Dental hygiene, oral medicine and dentistry

If tooth decay or external influences have destroyed the tooth structure, it needs to be repaired. This involves using a minimally invasive procedure to remove the area destroyed by bacteria (only as much as necessary) and replacing it with tooth-coloured filling material. If the teeth are broken, they can be repaired either using white filling material or with a crown (see Bridges and crowns) depending on the extent of the damage. Non-metallic filling material (amalgam-free) has been successfully used in placing fillings for years.

Twinkles and brillies are small gemstones or imitation gems used as dental jewellery, while dazzlers consist of a gold film that can also be adorned with stones and other decoration. The jewels are attached to the tooth by roughening the enamel using an acid and then gluing the decorative elements on using white filling material. The jewel can be removed again without leaving any lasting damage. It is also possible to have any special requests carried out, for example, in cooperation with a goldsmith. It is important that this type of procedure is completely reversible.

If multiple or even all teeth are missing, they can be replaced using removable appliances (dentures). If there are no teeth left, full dentures are required. Under optimum conditions, they stick to the mucous membrane using a suction effect. If there are still teeth present, partial dentures are offered, which can be fixed to the existing teeth or implants using clamps or similar retention elements. Due to the constant changes in the jawbone, minor alterations to the dentures are normal after a certain period of wear.

This is a special field of dentistry dealing with infections in the root canal system inside the teeth. The dental nerve (pulp) can become inflamed due to deep tooth decay or even a deep filling, causing it to later die. While severe toothache is an indicator of this inflammation, the inside of the tooth can sometimes die even without any symptoms. At this point, an inflammation forms at the root end. In both cases, the inside of the tooth is removed and the canal system disinfected before ultimately being filled with cement and gutta-percha. After the procedure, the tooth crown has to be stabilised with a filling or crown.

Enamel can be naturally dark. However, foodstuffs and luxury products such as fruit juice, tea, red wine and tobacco can cause discolouration to the tooth from the outside, in addition to internal discolouration which, for example, can result from medication, poor diet or death of the tooth pulp. One solution is to have the teeth bleached in one session at the practice (power bleaching). Another option is to use custom-made retainers with a gel that can be worn at home, for example, overnight. Discoloured teeth that have undergone root canal treatment are special cases and require more elaborate bleaching from the inside.

If damage to the tooth is so severe that it cannot be reconstructed using a filling treatment, then a crown needs to be placed. This involves grinding down the tooth to allow the crown to fit over it like a cap. A bridge is an artificial tooth supported by neighbouring teeth, tooth roots or tooth implants. This technique is used to fill gaps between teeth, with bridges usually fixed permanently. Each crown or bridge is a highly precise custom product made by the dental technician and is usually manufactured using high-performance ceramics without any metal.

This deals with the incorrect structural and functional regulation of the temporomandibular joint and its muscles. On the one hand, incorrect interlocking of the teeth can cause tooth abrasion, tissue hardening in the muscles, headaches and even tinnitus, while on the other hand, an unnatural posture or diet can be a cause of malocclusion. The position of the teeth and entire organism have a mutual influence on each other. Along with occlusal splints, stretching and relaxation techniques or physiotherapy can be useful for treating jaw problems.

The canton of Zug gives every child from nursery school age until the ninth year of school a voucher every year, which includes a check-up, tooth cleaning and fluoride gel application. We will be happy to accept this voucher. Simply bring the voucher to me for the school check-up. The canton of Schwyz only offers vouchers for check-ups. We will also be happy to accept this.

It can be a good idea to bring your child to the dentist even before they reach nursery school age to allow them to prepare for a visit in a fun way.

Nitrous oxide, or ‘laughing gas’, is an odourless and colourless gas that has a calming and sedating effect. It is administered with an oxygen mixture and is highly suitable for children with more substantial planned dental procedures (multiple fillings, milk tooth removal, etc.). Likewise, adult patients who suffer from a gag reflex, who are afraid of going to the dentist, or who have a fear of needles, can also benefit from being sedated with nitrous oxide. We’ll be happy to advise you.

Implants are titanium screws that replace the natural tooth root and are fixed entirely in the bone. Recently, screws made of high-performance ceramic have also come onto the market. An operating procedure is used to fix the screws in the bone. If not enough bone is present, advanced measures, either using the patient’s own bone from a donor region or artificial bone-graft material, can be used to increase the bone volume. Individual crowns, bridges or retention elements for dentures can be fixed onto these implants.

Tooth transplant

If teeth are missing in the growing jaw (in children and teenagers), they can be replaced by way of a tooth bud transplant. The major advantage of this kind of transplant is that it allows the teeth to take root in the new position and continue growing. In most cases, the tooth remains healthy. Donor teeth may include wisdom teeth, premolars or primary canines. The tooth transplant is usually carried out together with an orthodontist and is only feasible in very specific cases. Despite this, it is a very elegant method for replacing missing teeth in the growing jaw.

Any changes to the mucous membrane need to be examined as soon as possible. Diseases in this area include oral cancer or its preliminary stages. If the change cannot be attributed to a specific disease solely through its outer appearance, it needs to be completely or partly removed and sent to a pathologist to be inspected under a microscope. Treatment for mucous membrane diseases can range from the use of local medication to systemic medication. It is crucial that the affected areas are checked on a regular basis.

Traumatology deals with all kinds of tooth accidents. Due to the complexity of the accidents, the involvement of all areas of dentistry may be required to restore chewing ability and appearance. The treatment of extensive tooth accidents is part of oral surgery training. In the event of a tooth accident, please contact the dentist immediately and/or read further: Info brochure on tooth accidents

This is a special form of implantology where the arrangement of the teeth is planned virtually before the implantation procedure using X-ray technology and scans of the existing teeth. This planning allows the implants to be placed exactly where they are needed. For this, a stencil is created, with drilling work and implant placement being carried out through this. This method is much safer than conventional implantology and significantly reduces the risk of injury to important anatomical structures (nerves or blood vessels).

If extensive destruction of a tooth – either due to tooth decay or trauma – is putting the biology around the tooth at risk or the reconstruction cannot be inserted at a suitable distance to the bone, then surgery is necessary in order to save the teeth. This involves extending the crown, and two options are available. The first involves removing some bone material around the tooth root, while the second sees the tooth loosened from the periodontium by several millimetres and fixed again in the new position. Only then is the creation and integration of the reconstruction possible.

Advanced periodontitis (see Periodontology), which cannot be cured using conventional treatment, may need to be treated through surgery. In this procedure, the gum around the tooth is loosened, the tartar on the root surface removed and in some cases, bone-graft material inserted. The aim of this operation is to prevent further destruction of the bone and the periodontium. It is recommended that periodontal surgery is followed up with a strict inspection and professional cleaning.

Jaw cysts are cavities that can form in the jawbone, with a differentiation made between the causes – either developmental or inflammatory. Developmental cysts arise as a result of the tissue being programmed incorrectly and can be associated with certain syndromes. Inflammatory cysts are caused by inflammatory changes to the root end of dead teeth. Both types of cysts are treated in the same way. Depending on the size of the cyst, they can be removed surgically in one or two steps. If a tooth is linked to the cyst, this is also usually removed.

Gum inflammations can also develop around implants, as with periodontitis (see Periodontology). At an early stage, this inflammation can be treated by cleaning and disinfection. If the disease has progressed, an operation needs to be performed either to improve the cleanability of the implant (resective therapy) or to rebuild the missing bone tissue (regenerative therapy). If the disease has progressed to such an extent that the implant is moving, it needs to be removed.

Wisdom teeth can cause problems if they do not shift into their normal position naturally. These problems can include destruction of the second molar, recurring inflammations, pain, the formation of jaw cysts, abscesses or disruption to nerves (in the lower jaw). If any of these symptoms occur or are foreseen thanks to early diagnostics, the wisdom teeth should be removed.

If the root end is inflamed and cannot be treated using root canal treatment, a root end resection can be a suitable method for saving the tooth. Inflammation can be caused by remaining bacteria that cannot be removed from the root canal on account of its anatomy. The lowest part of the root is cut away through a surgical procedure and a small filling is inserted from below. The inflamed tissue is then removed and in some cases, sent to a pathologist for diagnosis.

More simple treatments can be performed at your home or in a retirement home. For more information, please call the practice directly.

Working together with an external team of anaesthetists, we are able to perform tooth treatment under general anaesthetic. The treatments are planned in advance and, if possible, the necessary X-ray images created. This type of treatment is mainly useful for small children, patients with a pronounced phobia of dental procedures or those with a disability or advanced dementia. The cost of the anaesthesia is invoiced by the anaesthetists separately from the costs of the dental treatment.

Similar to photography, X-rays involve exposure of a film using X-ray radiation. For analogue images, the film is developed using chemicals, as with analogue photography in the past. For digital X-rays, an imaging plate is used instead of film, and can be read using a special scanner. The advantage of this method is first and foremost reduced exposure to radiation, as less long exposure times are needed. Other advantages include no chemicals, faster development time and the reusability of the imaging plate.

The panoramic X-ray image, also known as the orthopantomogram (OPT), provides an overview. It is used to diagnose diseases in the jawbone, temporomandibular joint and around the tooth roots. The OPT is a standard image used in implantology or to clarify the position of the wisdom teeth. In practice, the OPT is generated in digital format, significantly reducing radiation exposure compared to conventional images. Referring dentists are welcome to register patients by telephone or email.

This form of digital radiology allows sections of the jaw to be shown three-dimensionally. The technique can be used for additional imaging, e.g. when the course of the nerve canal in the lower jaw is unclear before operating on a wisdom tooth, when planning implants, in the case of unclear results on a two-dimensional X-ray, for complaints in the maxillary sinus, for cysts and other pathological conditions that are unable to be shown sufficiently using two-dimensional imaging. Professional colleagues are welcome to register patients using the HIN address.

Our long-standing employee Ms Mujic is responsible for school dentistry in the Walchwil municipality. All children from nursery school age until their fourth year of school are visited by the school dentist at regular intervals. During these visits, they are shown the best way to take care of their teeth and learn basic information about teeth and dental care. All children/teenagers in the canton of Zug, from nursery school age to their ninth year of school, are given a voucher for a check-up, tooth cleaning and fluoride administration every year. The voucher can be redeemed with the dentist of your choice.

All of the team and particularly the dentists regularly take part in external training. The dental hygienists and prophylaxis assistants also have to undergo regular further training to enable them to provide the best possible advice. Every year, we refresh our specialist knowledge on emergency situations in the dental practice.

Dr Nobilis is trained in ear acupuncture and successfully uses this treatment primarily in patients who suffer from a strong gag reflex. The targeted activation and deactivation of acupuncture points on the ear helps to inhibit the reflex. We’d be happy to advise you personally.