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Wisdom teeth (not associated with wisdom) are the last molars that erupt at between the age of 18-25 years. These are now classified as vestigial as our jaws have become smaller and completely grown to adult size before the age of eruption of the wisdom molars, thus making them erupt in some weird position or remain partially unerupted, not contributing to the function of chewing. Wisdom molars start erupting and become visible in the mouth between 18-25 yrs. If enough space is present, they erupt in the correct position. In case of lack of space (majority times), they erupt partially and get locked by the adjacent 2nd molar in the bone. A lot of instances have shown absence of the 3rd molar tooth bud inside jaw bone (missing congenitally). Partially erupted or erupting 3rd molars pose problems like pain, difficulty in brushing and maintaining the area with toothbrush, leading to decay. In case they completely erupt, a gum flap may often cover the tooth crown (operculum), which acts as a trap for food debris, often resulting in pain, inflammation and ultimately abscess. In such cases, is the tooth has a good alignment and the opposing arch wisdom molar is present, the gingival flap covering the lower wisdom tooth can be removed (operculectomy). All such partially erupted wisdom molars have to be removed surgically, in situations of pain or decay or can be removed prior, when anticipating such condition. 3rd (wisdom) molar extraction is planned by taking X-rays (local as well as full mouth). It is extracted under Local anesthesia. Due to the weird positioning, bone might have to be reduced and the tooth might have to be sectioned, to pave the path for its removal. A suture (stitch) is placed after the procedure. Slight swelling is common following this procedure, which settles within a week.

Gingival flap surgery is a type of gum procedure. The gums are separated from the teeth and folded back temporarily to reach the root of the tooth and the bone. Tartar on teeth which is deep seated inside the gums, responsible for gum infection, is removed during this procedure. Deficiencies in bone are also treated by adding some artificial bone materials to improve the life of teeth. Flap surgery is recommended for people with moderate or advanced periodontitis. Prior to surgery, scaling is done to eliminate the gum infection, after which a decision is made for gingival flap surgery. Preparation Your periodontist or your dental hygienist will first remove all plaque and tartar (calculus) from around your teeth. He or she will make sure that your oral hygiene is good. Your periodontist also will evaluate your health and the medicines you take. This is important to make sure that surgery is safe for you. Indications of flap surgery- Pockets in the gums that persist after proper cleaning Pus discharge Continued bleeding from pockets Abnormal bone contour and defects Tooth mobility (loose teeth) Dull pain in the gums, causing difficulty in chewing

Gum Lift is the surgical procedure which is often performed to reduce the “gummy smile’ that some individuals have. The existing gum is separated from the underlying bone, the excess bone is trimmed and the same gum tissue is placed back and stitched at a higher level but we just like to call it the gummy smile surgery. The result is a biologically stable and acceptable proportion of bone and gum which are now less visible. This procedure is different from the simple “cutting off” (gingivectomy) of the excess gum that can be achieved by a: Laser, b: Radio-surgery or c: Surgical knife. The “cutting off” of the gum edge, while having some useful indications, is very limited in what it can achieve. When the very limited biological restrictions are violated, the gum will either re-grow or a permanent state of gingivitis will develop. For a stable and permanent improvement the underlying bone must be also reduced proportionately. In case of badly broken down/attrited teeth, crowns or veneers may be placed to enhance the aesthetics of front teeth. It is also a treatment option for short teeth as well as remaining excessive gum display after orthodontic (braces) treatment.

Gum depigmentation, also known as gum bleaching, is a procedure used in cosmetic dentistry to lighten or remove black spots or patches on the gums caused by melanin. Discolouration may also be caused by long-term use of certain medications, certain systemic conditions or may be genetic. Melanocytes are cells which reside in the basal layer of the gingival epithelium. These cells produce melanin, which are pigments that cause discoloration or dark spots in gums. This procedure can be accomplished by blade, electrocautery or LASER. Our clinic possesses an electrocautery unit and this procedure can be performed without bleeding, very quickly. Repigmentation following gum depigmentation occurs usually after 1.5-2 years.

A dental implant is a titanium post (like a tooth root) that is surgically positioned into the jawbone beneath the gum line that allows your dentist to mount replacement teeth or a bridge into that area. An implant doesn't come loose like a denture can. Dental implants also benefit general oral health because they do not have to be anchored to other teeth, like bridges. Because implants fuse to your jawbone, they provide stable support for artificial teeth. Dentures and bridges mounted to implants won't slip or shift in your mouth — an especially important benefit when eating and speaking. This secure fit helps the dentures and bridges — as well as individual crowns placed over implants — feel more natural than conventional bridges or dentures. For some people, ordinary bridges and dentures are simply not comfortable or even possible, due to sore spots, poor ridges or gagging. In addition, ordinary bridges must be attached to teeth on either side of the space left by the missing tooth. An advantage of implants is that no adjacent teeth need to be prepared or ground down to hold your new replacement tooth/teeth in place. To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also commit to keeping these structures healthy. Meticulous oral hygiene and regular dental visits are critical to the long-term success of dental implants. Implants can be done in young as well as aged individuals. Dental Implants stay in the jawbone without reacting for years together and maybe a lifetime. Dental implants can be used to replace a single missing tooth to multiple teeth or even completely missing teeth. Implants can be used in various combinations to manufacture an implant supported bridge and dentures too. Implant placement involves surgical reflection of the gums/mucosa and placement of the implant, followed by closure, after which the croens are placed. Implant can be place immediately after tooth extraction too, provided infection is not present in bone. Implants have several advantages over a conventional tooth supported bridge.

A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening and protecting a damaged tooth, a crown can be used to improve its appearance, shape or alignment of a tooth. A crown can also be placed on top of a natural tooth or an implant to provide a tooth-like shape and structure for function. A crown restores the function and appearance of a damaged, reconstructed or missing tooth. Traditionally, crowns are of 3 types- metal (non-aesthetic), metal-ceramic (Porcelain fused to metal/ PFM) which is tooth colored or ceramic only (metal-free). A Bridge (Fixed partial denture/FPD) - may be recommended if you have missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders. Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Crowns may be recommend in the following situations: Replace a large filling when there isn't enough tooth remaining Protect a weak tooth from fracturing Restore a fractured tooth Attach a bridge Cover a dental implant Cover a discolored or poorly shaped tooth Cover a tooth that has had root canal treatment