Very often our patients come to the clinic because of a specific concern: pain, a lost filling, a wish to have their teeth straightened, and so on. At the first examination, we find out what is causing the patient's complaint, but we also see many other problems: tooth decay, inflamed and bleeding gums, old, unsightly fillings, crowns with short margins and chipped ceramic, and teeth that need root canal treatment. That is when we need to draw up a comprehensive treatment plan for our patients. This plan usually starts with scaling to remove tartar and plaque, and training in proper oral hygiene. In some cases, however, more serious and longer periodontal treatment is needed. After that, we replace defective fillings and treat primary caries.
When patients need orthodontic treatment, this is the point at which Dr Ivanova-Koycheva fits an appliance or braces. Sometimes old crowns need to be replaced with temporary plastic ones during treatment, so that the brackets hold better on them. Patients must learn to clean their teeth extremely well throughout orthodontic treatment. Only once the teeth have been aligned does Dr Neychev replace the temporary crowns with permanent ones, and we can choose restorations with or without metal. In some cases, we can change the shape and size of the teeth to achieve a more beautiful and harmonious smile. This procedure is called bonding and is done with highly aesthetic composites.
Very often, at the end of comprehensive treatment, we also whiten the teeth. At iSmile we recommend doing this with a home whitening system that patients apply themselves at home. Because fillings and crowns are not affected by the whitening agent, we have 2 options: either we wait for the final whitening result and then match the colour of the new fillings to it, or we make the restorations 1-2 shades lighter in advance. Once all the goals of the comprehensive plan have been achieved, we schedule regular preventive check-ups and scaling at least once every 6 months.