Plaque is a soft yellow-grayish substance that adheres to the tooth surfaces including removable and fixed restorations. It is an organised bio-film that is primarily composed of bacteria in a matrix of glycoproteins and extracellular polysaccharides. This matrix makes it impossible to remove the plaque by rinsing or using sprays. Materia alba is similar to plaque but it lacks the organized structure of plaque and hence easily displaced with rinses and sprays. .

All individuals develop plaque and materia alba. Through regular brushing and flossing, these organized colonies of bacteria are disturbed and eliminated from the oral cavity. In general, the more effective one's brushing, flossing, and other oral homecare practices, the less plaque will accumulate on the teeth. However, if, after 24 hours in the oral environment, biofilm remains undisturbed by brushing or flossing, it begins to absorb the mineral content of saliva. Through this absorption of calcium and phosphorus from the saliva, oral biofilm transforms from the soft, easily removable plaque into a hard substance known as calculus. Commonly known as 'tartar', calculus provides a base for new layers of plaque biofilm to settle on and builds up over time.

These are tooth coloured restorations available in various shades to provide natural look to the restored teeth. Made from a mixture of glass and quartz in resin, the composite filling requires less tooth cutting and is in accordance with minimal invasive dentistry. These are also hard wearing and compliment the adjoining teeth.

It is a dental restorative material used for filling teeth and as luting cement. There bond chemically to dental hard tissues and release fluoride for a relatively long period. They are tooth – colored and addition of resin has further improved their translucency but are still rather opaque and not as aesthetic as composite – resins. It is a bio-compatible material. It requires minimal cavity preparation hence easy to use on children

All individuals develop plaque and materia alba. Through regular brushing and flossing, these organized colonies of bacteria are disturbed and eliminated from the oral cavity. In general, the more effective one's brushing, flossing, and other oral homecare practices, the less plaque will accumulate on the teeth. However, if, after 24 hours in the oral environment, biofilm remains undisturbed by brushing or flossing, it begins to absorb the mineral content of saliva. Through this absorption of calcium and phosphorus from the saliva, oral biofilm transforms from the soft, easily removable plaque into a hard substance known as calculus. Commonly known as 'tartar', calculus provides a base for new layers of plaque biofilm to settle on and builds up over time.

In olden days, silver color dental fillings were used which was unaesthetic and had other disadvantages like recurrence of decay due to weak bonding between filling and tooth. Apart from the aesthetic concern the mercury content in the Silver Amalgam fillings is hazardous to health because of its potential to induce toxic and allergic reactions directly proportional to the mercury exposure. So ‘Mercury Free Dentistry’ is the need of the hour. Besides, Silver Amalgam Fillings can be easily replaced by White Fillings

• Severe toothache which is during chewing or during contact with any extreme hot or extreme cold temperature material which is usually tolerated by the mouth
• Darkening of the tooth
• Swelling seen in the areas of gums around the tooth
• When tooth is broken

Root canal treatment : A boon for the patients

In the past, when there was no existence of ‘Root canal treatment ‘ the only answer to extremely painful tooth or grossly destructed tooth was ‘Tooth removal!!!’ which is now the last resort when all the treatments have failed to save the tooth.So basically, root canal treatment is an advanced procedure to save a tooth in bad but restorable condition which was otherwise extracted and indicated for extraction. An untreated cavity is the most common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it reaches pulp and/or root canal. This allows bacteria to infect the pulp. The inflammation caused by the infection reduces the blood supply to the tooth and keeps it from healing. The second reason for a root canal treatment is damage to the pulp that can't be fixed. Trauma or a fractured tooth can damage the pulp. Sometimes, common dental procedures, such as preparing a tooth for a crown, end up hurting the pulp creating the need for a root canal. In certain cases, when the pulp is inflamed but not infected, it may heal on its own. Your dentist may want to see if this will happen before endodontic treatment. However, if the pulp remains inflamed, it can be painful and may lead to infection.

There are several steps in root canal treatment that your dentist will perform to save your tooth. You may have to make more than one visit.

• To begin with, the dentist will administer local anaesthesia to make sure that you will not experience pain during the procedure
• He will then isolate the tooth with a rubber dam, which is a thin sheet of latex rubber or plastic to keep the tooth dry and isolated.
• A cavity is prepared using a bur, in the crown of the tooth into the pulp chamber.
• The pulp or remaining tissue is then carefully removed from both the pulp chamber and the root canals.
• Each root canal is then cleaned and shaped to allow it to be filled.
• Medication may be placed in the pulp chamber and root canals to help eliminate bacteria.
• A temporary filling may be placed in the crown opening to prevent saliva from entering the chamber and root canals, or your dentist might immediately begin the next stage of filling the root canal.
• During the next stage of treatment, after placing the rubber dam, the dentist will remove the temporary filling (if one was placed during the previous visit). The root canals are usually filled with gutta-percha, a rubber-like material made from various tropical trees.
• In the final step, the temporary filling is removed and the tooth may be restored by a crown or a filling to strengthen and improve its appearance.
• The crown may be made of porcelain or metal alloy, and the filling may be made of many different materials.
• You might be prescribed antibiotics and other medication during the course of your treatment.

Even though impacted wisdom teeth are not visible in the mouth they can cause a number of problems. Commonly, patients will go to their dentist because of pain in the back of the jaws. Removal of the offending impacted tooth or teeth usually resolves the problem. The impacted wisdom tooth itself may be the source of the pain or there may be an infection associated it. Bacteria that are always present in the mouth, can work their way down under the gum tissue and cause a painful infection around the crown of the wisdom tooth even though you can’t see the tooth. People often mistake repeated soreness of the gum tissue overlying the wisdom teeth as an effort by the teeth to erupt. Unfortunately this is often a warning sign that trouble is brewing. If this situations goes untreated for an extended period of time (removal of the impacted tooth), the infection may become chronic and lead to destruction of bone around the impacted tooth (a condition known as periodontal disease). This bone destruction can extend around the other teeth in the back of the mouth and lead to future tooth loss. The same types of bacteria that are responsible for infections can also cause tooth decay or cavities on the roots of the other molar teeth. Just the constant pressure from the impacted wisdom tooth can lead to destruction of the tooth or teeth adjacent to it. Although the overall occurrence of cysts and tumors associated with the jaws is low, when they do occur it is most frequently around an impacted wisdom tooth. The orthodontist may request that wisdom teeth be removal prior to braces as they may interfere with straightening the other teeth. Finally, an impacted wisdom tooth in the lower jaw occupies space that is usually filled by bone. This creates an inherent area of weakness in the lower jaw which may render it more susceptible to fractures (broken jaw)..

As soon as it is determined that the wisdom teeth will become impacted, they should be removed. This can usually be determined by sixteen or seventeen years of age as the jaws have attained the majority of their adult size. Removal of impacted wisdom teeth in this age group has several distinct advantages. Toothache prompts patients to come to the dentist. However, wisdom teeth do not usually cause pain until damage has already been done! Wisdom teeth removal surgery is best performed sooner rather than later. Firstly, at this age the roots are seldom fully formed, even though the tooth has become impacted. If left in place, the tooth will not erupt into the mouth but the roots will continue to grow. Removing an impacted wisdom tooth before the roots are fully formed is easier and less traumatic for the patient. Also, at this stage of patient development the bone surrounding the impacted tooth is more pliable. Typically, patient’s having impacted wisdom teeth removed in their mid-teens heal more rapidly and have a shorter and less complicated post-operative recovery..

During a consultation involving x-rays or OPG (panoramic x-ray) and examination, the dental surgeon or the oral surgeon can determine which wisdom teeth or wisdom tooth will be, or are, functional, and which ones need to be removed. In many cases all four wisdom teeth will need to be removed. The wisdom teeth removal commonly involves an incision to open the gum, and sometimes a small portion of the bone may need to be removed to provide access for the wisdom teeth removal. The wisdom teeth may also need to be divided into segments so it can be removed safely and easily. Perfect wisdom teeth technique and a lot of experience is a must for these surgical procedures. The incision in the gum may then need to be closed with stitches..

Many orthodontists believe that developing wisdom teeth can cause the front teeth to become over crowded, and often recommend wisdom teeth removal before or immediately after orthodontic treatment.

Impacted wisdom teeth fall into several categories. Mesioangular impaction is the most common and means the wisdom tooth is angled forward, towards the front of the mouth. Vertical impaction means the tooth is angled backwards, towards the rear of the mouth. Horizontal impaction means fully 90 degrees forward. Most of the time wisdom teeth with distoangulation are the easiest to extract in the maxilla and the most difficult in the mandible. The wisdom teeth with mesioangulation are easier to remove in the mandible and more difficult in the maxilla.

Orthodontic treatments works by using appliances, braces and aligners to move teeth that are crooked or that do not fit together right. By fixing these problems, orthodontics can Improve the appearance, biting position , chewing function and keep your mouth healthy.

Normally the orthodontic treatment is begun between the ages 10 and 14. This is when a child's head and mouth are still growing and teeth are easier to straighten, treatment duration will be 8 months to 16 months based upon the severity of the condition. Certain jaw growth problems can be handled simply in mixed dentition period, before the permanent teeth erupt – hence the treatment can begin at eth age of 6 ! But it’s can be done at any age – better late than never. In some children with mouthbreathing habits, thumb sucking – the habits can be broken with orthodontic appliances. .