What is a diastema

A diastema is a gap that is seen especially between the upper front teeth; the teeth do not touch side by side, and it is often experienced only as an aesthetic concern.

The causes differ from person to person:

• A mismatch between tooth size and jawbone, that is, the teeth being small relative to the jaw
• The tissue that connects the upper lip to the gum being low, thick or wide
• Thumb-sucking or tongue-thrust habits left over from childhood
• Gum disease or drifting caused by a lost tooth
• Missing or small lateral incisors

So it is necessary to look at the cause first. Unless the cause is removed, the result can change; bonding only covers the appearance of the gap and does not move the teeth.

How closing with bonding is done

Bonding is the process of adding composite material to the teeth on both sides of the gap to widen them and close the space; it is preferred because in most cases it can be done without wearing the tooth down much.

1. Exam and shade selection. The gap is measured and the material closest to the color of the teeth is chosen.
2. Surface preparation. The tooth surface is cleaned and lightly prepared so that the material holds. Whether the tooth needs to be cut is decided by the dentist.
3. Adding the material. The composite is applied in thin layers and shaped according to the side edge of the tooth.
4. Hardening with light. Each layer hardens with a special light.
5. Shape and polish. The length and width of the teeth are brought into harmony with your face, the surface is polished and the bite is checked.

How many appointments the procedure will be completed in changes with the size of the gap and the number of teeth to be treated; the dentist explains this to you at the exam. You can find the details in our article how is bonding done and the general framework of the service on our Kadıköy bonding page.

For which gaps is bonding considered

Bonding is generally the option that comes to mind for small gaps and for cases where the teeth stand upright and healthy. As the gap grows, adding composite material to the two neighboring teeth can make the teeth look wider than they are; for this reason the size of the gap is the first thing looked at in the decision.

The gum line of the teeth, the midline and the proportion with neighboring teeth are examined. If there is crowding, a bite problem or gum disease next to the gap, these are dealt with first. You can read who it is suitable for on the page who is bonding suitable for.

Bonding or orthodontics

Bonding closes the gap in appearance, while orthodontics closes it by actually moving the teeth; which one is suitable depends on the size and the cause of the gap.

For the orthodontic option you can look at which dental problems orthodontics deals with; for the clear aligner option you can look at the Kadıköy Invisalign and clear aligners page. In some people the teeth are first brought into place with orthodontics, and then the result is completed with a small bonding correction. If the teeth are small or irregular in shape, veneers may also come into question; if you want to compare bonding with porcelain veneers, the article differences between bonding and porcelain veneers can help.

How the result looks

When color and shape are chosen carefully, bonding can give an appearance in harmony with the neighboring teeth; however, the size of the gap and the structure of the teeth set limits on the result.

Three things determine the appearance: the material matching the color and translucency of the tooth, the length and width of the tooth staying in proportion, and the surface being polished to the same texture as the neighboring teeth. Placing a very wide gap on a single tooth can make the tooth look square and wide. For this reason sharing the gap between the two neighboring teeth or orthodontic support can be planned. The overall look of the smile is also taken into account: the midline of the teeth, the lip line and the amount of tooth that shows when smiling influence the decision.

Looking together at how your teeth appear when you smile or speak during the exam clarifies your expectations. Talking before starting the procedure about what is possible and what will remain limited makes it easier for you to evaluate the result.

How long does it last, can it open again

Bonding is not a permanent method: because the closed gap does not move the teeth, it does not open by itself, but the material can wear over time, change color or chip at the edge, and it can be renewed when needed.

Durability depends on your habits:

• Breaking hard foods and ice with the teeth strains the material.
• Habits such as biting pens or nails can crack the edge.
• Tea, coffee and cigarettes can cause discoloration in composite over time.
• If there is clenching or grinding at night, the material wears down sooner; a protective splint can be discussed.

If it breaks or changes color, the dentist looks at whether the material can be repaired or needs to be renewed. If the cause of the gap was drifting of the teeth, the teeth can space out again; the reason is not the bonding but the continuation of the underlying cause. If you notice the gap appearing again, let your dentist know without waiting for a check-up appointment. You can find the limits of the method and its possible downsides in the article are there disadvantages of bonding.

The question of age in children and teenagers

In children, a gap between the upper front teeth is often a normal stage while the permanent teeth are coming in and can close by itself; for this reason there is no rush.

There is no fixed age limit for bonding, but the decision is made by looking at how the teeth have erupted and at jaw development. Aesthetic corrections made before development is complete may have to be renewed later. If a gap catches your attention in your child, waiting for an orthodontic check and following development is often the right course. You can read when orthodontics should start in the article at what age should orthodontic treatment start.

Nothing special is needed for care: daily brushing, floss and regular check-ups are enough. During a check-up the edges of the composite, the surface shine and the bite fit are reviewed; small rough spots are easier to deal with when noticed early.

The process and what affects the cost

The process and the cost vary with the number of teeth to be treated, the size of the gap and whether orthodontic support is needed.

• Width of the gap: a small gap needs less material, while a wide gap may need more material and time.
• Number of gaps: the plan for a single diastema differs from that for several gaps.
• Additional treatments: if a gum problem, a lip frenum issue or orthodontics is needed, the process gets longer.
• Aesthetic expectation: extra wishes such as lengthening the teeth or changing the form enlarge the procedure.

A definite duration or amount can only be given after the exam and the plan; general figures on the internet may not apply to your teeth.

What is discussed at the first exam

At the first exam the dentist investigates the cause of the gap and, with photographs and measurements, explains which method is suitable for you.

It helps to bring these questions to the exam: Did the gap grow over time? Do you clench your teeth? What result do you expect? What are the limits of bonding? Is there an orthodontic option? When will the result need to be renewed? What should I pay attention to in daily care? A plan is drawn up together according to the answers you receive. OPC Klinik is a dental clinic in Kadıköy that also offers advanced treatments such as zygomatic implants and orthognathic surgery, and whose founding partners are university faculty members; we also offer bonding, and in addition to Turkish we serve in English, German and Italian. For the exam you can request an appointment through our contact page.

Frequently asked questions

How is a diastema closed?

Small gaps are handled with bonding, large gaps with orthodontics, or with a combination of the two. The dentist decides which is suitable.

Can a gapped tooth be filled?

Yes; this procedure is called bonding, and tooth-colored composite is added to the tooth on either side of the gap to close the space.

How is a gap between the front teeth closed?

A gap in the front teeth can be closed with bonding, or the teeth are brought closer together with orthodontics. The dentist decides which is suitable for you at the exam.

Does a gap closed with bonding open again?

Because bonding does not move the teeth, the gap does not open by itself; however, if a cause that makes the teeth drift continues, the gap can appear again, and the material may need to be renewed over time.

What is a hybrid prosthesis implant?

A hybrid prosthesis renews not single teeth but all the teeth in a jaw with one prosthetic body seated on several implants. Here the implants are titanium screws placed in the jawbone; the prosthesis is the tooth and gum part attached to these screws. At OPC Klinik, the forms of this approach you will encounter most often are All-on-4 and All-on-6 implant treatments; they aim to carry the whole jaw with only four or six implants. You can find the details on the All-on-4 / All-on-6 implant page.

Because a separate implant is not needed for every missing tooth, treatment is planned more simply in complete tooth loss. For the general logic of implants, you can also look at our article the place of implants in treating missing teeth.

Who is a hybrid prosthesis applied to?

The hybrid prosthesis implant option is considered in the following situations:

• If most of the teeth in the upper, lower or both jaws are missing or cannot be kept
• If the removable denture often moves, causes sores or makes eating difficult
• If the bone support of the remaining teeth has weakened and extraction is needed
• If a fixed solution with high chewing strength is wanted

It is not suitable for everyone. Conditions such as uncontrolled diabetes, advanced gum disease, heavy smoking and insufficient bone can change the plan or require other treatments first. The amount of bone is decisive in this decision. When the bone is insufficient, alternatives such as bone augmentation surgery or zygomatic implants can come up; OPC Klinik also offers a Zygomatic Implants service.

Waiting time in the upper and lower jaw

The waiting time for implants in the upper jaw and the lower jaw is not the same. Because the lower jawbone is denser and harder, the implant’s fusing to the bone is usually completed in a shorter time. The upper jawbone is more spongy, so this time is mostly longer. The duration varies with bone grafting, the sinus area and the person’s healing rate.

It would not be right to state this time as a fixed number, because what sets the plan is the quality of the bone and the number of teeth to be extracted. For the general process, you can look at our article how many months does implant treatment take.

Osseointegration: the implant fusing with the bone

Osseointegration means the titanium implant biologically fusing with the jawbone. After the implant is placed in the bone, within a certain time bone cells attach to the surface of the implant and the screw starts to act like a solid root. This fusion needs to be sufficient before chewing force is applied to the hybrid prosthesis.

The factors that affect fusion are bone quality, oral hygiene, smoking, chronic diseases and the precision of the surgery. For this reason the check-ups during the healing period must not be neglected.

Temporary solutions and how they differ from an implant

Being without teeth between the extraction of the teeth and the fitting of the final prosthesis is the biggest worry for most people. During this time temporary prostheses can be used; they can be removable or fixed. The aim is to make eating and speaking easier and to preserve appearance. However, temporary solutions do not take the place of an implant; in terms of chewing strength and bone protection they cannot be compared with an implant.

Advantages and limits of the hybrid prosthesis

Being fixed is its most obvious advantage: the problems of a removable denture, such as moving, taking up room on the palate and causing sores, are largely removed. Because the implants carry the chewing load on the bone, eating is also easier. In terms of appearance, the teeth and the gum part are planned to suit the facial structure.

It is also necessary to know the limits. A hybrid prosthesis requires cleaning every day; if the area under the prosthesis and around the implants is not cleaned with special brushes and floss, gum inflammation can develop. In addition, the prosthesis itself can wear over time, and maintenance or repair may be needed at periodic check-ups.

Common worries

The thought that the procedure will be painful is the most common worry; what you will feel varies with the person and the procedure to be done, so ask your dentist at the exam about the anesthesia options and how the period after the procedure will be managed. Another worry is the “rejection” of the implant. Titanium is generally accepted by the body; a failure to fuse is mostly related to infection, smoking, insufficient bone or neglected oral care. A third worry is that the prosthesis will not look natural; at the planning stage the color, length and gum form are chosen together with the dentist.

Another frequent question is how long the prosthesis will last. Durability depends on oral care, on habits such as clenching, on smoking and on the regularity of check-ups. If you clench your teeth at night, the dentist may recommend a protective guard.

Implant or crown: which is more suitable?

A crown is made to keep a tooth when a sound tooth root or structure still exists; an implant, on the other hand, gives a new root in place of a missing tooth. So the two are not two answers to the same problem but solutions to different situations. If the root of the tooth is sound and can be saved, a crown is considered. If the tooth is lost from the root, broken or damaged to the point that it cannot be saved, an implant comes up. When many teeth are affected, crowns alone are not enough and a comprehensive solution such as a hybrid prosthesis is planned.

Implant types and how the dentist chooses

The length, diameter and number of implants are determined by the bone structure of the jaw, the position of the teeth and the chewing load. The dentist does not look for a single “right implant”; they plan the size and position that suit your bone. In a hybrid prosthesis the number and angle of the implants are calculated so that the prosthesis distributes the load in a balanced way.

How does the treatment process go?

The process usually starts with an exam and imaging. After that, if needed, treatments for decay and gums are completed, teeth that cannot be kept are extracted and the implants are placed. While the implants fuse with the bone, daily life goes on with a temporary prosthesis. When fusion is complete, an impression is taken, the final prosthesis is prepared and attached to the implants. Finally the bite fit is checked and the care plan is explained.

The order and duration of these steps vary from person to person. In some people an implant can be placed on the day the tooth is extracted; in others the healing of the bone is awaited first. The decision depends on the condition of the bone and gum. For this reason the answer to whether an implant can be placed right after an extraction is not the same for everyone either. The dentist determines the timing specific to you by looking at the infection status of the area to be extracted and the integrity of the bone walls.

What is assessed at the first exam?

At the first exam an examination of the mouth is done, and X-rays and, if needed, a three-dimensional image are taken. The dentist looks at the health of the remaining teeth and gums, the amount of bone, your general health, the medications you use and your expectations. You can read this exam step by step in our article what is done at the first exam in implant treatment. To find out whether a hybrid prosthesis implant is suitable for you, you can request an exam appointment through our contact page.

How you can tell a root canal has failed

Failure means that the infection in a treated tooth continues or comes back. These signs suggest it:

• Pain when biting or touching the treated tooth.
• Swelling, a pimple or discharge (fistula) on the gum.
• Pain that does not go away after treatment or starts again later.
• A dark area at the tip of the root on the X-ray and bone that does not appear to be healing.

Sometimes there are no complaints at all and the problem is seen only on a check-up X-ray; this is why check-ups after treatment matter. We explained when a root canal is needed on our page in which situations a root canal is needed.

Treating the same tooth a second or third time

A root canal can be done again on the same tooth, but with each repetition the chance of success and the durability of the tooth depend on the dentist’s assessment. A second treatment means removing the old filling, cleaning the canals again and filling them. If there is a missed canal, an inadequate filling or a leaking restoration on top, the chance that the second treatment succeeds is higher.

What limits a third treatment is the structure left in the tooth and the condition of the root. If the root is cracked, the tooth has become very thin or repeated infection has damaged the bone, other options are discussed instead of trying a third time. For the duration and session plan, you can also look at our article on how a root canal is done.

Retreatment versus surgical options

If a repeat root canal is not enough or the canals cannot be reached, apical surgery (root-end surgery) may be considered. In this procedure, the inflamed tissue at the root tip is cleaned and the root tip is sealed; the tooth stays in the mouth. Surgery is chosen when the root is suitable and the upper structure of the tooth is sound. The dentist explains at the examination which path is more suitable.

In which situations extraction is considered

Extraction is recommended in situations where preserving the tooth would bring no benefit. The main reasons are these:

• The root has fractured or cracked vertically.
• The upper structure of the tooth has broken down so much that it cannot be repaired with a crown or filling.
• There is advanced loss in the surrounding bone and constant inflammation with the gum.
• The infection continues despite retreatment and surgery.

The question of whether a root canal or an extraction is more correct has no single answer: keeping a tooth that can be preserved is mostly an advantage, but trying to keep a tooth that cannot be saved can prolong the infection.

Implants and other options after extraction

After extraction, the space can be closed with an implant, a bridge or a denture. An implant is one of the options that provide chewing strength and the protection of the neighboring teeth; depending on the condition of the bone and the healing process, the dentist decides the timing. You can look at whether an implant can be placed right after an extraction in our article can an implant be placed right after a tooth extraction.

What the dentist looks at when deciding

The dentist first looks at the tooth structure, the condition of the root, the bone loss and how widespread the infection is. For this, the examination, X-ray and, if needed, three-dimensional imaging are used. The function of the tooth in the mouth, its chewing load and its relationship with the neighboring teeth also affect the decision.

Check-ups and imaging are very important in deciding to save a tooth: a failure noticed early can be solved with retreatment, whereas a delayed infection can damage the surrounding bone. If you have complaints in a treated tooth or it is time for a check-up, you can talk to OPC Klinik through our contact page.

Situations where bonding is limited

Bonding works very well for small and medium aesthetic corrections; for large corrections that bear a heavy load, it is limited. Covering a small chip, reducing the gap between two teeth or adjusting shape and length are suitable for bonding. If the color and shape of many teeth need to be changed together for the long term, options such as laminate or porcelain veneers may be more suitable.

The advantages of bonding alongside its disadvantages

To weigh the disadvantages properly, you also need to know the advantages: bonding often takes very little from the tooth, in some cases nothing at all, and is finished at the dentist’s chair in a single appointment. Because the composite material is shaped in the mouth, color and form are matched to the neighboring tooth on the spot. If a problem arises, the material can usually be repaired or renewed; with porcelain veneers this convenience is limited.

Color change and staining

Bonding can change color over time, because the surface of composite material is not as tight as porcelain. Tea, coffee, red wine, dark sauces and cigarettes can leave stains on the surface. Mild discoloration can often be reversed by polishing the surface; with a noticeable change, the bonding is renewed.

Another point is that bonding material does not respond to whitening gel: if you have teeth whitening, natural teeth become lighter but the bonding stays the same. So it is a healthier order to whiten first and then do the bonding to match the color.

The likelihood of chipping and cracking

Bonding is more sensitive to impact than porcelain; biting a hard object, biting your nails or chewing the tip of a pen can cause it to chip. A chip can often be repaired with the same material, so you do not need to start over.

The risk of chipping also depends on where the bonding is placed. On front tooth edges and back teeth, where the biting load is heavy, the material is put under more strain; so the dentist looks at your bite and plans the placement and thickness accordingly.

Bonding or porcelain veneer: which is more suitable

Bonding is a quick method that is easy to reverse and removes little of the tooth; a porcelain veneer is more durable and more resistant to staining, but it requires more tissue to be removed from the tooth surface. The decision depends on expectations: for a small correction on one or a few teeth, bonding; for a broad and long-lasting smile change, a veneer comes to mind. We compared the difference between the two methods in detail in our article on the differences between bonding and porcelain veneer.

Edge fit and the risk of decay

If the bonding edge does not fit the tooth surface well, or if care is neglected, plaque can build up at the edge and decay can develop underneath. This is why care matters in the steps of the procedure such as preparing the tooth, keeping it protected from moisture and polishing the edges. At home, the edge needs to be kept clean with dental floss.

Sensitivity and the adjustment period

After bonding, you may feel mild cold and hot sensitivity or a sense of bite height for a day or two. If the bonding feels high when you bite, the dentist corrects it with a brief adjustment; rather than waiting for it to settle by itself, it is better to come for a check-up.

The need for renewal and polishing

Bonding is not an application that stays without care for a lifetime; over time its surface may dull and a small line of discoloration may form at its edge. At regular check-ups, the dentist can polish the surface or, if needed, renew the material. How often it needs renewing varies from person to person according to your care routine, your habits and the location of the bonding; giving a fixed date would be misleading.

How teeth clenching and grinding affect bonding

Teeth clenching and grinding are among the biggest enemies of bonding, because they put constant, excessive load on the tooth, which damages the edges of the material and raises the risk of chipping. Someone with bruxism can have bonding; however, the dentist first assesses the situation and, if needed, plans protection with a night guard. We explained this topic on the page about the role of the night guard in treating teeth clenching.

Common worries and the facts

The worry that “bonding harms the tooth” is mostly unnecessary; the material is bonded to the tooth, tooth tissue is often not cut, and if needed the material can be removed later. The thought that “bonding does not look natural” is largely overcome by good color matching. The real limit is that the material is not as hard and stain-resistant as porcelain; deciding with this limit in mind prevents disappointment later.

A filling and bonding can be confused: a filling is for filling a cavity, while bonding adjusts the shape and color of the tooth for aesthetic purposes. In some cases the two are done together; the dentist explains the distinction clearly at the examination.

Situations where another solution is considered instead of bonding

For some teeth, bonding may not be the most suitable method. The dentist brings alternatives forward in these situations:

• If a large part of the tooth has broken down; here a crown protects the tooth better.
• If a fundamental change of color and shape is wanted on many teeth; laminate or zirconia crowns are considered.
• If severe teeth clenching and grinding is not under control; this problem is solved first.
• If there is gum disease or decay; these are treated first.

You can read about who is suitable for bonding on the page who is bonding suitable for.

Care recommendations to increase durability

What extends the life of bonding is small but regular habits. We can summarize the rules as follows:

1. Brush twice a day with a soft brush and use dental floss.
2. Limit tea, coffee, red wine and cigarettes.
3. Do not bite hard objects or your nails.
4. If you clench your teeth, tell your dentist and use the protective guard that is recommended.
5. Do not skip check-up appointments; a small chip or discoloration is easy to fix if noticed early.

How the decision is made at the dentist’s examination

Whether bonding is right for you is looked at during the examination. The dentist assesses the condition of your teeth, your bite, whether you clench your teeth and your aesthetic expectations together; if needed, options such as bonding, whitening or crowns are explained side by side. When the advantages and limits of bonding are discussed from the start, the result also matches your expectation. If you note the fillings and crowns you have had before, your sensitivity complaints and any suspicion of teeth clenching at night when you come to the examination, the dentist reaches the decision more quickly and more accurately.

Because bonding, laminate and zirconia crowns, teeth whitening and bruxism treatment are offered together at OPC Klinik, you can choose together not a single method but the one that suits your situation. For an appointment or your questions, you can reach us through our contact page.

What is a jaw dislocation?

A jaw dislocation is when the joint head of the lower jaw slips out of its socket in front of the ear and gets stuck forward. A very wide yawn, laughter, a long dental treatment, a blow or opening the mouth too wide can lead to this. Dislocation is more common in people with loose joint ligaments. It may be on one side or on both sides. The risk of dislocation is also higher in people who have previously had a jaw joint problem, teeth clenching or noises from the jaw; so it is useful not to take these complaints lightly and to go for an examination.

Symptoms noticed immediately

When the jaw dislocates, the symptoms usually appear within a few seconds and are obvious:

• The mouth stays open and cannot be closed
• The jaw looks pushed forward; if it is on one side, it shifts to that side
• A hollow or a bulge is felt in front of the ear or over the cheek
• Speech is impaired, saliva may drool and swallowing becomes difficult
• There is sudden pain around the jaw and ear
• The lower and upper teeth do not touch each other

How is it different from a locked jaw?

In a jaw dislocation the mouth stays open and cannot close; in a locked jaw, the mouth stays closed and cannot open. Locking is mostly related to a displaced disc in the jaw joint or a muscle spasm. If your jaw makes noises or you have difficulty opening and closing it, the article on symptoms of jaw joint problems can guide you; a dislocation, however, is a different and urgent situation.

First steps when the jaw dislocates

When the jaw dislocates, do the following in order:

1. Stay calm and do not force the mouth. Trying to close it increases pain and muscle spasm.
2. Support the jaw. Put one hand under your chin and hold it gently, or support the jaw with a clean cloth; do not speak, eat or drink.
3. Apply cold. Holding an ice pack wrapped in a cloth around the ear reduces swelling and pain.
4. Have someone with you. Do not drive yourself; if possible, go to the doctor or the emergency room with someone.
5. Let the doctor put the jaw back. The procedure is done in a suitable position and, if needed, with a relaxing measure; it often takes a few minutes.

The risk of trying to put it back yourself at home

If the jaw is put back without knowing how, the jaw joint, ligaments, teeth and fingers can be harmed. Because the muscles are contracted, pushing in the wrong direction can make the dislocation permanent. For this reason, even if you have had a dislocation before, it is more sensible to wait for suitable intervention by a doctor in the first moments.

Can the jaw dislocate during sleep?

The jaw can dislocate during sleep, but this is seen less often. Teeth clenching at night, opening the mouth too far or a long yawn that opens the mouth too wide can lead to this. If in the morning your mouth will not close, or you wake up with the jaw painful and shifted to one side, the same first aid steps apply. If you have a habit of clenching at night, the article on the role of the night guard may be useful.

When do you go to the emergency room or the doctor?

When the jaw dislocates, go to the doctor without losing time. In the following cases, going to the emergency room should not be delayed:

• If the mouth does not close completely and the pain does not go away
• If the jaw dislocated after a blow or a fall (there may also be a fracture)
• If breathing, swallowing or speaking has become seriously difficult
• If pain, numbness or a bite problem continues even after the jaw is back in place

A jaw dislocation can slip back by itself, but if pain and restriction do not go away, an examination is still needed.

What not to do when the jaw dislocates

Some movements made in a moment of panic can make the situation worse. Do not try to close the jaw by force, do not ask someone else to press on your jaw, do not try to eat or drink, and do not cover up the problem with a painkiller and wait. The earlier a dislocation is corrected, the less the muscles are strained and the easier the procedure is; so waiting often makes things harder.

The first days after the dislocation is corrected

After the jaw is back in place there may be tenderness and mild pain for a few days. During this period prefer soft foods, avoid opening the mouth too wide and avoid hard or sticky foods, and support the jaw with your hand when yawning. Your dentist may give a short-term check-up or recommendations aimed at resting the jaw. If the pain lasts longer than a few days, if the jaw slips again or if mouth opening remains limited, go for a check-up.

What does the dentist look at during the examination?

After the jaw is back in place, the dentist checks the movement of the jaw, the bite pattern and the muscles around the joint. If the dislocation was caused by a blow, imaging may be requested for the possibility of a fracture. You are asked questions about whether you have had a dislocation before, your sleep pattern and your teeth-clenching habit; this information determines the risk of recurrence and the treatment plan. Briefly noting down and bringing the symptoms you had, how the dislocation started and how long it has been going on makes the assessment easier.

Treatment and exercises for a recurrent dislocation

If the jaw dislocates more than once, the cause needs to be investigated instead of short-term management. The dentist looks at the structure of the jaw joint, the looseness of the ligaments and the muscle balance, and requests imaging if necessary. Treatment may consist of exercises that regulate muscle balance and joint movement, a night guard and changes in habits. There are also options for the few cases that require oral and jaw surgery. You can read about the role of exercises in the article the effect of jaw joint exercises. For information on jaw joint treatment, you can look at the Kadıköy jaw joint treatment page.

Daily precautions to prevent a dislocation

After a dislocation, a few habits make a difference in protecting the jaw joint:

• Support your jaw with your hand when yawning and do not open the mouth all the way
• Cut foods that need a big bite (a large sandwich, an apple) into small pieces
• Give up chewing gum and biting nails or pens
• If you clench your teeth, ask your dentist about a night guard
• In the days after a dislocation, prefer soft foods and do not open the mouth too wide

If you have had a dislocation, you can request an appointment for an examination through the contact page.

Frequently asked questions

What are the symptoms of a dislocated jaw?

The mouth not closing, the jaw sliding forward or to the side, a hollow in front of the ear and sudden pain.

What is the first aid when the jaw dislocates?

Support the jaw without forcing the mouth, apply cold and go to the doctor or the emergency room without delay.

Does a jaw dislocation go back by itself?

Sometimes it does, but if pain or restriction continues, a doctor’s examination is needed.

What should be done so the jaw does not dislocate again?

Avoid opening the mouth too wide, manage teeth clenching and, in a recurrent dislocation, get an exercise and treatment plan from the dentist.

What decides whether it finishes in one session or several

What decides the number of sessions is mainly how clean the inside of the tooth is and how complex the canals are. The dentist assesses this beforehand with an examination and an X-ray.

• Number and shape of the canals: Front teeth usually have a single canal; molars may have more than one, and curved ones. The more canals there are, the longer it takes.
• State of infection: If there is inflammation, an abscess or drainage at the root of the tooth, the canal may need to be cleaned with medication for a while.
• Treatment done before: In teeth that need renewal, that is, where an old canal filling has to be removed, the process is longer.
• Structure of the tooth and root: Teeth that are broken, cracked or have a thin root need extra precautions.
• Personal situation: How easily the mouth opens, whether the anesthesia takes and your general health also affect the plan.

For this reason, giving an exact number of sessions before the examination would be misleading; after looking at the images, the dentist presents a clear plan.

How a root canal proceeds step by step

A root canal is made up of steps that proceed in order; knowing what happens at each step makes it easier to understand the time. For a detailed description, you can also look at our page on how a root canal is done.

1. Examination and X-ray: The dentist examines the tooth and its surroundings and sees the structure of the canals and the location of the inflammation on the X-ray. This step makes up an important part of the first appointment.
2. Anesthesia: The tooth and its surroundings are numbed. Once the anesthesia has taken, you do not feel pain during the procedure; you may feel pressure or vibration.
3. Opening the tooth and finding the canals: A small access is opened at the top of the tooth and the openings of the canals are found.
4. Cleaning and shaping: Infected or dead nerve tissue is removed, and the canals are cleaned and shaped with fine instruments and irrigation solutions. This is the step that lengthens the time the most.
5. Disinfection and, if needed, medication: If there is infection, medication is placed in the canal and the tooth is closed with a temporary filling; in this case, treatment continues at the next session.
6. Filling the canal: The clean canals are filled with a suitable filling material and sealed.
7. Permanent filling or crown: The tooth is protected with a permanent filling or, if needed, a crown so that it regains its function.

What happens at the first appointment

At the first appointment, the examination, X-ray, anesthesia and the start of cleaning the canals usually take place. If the condition of the tooth allows, the work can go as far as the canal filling in the same session; if the infection is marked, cleaning and medication are done in this session and the filling is left for later. Telling the dentist about your complaint, when the pain began, the medications you use and your allergies makes planning easier.

How long you wait between sessions

The wait between sessions varies with the settling of the infection and the dentist’s plan; it is often between a few days and a few weeks. This time is given so that the medication inside the canal can work and the surrounding tissue can calm down. It is important not to delay the appointment, because a temporary filling is not designed to stay in the mouth for long and may leak.

Mild sensitivity in the meantime is normal. If there is swelling, increasing pain or fever, call the clinic without waiting for the next appointment.

The process in infected and multi-canal teeth

In an infected tooth, the aim is first to calm the inflammation and then to fill the canal permanently; this usually means more than one session. In multi-canal molars, each canal has to be found and cleaned one by one, so the time naturally grows. In these cases the quality of the treatment matters as much as its number of sessions; a rushed cleaning may require retreatment later. We explained in which situations a root canal is needed in our article when a root canal is needed.

Appointment pattern in treatment planned in two stages

When a root canal is planned in two stages, the first stage is cleaning and medication, and the second stage is sealing the canal and repairing the tooth. The reason for the two-stage approach is to bring the infection fully under control first and to fill the canal in a clean environment. At the first session the inside of the tooth is cleaned and a temporary filling is placed; at the second session, if the complaints have settled and the canal is clean, the filling is done.

When planning appointments, if you tell the dentist beforehand about travel, long meetings or a busy work period between the two sessions, the calendar can be arranged accordingly.

Can a root canal be done on more than one tooth at the same time

More than one tooth may need a root canal, and these are often planned in order, with as many in the same session as the dentist finds suitable. The dentist sets the order according to the position of the teeth, the state of infection and your ease. The tooth with the most pain and a risk of the infection spreading comes first; because a long session may tire you, the procedure can be divided into several appointments. Since a root canal and a filling call for different approaches in some teeth, the page on the differences between a root canal and a filling is also a useful guide.

When the permanent filling and crown are done after treatment

After the canal filling, the tooth should be protected with a permanent filling or a crown within a short time, because a tooth with a root canal is more prone to breaking. In front teeth a permanent filling is often enough; for molars that carry a heavy chewing load, a crown is recommended. Since a crown needs a separate impression and cementing appointment, the total treatment time grows accordingly. Delaying the permanent filling or crown unnecessarily can cause the temporary filling to leak and the tooth to become contaminated again; so add this appointment to your plan from the start.

It is normal for the tooth to be sensitive in the first days after treatment; eating soft foods and not biting hard objects with the treated tooth is enough. Use the painkiller the dentist recommended as advised; if the complaints increase instead of decreasing or swelling develops, let the clinic know without waiting for the check-up appointment.

What to pay attention to when preparing for the appointment

A few simple steps are enough to prepare for the first root canal appointment. Before the appointment, try to stay calm, eat something light, brush your teeth and note the medications you use. If you use blood thinners or have a chronic condition, be sure to say so.

Because the effect of the anesthesia will continue for a while after the appointment, postpone eating until it has worn off so that you do not bite your tongue or cheek. If you want to book an examination appointment for a root canal or learn the duration for your tooth, you can talk to OPC Klinik through our contact page.

When mild aching after treatment is normal

A mild and fading ache after treatment can be part of the healing of the tissues around the tooth. The tooth can stay sensitive for a few days because it was worked on during treatment.

• Mild sensitivity when biting
• An ache that fades as the days pass
• No swelling, fever or pus

If this picture applies to you, waiting as the dentist recommends is often enough. We described how the treatment is done in our article how is root canal treatment done.

Possible reasons why the pain continues

If the pain lasts longer than a few days, its cause should be investigated with an examination. The possible causes are these:

• The biting height of the filling or crown being too high
• A part of the canal not being fully cleaned or not being filled sufficiently
• Inflammation continuing around the tooth root
• A crack or fracture in the tooth
• The pain coming from a neighbouring tooth or from another source such as the jaw joint

The dentist determines the cause with an X-ray and an examination; getting by continuously on painkillers does not solve the problem.

Warning signs such as swelling and fever

Swelling in the face or gum, fever and pus can point to growing inflammation and should not be left waiting. With these signs, reach the dentist the same day.

If the swelling grows very quickly and makes swallowing or breathing difficult, go to emergency health services. You can read in which situations root canal treatment is needed in the article in which situations is root canal treatment needed.

When antibiotics are needed

Antibiotics are not needed in every root canal treatment; the dentist decides by looking at findings such as swelling, fever or a spreading infection. An antibiotic on its own does not solve the problem inside the tooth, because the real work is cleaning the canal.

For this reason, do not take antibiotics on your own and do not reuse an old prescription.

When bleeding is considered an emergency

Mild bleeding can occur after treatment, but if the bleeding does not stop or is very heavy, contact the dentist. Applying pressure with a clean piece of gauze is the first step.

Treatment during pregnancy and menstruation

Pregnancy and menstruation do not have to be an obstacle to root canal treatment, but they should be discussed with the dentist. Be sure to tell the dentist if you are pregnant or breastfeeding; the medication and anaesthesia plan is made accordingly. Because untreated pain and infection can grow into a bigger problem, postponing is often not the answer.

Check-up appointment and options for retreatment

If the pain continues, make a check-up appointment; the dentist assesses the situation with an X-ray. If needed, the root canal treatment can be repeated or different options are discussed.

If you cannot reach the dentist who did the treatment, you can contact OPC Klinik through our contact page.

Frequently asked questions

What should I do if my tooth that has had root canal treatment hurts?

A mild and fading ache can be normal. If the pain is increasing or lasts a long time, contact the dentist who did the treatment.

Does root canal treatment hurt?

The treatment is done under local anaesthesia. Mild sensitivity may occur after the procedure and it generally fades with time.

What is done if swelling occurs after root canal treatment?

Swelling can be a sign of inflammation; reach the dentist the same day. If it grows quickly and makes swallowing difficult, go to emergency health services.

Are antibiotics needed in root canal treatment?

Not always. The dentist decides according to the findings; an antibiotic on its own does not replace the treatment.

Is bleeding after root canal treatment normal?

Mild bleeding can occur. If the bleeding does not stop or is heavy, contact the dentist.

What is jaw osteoarthritis (arthrosis)

Jaw osteoarthritis is the gradual wear and breakdown of the cartilage and bone surfaces that make up the jaw joint (the temporomandibular joint, or TMJ for short). In medicine it is called arthrosis or osteoarthritis; in everyday Turkish it is known as “çenede kireçlenme” (jaw calcification).

The jaw joint works all day long as you talk, swallow and chew. When the cartilage on the joint surface wears away, the bones rub against each other more, and inflammation and pain can develop around the joint.

Causes and risk factors

Jaw arthrosis does not have a single cause; several factors can come together. Commonly mentioned risk factors are:

• Prolonged overloading of the joint because of teeth clenching and grinding (bruxism)
• Blows to the jaw and previous jaw injuries
• Displacement or damage of the disc (the cartilage cushion) inside the joint
• Advanced age and natural wear of the joints
• Conditions that also affect other joints, such as rheumatic diseases
• Bite irregularities and missing teeth

Common symptoms

For most people, the first signs of jaw arthrosis are pain felt while chewing and opening the mouth, and noises coming from the joint. Complaints usually start slowly and become more noticeable over time.

• Pain in the jaw joint, in front of the ear and in the cheek that increases while chewing
• Grinding, gravel-like sounds (crackling) from the joint when opening and closing the mouth
• Stiffness in the jaw in the morning and difficulty opening the mouth fully
• The jaw shifting to one side when opening
• Tenderness and a slight feeling of swelling around the joint
• A feeling of fullness in the ear, ear pain or headache in the temple area
• Difficulty chewing hard foods

Many of these symptoms also occur in other jaw joint problems. You can also read about the general picture of joint problems in our article on the symptoms of jaw joint problems.

How to tell if you have jaw osteoarthritis

Jaw osteoarthritis is suspected when symptoms occur together and continue for a long time, but it is confirmed only by an examination and imaging. If pain increases with chewing, mouth opening is reduced and there is a grinding sound in the joint all at once, you should see a doctor. A sound on its own or temporary pain does not necessarily mean osteoarthritis.

What does pain that gets worse at night mean

Jaw pain that gets worse at night suggests there may be inflammation in the joint, or that clenching and grinding during sleep is straining the joint. This symptom alone does not give a diagnosis; the cause is investigated during the examination.

If you have night pain, the following may help:

• Avoid hard and sticky foods and chewing gum during the day.
• Try not to clench your jaw unnecessarily and keep your teeth slightly apart.
• Avoid sleeping on your stomach or in positions that put pressure on the jaw.
• Apply warmth to the painful area as your doctor recommends.
• If you plan to take a painkiller, ask your doctor or pharmacist.

If the pain lasts longer than a few days, you cannot open your mouth, or you have clear swelling in the jaw, fever or numbness in the face, you should see a doctor without waiting. If you suspect night-time clenching, take a look at our article on the role of the night guard.

Difference between arthrosis and a jaw joint (TMJ) disorder

A jaw joint disorder is the name of a broad group of complaints affecting the joint and the surrounding muscles; arthrosis is a specific condition within this group in which the joint structure wears down. In other words, not every TMJ disorder is osteoarthritis.

• Muscle-related problems: Fatigue and pain in the chewing muscles stand out; the joint structure is usually not damaged.
• Disc displacement: A clicking or “pop” sound is heard when opening the mouth; sometimes the jaw catches.
• Arthrosis: There is wear on the joint surface; grinding or crackling sounds, pain when chewing and, over time, limited opening are seen.

This distinction cannot be made by looking at the complaints alone. An examination and, when needed, imaging are required for the right treatment plan.

Which tests are requested during the examination

During the examination, your complaints are first listened to, then the jaw joint, chewing muscles and bite are examined; imaging is requested if it is considered necessary.

• Assessment of mouth opening and jaw movements
• Hands-on examination of the joint and muscles for pain, and listening to joint sounds
• A panoramic X-ray for a general look at the bone structure
• Three-dimensional tomography to see bone changes in the joint in more detail
• Magnetic resonance imaging (MRI) when the disc and soft tissues need to be evaluated

We described how the examination proceeds in our article on examination for jaw pain.

Treatment options

Jaw osteoarthritis treatment usually starts with non-surgical methods, and the aim is to reduce pain, ease the load on the joint and preserve jaw function. The doctor decides which method is suitable according to the level of the complaint and the imaging findings.

• Resting the jaw: Soft foods, avoiding wide yawning and chewing gum.
• Occlusal splint (night guard): Used to reduce the load on the joint, especially when there is clenching and grinding.
• Medication: Medicines the doctor considers appropriate to control pain and inflammation.
• Exercise and physiotherapy: Guided exercises to support jaw movements and muscle balance.
• Stress management: Reducing the clenching habit that increases with tension.
• Intra-articular procedures: In selected cases, washing out the joint or procedures performed inside the joint may be considered.

You can find our clinic’s approach on our jaw joint treatment page.

Does jaw arthrosis progress

Arthrosis is a condition that can progress over time, especially if the risk factors continue; however, the speed of progression varies from person to person, and in some people the complaints may stay stable for a long time. Keeping clenching under control, avoiding unnecessary strain on the jaw and regular follow-up can help slow progression.

Lifestyle and preventive measures

Daily habits directly affect the load on the joint. The following can help:

• Giving up chewing gum and biting nails or pens
• Cutting very hard and large bites into smaller pieces
• Making it a habit to keep the jaw relaxed during the day
• Doing breathing and relaxation exercises to reduce tension
• Having missing teeth or irregular bites evaluated by a doctor
• Not skipping regular dental and jaw check-ups

When surgery comes into question

Surgery is considered only when pain and loss of function continue despite following non-surgical treatments for long enough, or when there is a serious structural problem in the joint. For most patients, the first step is non-surgical methods.

Surgical options may include minimally invasive washing of the joint or procedures inside the joint and, in more advanced cases, repairing or reshaping the joint surface. Which procedure is suitable is determined by the imaging findings, the duration of the complaint and general health. You can read about the place of surgery in joint problems in our article on treating TMJ problems with jaw surgery.

Which department to see

The first point of contact for jaw pain and joint complaints is an oral, dental and maxillofacial surgery specialist. Depending on the source of the complaint, a joint evaluation with departments such as physical therapy, ear-nose-throat or rheumatology may be needed.

If you are not sure which specialist to see, the article which doctor should I see for jaw pain can guide you.

Frequently Asked Questions

What are the symptoms of jaw osteoarthritis?

Pain in front of the ear while chewing, grinding or crackling sounds from the joint, morning stiffness, being unable to open the mouth fully and the jaw shifting to one side are the most common symptoms. In some people, a feeling of fullness in the ear and headache in the temple area also occur.

How can you tell if you have osteoarthritis in the jaw?

If pain, noises and limited opening continue together for a long time, osteoarthritis is suspected. A definite diagnosis requires a jaw joint examination and, when needed, imaging such as an X-ray, tomography or MRI.

What should I do if jaw pain gets worse at night?

You can try resting the jaw during the day, avoiding hard foods, and noticing and relaxing clenching. If the pain lasts longer than a few days, you cannot open your mouth, or you have swelling, fever or numbness, see a doctor without delay.

Does jaw arthrosis progress?

Arthrosis can progress over time, but the speed varies from person to person. Controlling clenching, avoiding unnecessary strain on the jaw and regular follow-up by a doctor can help slow progression.

How is jaw osteoarthritis treated?

Treatment usually starts with non-surgical methods such as resting the jaw, a night guard, doctor-supervised medication, exercise and stress management. If these are not enough, intra-articular procedures or surgery may come into question; the choice is made according to the examination findings.

If your jaw joint complaints continue, you can make an appointment for an examination and decide on the right treatment plan together with your doctor.

Specialties that carry out the surgical stage

Placing an implant into the jawbone is a surgical procedure. This stage can be carried out by dentists working in oral and maxillofacial surgery or by periodontists, who specialize in the gums and surrounding tissues. Both know bone and gum tissue and can perform the surgical procedure in a planned way.

When the amount of bone has decreased, when the area is close to the sinus, or in cases where the amount of bone matters, surgical experience becomes even more decisive. In such a case, the dentist is expected to know advanced options such as bone grafting, sinus procedures or zygomatic implants, and to be able to plan them when needed.

The prosthetic specialist who plans the upper structure

An implant is a titanium screw that carries the root of the tooth; the part you see in the mouth is the crown or prosthesis made on top of it. The dentist working in prosthetics who plans this upper structure determines the length and colour of the tooth, the bite relationship and the harmony with neighbouring teeth.

In good planning, the implant is placed according to the position of the future tooth; in other words, the target tooth is thought of first, and then the position of the implant is decided. It affects the result when the surgical dentist and the prosthetic dentist decide on this together from the start.

Teamwork and who holds the plan

Implant treatment is often completed not by a single dentist but through teamwork. The surgeon, the prosthetic dentist and, when needed, dentists in orthodontics or gum care share the same plan. What matters for you is that at the end of the process there is one responsible dentist who explains every stage and answers your questions.

For this reason, it is more accurate to ask “which specialist should do it” together with the question “how does this team work together”. A clinic that has several fields, such as jaw surgery, paediatric dentistry, orthodontics and aesthetic dentistry, can evaluate your case across these fields under one roof when needed.

Questions to ask when choosing a dentist

• Who will perform the implant surgery, and who will plan the upper structure?
• If the bone is insufficient, what options are there, and can the clinic carry them out itself?
• How are the treatment stages, duration and check-up intervals planned?
• Is three-dimensional imaging taken before treatment?
• Who looks after you if a problem comes up?

You can get to know our dentists on our dentists page.

What should be explained at the first examination

At the first examination, the dentist examines your mouth, takes the necessary images and shows you the findings. Which tooth the implant is for, how many implants are recommended, the condition of the bone and the stages the treatment will consist of should all be explained. You can find what is done in the first meeting in detail in our article on the first examination in implant treatment.

Follow-up and check-up process

After the implant is placed, the healing period begins; during this time you are called back for check-ups at certain intervals. Regular check-ups after the upper structure is fitted are also necessary for the implant to stay healthy for a long time. Find out from the start who will follow your plan and how often the check-ups are. It is also good to know whom to contact and how in case of pain, swelling or a tooth that feels loose. For your questions, you can arrange a meeting with our clinic through our contact page.

In which cases can it be done on the same day?

For it to be done on the same day, the cleaning of the canal must be completed in a single session. It is generally possible in the following cases:

• No obvious abscess or facial swelling around the tooth
• The canals are open, straight and can be cleaned
• The tooth contains enough sound tissue to carry the permanent filling
• The patient is able to stay for the treatment time and the session goes smoothly

You can read step by step how a root canal treatment proceeds in our article how is root canal treatment done.

When is it not suitable to do it on the same day?

If there is infection, pus or constant leakage inside the canal, the canal is disinfected over several sessions and medication may be placed inside between sessions. If the canals are very curved or blocked, the time is longer and a single session may not be enough. If most of the tooth has been lost to decay, a filling alone is not enough and the dentist first plans for the loss of structure.

How long does a temporary filling last?

A temporary filling is placed to keep the canal closed until the permanent restoration is made, and it can be damaged by hard foods. How long it lasts depends on the material and the chewing load; for this reason you should not miss the appointment given by the dentist. If the filling falls out or breaks, the canal can become contaminated again. For this reason, a patient who comes with a temporary filling should be told which foods to avoid, within how many days to return for a check and in which cases to call straight away; questions can be asked without hesitation.

Is a crown necessary after root canal treatment?

Because a tooth that has had root canal treatment can become brittle over time, a crown is often recommended, especially for molars. For front teeth and teeth with sound tissue, a composite filling may be enough. You can read about the difference between a filling and root canal treatment in the article differences between root canal treatment and a filling.

When is a post (screw) placed in the tooth?

If most of the crown of the tooth has been lost, a post can be placed inside the canal to strengthen the structure that will hold the filling or crown. A post is not placed in every root canal treatment; the dentist decides on this only when not enough tissue is left in the tooth.

What should you do if the filling or crown falls out?

If a filling or crown has fallen out, do not chew on the tooth, keep the area clean and see the dentist without losing time. Keeping the piece that fell out and bringing it to the appointment can help. For care of fillings, you can look at the article what should be considered after a tooth filling.

What does the dentist base the decision on?

Although same-day treatment is practical for some patients, it is not the right option for every tooth; rushing and sealing an incompletely cleaned canal can lead to the treatment having to be repeated later. The dentist looks at the X-ray of the tooth, the signs of infection, the structure of the canal and the remaining tooth tissue, and decides whether to proceed on the same day or in stages. For your situation, you can request an appointment through the contact page.

Frequently asked questions

Are root canal treatment and a filling done on the same day?

Yes, if there is no infection and the canal can be cleaned in a single session; otherwise it is divided into several sessions.

Is a crown necessary after root canal treatment?

It is recommended especially for molars; if the tooth tissue is sound, a filling may be enough.

Is a screw placed in the tooth during root canal treatment?

A post is placed only when the tooth tissue has decreased greatly, to carry the filling or crown.

What should be done if the filling falls out after root canal treatment?

Do not chew on the tooth and see the dentist without delay.