Dr Stephan Delschen, DDS, is a highly respected dentist who plays a leading role in the town of Troisdorf thanks to his extensive expertise and modern dental practices. In his state-of-the-art practice, DENTEINS, he offers his patients a wide range of dental care, focusing in particular on two key areas: endodontics and cosmetic dentistry. The environment at DENTEINS is designed to ensure patients feel at ease, from air-conditioned rooms to a high level of empathy and trust in the care provided. Dr Delschen always takes ample time for consultations to understand his patients’ individual wishes and needs and to draw up tailor-made treatment plans accordingly.
The practice places great emphasis on pain-free treatments and a smooth patient experience. By using proven and state-of-the-art treatment methods as well as high-quality materials, patients’ dental health is optimally maintained. A dedicated pediatric dentist looks after the younger patients at the practice. Dr Delschen’s expertise in the fields of endodontics and cosmetic dentistry is particularly outstanding. In endodontics, the study of the tooth root and its treatment, he uses innovative technologies such as a surgical microscope and digital X-rays to perform precise procedures to preserve teeth.
Dr Delschen boasts an impressive educational background and memberships in various professional societies, such as the German Society of Endodontology and Dental Traumatology (DGET) and the German Society of Implantology (DGI). His ongoing professional development in various fields of dentistry and his certification as an Invisalign practitioner demonstrate his commitment to the highest standards of quality. He has been working at the DENTEINS dental practice since 2012 and has been its sole owner since 2022. The editorial team at Leading Medicine Guide wanted to find out more about dental aesthetics and dental prosthetics and had the opportunity to speak with Dr Delschen.
Modern dentistry encompasses a wide range of specialisms designed to maintain and restore the health, function and aesthetics of the teeth. In this context, four key areas are of particular importance: endodontics, cosmetic dentistry, implantology and dentures. Each of these areas plays an important role in maintaining and improving dental health and beauty. Endodontics deals with the treatment of diseased dental tissue, cosmetic dentistry aims to create a radiant smile, implantology offers solutions for tooth loss, and dentures enable the restoration of gaps between teeth. These areas are crucial for keeping teeth healthy and maintaining a confident smile.
The signs that root canal treatment is necessary can vary, and it is important to be aware of these symptoms.
Root canal treatment is often necessary when the inside of a tooth, known as the pulp, becomes inflamed or infected. This can be caused by deep tooth decay, trauma or other damage to the tooth. The treatment involves removing the infected tissue, cleaning and disinfecting the root canal, and sealing it to preserve the tooth and prevent re-infection. “Severe and persistent toothache, particularly when exposed to pressure or temperature changes, can be a sign of inflammation or infection inside the tooth, which may manifest as a fistula, swelling, or pus formation. Sensitivity to hot or cold drinks and food that lasts longer than usual can also indicate a problem inside the tooth. However, if the tooth is ‘dead’, for example, the patient may not notice any inflammation for a long time. “In any case, treatment is necessary because the inflammation can spread to other parts of the body,” explains Dr Delschen at the start of our interview.
The root canal treatment process:
First, the dentist carries out a thorough examination and takes X-rays to assess the condition of the affected tooth and the surrounding structures. Based on this diagnosis, a decision is made as to whether root canal treatment is necessary. Before the actual treatment begins, the affected area around the tooth is numbed with a local anesthetic to prevent pain during the procedure. The dentist drills a small hole into the affected tooth to gain access to the inside of the tooth. The infected or inflamed nerve tissue located within the root canals is carefully removed. The root canals are thoroughly cleaned and disinfected to eliminate all bacteria and infection. After cleaning, the root canals are filled with a special filling material to stabilize the tooth and prevent re-infection. In most cases, the treated tooth is restored with a crown to restore its stability and function.
Root canal treatments are generally very effective and can often save the affected tooth for many years. It is important to carry out a root canal treatment as early as possible to prevent the spread of infection and relieve pain. Most patients find the treatment far less painful than the toothache they experienced before the procedure.
Endodontics, the branch of dentistry that deals with root canal treatments, has made significant advances in recent years, which have substantially improved the success rate of root canal treatments.
Modern X-ray and imaging technologies, such as digital X-rays and 3D imaging, enable dentists to make a more accurate diagnosis and visualize the structure of the root canals more precisely. This leads to more precise treatments and a higher success rate. “We have excellent imaging techniques using high-resolution microscopes, and 3D diagnostics allow us to scroll through the tooth, much like a CT scan, to examine the anatomy. Even the finest canals and branches can be better identified and cleaned. This technology has also led to a completely different fundamental understanding. We know the bacteria much better and understand how to combat them, ranging from various disinfectant rinses to technical options such as ultrasonic-activated rinses, enabling deep disinfection. In addition, communication networks are better. ‘I am still in contact with my supervisor and colleagues with whom I can exchange ideas,’ says Dr Delschen.
Compared to the past, the number of appointments required for root canal treatment has decreased. Dr Delschen explains: “As part of root canal treatment, the patient now only needs to visit the practice once or twice. The appointments then last a little longer, but patients no longer have to visit the dentist several times as they used to, only to spend just a few minutes there in the end.” These advances in endodontics help to significantly increase the success rate of root canal treatments and extend the lifespan of saved teeth.
Dental implants are an advanced method in dentistry for replacing missing teeth. They usually consist of three main components: the implant body, the abutment and the crown.
For a long time, the view prevailed that implants were only suitable for younger people. “Basically, one can say that implants are generally suitable for people of all ages. I recently had an 82-year-old patient who left the practice happy with his implants. For someone who is fit, anything is possible in implantology; so it depends a bit on the patient’s general health. One needs to look more at pre-existing conditions and what medication the patient might be taking. There are, for example, bisphosphonates, which people take as part of osteoporosis treatment. In such cases, one should steer clear of implants, as irreversible bone damage can occur,” explains Dr Delschen.
Implants offer several advantages over bridges and crowns. A key difference is that implants are inserted into the jawbone, providing a stable foundation for replacing a missing tooth. In comparison, bridges rely on adjacent teeth, which must be ground down to hold the bridge in place, potentially damaging healthy tooth structure. Implants also prevent bone loss in the jaw, as they act like a natural tooth root and stimulate the bone structure. Furthermore, implants often feel more natural and offer a long-term solution for tooth replacement. “An implant is, after all, a complete replacement for the tooth root; you’re not just creating a replacement for the clinically visible crown. A truly firm anchorage is created. And even at a later stage, the implant superstructure can be modified. Incidentally, in our practice, implants can also be inserted under general anesthesia,” says Dr Delschen.
The implant body is a small screw made of high-quality titanium or ceramic. It is inserted into the jawbone, where it fuses with the surrounding tissue. This process is known as osseointegration and forms a stable base for the implant. The so-called abutment is the connecting piece between the implant body and the dental crown. It is placed on top of the implant body and acts as a support for the crown. The crown is the visible part of the dental implant and is custom-made to match natural teeth in shape and color. It is attached to the abutment and is the aesthetically visible element that restores the functionality of the missing tooth.
When it comes to materials, patients often have the option to choose between different options. The implant body is usually made of titanium or ceramic, as these materials offer high biocompatibility. For the visible crown, patients can choose between various materials such as ceramic, metal-ceramic or all-ceramic. The choice depends on aesthetic preferences, budget and other individual factors. “I always work with the patient to find the solution that really suits them, regardless of the costs that may arise in case of doubt. There is always a Plan B,” clarifies Dr Delschen.
There are various types of dental restoration options available to replace missing teeth or repair damaged teeth.
The choice of the best solution depends on individual needs, the condition of the mouth and personal preferences. “First, you need to distinguish between fixed and removable dentures. In our practice, dentures are usually metal-free (except for implants; however, in special cases these can also be made of ceramic). There are implant-supported dentures, as well as replacements supported by one’s own teeth or the gum tissue. Biocompatibility is important in terms of allergies, which is why metal-free materials such as ceramic are usually chosen. As far as durability is concerned, there is no difference in the material used for fixed dentures compared to removable dentures. However, removable dentures should definitely be made of plastic to allow for repairs.
Then, of course, there is the question of aesthetics. It is easy to create attractive dentures using plastic and ceramic. We still use certain metals, such as high-gold, a gold alloy that contains a higher concentration of pure gold than conventional gold alloys. Personally, I prefer the so-called telescopic solution, which means the substructure is made of gold, and the clinically visible part is then made of ceramic or plastic,” explains Dr Delschen regarding the various options.
The different materials used in dentures:
Metal alloys such as cobalt-chrome and stainless steel are often used in the manufacture of partial dentures. They are very durable, stable and corrosion-resistant, but less aesthetically pleasing as they may be visible.
All-ceramic is a popular choice for crowns, bridges and implant abutments. This material is characterized by excellent aesthetics, as it is tooth-colored and offers a more natural appearance.
Zirconia is a ceramic material used for crowns and bridges. It offers high durability and aesthetic benefits. Zirconia is particularly suitable for people with allergies, as it is metal-free.
Resins such as acrylic resin are often used for full dentures. They are a cost-effective option, but do not offer the durability and aesthetics of other materials.
Titanium is frequently used in implantology for the manufacture of implants and implant abutments. It is lightweight, strong and corrosion-resistant.
Teeth whitening (bleaching) and veneers are two popular procedures in cosmetic dentistry used to improve the appearance of teeth.
Bleaching can lighten the teeth and reduce discoloration caused by food, drink, smoking or aging. The results are usually visible immediately and can be further improved after several sessions or weeks. The longevity of the results depends on individual oral hygiene and lifestyle habits.
Teeth whitening involves the use of special bleaching agents to remove stains and discoloration from the tooth surfaces. There are two main types of teeth whitening: in-office whitening and home whitening. With in-office bleaching, a dentist carries out the procedure in the surgery. A stronger bleaching agent is used here and is usually activated by a special light source. With home bleaching, the patient receives a custom-made bleaching agent and wears it at home in a special tray.
“I definitely recommend having your teeth whitened by a professional rather than buying kits from the chemist’s. That is the safe method, and you really shouldn’t experiment. The desire for beautiful and attractive teeth is understandable, but it should be left to the professionals. Then you don’t have to worry that it’s harmful. It’s different with home kits from the chemist’s, and the effect isn’t as significant as in the clinic, where the correct concentration of hydrogen peroxide is used. With in-office whitening, the patient spends about an hour with us, and we take a very gentle approach. And if the patient isn’t 100% satisfied with the result, we offer free follow-up appointments to further optimize it. A full whitening treatment often lasts 1–2 years, though this also depends on lifestyle (for smokers and red wine lovers, the whitening certainly won’t last as long),” advises and explains Dr Delschmann.
Veneers are thin, custom-made ceramic shells that are applied to the front of the teeth.
Veneers can correct discoloration, chipped teeth, uneven tooth shapes or gaps between the teeth. They offer immediate aesthetic improvements and a natural appearance. Veneers last longer than teeth whitening and can last for many years. “I love veneers and have a really good laboratory working with me, the dental aestheticians, who are independent. This results in a fantastic aesthetic with minimal grinding and minimally invasive procedures, and the result is perfect. After all, people should be happy to see themselves smiling in photos. And when it comes to perfection, I settle for nothing less. You only need a layer thickness of 0.5 mm on the tooth. If the teeth are set back slightly, you need even less. The bonded ceramic blends in visually with the tooth,” says Dr Delschmann, adding: “Prophylaxis also proceeds as normal with veneers.”
Research and development in dentistry has seen numerous advances in recent years.
“Hopefully, the future will bring even more possibilities for digital scanning. Artificial intelligence (AI) is also becoming increasingly prevalent in dentistry. And we will likely be able to work in an even more minimally invasive and tooth-preserving manner, including in the field of implants, which could then actually last a lifetime – something that doesn’t work yet because bone deficits often pose a problem. And bone could be grown to produce secure, lifelong dental prostheses,” says Dr Delschmann, bringing our conversation to a close.
Thank you very much, Dr Delschmann, for this valuable information on the subject of dental prosthetics and cosmetic dentistry, which affects everyone!
