Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.

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Diagnosis and Evaluation

Dentistry is the medical field dedicated to the study, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. This primarily includes the teeth, gums, and other related structures of the mouth. A dentist’s work is crucial not only for oral health but also for systemic health, as the mouth can often be a window to the body’s overall well-being, showing signs of nutritional deficiencies or systemic infections.

Advanced Clinical Assessment Protocols

DENTISTRY

Digital Imaging and Structural Analysis

Modern diagnosis relies on seeing what is happening both on the surface and deep within the tooth structure.

The Role of High Resolution Radiography

Radiographs are essential for identifying the depth of decay and the integrity of previous dental work.

  • Bitewing X-rays: These are used to detect decay between teeth and under existing fillings that may require an inlay.
  • Periapical X-rays: These help evaluate the health of the tooth root and surrounding bone to determine whether the tooth is a good candidate for restoration.
  • Intraoral Photography: High-magnification photos allow the patient to see the fractures or decay that the dentist is evaluating.
  • Transillumination: Using a special light to detect cracks in the enamel that might not be visible on an X-ray.
  • Pulp Vitality Testing: Checking the health of the tooth’s nerve to ensure it doesn’t require a root canal before the restoration.
  • Occlusal Mapping: Analyzing how the teeth meet to ensure the new onlay will not be subjected to excessive force.

Intraoral Scanning and 3D Modeling

DENTISTRY

At Liv Hospital, the diagnostic evaluation often includes a digital intraoral scan. This technology replaces the traditional “goop” impressions and provides a highly accurate 3D model of the tooth. This digital model allows the clinician to rotate and zoom in on the tooth’s anatomy, identifying areas where the walls are too thin or where a cusp is unsupported. This level of detail is critical for deciding between an inlay and an onlay. If the 3D model shows that a cusp is likely to fracture under pressure, an onlay will be recommended to provide the necessary structural reinforcement.



Evaluating Remaining Tooth Structure

The primary criterion for choosing inlays and onlays is the amount of healthy tooth structure remaining. A general rule in dentistry is that if more than half of the tooth’s width is compromised, a direct filling will likely fail over time. During the evaluation at Liv Hospital, we measure the thickness of the remaining enamel walls. If the walls are less than 2 millimeters thick, they are considered high-risk for fracture. In these cases, an onlay is the preferred choice because it can “overlay” these weak walls, protecting them from the stresses of chewing and significantly increasing the tooth’s lifespan.

DENTISTRY

Assessing the Pulp Dentin Complex

Before placing any restoration, it is vital to assess the health of the dental pulp. If the decay is intense, the pulp may be irritated. At Liv Hospital, we use biological markers and sensitivity tests to determine if the pulpitis is reversible. If the tooth shows signs of healthy recovery, an inlay or onlay can be placed with a protective base. This biological focus ensures that we are not just fixing the “hole” in the tooth but are also supporting the long-term vitality of the living tissue inside, which is a key part of what inlays and onlays are in dentistry.

The most common dental problems are interconnected:

  • Dental Plaque: A sticky, colorless film of bacteria that constantly forms on teeth.
  • Dental Caries (Cavities): When plaque bacteria consume sugars, they produce acids. These acids attack the tooth’s hard outer layer (enamel), creating a hole (cavity).
  • Gingivitis: the early, reversible stage of gum disease. It is caused by plaque buildup irritating the gums, making them red and swollen.
  • Periodontitis: If gingivitis is left untreated, it can advance to periodontitis. The gums pull away from the tooth, and the supporting bone is destroyed, leading to tooth loss.

Material Selection and Biocompatibility Testing

Not all patients have the exact needs when it comes to restorative materials. During the evaluation, we consider the patient’s aesthetic goals, their bite strength, and any potential sensitivities. For patients with heavy biting forces, a high-strength ceramic may be chosen. For those focused on the most natural look, a more translucent porcelain might be selected. Liv Hospital also considers the biocompatibility of the bonding agents. We ensure that the materials used for your ceramic inlays and onlays are the most advanced and least reactive options available in modern dentistry.

Risk Assessment for Bruxism and Wear

A crucial part of the diagnosis is identifying habits like teeth grinding or clenching. Patients who grind their teeth put immense pressure on their restorations. If this is determined during the evaluation at Liv Hospital, we may modify the onlay design to make it thicker or use a more resilient material. We may also recommend a night guard to protect the new restoration. This comprehensive risk assessment ensures that the inlay or onlay is not only placed but also given the best possible environment to succeed for decades.

Periodontal and Gingival Evaluation

The relationship between the restoration and the gums is a vital part of the diagnosis. If a cavity extends below the gum line, it can be difficult to achieve a good seal with a traditional filling. During the evaluation, we check the “biological width,” the space needed for healthy gum attachment. If the damage is too severe, we may need to perform a minor gum adjustment before placing the onlay. At Liv Hospital, we ensure the margins of porcelain inlays and onlays are placed to facilitate easy cleaning and prevent chronic gum inflammation.

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FREQUENTLY ASKED QUESTIONS

How do you decide if I need an inlay or a crown?

We look at how many healthy teeth are left; if we can save most of the tooth, an inlay or onlay is better than a crown.

Tympanoplasty is highly successful, with success rates generally reported between 85% and 90% for closing the hole permanently.

X-rays are essential, but we also use digital scans and visual exams to check for cracks that X-rays might miss.

It is a painless way to take a 3D picture of your teeth using a small camera, replacing the old-fashioned molds

Yes, we always test the nerve to ensure the tooth is strong enough for restoration.

Yes, using magnification and X-rays, we can see if bacteria are getting under your old fillings.


Most patients report mild to moderate discomfort rather than severe pain. The anesthesia wears off gently, and pain medication is provided for home use to manage any soreness.

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