Charu Bhatia, Senior News Editor, Business Remedies, in conversation with Dr. Hardik Gupta of Gupta Dental Clinic and Perio Surgery Hospital, Jaipur
Oral healthcare is evolving with advances in dental implants, digital treatment planning, modern biomaterials and aesthetic dentistry. At Gupta Dental Clinic and Perio Surgery Hospital, Jaipur, Dr. Hardik Gupta highlights the importance of combining technological innovation with clinical expertise, ethical practice and patient education. From understanding dental implant failures and preserving natural teeth to addressing gum diseases and the growing demand for aesthetic treatments, he discusses the changing landscape of dentistry and the importance of preventive oral healthcare. He also shares his perspective on the role of artificial intelligence, the challenges of an ageing population and the technological developments expected to shape dental care in the coming decade.
Question: What are the possible causes of dental implant failure?
Answer: Dental implant failure can occur due to several factors, including poor oral hygiene, improper implant placement, excessive pressure and the patient’s overall health. Maintaining good dental hygiene is essential because plaque accumulation and bacterial infections can affect the tissues surrounding an implant.
Chewing habits can also influence the distribution of pressure inside the mouth. Some patients rely predominantly on one side for chewing because of missing teeth or other dental problems. This can lead to uneven biting forces. The dentist’s role is equally important. Proper assessment, treatment planning and surgical technique are crucial for successful outcomes.
Question: How has digital implant planning changed dentistry?
Answer: Technology has significantly improved dentistry, particularly implant planning and surgical precision. One important development is Cone-Beam Computed Tomography (CBCT), which provides three-dimensional images of the teeth, jawbone and surrounding structures.
Specialised software helps dentists assess bone thickness, height and angulation, identify important structures such as nerves, and determine the appropriate implant size. Digital planning can also support surgical guides, helping dentists position implants more accurately. However, technology cannot replace clinical judgement. Interpreting scans and selecting the right treatment require professional expertise.
Newer materials have also expanded treatment options. Zirconia implants, made from tooth-coloured ceramic, offer a metal-free alternative in selected cases. They have favourable aesthetic properties and may provide beneficial soft-tissue responses.
Question: How does smoking affect dental implant prognosis?
Answer: Immediately after implant, if the patient opts for smoking, the suction of the puffs in smoking process can bring blood into the mouth, and that can be dangerous as it can cause blood to clot. However, for a regular smoker, completely quitting smoking is not possible. Therefore, practically, what is advised for an addicted person is that he should take short puffs. Otherwise, leaving smoking entirely for atleast a week is right path.
Question: When should a dentist recommend treating a tooth rather than extracting it?
Answer: The decision to preserve or extract a natural tooth depends primarily on its condition. Root canal treatment is an important option when the pulp inside a tooth becomes infected or damaged. The procedure involves cleaning and disinfecting the root canals before sealing them and restoring the tooth.
It requires precision because the dentist must assess the extent of decay, the condition of the pulp and the remaining tooth structure. When sufficient healthy structure remains, root canal treatment followed by an appropriate restoration can preserve the natural tooth.
However, if the tooth is severely damaged, fractured or structurally compromised, extraction may be necessary. Replacement options, including dental implants, can then be considered.
Every case requires individual assessment. Patients should be informed about their condition, treatment options, benefits, limitations and costs. The dentist must explain the situation clearly, allowing the patient to participate in the decision. Preserving a natural tooth is desirable whenever a predictable and safe outcome is possible.
Question: What advances have been made in endodontic materials, and how have they improved dentistry?
Answer: Endodontics has benefited considerably from advances in dental materials. Traditionally, calcium hydroxide was widely used because it was affordable and offered useful antibacterial properties. However, depending on the application, conventional materials could have limitations, including solubility, degradation and inadequate sealing.
Today, bioceramic materials are increasingly used in procedures involving root repair, pulp protection and other endodontic applications. Certain bioceramics demonstrate favourable biocompatibility and sealing properties. They can support tissue healing and mineralised tissue formation in appropriate clinical situations.
Question: Social media has popularised the idea of a ‘perfect smile.’ What is your opinion on this trend?
Answer: I do not believe there is one universally perfect smile. Every person’s smile is different, and variations in tooth shape, colour and alignment are part of individual identity. Dentistry recognises different patterns of tooth alignment, including Class I occlusion, in which the upper and lower teeth generally have a normal relationship.
However, people increasingly seek aesthetic improvements influenced by social media and changing beauty standards. Depending on their needs, options may include orthodontic treatment, veneers, whitening or crowns. Certain types of tooth discolouration may also require specific treatment after the cause has been identified.
Patients should also seek professional evaluation for persistent pain, sensitivity, gum bleeding or bad breath, as these may indicate underlying dental problems. The objective should be a healthy, functional smile that suits the individual rather than an unrealistic standard of perfection.
Question: How do you distinguish between gingivitis and periodontitis?
Answer: Gingivitis and periodontitis are both gum diseases, but they differ in the extent of damage. Gingivitis is inflammation of the gums, commonly caused by plaque accumulation. Symptoms include redness, swelling and bleeding while brushing or flossing.
Gingivitis is generally reversible with professional cleaning and consistent oral hygiene. However, untreated inflammation may progress in susceptible individuals.
Periodontitis involves damage to the supporting structures of the teeth, including the periodontal ligament and alveolar bone. Pockets may develop between the teeth and gums, allowing plaque and bacteria to accumulate beneath the gumline. As the condition advances, bone loss and tooth mobility may occur.
Dentists assess gum health through clinical examination, periodontal probing and, when necessary, dental imaging. Early diagnosis helps prevent further damage.
I strongly emphasise brushing at night before going to sleep. Patients should also clean between their teeth, attend regular dental check-ups and seek treatment for persistent bleeding or swelling.
Question: What is the difference between restorative and cosmetic dentistry?
Answer: Restorative dentistry focuses on repairing damaged teeth and maintaining oral function. Its objective is to preserve natural teeth wherever possible and restore their ability to perform essential functions such as chewing and speaking. Treatments include fillings, crowns and root canal procedures.
Cosmetic dentistry primarily focuses on improving the appearance of teeth and smiles. Procedures include whitening, veneers, bonding and treatments to improve alignment.
An emerging trend is dental jewellery, including tooth gems, crystals and decorative charms. Influenced by global pop culture, celebrities and social media, these accessories have attracted interest among younger consumers in urban India.
Question: What ethical responsibilities arise from the commercialisation of aesthetic dentistry?
Answer: Dentistry includes several specialised branches, each requiring specific training and expertise. As aesthetic procedures become more popular, commercial interests must not take priority over patient welfare.
Dentists should practise within the limits of their qualifications and training. General dentists may provide many routine aesthetic treatments, while complex procedures may require specialists such as prosthodontists, orthodontists or oral and maxillofacial surgeons.
Problems arise when practitioners offer treatments beyond their competence or fail to recognise when specialist intervention is necessary. This can expose patients to unnecessary risks.
Ethical dentistry requires transparent communication, informed consent and realistic explanations of a procedure’s benefits, costs and limitations. Referral is an essential part of responsible practice. When a case requires specialised expertise, patients should be directed to the appropriate professional. Patient safety, clinical standards and long-term oral health must remain more important than commercial considerations.
Question: What role can artificial intelligence play in detecting oral cancer early?
Answer: Artificial intelligence has considerable potential to support dentistry, particularly in analysing diagnostic images, identifying patterns and assisting clinicians in assessing oral conditions. However, AI should support rather than replace clinical expertise. A biopsy remains the definitive method for confirming oral cancer in most cases.
Question: How should dental treatment planning evolve as India’s elderly population grows?
Answer: Dental needs often become more complex with age. Older adults may experience tooth loss, gum disease, dry mouth, root decay and difficulties maintaining oral hygiene. Dental planning for older patients should consider their overall health, functional needs, ability to maintain hygiene and personal preferences.
However, dental problems are not limited to older people. Young adults and adolescents can also experience sensitivity, tooth decay and gum inflammation. Poor dietary habits, inadequate brushing, tobacco use and limited awareness contribute to problems across age groups.
The larger challenge is improving awareness and encouraging preventive care. Regular dental examinations, proper brushing, a balanced diet and timely treatment can prevent many problems.
Question: How do you see dentistry evolving over the next decade?
Answer: Dentistry is likely to advance significantly over the next decade, particularly in digital diagnostics, implant technology, biomaterials and treatment planning. Improvements in imaging, computer-assisted procedures and customised treatment approaches will help dentists manage complex cases with greater precision. Implant dentistry will continue to evolve through developments in implant design, materials and surgical techniques.
Patient comfort will remain another important priority. With appropriate planning and improved techniques, many dental procedures can be performed more comfortably, helping reduce anxiety and encouraging people to seek timely treatment. I believe the future of dentistry will combine technological innovation with prevention, patient education and personalised care.
