to eradicate germs from the contaminated root canal, thus preventing re-infection of the tooth and saving the natural tooth. When one undergoes a root canal treatment, the swollen or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed.
A young male patient visited us complaining of a fracture in the upper right front tooth. We did a complete oral checkup and took the required x-rays. The tooth was tender on percussion. An x-ray showed mild periapical infection.
The treatment plan finalized was multiple sitting RCT with the placement of intra-canal medicament followed by the crown for upper right central incisor.



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Dental Fluorosis

What is Fluorosis?

Dental fluorosis is a chronic condition caused by excessive intake of fluorine compounds, marked by mottling of the teeth and, if severe, calcification of the ligaments.

It is a common disorder, characterized by hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation.
Fluoride is good for teeth because it helps prevent tooth decay. However, applying and consuming too much fluoride while teeth are developing can cause dental fluorosis.
Fluorosis affects the tooth’s enamel. Milder cases cause barely noticeable white flecks on the teeth, whereas more severe cases can include heavy staining or even very visible pitting and pocking.
Children under eight years of age are the most susceptible to developing fluorosis because their developing permanent teeth are still under the gum line and dental fluorosis damaged teeth that haven’t erupted yet. Once teeth have erupted, children are no longer at risk. Due to the risk of fluorosis, children under the age of three should use just a “smear” of fluoride toothpaste and children three to six should use a pea-sized amount of fluoride toothpaste

How do teeth with Fluorosis appear?

It appears as a range of visual changes in enamel causing degrees of intrinsic tooth discolouration, and, in some cases, physical damage to the teeth. The severity of the condition is dependent on the dose, duration, and age of the individual during the exposure.

The “very mild” (and most common) form of fluorosis, is characterized by small, opaque, “paper white” areas scattered irregularly over the tooth, covering less than 25% of the tooth surface. In the “mild” form of the disease, these mottled patches can involve up to half of the surface area of the teeth. When fluorosis is moderate, all of the surfaces of the teeth are mottled and teeth may be ground down and brown stains frequently “disfigure” the teeth. Severe fluorosis is characterized by brown discoloration and discrete or confluent pitting; brown stains are widespread and teeth often present a corroded-looking appearance.

People with fluorosis are relatively resistant to dental caries (tooth decay caused by bacteria), although there may be cosmetic concern. In moderate to severe fluorosis, teeth are weakened and suffer permanent physical damage.

Management of Fluorosis

Dental fluorosis may or may not be of cosmetic concern. In some cases, there may be varying degrees of negative psychosocial effects. The treatment options are:

Gummy Smile


A Gummy smile occurs when there is excessive   gingival (gums) display while smiling. It is a very subjective concept. Usually gum display of more than 3 to 4 mm is interpreted as gummy smile.

Some people may be extra conscious of this condition while some may try to avoid smiling wide or smile with a closed mouth to hide their gums.








An ideal smile needs the gums, teeth , bones and lips to be in harmony and  of the correct size and shape. Any disruption in the proportion may cause deviation from the ideal smile line.

 It is a common unaesthetic clinical condition, which can be caused by an

  • Abnormal dental eruption(delayed passive eruption),
  • Excessive vertical growth of the maxillabone,
  • Over-eruption of the maxillary anterior teeth, or
  • Hyper function of the upper lipelevator muscle,
  • A combination of the above described factors.


Smile line assessment is important to determine the treatment of Gummy Smile.

Proper assessment of the parameters involving the gums, teeth, bones and lips in relation to the position and function is done.

 Proper elaborate history needs to be taken so as to know the time of occurrence and recognization of the condition by the patient.

Study models and radiographs help to assess the structural relationship of the bone and teeth.



  • Gingival contouring / Gingivectomy: Reshaping or excision  of the excessive gingival margin can be done using LASER , Thermo excision or conventional surgical method.







    • Apical repositioning of the Gingiva

    In some cases apical repositioning of the entire soft tissue component may be necessary.








  • Orthodontic rehabilitation of teeth (Braces)

If incorrect teeth position is the cause of gummy smile it can be corrected with braces treatment.


  • Surgical correction

In cases of gummy smiles due to excessive growth of the jaw bones; maxillofacial surgical correction may be necessary.


  • Lip repositioning/Lip contouring

Deficit lip height can be corrected surgically.


  • Lip Rehabilitation

This is done to reduce the muscular hyperactivity of the muscles associated with the lip, it restricts the contraction of  the lips while smiling  which in turn helps in reducing the amount of gums exposed while smiling.


  • Use of Botulinum Toxin (BOTOX)

To reduce the muscular hyperactivity of the lip by reducing muscle contraction.







  • Use of Prosthetic teeth / Crowns

Crowns or veneers can be used to correct the shape and size of the teeth to make it look more esthetic.

 The complete correction of Gummy Smile usually needs a multi disciplinary approach. Which can be best suggested by your dentist.


After treating 32000+ patients we are ready to help you!

Book your appointment with us today!

Call us on 9377777303

Visit us on

Summirow Dental Clinic