Dentistry — Town Hospital

Dentistry at Town Hospital: an overview

Town Hospital's Dentistry department in the Fifth Settlement, New Cairo, covers conditions of the teeth, gums and mouth, from tooth decay, toothache and gum inflammation to root canal treatment, crowns and bridges, braces, extractions and oral surgery, along with cosmetic dentistry. The department's dentists specialise in orthodontics, fixed prosthodontics, gum disease and root canal treatment, alongside general dentistry; you will find them in the list of doctors below.

Most dental treatment is carried out in the hospital's dental clinic under local anaesthetic, in one visit or over several, depending on the case. The dental clinic has its own X-ray unit for the teeth and jaws; the laboratory and radiology run 24 hours a day for anyone who needs tests or other imaging before a procedure, and so does the emergency department. The outpatient clinics are open every day from 10 am to 10 pm; each dentist's clinic days and times are shown in the up-to-date clinic schedule.

Conditions the dentistry department looks after

The diagnosis and the choice of treatment remain the dentist's decision after the examination and any X-rays that are needed. These are the problems patients most often come to the department with.

Tooth decay and fillings

Tooth decay is the wearing away of the layers of a tooth by mouth bacteria feeding on leftover sugars. It starts as a painless spot, becomes a cavity that is sensitive to cold and sweet things, and causes constant pain once it reaches the nerve. It is found on examination and, when needed, on an X-ray. Early decay is treated by removing the decayed part and filling the tooth, with a tooth-coloured filling or another material depending on where the tooth is and how large the cavity is. Extensive decay may need root canal treatment, or a crown to protect what is left of the tooth. Prevention means brushing twice a day with a fluoride toothpaste, cleaning between the teeth, cutting down on sugar, and regular check-ups that catch decay early.

Root canal treatment

When decay or a crack reaches the nerve of a tooth, the nerve becomes inflamed or dies, causing severe, constant or throbbing pain that is worse at night or with hot drinks, sometimes with a swollen gum or an abscess. Root canal treatment removes the inflamed nerve, cleans and disinfects the canals inside the root, then seals them with a special filling, the aim being to keep the tooth rather than extract it. It is done under local anaesthetic in one or more visits, and the severe pain usually settles after the first. The tooth is weaker afterwards and often needs a crown to protect it from cracking. One of the department's dentists specialises in root canal treatment.

Gum disease: gingivitis and periodontitis

Gum inflammation is very common. Its main cause is the build-up of plaque and then tartar along the gum line when brushing is not thorough enough, made worse by smoking, poorly controlled diabetes, the hormone changes of pregnancy, a dry mouth, some medicines and a lack of certain vitamins. The first signs are red, swollen gums that bleed when you brush, with bad breath; at this early stage, gingivitis, it usually settles with a professional clean to remove the tartar and better daily cleaning. Left untreated, it can progress to periodontitis, where the gum recedes and the bone around the roots is lost, pockets form between gum and tooth, and teeth become loose and can be lost. Treatment then relies on deep cleaning of the roots under local anaesthetic, an antiseptic mouthwash, an antibiotic in certain cases the dentist decides on, and, in advanced cases, an assessment for gum surgery by a dentist who specialises in gum disease. Afterwards, regular follow-up and tartar removal keep the result. Do not stop brushing gums that bleed; the bleeding settles with cleaning, not without it.

Mouth and gum ulcers

Small mouth ulcers are white or yellow spots with a red border on the gum, the inside of the cheek or lip, or the tongue. They hurt when you eat or talk and usually heal on their own within one to two weeks. Causes include biting the cheek, rubbing from the edge of a broken tooth, a filling or an ill-fitting denture, stress, a lack of iron or certain vitamins, and some foods. An antiseptic mouthwash and a soothing gel from the dentist ease the pain, along with avoiding spicy and acidic food and removing any sharp edge. White patches that wipe off and leave redness underneath may be oral thrush, which the dentist treats with an antifungal. Gum ulcers that come with gum disease improve as the gum itself is treated. See a dentist, or the ENT department, for an ulcer that has not healed within three weeks, ulcers that keep coming back, or ulcers with a fever, a skin rash or weight loss, because an ulcer that does not heal needs to be examined to rule out other causes.

Crowns, bridges and implants

A crown is a cap made to the shape of the tooth that protects a weak tooth after root canal treatment, a fracture or extensive decay, and restores its shape and function. A bridge is a fixed restoration that replaces one or more missing teeth by resting on the teeth either side. A dental implant, which the department also provides, replaces a missing tooth with an artificial root placed in the jawbone, with a crown fitted onto it; it suits people with enough bone and healthy gums, and the dentist decides after an examination and X-rays whether it is a suitable option for you. One of the department's dentists specialises in fixed prosthodontics, that is crowns and bridges, and will discuss the right way to replace the tooth with you, according to the neighbouring teeth, the jawbone and your own preference.

Orthodontics: braces

Orthodontics corrects crowded or widely spaced teeth, a protruding upper or lower jaw, and a bite that makes chewing or cleaning difficult. Assessment starts with an examination, X-rays and a study of how the jaws meet, then the orthodontist chooses between fixed and removable braces according to the case and the patient's age. Treatment usually takes one to three years, with an adjustment visit every few weeks, then a retainer that holds the result. As a general rule, a child's first orthodontic assessment is advised at around the age of seven, when the permanent teeth start to come through, because some jaw problems are easier to correct while the child is still growing, although most treatment starts once all the permanent teeth are in. One of the department's dentists specialises in orthodontics.

Extraction, oral surgery and wisdom teeth

A tooth is extracted when it cannot be saved with a filling or root canal treatment, as with destructive decay, a fracture below the gum or severe loosening from gum disease; a simple extraction is done under local anaesthetic. Wisdom teeth come through at around 17 to 25 years of age and are often impacted or tilted for lack of room, causing recurrent pain, inflammation of the gum around them or decay in the neighbouring tooth. They are then removed surgically by opening the gum, sometimes dividing the tooth to ease it out, and stitching the gum afterwards. Not every wisdom tooth needs to come out: one that has come through fully, in a good position, and can be cleaned is left and kept under review. After an extraction the dentist explains what to do about bleeding, swelling and eating, and may prescribe a suitable class of painkiller and an antibiotic when needed. Tell the dentist about blood thinners and long-term illnesses beforehand.

Cosmetic dentistry

Cosmetic dentistry covers teeth whitening to remove yellowing and stains, thin veneers bonded to the front teeth to correct their colour, shape or small gaps between them, tooth-coloured fillings, and the repair of chipped teeth. Any cosmetic treatment starts with treating decay and gum inflammation, and the dentist explains what whitening can and cannot do: it does not change the colour of fillings or crowns, and it can cause temporary sensitivity.

Tests and procedures in the hospital

• Check-up and scaling: examination of the teeth and gums and removal of tartar and plaque, the basis of treating and preventing gum disease.
• Fillings and root canal treatment: removal of decay and filling of the tooth; root canal treatment when the nerve is involved.
• Gum treatment: deep cleaning of the roots, follow-up of periodontitis, and assessment of cases that need gum surgery.
• Fixed prosthodontics: crowns, bridges and dental implants.
• Orthodontics: assessment of the bite, fitting of braces and follow-up through to the retainer.
• Extraction and oral surgery: simple extractions in the clinic, and oral surgery including the surgical removal of impacted wisdom teeth.
• Whitening and veneers: teeth whitening, veneers and tooth-coloured fillings.
• Laboratory and imaging: a dental X-ray unit in the clinic itself, and the hospital's laboratory and radiology, open 24 hours a day, for blood tests before a surgical procedure or any other imaging the dentist asks for.

You will find imaging and laboratory services on the Diagnostics page.

When you need emergency care straight away

Most dental problems can wait for a clinic appointment, but some cannot. Call an ambulance or go to the nearest emergency department straight away for:

• Swelling of the face or jaw that spreads towards the eye or down the neck, or comes with difficulty swallowing, opening the mouth or breathing: these are signs of spreading infection and need urgent treatment.
• Bleeding from the mouth that does not stop after 20 minutes of firm pressure with clean gauze, especially after an extraction or an injury, or if you take blood thinners.
• An injury to the face or jaw after an accident or a fall, especially if the jaw looks out of shape or the teeth no longer meet properly.
• A permanent tooth knocked out completely: hold it by the crown, not the root, rinse it gently in water without scrubbing, put it back in its socket if you can or keep it in milk, and get to a dentist or an emergency department within the hour, because every minute counts.
• A high fever with toothache and swelling.

Town Hospital's emergency department is open 24 hours a day. Once the emergency is under control, treatment of the tooth itself is completed in the dental clinic during its hours.

Your care, step by step

• Consultation: the dentist asks about your complaint, long-term illnesses and medicines, especially diabetes and blood thinners, and examines your teeth, gums and mouth.
• Tests: the X-rays the dentist asks for and, when needed, blood tests before any surgical procedure.
• Decision: the dentist explains the diagnosis, the treatment options and the likely number of visits, and the decision is made together with you.
• Treatment: carried out in the clinic under local anaesthetic, in one or several visits depending on the procedure, with clear instructions after each.
• Follow-up: regular check-ups and scaling, follow-up of braces and restorations, and never stop a prescribed medicine on your own.

The hospital is contracted with more than 40 payers, including insurance companies, professional syndicates and government bodies; cover depends on the payer and the terms of the contract, and the list is on the insurance page.